martes, 2 de julio de 2013

Nota en Global Press

Workshops Promote Mental Health and Build Community in Argentina’s Capital

Under the guidance of health professionals, residents of Buenos Aires meet weekly to discuss personal problems and do activities that promote mental health. About 3,000 people participate in the program, which operates under a public hospital. Volunteers conceive and lead the workshops to rebuild social ties lost in the big city.

BUENOS AIRES, ARGENTINA – The dim light of the cafe in Buenos Aires, Argentina’s capital, invites confession. At a table next to a window overlooking a street corner, residents withdraw from the autumn evening to focus on the group discussion.

Participants exchange markers to the beat of the words. They color the mandalas distributed by Zulma Fuentes, who runs this workshop, Puerto de Ilusiones, to promote mental health.

“You come to bare your person, knowing that others perhaps cannot contain you, but they are not going to make you suffer.” Irma Cichello, workshop participant
“Here we have the opportunity of expressing what we feel and what we think,” Fuente says. “What I highlight and what I love about this program is that it is fundamentally mutual aid. This means that we all help each other with our experiences.”

While some talk about their problems, others color the patterns. Coloring is a way to reduce anxiety, says Fuentes, a social psychologist who has led this workshop for five years.

The objective of the workshop is to provide a space where one can chat with friends. Participants meet from 6 p.m. to 7:30 p.m. every Monday in a cafe in the center of the city to share their experiences from the past week.

The workshop is one of many under the Programa de Salud Mental Barrial del Hospital Pirovano, a community organization that promotes mental health. It operates under Hospital General de Agudos Ignacio Pirovano, a public hospital run by the city government’s Ministery of Health.

The mental health program is unique because local residents conceive and lead its free workshops, which offer participants the opportunity to discuss their problems in an accepting environment. The design also departs from past handling of mental health by promoting the complete physical, mental and social well-being of the entire community, and not merely preventing illness. In pursuit of this objective, the program builds community to erode the anonymity and isolation in a big city like Buenos Aires.

Argentine psychologist Carlos Campelo launched the program in 1985 while working in mental health at the hospital, says psychologist Miguel Enrique Espeche, who currently runs the program. Campelo gathered residents who had similar problems so that they could share them with each other. In hardly a decade, the prestige of the program grew thanks to the number of participants, the originality of the topics and the benefits for the community.

The program now consists of 200 workshops that draw 3,000 participants in various neighborhoods of Buenos Aires and its suburbs. They meet in unused spaces within the hospital, outdoors or in cafes to promote mental health and to restore a sense of community in the massive city.

The program is unique because local residents, “called animators,” conceive and lead the workshops for their fellow community members based on topics they want to work on or share with their neighbors. The only requirements are that they attend a three-month preparatory course and then participate in a weekly meeting of animators to supervise their work.

In this way, the program provides an essential role for the city's residents as promoters of their peers’ health. The animators of the workshops are the heart of the program, Espeche says.

Fuentes emphasizes that the animators are not coordinators.

“To coordinate consists of always maintaining an optimal distance from the other,” Fuentes says. “To animate means to be in a good mood, also devoting oneself [to] that role.”

About 35 people make up the Comité de Conducción, a committee that trains and supervises the workshop animators.

The program requires just a single salary from the state, Espeche’s. The members of the supervisory committee and the animators are volunteers.

The breadth of the topics that animators have chosen for workshops aims to attract all community members by focusing on the issues that they care about, Espeche says.

“The workshops are of a wide spectrum because they are tied to the real interests of the real neighbors,” Espeche says.
The titles of the workshops demonstrate this diversity: “Links from solitude to harmony”; “We talk about desire, projects, postponements and secrets”; and “How we relate with our adult children.” Other health workshops are more physical or academic, including yoga, cinema, literature, neurolinguistic programming, astrology and bioenergetics.

In order to participate in the workshops, residents only need to attend an orientation meeting and then at least three meetings to understand how the program functions, Fuentes says. Workshops are free.

“The only payment that is asked for is trust,” Fuentes says, “that they have confidence in us. With confidence, everything is obtained.”

Martha Vázquez, a 71-year-old retired woman, participates in the Puerto de Ilusiones workshop.

“I come here because it really satisfies me,” she says. “I do not know what we are going to talk about, but I know that something interesting is going to happen. And I go with the happiness of having gathered with friends, of having chatted with them – sometimes about difficult issues, other times we laugh.”

Another member the workshop, Irma Cichello, 68 and also retired, values the opportunity that the workshop gives her to be authentic and find acceptance from her peers.

“Here one comes and is oneself,” Cichello says. “One does not have to hide anything because, among us, there are not unfavorable criticisms. You come to bare your person, knowing that others perhaps cannot comfort you, but they are not going to make you suffer.”

The program is also unique because it aims to promote mental health, Espeche says. This differs from assistance or prevention because it focuses on the population as healthy, regardless of whether people may suffer mental illnesses during their lifetimes.

Animators stress the strengths of people, not their weaknesses, Fuentes says.

 “We are here with our potentials, with the positive things, with the strengths,” Fuentes says. “We work with what we have, not with the lack.”

María Emilia Holmberg, a social psychologist and member of the program’s superviory committee, says that promoting health – rather than treating illness – is one of the novel aspects of the program.

“What was revolutionary was that, before, the hospital was nothing more than for sick people,” Holmberg says. “And Campelo proposed that the hospital was also a place where healthy people could gather to talk about their affairs, their interests, their problems, anything.”

This feature of the program initially generated some resistance among health professionals working in the hospital, Holmberg says.

“That was also what was most difficult for professionals of the hospital to understand,” she says. “To understand that those people came to talk about their issues of daily life and did not come to treat an illness.”

Florencia Ortiz is a psychologist not affiliated with the program who is on the psychological diagnosis team at Hospital José María Ramos Mejía, another public hospital operated by the city’s Ministry of Health. She highlights the importance of promoting mental health and being active users of the mental health system.

“Users should assume an active and responsible attitude in respect to their health,” she says. “In this sense, the hospital abandons its position of ‘master’ and moves the focus from the professional to the user.”

As part of promoting mental health, the program aims to restore community in the massive city.

Organizing meetings among residents aims to rebuild social ties that the dynamics of large cities such as Buenos Aires weaken, Espeche says. People move here from other parts of Argentina and from other countries. Apartment buildings mean residents have many neighbors who remain strangers rather than a few whom they get to know well.

“The large city is deficient on that level,” Espeche says, “because there is a lot of isolation: many people who move and lose the[ir] roots, the type of building that does not help, the public spaces are few. So social life takes place many times through workshops.”

Ortiz recommends attending the program’s workshops to combat the isolation of urban dynamics. The greater the isolation of people, the more at risk and impoverished they are, she says.

Holmberg says ​​the program is a network of spaces where people can gather when they need to talk to their neighbors.

“The idea is that it continues being a network,” she says, “an island perhaps within the city, but one more resource on which people can count when they want to meet with neighbors to address their issue. That to me seems to be a very valuable objective.”
 Programa de Salud Mental Barrial del Hospital Pirovano is close to celebrating 30 years of existence. But there are no ambitious goals or grandiloquent expectations. Its main objective is to unfold naturally, like life itself.

“One of the characteristics of the program is that it is not alterative,” Espeche says. “We do not pretend to change anyone. For these reasons, we also do not want to change ourselves. If we grow, better, because the program is to accompany you.”

While Espeche says he lets time decide how much more this network of neighbors will expand, surely some group of people are coming together in a corner of the city to share some feature of life with their peers.

Interviews were translated from Spanish.

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