Care in the community: As Covid-19 shuts down vital services, one mental healthcare provider has adapted its support

While the coronavirus crisis is predicted to have a profound influence on people’s mental health, it is already having a huge impact on those with existing psychosocial conditions.

Although self-isolation offers protection and security, the loss of routine, activities and uncertainty about the future, can all trigger further anxiety.

Across the country, mental health services have had to adapt their care for some of the more vulnerable people in society. VZW IPSO is a community mental health provider in Ghent that offers care for people with psychosocial vulnerabilities. Operating in three neighbourhoods and one smaller area outside the city, it organises leisure activities, work programmes and education through a recovery college.

Coordinator Jochen Van den Steen explains to the Bulletin how the centre functions and how it is doing its best to continue to meet the needs of the people it supports.

“Most of our clients have psychological or emotional problems combined with other social difficulties (financial trouble, loneliness, physical problems…). We support 23 people - aged between 18 and 80 -  living in either sheltered houses or flats that are owned by the organisation, as well as 15 people living independently. Our staff include social workers, sociologists, remedial teachers, animators, a psychiatrist, health managers, gardeners and woodcraft specialists.

Farm work and activities
In addition to the housing support, we assist 25 people in work projects at our farm or help them in regular workplaces. At our community centre in the city, we usually host sessions two days a week for people who want to come to chat, do activities, play a game, or just get together. Some 50 people attend our farm outside Ghent every day. They participate in work programmes (woodcraft, gardening, kitchen), leisure activities or volunteering (bookkeeping, taking care of the animals, looking after the reception).

We're an organisation that tries to be very close to our clients with face-to-face contact in all our departments. For clients attending community services, Covid-19 has meant a dramatic change. Our locations had to be closed and we had to switch to other ways of delivering services. But I was pleasantly surprised and proud that staff and clients adapted quickly to chatting online or on the telephone. The digital alternatives in communication are one positive that have arisen from the crisis. I hope they can continue to be an option in the future for people who may be unable to attend our services.

Psychological support should be essential
It’s weird with the current crisis and the measures taken, that psychological support isn’t seen as being essential. For a physical problem, it is considered essential to go to a clinic, but it’s taken too much for granted that psychological support can be done via phone calls or online. If a lockdown should ever happen ever again, this needs to be taken into account.

Where necessary, we have continued to offer outreach community services. For some people, direct contact remains essential and we provide this by meeting them outside their homes. We go on walks, talk on pavements etc. For people in sheltered housing, it's fantastic how they have adapted and responded to the measures, but living together and being together every day is starting to get hard. The isolation and lack of work and leisure activities is difficult for them. At first, some people were happy that they didn't have to go to work. But that has changed now.

Getting life back on track, together, will be one of our main goals to focus on when everything starts up again. Our clients have put in a lot of hard work over the years to get out of isolation and I hope we can support them to the same again.

Lockdown lessons to be learned
It's the first time that we have had to handle such a situation so there are lessons to be learned. Closing down all our services could maybe have been avoided; dialogue with the governments would have been great. We have to develop plans on how to deal with this in the future and how we can ensure that we can continue to provide our services.

For a lot of people, working from a distance works for a while, but for people with psychosocial problems, you need to be close by. There’s a nice slogan: 'Physically away from each other, but psychologically close by'.”

Photos: Courtesy IPSO VZW Gent website (taken before coronavirus security measures)