Mutual support groups in the field of mental health
Social support, mutual support, and cooperative relationships are perhaps the most important ways to cope with difficulties, organize ourselves, and build a fulfilling life. Having the support of people who are important to us is so crucial that it is one of the many determinants of mental health. We all need it.
Paradoxically, structural and systematic discrimination against those of us who experience mental health problems is often what most compromises our support networks and personal relationships. Stigmatization is the main barrier to improving our well-being. We are discriminated against through judgment, infantilization, or outright rejection. For this reason, people with experiences of psychological suffering and medicalization consider safe and independent spaces where support can be built on horizontal and reciprocal relationships to be so valuable. These spaces, which, as Guzmán-Martínez et al. (2021) rigorously explain, originated in the social movements of women and the mentally ill, are Mutual Support Groups (MSGs).
Mónica Civill Quintana
Women's Support Groups (GAMs) are alternative, distinct, and sometimes complementary spaces to professional resources. Professional support addresses health and community needs that we cannot meet on our own, bases its interventions on academic knowledge, and allows us to respond to situations that overwhelm us and where we need a solution sooner rather than later.
In contrast, in the GAMs we find answers to universal social and emotional needs such as sharing and sheltering, we base our activity on experiential knowledge, and we relate to each other through reciprocity and co-responsibility.
In these spaces, the suffering we experience can become a source of learning and growth. Our own experience can acquire value for ourselves and others, and we not only receive support from our peers but also give it to them. Thanks to these dynamics, over time, we also abandon learned helplessness and the sick role, assume responsibility for our own well-being and that of the group, and develop a process of personal and collective empowerment.
Voice Listeners: Understanding and Accompanying
Therefore, a GAM (Group of Friendship with People) is a self-managed group space or activity for people who have experienced a common difficulty or adverse event, where we share our experiences firsthand. People with psychological suffering who have been medicalized need these spaces to talk about the psychosocial consequences of medicalization, the burden of the psychiatric diagnosis, the medicalization, the symptoms, and the distress. But also about our resources for coping with difficulties, our strengths, our capacity to build satisfaction and well-being, and our life projects, desires, and dreams.
The objectives include learning collectively, creating networks where support flows horizontally and reciprocally, and improving our daily and long-term well-being. Furthermore, the GAM is a space that should serve to deconstruct our own stigma and self-stigma, shed the identity burden of psychiatric diagnoses, value our unique knowledge derived from our experience, and take responsibility for our personal and collective well-being.
What motivates us to want to participate in a GAM?
Most of us who decide to participate in a GAM (Group for Mutual Support) often have different reasons. Some of the most common are expanding our personal network, breaking social isolation, sharing our experiences in a supportive and understanding environment, connecting with peers, overcoming the fear of rejection, or seeking information and resolving doubts. However, many of us decide to maintain our participation in a group even after we've satisfied the concerns that initially drew us there. Why do so many of us continue participating in a GAM after so much time?
Participating and contributing to the long-term sustainability of a GAM (Group of Mutual Aid) gives a positive meaning to our experience, makes us value ourselves when we are a support to others, and makes us feel that we are contributing to a collective change that transcends ourselves.
But how do we ensure that the GAM is a self-managed and safe space that guarantees its objectives? Just as feminists and the LGBTI community have done, the mental health community and the social and associative movement for mental health have also generated situated knowledge based on the systematization of collective experience. The conclusions of these participatory action research processes in our context have helped us to establish basic principles and norms for the GAM.
Mutual support groups
A GAM (Group for the Advancement of Women) should be characterized by horizontality, voluntariness, and respect . Horizontality implies that participants must have a common and shared experience, that relationships must be free of hierarchies and based on equality of authority and recognition, and that everyone speaks in the first person, with no place for professional roles. Voluntariness requires free and committed decisions to be present in the space, or to speak; each person must find their own pace. And respect necessarily involves recognizing the value of diverse voices and the enrichment they bring to the group, as well as understanding listening as the primary channel for acknowledging the other, their subjectivity, and their pain. The functioning of a GAM requires that all of us who are part of it learn to identify and validate the needs of our fellow members.
Undoubtedly, guaranteeing these principles requires relational practices based on equality, reciprocity, co-responsibility, and self-management. All individuals must adhere to basic relational norms that constitute red lines, based on ethical and functional criteria such as respect, confidentiality, inclusion, and commitment. These norms, as well as the reasons for their importance, are explained in detail in the Guide for First-Person Mental Health Mutual Support Groups (Sampietro and Sicilia, 2017), developed by the ActivaMent Catalunya Associació team within the framework of the Activa't per la salut mental project.
Ensuring the long-term functioning of a GAM means guaranteeing the practice of mutual support beyond the group itself, promoting the creation of support networks in daily life and accompaniment in crises, generating care and letting each other know that we are not alone for both good and bad times, building places of resistance to oppression and, ultimately, conquering a space of personal, social and political agency.
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