Cosain Community Wellness

‘What people experiencing mental health difficulties need most is to be shown compassion, empathy, a voice, to be listened to, to be believed in, somewhere to go where they will be given hope of a more meaningful life.’

Cosáin Community Wellness is a recent initiative to develop a peer-led community-based support system for people with emotional distress and mental health issues, and to promote wellness for all. Cosáin is the Irish word for ‘pathways’, reflecting our belief in different paths not single roads, and the guidance, wisdom and support that we can find in the stories of each others individual journeys. All quotes within this article are from research performed by Galway Mental Health Services Consumer Panel, the local representative body of mental health service users for the geographic region.

GMHSCP advocates for supports and services which are fit for purpose from the perspective of service users, and the integration of users of services into the design,  development and delivery of services, working in partnership with the Irish Health Services (HSE) based on the value of our lived experience of current systems of care, and the evidence of our own healing processes.

‘The most effective help I have experienced over the years, having had years of medication, psychotherapy, hospitalisation, is the support of peers, where I am treated as normal, with kindness, not judged, and not expected to conform to the medical model of treatment.’

Where progress was slow or absent within the system, we took it upon ourselves to prototype and demonstrate how necessary supports could be delivered in partnership and collaboration between health providers, community groups, and local authorities based on a cooperative ethos of mutual support. We believe our approach will be of value and benefit because

‘it’s a community based project concerned with ‘well-being’ which is preparing fertile ground for the empowerment and transformation of people, individually and as a group. It’s organic growth reflects the personalities and desires of the people involved, making it of and for the people.’

Our belief is that properly resourced and equipped communities can provide more effective intervention in cases of crisis, care in a more person-centred and human manner, and both at a lower cost than the dominant acute-oriented, clinical and biomedical approaches. We believe that only approaches that are grounded in local communities and emerge from their dreams and aspirations can meet the needs which we are presented with in the time that we have.

‘My experience of large organisations is that the individual gets lost in the system and become just another number… I’m sick and tired of waiting for the HSE to offer people the support they want’

We also believe that the act of mutual support is amongst the most therapeutic of acts, transforming relationships from ones of being a recipient and subject of care, to a space of autonomy, collective development, peer provision and mutual reliance that involves people in generating their own solutions.

‘Being with people who are doing whatever we can to have our lives the way we want them, seeing the evidence that people can succeed, that we can make a difference – all this has a positive effect on my own mental health, self-esteem and my ability to shape my life the way I want it.’

We developed our initiative over the course of the Galway 2020 Bid process, using  participatory design exercises that brought together a range of groups and individuals including independent therapists, health professionals, service users and patients, and other interested parties who are seeking to develop new models of community-based health promotion and care. We then used the blank canvas of a disused city building, visioning and combining elements of artspace, green makerspace, and wellness supports that were brought together using the concept of an integrated cultural and community hub. During this time we came into contact with EdgeRyders and the Opencare research project, and welcomed the opportunity to form productive partnerships at European level with groups and initiatives with similar ethos.

Our current operating model exists with the support of Galway City Museum, who have provided us with the use of a room one day a week for prototyping and co-design. This is taking place as part of the Galway City Cultural Strategy, which seeks to use  cultural resources and infrastructure for wellness supports and public health. These sessions were an extension of the earlier co-design process, deployed in a real-life environment for feedback from stakeholders and re-design. Our sessions to date have included artistic and creative process, peer support and educational sessions, based on the demand from service users.

Currently delivered on a volunteer basis for proof of concept, our intent is to progress towards a cultural space and ‘crisis cafe’ on a social enterprise model, with a welcoming cafe-type front-of-house drop-in space that can be used as an open studio and learning space, with a supportive backstage of more intensive interventions, therapies and supports for those people in emotional distress. Our model is grounded in the value and authenticity of provision of supports and services that are delivered by people with the direct personal experience of the situations in question, and the expressed need based on our research for appropriate creative outlets that support emotional wellbeing and generate meaning and community for the participants.

‘in Irish culture mental health tends to be seen as a failing by an individual, of an individual, in an individual. This attitude views the natural processes of emotional distress and recovery through a lens of pathology, individualised blame, guilt and shame. In contrast, rather than attempt to seek what Zygmunt Bauman called ‘individual solutions to collective problems’, an impossible task, we felt the need for the sake of our collective sanity, to use an approach based on collective support and interdependence.

Our story is just beginning.

“mutual support is amongst the most therapeutic of acts”

This. Over and over again.

I’m an avid supporter of Cosain and look forward to returning to Galway soon! <3

Unlikely allies

So, what we have here is:

  • A peer-to-peer support group of mental health patients and caregivers.
  • Which formed with the idea to give out recommendations for improving HSE (state-provided) services.
  • But which ended up having to take on the role of innovators and start prototyping stuff, as institutional response was slow.
  • And reconfigured itself in the context of the process through which Galway has re-invented itself to bid (successfully) for European Capital of Culture 2020.
  • With its main ally so far being not a hospital or a clinic, but an Arts Museum. 

It is paradoxical and completely logical at once! I guess, in its own way, this is fairly typical of the idiosyncratic paths taken by communities of care. You work with the tools you find lying around, and they might be highly specific of your place and time.

ECOC processes have one thing going for them: they do encourage everyone in the bidding city to think as a local community, like a piece of a local system. Maybe it made it more natural for a group interested in mental health issues and an arts museum to form an alliance.

Sharing experiences between Ireland, Greece and other places

@MAZI I figured you might want to read this. Thom, @Bernard @Teresa_Nilan and their team are incredibly committed to this project and I see you guys comparing notes.

For reference, MAZI’s story also makes a compelling case for peer support groups and they run these gatherings in both Athens and Thessaloniki. It seems to me they also have had some successes with funding coming in.


Wow! @Noemi told me to check this out almost 7 months ago and for some reason I completely spaced. This sounds fantastic! I would love to hear any updates you have since your original post.

Great ways of using systems

Thanks for this post!  Just getting around to reading it and impressed with the scope and vision.  The idea of the “crisis cafe” is very similar to what we have been thinking about in Woodbine.  How can we begin to view mental health  issues not as a failure of the individual necesitating treatment but rather as a symptom of an unmet need.  And then using our spaces and fostering the manipulation of other resources to meet that need.  Keep up the great work and looking forward to hearing how it progresses.