Does Trialogue do what it says on the tin?
When I heard about Trialogue, a community forum of open dialogue around mental health issues, I was sold on the concept. A Trialogue group is comprised of a triumvirate of mental health service users, service providers and family members. It is non-hierarchal, where everyone’s lived experience is equally valued and is an opportunity to open up the conversation on mental health from different perspectives.
A 2017 Report to the United Nation Human Rights Council called for a need to empower individuals and to ensure representative and meaningful participation in health service development and provision, and cited Trialogues as a vehicle for this. With all this is mind, I jumped at the opportunity to be involved in a taster session of Trialogue facilitated by the Recovery College at the Winter Well Being Day, which was held in Dundalk in January. The topic was ‘Normal is an Illusion’ and it generated an enlightening conversation amongst 48 people, from many different perspectives.
It is important to note at this stage that Trialogue is not a group therapy session, it is a sharing of experience and knowledge and an incredible opportunity to voice the ‘dirty secret’ of mental health difficulties and issues in a non-judgemental arena.
Armed with this information, I was eager to attend the first Trialogue session of 2018 in the Recovery College, which takes place on the first Monday of every month. Twelve people gathered and the topic was ‘New Awakenings’. The ground rules were gone through, which established that everyone could ‘leave their hat at the door’ and not feel constrained to be able to speak their mind freely. Another ground rule is that participants should ensure that they feel personally safe and comfortable, all good so far. However, what ensued was the recounting of some deeply personal and traumatic experiences. To reiterate, this is not a form of group therapy with ‘fixers’ on hand to provide answers, but what became apparent very quickly was that if the proper balance of service users, service providers and family members is not there, the situation can feel a long way from safe. Absolutely open up the conversation on your personal struggles, as the accepted norm is to try and shut that up, that’s healthy, but I don’t feel that the Trialogue space is appropriate for a personal venting session. I cannot say that it was badly facilitated and there were stories of resilience and tools for reawakening, but I felt myself affected by the stories. I was aware that while I am very fortunate to have supports in place, many around the room have not been afforded that luxury. I felt myself very conflicted. While one part of me wanted just to see the proposed benefits of Trialogue, the more critical side of me was aware of the safety issue of people offloading very traumatic experiences in a group.
For Trialogue to work there has to be the right mix of that triumvirate I spoke of. If this is being hailed as the way forward in mental health recovery, there needs to be serious and sustained buy in from service providers to gain balance in the room. Facilitation is also key to avoid the group getting stuck in one narrative and running the risk of becoming an echo chamber. With these checks in place, I have no doubt that the challenges faced can be overcome and Trialogue can do exactly what it says on the tin.