CHS interview

CHS: 50 years of supporting expats’ mental health in Belgium

Interview with Alessia Ciani, Clinical Director at CHS

Hello Alessia! Thank you for taking the time to speak with us and share more about Community Help Service (CHS). Before we delve into that, can you introduce yourself and tell us how you are involved with CHS?

I am a consultant psychiatrist and clinical director of CHS. My main area of work is in the management of young patients with a broad range of psychiatric conditions, such as mood and anxiety disorders, as well as more severe conditions such as schizophrenia. I have a special interest and academic training in developmental psychiatry and the assessment and management of Eating Disorders, OCD, ADHD and people who are in the Autism Spectrum Disorder.

I started my career as a doctor in Italy, worked in France before moving to London, where I trained in psychiatry and became a consultant in the NHS and led a large community mental health team. Before moving to Brussels in 2017, I worked for the two main mental health hospitals in London. 

When arriving in Brussels in 2017, I decided to focus on mental health issues affecting expatriate communities – in particular understanding their unmet healthcare needs. CHS was the perfect fit for me as their model of care is a multidisciplinary approach with high ethical standards

How does CHS support the international community in Belgium?

CHS is a non-profit organization which operates a mental health services center and a helpline. The mental health center has about 20 clinicians at any time, with a mix of psychiatrists, clinical psychologists and other mental health professionals. Our main working language is English, although we have therapists who work in variety of European languages. 

CHS has a unique position as a health service provider to the expatriate community in Belgium: We are one of the few mental health services in Brussels that operates in other than the three national languages of Belgium. The regional health services of the three Belgian language communities operate principally in their own languages, and many expatriates find it difficult to communicate mental health concerns in languages other than their mother tongue.

Have you experienced an increased demand for your services during the pandemic? 

The pandemic has certainly increased levels of stress and therefore the demand for treatment of anxiety and depression. 

Also, there are mental health impacts of the unique aspects of the COVID-19 pandemic – in particular, the effect of social distancing and quarantine. Unsurprisingly, studies have shown that social distancing may lead to an increase in loneliness, anxiety, depression, domestic violence, child abuse and substance abuse.

Similarly, persistent high levels of anxiety, depression and post-traumatic stress disorder are seen in survivors of critical illnesses a year after discharge. This may translate into neurocognitive impairment – impaired attention, concentration, memory – sleep disorders and substance misuse. 

The mental health impact of the COVID-19 pandemic will probably last several years with ongoing fear and anxiety among expats in particular. 

What are the priorities for organizations like CHS?

In general terms, the immediate priority for mental health organizations such as CHS is to enhance affordable access to mental healthcare and treatment, whether this is through in-person appointments, telepsychiatry and tele-counselling or helpline support. This requires investments in multi-lingual clinical and helpline staff training and in upgraded facilities and new technology platforms; the latter principally because of increased cybersecurity risks and the sensitive nature of personal health data. 

Separately, the expatriate community is rarely the subject of specific studies, and it is clear that the issues of that community may differ from those experienced by the general population in Belgium – for instance, because of the lack of proximity to family and social support systems. It is therefore a priority for CHS to collect high-quality data on mental health and psychological effects on the expatriate community in Belgium of the COVID-19 pandemic. This will allow us to better reach and help our patients and target groups.

How can the international business community in Belgium support CHS's mission?

Thank you for asking this question. CHS is a non-profit organization that relies largely on charitable contributions to support its operations. We continue to have a very limited budget, and we have seen shrinking charitable contributions. This happened at a time when we have not only seen a significant increase in demand for our services, but we must increasingly move from face-to-face consultations to video and audio consultations that require secure technology platforms.

The expatriate community that CHS serves comes largely from the international business community in Belgium or from the international organizations based around Brussels. We would therefore encourage the international business community to help us fund an endowment for the CHS that will ensure that we can continue to provide affordable mental health services to the expatriate community in the coming years. 

Anyone interested in supporting CHS can reach out to me: alessia.ciani@chsbelgium.org