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Improving Mental Health by keeping nature in mind

In this Women’s Lives, Women’s Voices feature, Inishowen woman Michaela Mc Daid shares her extensive personal and professional experience of mental health and how this led her to Ecotherapy.  She also outlines Nature in Mind courses and why the facilitation she provides in Ecotherapy is so popular in the North West.


It’s Personal

Mental health has profoundly impacted all areas of my personal life.  At 16 I lost my only sister Katrina to suicide. She called me and I resuscitated her, but she still died.  She was 18.  By age 20 I still hadn’t grieved the loss of my sister, or talked about the trauma and tragedy of her death. When I sought professional help, I was diagnosed with depression and prescribed anti- depressants.  This made it easier not to talk, and just keep going.  So, that’s what I did.

In the 20 years that followed I moved house 11 times between Donegal, London, Derry and Donegal again. Teenage pregnancy, single parenthood, financial pressure, an abusive relationship and addiction were all life experiences that layered stress on top of my vulnerable emotional health.  There was also more grief; I lost my Mum in my 20’s and Dad in my 30’s.  My constant underlying feeling was of being utterly alone.

During this time, ‘depression’ was a very private battle. I was consumed by self loathing, often numb with sadness and felt completely disconnected. But I only ever cried inwardly, screamed silently and hurt myself in secret.  To the outside world, I was a bubbly fitness instructor, motivating others through high energy aerobics classes with a wide smile and perfect physique.  I also returned to education and excelled academically, graduating top of my class and earning a scholarship for post graduate studies.  I was a loving and conscientious Mother, managing a well kept home. I was also a sociable and popular friend, always the ‘together one’ that others came to for support.    

As a patient of mental health services, I was compliant and co-operative. I took medications as prescribed and engaged fully with psychiatrists, psychotherapists, mental health nurses and counsellors. I attended support group meetings and educated myself with countless self help books.  I fully accepted that I was ‘unwell’ and would have done anything to get better.

Then, in my 30’s I experienced elation and psychosis, was re-diagnosed bipolar and prescribed lithium.  With this diagnosis came a sense of relief that maybe I had previously been misdiagnosed, so now things would get better.  Things got worse; the highs got higher and the lows got lower. This intensity coupled with sheer exhaustion, resulted in more frequent and commanding suicidal thoughts. Twice, I was hospitalised for my own safety. My ever changing prescription now consisted of daily anti-depressant, mood stabiliser, anti – psychotics, anti- anxiety and sleeping medications.  I wasn’t forty yet.


It’s Professional

Running parallel to this personal experience was a very successful career, being described as ‘high functioning’ meant both were possible.  I knew my calling was to work in mental health, but wasn’t attracted to psychiatry, nursing or clinical settings, I was equally unsure of a role in psychotherapy or counselling.  My heart was in the community and I believed passionately in education as empowerment.

I worked throughout Northern Ireland and Donegal for Aware, Action Mental Health, National Learning Network and freelance; devising and delivering educational programmes, facilitating support groups and voluntarily advocating for other service users.  In these various roles, I was privileged to work with the broadest cross section of our society;  urban and rural, all age groups, in schools, universities, community settings, churches, ethnic minority groups, traveller projects, LGBTQ+, the prison population, disability groups, domestic violence survivors, sports clubs and businesses.  

The appetite for knowledge on the subject was striking, and listening attentively to peoples’ experiences of mental health and illness meant that I learned as much as I taught. ‘Being heard’ and ‘feeling connected’ were the most common responses to the question ‘what helped?’  This resonated deeply with me.  There was another theme that I heard over and over again:    “Gardening . . . . pets . . . .fishing . . . . the park . .. the beach . . . outdoors.”  It was nature. Without direction, irrespective of background, people repeatedly told me that they were drawn to nature for easing mental and emotional distress. 

I reviewed my own mental health history and the correlation was equally strong.  When I struggled in London, I went to Hampstead Heath. When I struggled in Derry I walked my dog on the country roads outside the city.  Even when I was an inpatient on suicide watch in Gransha, my greatest motivation for discharge was to get to the woods beside the hospital!  The more dis-eased I was, the stronger the pull to be in green outdoor spaces. 

Having exhausted every external treatment available to me, I chose for the first time to consciously tune in to my intuition, and let it guide my healing.  I moved to the countryside and immersed myself in nature; gardening, hill-walking and sea swimming. I didn’t know then that what I was doing had a name; Ecotherapy.  The results were incredible.  Within three years I was entirely medication free, with no depression, elation, anxiety or psychosis. I was enjoying better mental and physical health than I had ever known, or thought possible.

I was mindful that my experience was unique to me and that medication and talking therapies were beneficial for many. But remained convinced that reconnecting with nature is a powerful, accessible and free way to improve mental health, yet this value isn’t reflected in services.  

With serendipity I found Solas Donegal, a HSE mental health recovery programme using a model of walking, talking and listening in green spaces.  Having operated successfully in Falcarragh for many years, Solas opened a part time service in Buncrana in early 2019 and I was employed as a peer support worker.  Completing Ecotherapy training gave me the history, framework, references, evidence and language for what I already knew; nature heals.  This isn’t some hippy dippy, tree hugging nonsense, or just something that works for me. This is an evidence based, globally recognised approach to mental health care that predates both psychotherapy and the medical model.


It Just Makes Sense

Through Solas, I attended the Critical Perspectives in Mental Health Conference in University College Cork which brought together pioneering projects offering user centred, non – medical, context and trauma- informed ways of helping people experiencing mental distress and crisis.   These projects were centre stage instead of being sidelined as ‘alternative’, as they had been in the countless conferences I had attended throughout my career.  As well as the personal stories, I was captivated by the multi – disciplinary, world renowned specialists presenting academic research, irrefutable evidence and statistics that challenged the current system and dominance of the medical model.  The language was that of education, empathy, compassion, holding space, co-production, peer-support, creativity, community and open dialogue.  All that I had felt, experienced and believed was not only being taken seriously, but was recognised as an effective approach to mental health care.   Now I had a clear direction for my purpose and passion.

The success of Solas further underlined my learning.   Participants are referred to the programme from within the HSE mental health team, so are already ‘in the system’ receiving treatment and support for (often chronic) mental illness.  Without a doubt; walking, talking and listening in green spaces was having a hugely positive impact on their mental health.  My background in the community sector meant my focus remained on a proactive and preventative approach through education, empowerment and building resilience, before a person became unwell, and before they were in the system.


I devised ‘Nature in Mind’ courses with a view to supporting people with Ecotherapy, no matter where they were on the mental health spectrum.   A person with good mental health, taking the initiative to apply self care, or a person with a diagnosis of a mental illness and currently using medication and/ or talking therapies would both benefit, so why make a distinction? There is no waiting list, assessment, analysis, diagnosis or side effects.  These courses are not support groups, counselling or psychotherapy.  It is much simpler than that. It is human connection, stillness and creating time and space for the healing power of nature and the outdoors.

I’m not the therapist – nature is! The relationship between participant and nature already exists, but may have been ignored or undervalued. As a facilitator, I highlight and strengthen this relationship in three ways: education, experience and connection. I provide mental health education and a broad knowledge of Ecotherapy in a relaxed and informal way, without a PowerPoint presentation!  This explains why nature is good for us.  How nature is good for us is highlighted through the experience of forest bathing, sea swimming, hiking, guided walks and woodland retreats. 

For longer courses I also connect groups with co- facilitators who have a deeper knowledge and expertise in a specific area such as horticulture, foraging, animal assisted therapy, fly fishing, care farming and bushcraft.  Courses for specific groups are imbedded in their local community, forging relationships that are sustainable after the course has ended. Long term attitudinal change is also supported through the ‘Keeping Nature in Mind’ element, which gives advice, discussion and practice to encourage small and practical ways of embracing nature every day, in an urban environment, and in participants own homes. 

Group connection happens very naturally in the right environment, with the right facilitation. Time and space is held for participants to talk to each other and me, because simply having your voice heard is a vital part of emotional wellbeing. This is increasingly lost to hectic lifestyles, technology and social isolation.  Within mental health support services, a ‘listening ear’ is often devalued in pursuit of analysis, record – keeping, diagnosis and intervention.  A group dynamic is even more powerful when balanced with time for safe solitary reflection and an atmosphere contusive to participants only ever contributing as much as is comfortable for them. 

Respectful that for some people, a group setting is always difficult, I also offer one to one sessions.  These can be used as an introduction prior to joining a group, as extra support whilst part of the group, or as a preferable alternative.  Meeting people wherever they are up to is not only critical for meaningful engagement, it is also kind.

For many, the experience of corona virus and lockdown has led to a renewed appreciation of the simple things in life.  Ecotherapy celebrates simplicity by stripping back the layers of our lives that can be so stifling, allowing us to breathe deeply.  I believe that the hugely positive interest in Donegal is partly due to the accessibility of beautiful outdoor spaces. It is also the ‘common sense’ part, that connecting to nature, each other and ourselves makes us feel better. What could be more important than that?


Contact Details

Email:          michaela.ecotherapy@gmail.com

Tel:               (0044) 7517936613

Facebook   https://www.facebook.com/MichaelaMcDaid.Ecotherapy

Instagram   https://www.instagram.com/withnatureinmind/


Remember you are not alone, there are people you can talk to. If you or any one you know needs some support for your mental health, please know you can find support with the following services;

Pieta House

24/7 Freephone Tel: 1800 247 247  or Text HELP to 51444

Professional one-to-one therapeutic service to people who are in suicidal distress, those who engage in self-harm, and those bereaved by suicide. All services are provided free of charge and no referral is needed.


Samaritans

Tel: 116 123

Email: jo@samaritans.ie

Samaritans provides confidential non-judgemental support, 24 hours a day for people experiencing feelings of distress or despair, including those which could lead to suicide.


NCCWN Donegal are always looking for women to share their stories and looking for women to write features on topics of their choice which we will profile as part of our Women’s Lives, Women’s Voices’ series.

Do you know about the COVID-19 Restrictions in Maternity Services?

Maternity services in Ireland should matter, please get involved and show your support.


NCCWN Donegal Women’s Network as a project of The National Collective of Community based Women’s Networks (NCCWN) are calling on the Government to ease COVID-19 restrictions in maternity services and allow birthing partners to support pregnant people and be present at all pregnancy related appointments, scans, full labour and birth as soon as possible.

As part of this call, we are also asking members of the public to let Government representatives know that you are not happy with the current measures or treatment of pregnant people and you want restrictions in maternity services to ease.

To make it as easy as possible for you to contact your local TD we have drafted a letter you can use to express your concerns and support every pregnant person across the country. You can find who your local TD is and how they can be contacted at: https://www.whoismytd.com/.

If you are part of a women’s group and would like to draft your own letter, please feel free to contact your nearest NCCWN project for support. You can find where all of our projects are located here. Or, if you would like your nearest project to send the letter on your behalf please contact us and let us know. Your personal details will only be used for this campaign unless you indicate that you want us to retain your details.

Download the letter template

The Health impact of Covid-19 on Women in Donegal

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The NCCWN Donegal Women’s Network Covid-19 impact survey reveals that, 61.1% of women living in Donegal feel that their mental health has been impacted by Covid-19. This percentage increased to 78% for women within the 18-25 age group and 70% for women between 26-40 years of age. While women living in the Buncrana Electoral Area had the highest percentage at 68% and 68.6% of women with a civil status of living with a partner had the highest percentage for any civil status category.

 


When asked since Covid-19 how much time have you had to look after your own mental health and wellbeing? 36.7% of Women stated that they had less time. This increased to 46% for women in the 26-40 years’ age category, 49% for women living in the Buncrana Electoral Area and 50% for women living with a partner.

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It is clear the Covid-19 pandemic has created and highlighted additional stresses for women in Donegal.  Women who took part in our impact survey talked about a number of issues and challenges they have faced since March due to the pandemic, these include;

Dealing with Post Traumatic Stress with Covid-19 restrictions re-triggering past traumatic experiences, going through pregnancy during the pandemic, dealing with ongoing health issues while trying to stay safe through the pandemic.

Some of the most common themes raised by women which directly impacted their mental health related to childcare and work. Many women talked about the additional workload and the challenge of balancing working from home and childcare, expectations.  Many highlighted even with a partner or husband in the house it still fell on them to be responsible for childcare. Homeschooling was a particular issue raised by women, who stated many had experienced an assumption by their partner that it would be them who would look after homeschooling. Which was a cause of frustration for women.

Many highlighted experiencing feelings of anxiety, isolation and loneliness. With constant worrying and isolation leading to sleep issues. Being away from friends and family also contributing to this. For others stress and anxiety was being brought on by worrying about the uncertainty of the future, finances and how they were going to pay bills if no work continued because of Covid-19.

While there were, additional stresses brought about from a feeling of expectation that with more free time now you should be doing stuff and being active at home all the time when in reality you’re just trying to cope with getting through the day.

A number of women who were front-line workers also expressed that their mental health was being impacted by a lack of support from their employers in relation to new workloads, personal safety and proper communication during the last few months.


This is just a snapshot of the data we received from 832 women living across Donegal. We will continue to analysis all the data and share our findings and recommendations in the Autumn.

Sexual Health Matters

Copy of you define yourself (1)

In this Women’s Live’s, Women’s Voice’ feature Eilish Mc Art, Coordinator of the Sexual Health Education Programme at the Donegal Women’s Centre in Letterkenny, talks about the education and training programme she delivers, highlighting the topic of sexual health and the importance of including and discussing sexuality + health to support our health and wellbeing.


 

Donegal Women’s Centre Providing Sexual Health Services

Donegal Women’s Centre has long been associated with health care provision and began in 1989, providing a ‘Health and Family Planning’ clinic, one of the first in Ireland, in a community setting. In more recent years a Sexual Health Project for young people began, initiated by an insightful colleague and I became the Sexual Heath Project Coordinator, this was followed up with a Young Women’s Sexual Health Clinic in Donegal Women’s Centre, which is one of only two in Ireland in the community settings, funded by HSE Sexual Health & Crisis Pregnancy Programme.

logos she info & DWC


 

Sexuality Health not just Sexual Health and why it matters

I have always felt challenged that Sexuality Health is not given more recognition by society as a primary element of Health & Wellbeing, particularly the ‘BEING.’ Other areas of health are discussed in open forums, but the mere mention of sexuality, and social response is a nod to it (and possibly a wink!). This is rooted in our attitudes and values, garnered by our generational, historical and religious systemic culture.

But, yet is sexuality not at the very core of who we are, from birth until death, how we identify to ourselves and to others, how we connect spiritually and physically. We cannot merely reduce sexuality to a discussion on contraception, Sexually Transmitted Infection (STI’s), and gender identity, although essential to holistic sexuality health provision.

 

The World Health Organisation Statement on Sexuality

‘Sexual health cannot be defined, understood or made operational without a broad consideration of sexuality, which underlies important behaviours and outcomes related to sexual health. The working definition of sexuality is:

“…a central aspect of being human throughout life encompasses sex, gender identities and roles, sexual orientation, eroticism, pleasure, intimacy and reproduction. Sexuality is experienced and expressed in thoughts, fantasies, desires, beliefs, attitudes, values, behaviours, practices, roles and relationships. While sexuality can include all of these dimensions, not all of them are always experienced or expressed. Sexuality is influenced by the interaction of biological, psychological, social, economic, political, cultural, legal, historical, religious and spiritual factors.” (WHO, 2006)

I would also include the capacity for sensuality. It is within this statement I consider my testimony to sexuality to be true, it is in sync with my beliefs, but also from years of working with the subject, agencies and people.


 

The Power Of Sexuality

I would not underestimate the power of sexuality. Sexuality transcends differences and divides of culture and politics, it is a bio/physiological condition familiar to all humans. Sexuality is not defined or confined by issues of, or consequences of being gay, gender identity, race, marginalisation by any factors such as economic class, education level, religious practice, ethnic group, migrant, traveller or settled, prisoner or free, ability or disability, or age, no, it is a behaviour common to all, it is mutual and unifying. Nor is it the domain and responsibility of the female of the population groups. The power of sexuality has had a place in history and many fabled and real political liaisons and strategy.

I recently carried out a scoping exercise for HSE Sexual Health & Crisis Pregnancy Programme titled ‘The Sexual Health Needs of Marginalised and Migrant Communities’. Women refugees who had been displaced due to war, through direct provision and in resettlement programmes in this county and women from Irish ethnic minority communities.

This was a gift that enabled me to have privileged access to work with women. I have also worked with women and men from disability sectors in programmes and training in sexuality, and throughout my career in wellbeing and sexual health, which includes people from LGBT, gender identity, those from socially, emotionally and economically marginalised, and privileged areas, they have been my tutors, and I have learned that sexuality and the issues from sexual health are common to all.

It is the glue that binds us as Humans. It is our inherent need for connection, bonding, and sensuality, the need to give love and receive love, feel and be desired, ecstasy, fulfilled, and attraction, and the gift of humanness. The soul of human sexuality is Powerful, and full of affirmative Power.


I do have to mention, negative use of sexual power, for the greater part in the setting of domestic violence. This is an area that needs to be addressed. The issue of domestic violence rightly has been given a respectful setting within the political, community, and funding sectors, but, discussion of the relevance of sexual control is a developing awareness, and programmes are being created to address this. I tried to research this issue for work, and it is limited in terms of information in this country, with one cross border community group and local support group, including this issue, and doing excellent work in their training in domestic violence.

In war, sexual violence is one of the conquering, degrading demeaning and divisive tactics used by marauding nations.  This is one of the underlying experiences that the women who participated in the scoping exercise experienced. This awareness and visioning was provided by the most eminent of project workers who provided me with a deeper awareness of the impact of the ravages of war, refugee camps, displacement and direct provision have on men and women. The ugliness of emasculation for the men and that impact for women, the war that is unspoken, struggles of need – the silent war shaped by despair.  Where can that anger and rage go? There are consequences and this impacts on sexuality and sexual behaviour for men and women.


Irish women from ethnic minorities experience hardships and vulnerability that are further exacerbated by levels of education, issues of residence, alcohol, homelessness and mental health.

One common experience for marginalised women highlighted to me in the focus sessions was the inability to relate to ‘white middle class services and leaflets on sexual health’ and the non-familiar language, women cannot identify with it. The research highlighted that a patriarchal system was evident, and was mentioned, and had an impact on women’s’ experiencing of safe sexual encounters, and attending for health care.

When we experience assault, any assault, we separate ourselves from our sexuality self, but it is an innate part of who we are and that means being separated from our soulful self. It leaves a gap, an emptiness.

I don’t wish to dwell on the negative elements of sexuality health, for to do so is sad, but I don’t apologise for including the issue, not to do so would be remiss and insulting to all the women and men I have worked with.


 

The Relationship of Sexuality with Mental Health

To discuss sexuality, we cannot neglect the fundamental component of self-esteem. Self Esteem underpins our sexual health choices, and our sexual health behaviours, and this links sexual health to mental health. Without the inclusion of self-esteem then any discussion on sexual identity, contraceptives, STIs, abortion or signposting to sexual health services is less effective.

Consent is a major issue in sexual behaviour and it is relative to self-esteem, and this is largely dependent on having experienced the 3A’s, Affirmation, Approval, and Acceptance from an early age and throughout life. I call it the AAA battery for a positive life experience. Having or acquiring healthy self-esteem, enables us to make healthy decision, and choices with partner behaviour, recognise difficulties, and act for a better way, recognise or wonderful connections, and grow with that.


 

Sexual Rights

There is a growing consensus that sexual health cannot be achieved and maintained without respect for, and protection of, certain human rights. The working definition of sexual rights given below is a contribution to the continuing dialogue on human rights related to sexual health (1).

“The fulfilment of sexual health is tied to the extent to which human rights are respected, protected and fulfilled. Sexual rights embrace certain human rights that are already recognised in international and regional human rights documents and other consensus documents and in national laws.

  • Rights critical to the realisation of sexual health include:

  • Rights critical to the realisation of sexual health include:

  • the rights to equality and non-discrimination

  • the right to be free from torture or to cruel, inhumane or degrading treatment or punishment

  • the right to privacy

  • the rights to the highest attainable standard of health (including sexual health) and social security

  • the right to marry and to found a family and enter into marriage with the free and full consent of the intending spouses, and to equality in and at the dissolution of marriage

  • the right to decide the number and spacing of one’s children

  • the rights to information, as well as education

  • the rights to freedom of opinion and expression, and

  • the right to an effective remedy for violations of fundamental rights.

The responsible exercise of human rights requires that all persons respect the rights of others.

The application of existing human rights to sexuality and sexual health constitute sexual rights. Sexual rights protect all people’s rights to fulfil and express their sexuality and enjoy sexual health, with due regard for the rights of others and within a framework of protection against discrimination.” (WHO, 2006a, updated 2010)

 

(1) It should be noted that this definition does not represent an official WHO position and should not be used or quoted as such. It is offered instead as a contribution to ongoing discussion about sexual health.


 

Safe Sex

The physical act of sex, is often talked about under healthy and unhealthy headings. Literature on safe sex is available, and it is important to recognise the value of promoting safe sex, the correct use of contraception, information on STI’s, crisis pregnancy supports and services. There is also safer sex, and that is about responsibility in safe sex practice, respect for self and others. It means seeking consent, using contraception as directed. It may also include using visual aids, stimulating aids, where consent is agreed and partners are the legal age to use.


 

Reduce the risk of coronavirus during sex

It is not always obvious if someone has coronavirus. Being sexually active with another person involves some risk of getting the virus. There is a need to reduce this risk by following the advice below. 

  • Only be sexually active with someone you live with who does not have the virus or symptoms of the virus.

  • Avoid being sexually active with anyone outside your household.

  • Avoid kissing anyone outside of your household and anyone with symptoms. Kissing can easily pass on coronavirus.

  • Taking a break from physical and face-to face interactions is worth considering.

  • Consider using video dates. Make sure to disinfect keyboards and touch screens that you share with others

  • While the current advice is not to have sex with or kiss anyone outside of your household, if you do, it is important to limit it to as few partners as possible. Remember close sexual contact with anyone you are not living with can put you and others at risk of coronavirusUse condoms and dental dams to reduce contact with saliva or faeces, especially during oral .

  • Wash before and after sex. This is more important than ever. Wash hands thoroughly and often with soap and water.

The Donegal Women’s Centres, Sexual Health Information Project has compiled some useful advice about keeping on top of your sexual well-being now that it’s easier to get out and about and meet people. To find out more please visit here.


 

Training in enabling the normalising of sexual/ity health discussion for professionals.

I have the honour of working in partnership with a wonderful talented young woman from health promotion and improvement delivering training in Sexual Health Promotion, a national training programme funded by HSE Sexual Health & Crisis Pregnancy Programme. At the outset of the training the professionals often state that they seek confidence in discussing the subject, and indeed that is part of the design of the programme. It is often noticed that by the end of the 10 days the participants have achieved that confidence through discussion, heightened awareness of the relevance to human wellbeing, but also that taboo around the normalising of sexuality discussion has diminished and is joyful to witness.  The days are challenging and full of new consciousness of the positive value in sexuality health provision. It is emphasised to participants, nationally, to be inclusive of the affirmative element of pleasure, ecstasy and joy in sexual participation, and the benefits of self-satisfaction and connection, to the individual’s health and therefore societal health. When humans are happy, they are mostly in a healthy state of Being.

This does not direct that people have to be sexually active to achieve wellbeing, that is a choice. Rather, is it about the relationship with self to begin, an interpersonal connection, and that which achieves an ability to sense the higher self, fulfilment, it is sensuality, and knowing the components of and experiencing joy for self. Sensuality is the pleasure that we derive in being with someone, by choice, and that changes with age, ability, health, life events but the joy and pleasure remains in being a tuned with that core component of sensual pleasure.


 

The ‘Taboo’

Donegal Women’s Network invited me to contribute an article to the women’s lives, Women’s Voices series, an opportunity to address the taboo on the subject of sexuality, knowing that I am passionate about the subject, and also about putting across the relevance of Sexuality Health within general health provision, my view is, it has to be included to achieve Well-being.

I wondered how do I address ‘taboo’ part of the challenge. For me it is about making the subject acceptable, normalising the issue. How do I do that? – it concerns YOU, EVERY YOU. It matters to YOU, it is WHO YOU ARE in your world, how you choose to project yourself, and, your wellbeing.

So, in my processing world Sexuality and Sexual Health Care, cannot be separated from general health care, to do so, leaves out a core element. Sexuality Health is, will always be relevant, a priority, and core contributory factor to humans being and societal well-being. 

 

Thank you

I am grateful to all the women of the Donegal Women’s Centre who support me in doing the work of the Sexual Health Project, in schools in the community and delivering the national training, and also to HSE Sexual Health & Crisis Pregnancy Programme who fund the Project.

 


NCCWN Donegal are always looking for women to share their stories and looking for women to write features on topics of their choice which we will profile as part of our Women’s Lives, Women’s Voices’ series.