DiMH 2021 CONFERENCE KEYNOTE
intensive care units. Those are often environments that, when we go into them to inspect, feel anything but therapeutic.” She continued: “When you really look at our ratings, and whether things are ‘safe, effective, caring, responsive, and well-led’, you can see immediately that safety is our biggest concern.
The view of service-users “That is often where it goes wrong,” Jane Ray acknowledged. “The most important thing for us though is what really matters to the people who use the services – and I’m thus delighted to have Kenita with me today; she is going to share with you some of her reflections, drawing on her experiences of time spent in an inpatient service.”
Here Kenita Watson took over the presentation. She said: “I’ve got lived experience of being in a psychiatric inpatient facility, and I would like to share with you just some of my experiences. Initially, entering a ward, I vividly recall the
stale smell of musty air– it’s unique, and lends itself only to this environment. It’s not pleasant, and is its own smell, caused by a combination of poor ventilation, and a lack of fresh, clean air being circulated. The situation you find yourself in can feel surreal, both internally and externally. This is cemented by the lack of natural lighting. Thanks to the harsh artificial lighting, the whole ward is the same brightness, regardless of whether it’s day or night, which also affects sleep. I was frequently restless, with bright light shining through the observation panel on my door. Nights were thus often extremely unsettling. My bedroom was on a corridor, which made everything echo; almost a sense of surround-sound.”
Conditions led to an ‘overactive imagination’ She continued: “If there was an incident, I was often acutely aware of it – but having no idea what was happening can lead to an overactive imagination, which is not
control, and was extremely agitated and mentally suffocated. By this time I had also lost my subsequent job at a major bank’s call centre, since I couldn’t tell the bank when I might return to work. At least there – unlike with the toy retailer – when the working day finished I could enjoy my evenings and weekends unburdened by work worries.”
Release secured
her longest inpatient stay, spending five and a half months on an adult acute ward, again in Leigh. She said: “I was again sectioned, and the doctors suggested I might need 12-18 months in inpatient care, adding that they would try to find me more ‘specialist’ care elsewhere. “On the six- bedded ward,” she told me, “the only way to get any privacy was to pull a curtain around your bed; that is when it was actually up. We had to share a bathroom, and having a bath meant convincing staff you would not self-harm. The atmosphere – as per my previous experience – was depressing and institutional, and I suffered badly from boredom, had little dignity or
THE NETWORK | OCTOBER 2021
After five and half months, having absconded and returned voluntarily relatively unscathed, she told staff on the adult inpatient unit there was no reason to detain her further, gave her younger sister’s address locally as a place to stay, and secured her release. She said: “I found myself a rented property and began a new chapter in my life.” Four years ago, she met a new partner, a firefighter, and they now share their own home in Wigan. She said: “While the major toy retailer was not overly supportive over my mental ill health, the bank took a slightly more enlightened view, eventually medically retiring me. While I still have occasional episodes of depression and severe anxiety, and sometimes self- harm, the frequency is much less.” Although she has not since felt mentally ready to take up a full-time job – she pointed out that it is also difficult to account for periods not in work to prospective employers – she now works part-time for Choice Support – a social care charity that supports people with learning disabilities, autism, and mental ill health – accompanying CQC staff on inspections of a range of inpatient mental health facilities.
COVID’s impact
She said: “The COVID outbreak has curtailed the number of CQC visits I’ve been able to make, but before it began I was making visits up to three times a
remotely conducive to a good night’s rest. In the morning, still tired from the night before, I often wanted a shower, but the shower kept switching off, as it was on a timer. My only previous experience of a time-limited shower was in a swimming baths – a very public area, which simply reminded me of my lack of privacy on the ward, and left me feeling a sense of exposure.”
During the day on the inpatient ward, Kenita Watson tried to spend time in the public areas. She elaborated: “It wasn’t particularly spacious, and in these spaces I would regularly see other patients in crisis ‘venting’, or demonstrating distress. I think there is a general lack of understanding about how what might appear an insignificant issue to an ‘outsider’ can be so significant for an unwell and distressed inpatient. For example, if you were listening to music to and fell asleep the night before, you would have to surrender your mobile phone for charging, only to be told that phones are not charged during the day. Add to this then trying to explain to
month, accompanying a range of CQQ staff – from psychiatrists to community health nurses. During and after the visits I can not only suggest improvements to the environment, but can also talk to service-users to get their views. During the pandemic I have continued this work ‘virtually’, via platforms such as Zoom. Not only do I feel I am giving something back, based on my own lived experience, but the role is personally fulfilling and boosts my own mental health. It was great to speak at this year’s Design in Mental Health event, reaching mental healthcare staff and other service-users in the audience, and also to meet with a number of product suppliers – who I don’t think often have much direct contact with service-users.
Some good lessons
“My experience from the CQC visits is mixed – there are clearly some good lessons being learned on what constitutes a more fit-for-purpose inpatient or other mental healthcare environment, but equally some locations where I still see very poor wards and hear horrendous tales from service-users. Nursing and clinical staff are usually doing their level best to provide good and compassionate care, but, especially at lower seniority levels, have little say on improving the patient environment, despite being in one of the best positions to have a valid view. I heard of the opportunity to work with the CQC from another service-user, and would encourage other experts-by-experience to get involved in the Commission’s work, since only if service-user voices are heard and taken account of will real improvements to mental healthcare settings and the care provided within them continue to be made.”
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