Designing For Recovery
A service-user’s view – no ‘one right way’ to get better
In the second of two opening keynote speeches at Day Two of May’s Design in Mental Health conference in Solihull, Ian Callaghan, a long-standing user of mental health services, who is today the national service-user lead for My Shared Pathway and Recovery and Outcomes in secure mental healthcare, gave the perspective of a service-user, and now also a regular visitor to inpatient mental healthcare facilities in a professional role, on ‘best practice in design, with recovery in mind’.
Speaking on Day Two of the DIMH 2015 conference was Ian Callaghan, a long-standing user of mental health services, who is now the national service-user lead for My Shared Pathway and Recovery and Outcomes in secure mental health, a role that sees him co-ordinate and facilitate the nine Regional Recovery and Outcomes Groups. These groups ‘provide a place for service-users, staff, and commissioners to come together to share best practice and to stimulate developments in secure care’. Also a patient reviewer for the Quality Network for Forensic Mental Health Services of the Royal College of Psychiatrists – which undertakes peer-led reviews of medium and low secure services – he is a patient representative for the High/Medium and Low Secure Clinical Reference Groups of NHS England.
IMPORTANT TO HIS RECOVERY Opening his presentation, Ian Callaghan said: “My own perspective comes from having been a patient in a secure hospital. I spent just under five years, from 2007-2012, in the hospital and its ‘rehab’ unit. I have been discharged from hospitals for about three years, and the project I have been involved with has been really important to my recovery since leaving hospital.”
Ian Callaghan explained that his experiences of mental health ‘went much further back’ than 2007, however. He said: “When I was 23, I had my first episode of what turned out to be a bipolar disorder. I was at a meeting the other day when a life coach described how she
uses images to support people to move on. She had what she dubbed ‘a mood elevator’, which she drew on a flip chart, and I recognised that I spend most of my time in the basement, and occasionally the penthouse suite, which is paradoxically a more difficult place to be.”
FIRST EPISODE Returning to his ‘first episode’, in 1997, Ian Callaghan said he did not have very good early experience of mental health provision and psychiatry, although he acknowledged
Ian Callaghan is the national service-user lead for My Shared Pathway and Recovery and Outcomes in secure mental health.
that the field had ‘come on a lot in the past 27 years’. In the first hospital he spent time in he was in a dormitory ward with six beds, ‘a bit like a general hospital, separated by curtains, which only went down to bed level, meaning that a service-user could see what was going on in the next bed’. He said: “It thus wasn’t a terribly pleasant place to be, but at least throughout my journey through various hospitals things evolved to having two beds in a room, and then just one.” Today, in addressing ‘Design with our
recovery in mind’, the speaker said he would focus both on his own experience, and on the My Shared Pathway project. He said: “My journey with mental health problems has been a long one, taking up more than half my life, but the past four and half years, since my last
‘I wonder how many of you have seen, or been in, a seclusion suite and had the door locked behind you?’
24 THE NETWORK J u l y 2 0 1 5
period in hospital, has been the longest period of good mental health I have had in all of that time.”
INTERRUPTED CAREER Having mental ill health had interrupted his original career, and meant he could not go back to it, although he felt fortunate to be able to have found other roles as part of his recovery process. Thinking of people in secure mental hospitals, Ian Callaghan said part of the recovery process was ‘about taking responsibility for what might have happened, and looking forward more to the future’. Pat Deegan, an activist in the disability rights movement, psychologist, and researcher, who has ‘lived her own journey of recovery after being diagnosed with schizophrenia as a teenager’, in 1988 described recovery as ‘a process, a way of life, an attitude, and a way of approaching the day’s challenges’. Ian Callaghan said: “It’s about creating a new personal vison for one’s self – something I had to do.” All these things, he said, were adding up to addressing: ‘How can we best support such ambitions via the environment?’
IMPACT OF THE INPATIENT ENVIRONMENT
“When I was first admitted to an inpatient unit,” he told delegates, “I undoubtedly felt my life was hopeless, and had cut all ties with my family and friends. I lost my career with this catastrophic crisis that led to me being in a secure hospital. It was a long process to turn this around.”
Moving to discuss how the environment he stayed in had impacted on his mental state and his recovery, Ian Callaghan explained that when he was first in a secure hospital, there were 5.2 m high fences. He said: “I also couldn’t believe how many doors had to be unlocked before I went onto the ward. I had no conception of what an airlock was, or that I couldn’t get a key. The reception area was not welcoming – it certainly wasn’t a hotel lobby. It didn’t even have anywhere for people to sit down. It was just a small space, and that was my first experience of the hospital, which also included being searched while everybody was watching.”
He also discovered that there were ‘lots of
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