Why Occupational Therapy Saved Ellie

A weird thing happened the other week. I’d just been to an Occupational Therapy conference and, because I had saturated Twitter with posts about what had been going on, I ended up in a conversation around how Occupational Therapy had really benefited people. I encouraged them to write down what had been helpful to them. I thought very little of this until lo and behold this turned up in my inbox. Most OTs will find this a fairly interesting read.

Just to introduce Ellie: she is someone I met at the British and Irish Group for the Study of Personality Disorder annual conference, in Cardiff last year. She ended up being highly commended for her poster 'The Impact of Activity and Occupation on Borderline Personality Disorder'. She’s a big advocate for OT and at some point I hope she becomes one. Enjoy her tale…

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Trigger warning: Self-harm

Three years ago I was a very lost young woman. I was sectioned in an acute psychiatric ward for the fifth time, after years of borderline personality disorder (BPD) and an eating disorder slowly dragging my life away from me. My daily routine consisted of spending the nights in accident and emergency (A&E), getting stitched up after self-harm, coming back home in the early hours, sleeping in the day, self harming again in the evening, back to A&E - and so the cycle continued…Sometimes with the occasional break of an overdose or suicide attempt and sometimes with the addition of multiple trips to A&E in a day. I was admitted to A&E over 200 times in less than a year.

But something about this admission was different to the last. As someone who is pretty damn intelligent (if I do say so myself), acute wards are pretty dangerous for me, as I get very bored and spend my hours conjuring up inventive ways to hurt myself. So generally, acute admissions had brought no benefit apart from new self-harm methods. However, the big difference with this admission is that the ward that I was on had double doors at one end, that led straight through to the occupational therapy (OT) department. And this is where the first glimpses of healing began.

Here there were things to do, things to keep my mind and my hands occupied; I could make my own meals (which helped with my eating disorder). The staff had more time to chat to me and help me process my situation than the staff on the ward, that were rushed off their feet with medications and observations.

I was also more willing to talk. It's easier to chat to someone whilst you’re doing another task - rather than artificially sitting opposite someone in a chair, in a box room with no windows. Entries in the notes from around that time show that I was considered 'complex', 'a disruptive influence on the ward' and someone who would be in the system a long time. However, when I speak to the staff in that OT department from that time, they don’t recall that side of me. I was like a totally different person once I went through those double doors. Here I was celebrated for who I am. Staff encouraged me to teach other people to hoop (my favourite hobby), to write poems and explore art, to have a go at yoga and spend time outside. This also coincided with me coming off all my medication which, after years on antipsychotics, meant that I suddenly had a clearer head and could actually engage with these things, rather than just going through the motions. I was starting to FEEL again.

One day, the lead OT asked me if I would like to come and sit on the Therapeutic Activities Development Group, as a service user representative. He felt that I had a lot to contribute to ideas for activities, in the inpatient areas of the mental health trust. The first meeting was a fortnight after I was discharged from hospital. I hadn’t got out of bed or washed in over a week; I vividly remember turning up still with pyjama bottoms on and steristrips on my face. I didn’t want to go; I was anxious about being the only service user in the room and having nothing to contribute. But, to my surprise, I had a really positive reception and professionals were turning round to me and asking my opinion and valuing my input. I walked out of that meeting and went home.

I had a shower, changed my clothes and felt a glimmer of hope that maybe there was something I could do in the world.

I was admitted to a specialist unit in a different city for a year after that, which changed my life. All through it I worked remotely on tasks for the group and returned to Sheffield for monthly meetings, if I was able. Part-way through the year I was asked if I would like to start volunteering in the OT department on the ward; gathering service-user feedback about activity provision and just generally helping out. It meant that I had something to work towards and keep well for on my return to Sheffield - a city where I had been living a dysfunctional life for so long previously.

Fast-forward a further two years and I can’t believe how far I’ve come since attending a once-monthly meeting in my pyjamas! I spent a year volunteering in OT on the ward. During that time I learnt so much; I got opportunities to present what I was doing to the rest of the Trust and this lead to further people being interested in getting me involved. I started to deliver training on mental health to police officers and A&E staff, telling my story to people on induction to our Trust, running workshops and attending conferences. My life is full of hobbies and activity (I roller skate in skate parks and take part in other circus activities). From one person believing in me - and the power of occupation on someone’s recovery (even though they are very unwell), I am now employed by the Trust. I use my lived experience in my role as patient ambassador in medical education and research.

I still volunteer and I still speak about my experiences and advocate for the impact of occupation and activity on recovery.

I even wrote a poster presentation on the topic, which came highly commended at BIGSPD 2018, which was a huge boost to my confidence and also helped me get to where I am today.

My two years since returning to Sheffield have not been great in my personal life. I have battled with homelessness and been fighting for care; there have been a lot of issues with services (some of which have been quite frankly traumatic), which did not resolve certain unmet needs, that are still impacting on my life significantly. It has been incredibly hard to keep going.

But one of the reasons I have been able to soldier on is that now I have a purpose and a value in my existence.

I’m appreciated for what I bring to the table in mental health in the city and for speaking out about my experiences. I have a future ahead of me and a whole new potential career path I would never have envisaged. And if that doesn’t end up working out then I’d actually love to become an occupational therapist. I’ve learnt to put the bad stuff that has happened to me to good use and, for the first time, I am excited about the future. And I honestly don’t think it would have been possible if it wasn’t for that OT department believing in me and encouraging me when I was in my darkest times. Occupation and activity is my medicine and it is what keeps me alive every day.

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• You can hear more from Ellie here on this podcast

• Ellie talks lots of sense on Twitter: @elliewildbore
  

• Keir Harding provides clinical supervision, therapy, consultation and training via Beam Consultancy