The world can be a dark and lonely place for mental health patients. Especially for those on secure wards. But by providing patients the opportunity to get out in the open, this team is transforming lives through the simple act of walking and talking.
We entered into the airlock from the outer door, photographs were taken of our faces, security tags printed and then handed to us. With the outer door securely shut we were allowed into the courtyard. We then headed over to the allotments through a gate in the far right corner to chat to the team who were heading up the ‘Walking Therapy Group’.
The facility provides specialist medium and low secure services in a secure hospital setting for patients diagnosed with learning disabilities and autistic spectrum disorders. A lot of inpatients here have a history of offences that are directly related to their specific disorders. The focus is on rehabilitation aiming to get people back into the community. We met a few of the ‘drivers’ involved in this rehabilitation, one of them being Sarah Ommaney, a keen walker, who started as a healthcare assistant in 2014. She was keen to get the inpatients out of the confined environment and into the outside world. She said, “Exercise can help with anxiety, also being outside gives the inpatients a chance to interact with others they may meet and they can apply the social skills they learn in sessions here at the hospital.” She spoke to the ward staff and put together a proposal to get inpatients out for the day. However, it took the best part of a year to get the relevant permission and as soon as that happened there was plenty of interest to venture outside the walls from both inpatients and staff.
One of the interested staff was Sandie Pattison. She had been a healthcare assistant for over 25 years and retired two years ago, but the ties were strong and she returned ‘on the bank’. “As soon as I heard about the walking group I knew I wanted to be involved. There are some amazing places just outside these walls within half an hours drive and I knew the inpatients would really benefit from getting outside into the green space.” On some of the early walks the team noticed the inpatients were stopping to stroke dogs of fellow walkers. Sandie said, “There are lots of studies around animal therapy with direct links to reducing anxiety, so I started to bring my dog Bryan along with us.” Bryan quickly became a hit with most of the inpatients and they would save scraps of food for him when they knew they were going out.
Another professional facilitating the walks is Lucas Hollingsworth, an occupational therapist. He noticed that, “Anxiety levels of the inpatients were reducing and all the feedback we were getting was really positive.” He told us that the walks give inpatients a shared interest to discuss when they are back in the unit. They can help plan walks, come up with suggestions and ideas and all of them look forward to the freedom each walk brings.
Lucas’ role specifically looks at the life skills of the inpatients, concentrating on the overall aim of getting them back into the community. The walks provide him with an opportunity to witness the progression inpatients are making on a regular basis. As well as thinking for themselves, they are planning what they will wear, working out routes, understanding the country code and helping with navigation. Lucas said, “There was a patient who came out for the first time and noticed Sandie and me greeting fellow walkers and he asked if it was something he could do. Now he will say hello to people he sees on the walk. These moments just wouldn’t happen tucked away in the wards.”
The team take inpatients out every week but there are currently more people who want to go on walks than they can facilitate. This has led to a surprising trait of generosity, for instance Sandie told us that, “One of the lads came up to me and said, ‘I went on the walk last week so you can let someone else go this week.’ Not only that but I’ve noticed that when everyone is out walking there is a real sense of camaraderie, some will slow down for others or carry another person’s backpack. Even before we go on the walk some of the inpatients will ask others ‘are you going to be warm enough, have you got enough layers on?’” The walks bring a new found respect and a definite lack of aggression. Sarah said, “The new environment levels the playing field. The tensions that may have been high on the wards almost instantly dissolve as soon as we are outside.”
As well as reductions in anxiety and aggressive behaviour, the outside freedom has seen a number of impressive results in communication. Sandie recalls, “One real break through we had was when a patient who was an elective mute started to talk on one of the walks. Previously he would say the odd word with great reluctance but now he is openly talking, something he’d not done in any session back at the hospital.” Lucas adds, “On the walks there is no pressure to talk, so you find patients open up, talking about personal interests to do with films and sport and we get a real insight to their personalities.”
Rebecca Sanderson said, “The whole focus of what the unit does is to facilitate the inpatients’ journey back into the outside world and these trips really help to see how they can cope in a number of different situations.” There is a huge amount of trust and respect placed on the inpatients and in order to leave the compound they have to demonstrate good behaviour. It’s working because the findings and feedback have been very positive. The walking group is now well established and the team have the support of the doctors, nurses and management and have secured extra funding to allow the walks to continue. They are delivering a whole host of benefits both physically and mentally and the team will continue to offer the walking therapy to compliment all of the other treatments, helping improve the inpatient’s well-being and ultimately their move back to the outside world.