When I was sat in school at the age of 16 I didn’t really know what I wanted to do with my life. I had a vague notion that I wanted to be of help to others but no real notion of what that might entail. I pictured flying fighter planes, being a barrister, teaching and being a physiotherapist. A lackadaisical approach to education ruled out a few options but after much pondering, I eventually applied to university to do either physiotherapy or education. In their wisdom the admission tutors took one look at my lack of academia and attendance and decided that higher education was not for me. It was with much trepidation that I collected my A Level results knowing that I had no offers and while my peers were off to pack for uni, I was off home to go through clearing.
Keir is a Lead Therapist in an NHS Specialist Service and provides training, consultation and therapy around complex mental health problems through beamconsultancy.co.uk
Clearing is an interesting experience that I hope you never have to go through. You find a list of all the institutions that have vacancies on different courses and get in touch to see if they will take you on. You phone asking after one course e.g. Spanish and they offer you a different one like woodwork. I was on the phone making or waiting for calls for the next 2 days and eventually I spoke to a guy called Chris Bailey in London. Once we had ruled out physiotherapy (“not with those grades mate”) he asked me about Occupational Therapy. It had the word therapy in it so I said I was interested. He made me an offer to go and study Occupational Therapy at Brunel in London and as soon as I had accepted I went down to the library to find out what on earth Occupational Therapy was.
Occupational Therapy is great. You help people to do the things they want and need to do. Sometimes you teach people things so that they can do what they want and need to do better. Sometimes you change the environment around them so that it becomes easier to do them. When you’re working with people, more often than not you are doing things together – frequently things that either you or they love. You find that rather than stopping people from dying, you’re helping them to live.
What surprised me was the breadth of occupational therapy. I wanted to be like a physio when I turned up at uni and there was full scope for me to specialise in areas like hand therapy, people with amputations, traumatic injuries, blindness, stroke…any physical health problem that impacted on their ability to live the lives they wanted and needed to. One of my placements was in social services and I went around giving out equipment, fitting handrails and even designing houses so that people could live in their own homes and care for themselves independently. If this area of work had piqued my interest I could have spent my career working with people with physical health problems and making a profound difference to their lives.
Two things happened. Firstly I discovered that I found learning anatomy rather dull and there’s loads of it. Secondly I went on my first mental health placement and fell in love with it. I became fascinated by what went on in people’s minds that meant they were unable to do what they wanted and needed to. Equally I was shocked when what they wanted and needed to do in the moment, was totally outside of anything I’d ever thought of. After university I threw my green trousers away and never worked in physical health again.
Occupational therapy is a recognised profession within the NHS. This means you will find a job pretty much anywhere in the UK. I knew I wanted to work in forensic mental health so I took the first job that wanted me and moved to Edinburgh. I loved my first year in Scotland and took away some really important things from my first job that set me up well for the rest of my career.
After a year my wife got the chance to study in London and off we went without any doubt that I was going to get employment. While there I worked on hospital psychiatric wards running sports groups and making sure people were safe to go home. I went onto the psychiatric intensive care unit (PICU) and spent a while working with severely ill people, trying to help them get to a place where they could go back to a normal ward.
Once the PICU had seen through my incompetence I went off to work in community mental health before going on to the really exciting area of assertive outreach. This is where people who normal services struggle to be helpful for, get a more interested and determined approach. I used to love building relationships with people who rarely trusted anyone and whose experiences of mental health services were often around being forced to go into hospital. I also used to love using my knowledge of their likes and habits to find people who hadn’t been seen for a while, scoping out their regular haunts, waiting around in the hope of making contact with them, anything that would give a chance encounter and an opportunity to avoid the next relapse. There was a lot of talk about how important medication was but now I know it was all about the relationships.
One of my ambitions was to go and work abroad. At one point we decided to go and work for a year, then we wanted to to work for six months and we got to a point where we didn’t want to work at all. In 2003 I packed in my job and my wife and I bought round the world tickets which ended up including 3 months in a Community Mental Health Team in Masterton, New Zealand. While there we went to hot springs, climbed mountains and spent too long touring vineyards and sampling wine in an incredibly disproportionate ratio to the amount of wine that we bought. Those were happy days.
When I got back to the UK I was able to try a few different areas of mental health. I’ve found an area that I love and I’ve managed to build a specialism in a non-traditional role. Occupational therapy has so many opportunities to be forward thinking, creative and innovative and I’m aware of loads of OTs getting themselves into places we’ve never been before, crafting out opportunities to help people live the lives they want in multiple areas. Housing, homeless, asylum seekers, charities, schools…all over the place OTs are finding a way in and showing they can bring value.
Within the NHS its traditionally been hard for OTs to get into senior leadership roles but this is changing. I’ve loved seeing OT ward managers and Heads of Therapies come along. There’s a definite career path for those who want to make systemic change but growing scope for specialised clinicians. In our hospitals and universities OTs are researching so that we are more aware of what will be most helpful in the years to come.
In my area of work, its still hard for OTs to get into senior positions but this helped me to start my own business. I’d never have envisioned this 20 years ago but the core clinical skills I’ve developed over the years are valued in the private sector. Working for myself means that I can target the areas that I prioritise but the NHS finds difficult to work on. It’s immensely rewarding.
In OT you escape some of the worst parts of work that unfairly seem reserved for nurses. You skip away from most of the tedious bureaucracy I see social workers drown under. Occupational Therapy is the key to a great job and and the gateway to wherever you want to go.
There are many different ways of being able to help people. Occupational Therapy may not be the best one but because it’s OT week forgive me if I say it is. You get to be a part of helping people do what they want to do most. You get to help them by doing things that are fun, engaging and meaningful to you and those you help. Work has got me going to the cinema, going out for dinner and, because it was a client’s life long ambition, running the London marathon.
This year I joined the board of a national body and I’m going to give a keynote speech at a national conference. No one would have thought this possible from the socially anxious, awkward student that lazily turned up in Brunel 20 years ago. No one would have thought that the bumbling, incompetent practitioner I was for a good part of my career would ever get to a point where he was seen as an authority on anything. OT shaped me into someone who could avoid being judgemental and make sense out of why people did what they did. It shaped me to confidently stand up for the rights of others. It shaped me to push myself and others to do more, and I’ve loved the journey it has taken me on.
The point of the above is that OT is a decent job. You can spread out into multiple fields and change tack whenever you see fit. It makes you highly employable, it gives you experiences you might never have otherwise, and it can help you travel the world. It will let you help people without just talking to them, but by actively doing what’s important.
The health service workforce is changing. The influence of OTs is growing. When you’re thinking about your career don’t just think about if you want to help people, think about how you want to help people. I could very easily have missed my chance to be an OT as I knew so little about it when I was was younger. Make better choices than I made. Best career in the world.
Huge thanks to Ruth Hawley, Elaine Rutherford, Dianne Lane and Hollie Berrigan for reading over this and offering their feedback (which I did not pay enough attention to)
Keir provides training, consultation and therapy around complex mental health problems through beamconsultancy.co.uk