Participant 5 – Luke

Luke is a man in his late fifties who has a diagnosis of Major Depressive Disorder. He described himself as a European when asked his ethnicity. Luke’s interview was the shortest of the five as he answered all questions briefly. When efforts were made to redirect the questions or illicit further information he occasionally gave a little more but otherwise stuck to his concise, to the point, responses. Throughout the interview Luke presented himself as a man who experiences an ongoing low mood which appears to be related in large part to loneliness and low sense of self-worth. When it comes to determining whether or not he has a high quality of life, Luke appears to place high value on what people think of him, his ability to have relationships with others, and the volume of social contact he has with others. He also experiences chronic pain which impacts on his ability to maintain motivation and a stable mood. Luke has utilised the service for approximately two years and engages in physical activity, art and education based groups. Despite his use of the varied groups and the apparent value some of these have had for his wellbeing, it was clear that his use of the service was predominantly about having a social outlet and opportunities to feel included and

valued. Prior to service engagement he experienced extreme loneliness and low self- worth describing it as follows, “It just feels like, just empty, nobody wants you”.

Socialisation was relevant to Luke’s relationships with both staff and peers. It contributed to a feeling of belonging for Luke. This is because, as mentioned above, Luke highly values social relationships, so social engagement in this environment allows him to feel valued and part of something. This feeling of belonging was in part achieved via the support given to him by staff. Luke has had the experience of using another activity centre. He reported that this service placed him in a group with a lot of others. This did not take into account his learning disability and he failed to thrive with regards to learning to read and write which is why he had enrolled there. Conversely staff support is given on a one-to-one basis as required at the service that is the focus of this study. This allowed Luke to not only start making progress with his learning, but also allowed him to feel like he was not just another face in the crowd. Another facet of these social relationships that Luke found allowed him to feel comfortable was the fun he was able to have. He described being able to “have a laugh” as a valuable part of his experience at the centre. This engendered comfort, a feeling of friendship with peers, and allowed him to experience some positivity when he was experiencing a low mood.

The second important aspect of socialisation for Luke was that it helped him to develop and maintain a more positive sense of identity. During his interview he detailed a life of difficult relationships with those close to him. He had experienced a divorce and has trouble getting along with his adult children who he feels do not value him as a person or in his role as a father. His longing for and enjoyment of personal relationships was evident when he discussed a recent visit with his granddaughter and during the interview stopped to show me photos of her on his phone. He described his grandchildren as “something to live for” and he was obviously proud of her and enjoyed the contact, but noted that such visits are few and far between which often leaves him feeling bereft. It became apparent that use of the service was not just to develop a social network but an effort to gain friends and be able to enjoy a more personal relationship with others. This has also been a difficult exercise for him as he stated he sometimes has social difficulties at the service and does not know what has gone wrong. What he has been able to do however is maintain attendance and confidence and allow the difficulties to sort themselves out which is something he has in the past been unable to achieve in his private life. Given that his family roles had effectively been disestablished, attendance allowed him to begin to redefine himself and develop more appropriate social skills. Having social success, even though it has at times been difficult, has also allowed him to gain confidence. This has led him to develop the goal

of returning to where he was raised and re-establishing his relationships with his family of origin.

This improvement in confidence and self-esteem has not just been attributed by Luke to his social success but also to his skill building. He has worked through adversity to make some small improvements in his reading and writing. These small successes have slowly built confidence and a sense of self-worth. As a result Luke has been less likely to fall into bad habits when faced with a difficult situation or a return of low mood. His past pattern was to go to bed and try to sleep through his low mood and self-loathing. This created a negative cycle for him with further deterioration of mood. Now that he has more confidence and motivation he is less likely to do this and makes more of an effort to counter his negative thoughts. As a result he has been able to start fixing his house in an effort to move towards his goal of selling and moving back to family. It appears that this is a big achievement for him as he spoke of this in depth. This increase in self efficacy has fostered a sense of empowerment and an ability to start making decisions that would allow him to move towards the future he has been thinking of but has lacked the motivation and self-worth to strive for. Luke’s self- improvement was not confined to his psychological health but he has also experienced improvements physically. He reported an increase in fitness as a result of attending groups at the service. This also worked in his favour as it supported his ability to achieve physical tasks at home meaning he had another tool to reduce his likelihood of falling back into his negative coping cycle.

Throughout Luke’s interview his focus inevitably returned to the social aspects of his life. Even when asked to compare his experiences of working to attending the activity centre, he described the most important aspect of working for him as the companionship and having someone to talk to.

His experience at the activity centre has been one of learning and perseverance. What he has achieved through this is a stronger and more positive sense of self and what he would like to achieve in the future, and an increase in motivation and confidence. He expressed this by saying “I don’t feel I’m just nothing and all that. I feel a bit more confidence in meself”.

Chapter 5 – Results

This chapter outlines the study findings in terms of the five themes which are presented in the table below. They will be discussed in terms of their subthemes and derive from the narratives provided in the previous chapter. There will also be a short section on how the participants who had an experience of working felt the activity centre was similar to or contrasted with their time working. Whilst this is not a study that is hypothesis based, when I was completing my literature review for my research proposal it became apparent that studies about work and the meaning this provides in people’s lives is common. This led me to think about those who I have supported over the course of my career who are unable to work for reasons related to their acute and/or chronic mental illness. As such there was a part of the interview schedule that briefly touched on this area of interest and the comparisons or contrasts participants were able to make against their experiences at the activity centre.

Theme Subordinate Theme

Belonging Socialisation Staff

Enjoyment / fun

Non-judgemental / supportive environment Identity Flexibility / choice

Journey Skill building Personal growth

Social / peer engagement Self-Efficacy Responsibility / accountability

Flexibility / choice Independence Personal growth Empowerment Flexibility / choice

Resources / course outcomes Relationships

Skill building Personal growth Support Relationships with staff

Non-judgemental / unconditional Socialisation

Table 3: Themes and subordinate themes across all participants

5.1 Overview

A severe and enduring mental illness has the potential to be a debilitating experience. This study has sought to gain insight into the experiences of five people who live with such an illness and, more particularly, the experience of their use of a mental health activity based recovery centre. Following the completion of semi-structured interviews held with each of the five participants of the study, an analysis of the interview content was conducted as specified in the Methods chapter. Below are the results of this analysis which are illustrated with direct quotes from the participants’ interviews.