A Journey - Through Pain and Isolation to Acceptance

By Shaun Williams and Mark Bertram



The importance of employment for people who use mental health services has significantly been highlighted with the release of the Mental Health and Social Exclusion Report (ODPM, 2004). However, what remains less clear is what this process actually involves for service users and vocational rehabilitation staff. This is an inside account from a person receiving mental health services and also from a staff member providing vocational support. Both accounts highlight how crucial supportive relationships and time are as key factors in helping people on their vocational journeys.

Shaun’s Story:

My journey from a life of poverty, social exclusion and misery began when I was referred to the local Vocational Rehabilitation Officer. A real rarity, so I understood, in the dark days of mental health and vocation circa 2000. I suppose my psychiatrist must have seen a capable, intelligent person there somewhere, hidden behind all the pain, anger and hurt. At the time, little did I know this was the beginning of a prolonged and arduous uphill struggle! And yet this journey was necessary to enable my recovery towards independence, dignity and well being. 

When I first met Mark Bertram - the person who was going to play a major role in turning my life around - I was very unwell, incomprehensibly unwell by present standards. I was drinking almost constantly, which I am sure played a part in my paranoia, extreme depression, violent mood swings and a seemingly endless need and urge to hurt myself by all known methods. I had spent a long period taking various medications which destroyed my will to live and screwed me up no end. The result being that I remained in bed for around 18 hours each day, too scared to move for fear of what I might do to myself, and with very good reason. I had become extremely isolated, withdrawn, and was neglecting myself and my surroundings. In truth barely existing. In my mind I was dead - both physically and emotionally - and as far as vocation was concerned, I had well and truly retired into oblivion and obscurity. 

I cannot clearly recall how I felt when we started looking at my vocational options such was my distress and confusion. However I knew from experience that an effective partnership could only happen with a health professional possessing a warm and caring personality, and the ability to listen, understand and move the process forward with effective and empathic communication skills. This I found to be true of Mark. 

Each meeting seemed very much like therapy, but I felt a ‘realness’ and an empathy that had been sadly lacking in previous input. This was probably the key to our successful relationship. Even though he really tried to focus on vocation, I had so many problems to deal with that in many ways the vocational issues felt hard to reach, almost clouded by my distress and poor health. 

One event which nearly destroyed the whole relationship was when I saw my medical notes. In them, Mark had told my psychiatrist that he thought I was ‘acting out’ when I was standing on my balcony looking over. I had indeed mentioned on many occasions the urges I frequently had regarding jumping off balconies and the like. In reality, he was virtually my only visitor so I was eagerly awaiting his arrival. Even if I was feeling really bad, a visitor was better than none. Because I believed Mark was basically a ‘good guy’ I stuck with it. It is highly likely that if someone else with a far less empathic manner had been assisting me, then the whole process would have died at this point, and I would have disengaged with potentially disastrous consequences. 

When I look back now I can really understand his worries, but at the time I felt badly let down. To avoid this situation, get us back on the right track, and get me out of my ill fitting cocoon, I started meeting him at a rehabilitation centre in Brixton. This proved quite a hassle to get to and it was in an undesirable area - as if my living room was much better - but most of the time I felt the value of the meetings far outweighed any negatives. 

After quite a long period of skirting around the issue, Mark found a possible work placement in a local community rehabilitation ward. I went to have a look, but it just so happened that I had visited this place when I’d trained as a nurse and it brought back bad memories. Although I had done nothing for the previous six years or so, I felt the sort of work in question to be menial. The prospect failed to raise enough passion in me to make it feel a worthwhile step on the ladder, so I turned it down. Simultaneously, I felt a huge guilt that I had let both myself and Mark down.