When Lived Experience Joined the Ward

Mental health trusts in the United Kingdom increasingly encourage applications from people with lived experience of mental illness. This was already the case in 2014, when I was recovering from my first psychotic episode.

In 2015, I secured a healthcare assistant position on an acute psychiatric admissions ward. The recruitment materials explicitly welcomed applications from people with lived experience, and I entered the role believing that my experiences as a former patient would be viewed positively.

My experience was more complicated than I anticipated.

At interview, I met both the ward manager and a senior manager. As I left, I shook the senior manager's hand. She immediately performed a breakaway technique before I had finished thanking her. I suspect this was simply habit, given her role and training, but the moment stayed with me.

During my induction, I attended the trust's restraint training programme. When asked to introduce ourselves, I explained that I had recently been a patient on a psychiatric intensive care unit and had experienced restraint myself. The lead instructor was supportive and encouraging. Some future colleagues appeared less comfortable with the idea. I was told openly that there was suspicion about my reasons for wanting to work in mental health services.

Whether justified or not, I sensed that my background made some people uneasy.

On my first day, the ward manager offered a piece of advice that I would think about often in the years that followed. He suggested that I should be careful about who I told regarding my previous experiences as a patient because some people might use that information against me.

At the time, I dismissed the warning.

Over the following months, I increasingly felt that I occupied an unusual position. I had been allowed into the psychiatric system as a member of staff, but I never entirely felt accepted within it.

As I became more familiar with ward procedures, I occasionally raised concerns about practices that I believed might warrant review. One instance involved the way a patient's placement was being categorised within the service. Based on my understanding of the relevant policies at the time, I believed there may have been a discrepancy between what was occurring in practice and how it was being documented. I raised the issue through management channels and later with an individual involved in writing the policy itself.

The concern was never discussed with me directly, although the policy was subsequently revised. Whether the two events were related, I cannot say.

I later became involved in delivering restraint training to staff. While I valued the opportunity, my interests increasingly shifted towards communication, de-escalation, and the prevention of restrictive interventions. I often found it difficult to generate enthusiasm for these topics. Staff frequently emphasised the practical realities of ward work and the constraints under which they operated. I came away with the impression that organisational change occurred very slowly, even when there was broad agreement that improvements were desirable.

This became a recurring theme of my time in the service.

I often felt that my suggestions were modest: greater emphasis on communication, careful adherence to policy, and a stronger focus on prevention. Yet I frequently encountered resistance. Whether this was because of my ideas, my background, or the realities of large organisations, I never fully understood.

Eventually, I left the role following a period of deteriorating mental health. Looking back, I believe workplace stress contributed to this, although I recognise that it is difficult to disentangle occupational pressures from my pre-existing vulnerability to mental illness.

A decade later, after completing a PhD and establishing myself as a researcher, I returned to inpatient mental health work.

What struck me most was not how much had changed, but how familiar many of the same tensions felt.

The experience reinforced a conclusion I have reached repeatedly over the years. Mental health services often express a strong commitment to lived experience, and many individuals within those services genuinely value it. At the same time, translating lived experience into meaningful influence appears far more difficult than simply inviting people into the room.

My own experience has been that lived experience is welcomed most readily when it aligns with existing priorities. It becomes more complicated when it challenges assumptions, raises uncomfortable questions, or proposes alternative ways of working.

For that reason, I have become increasingly interested in the gap between the rhetoric of co-production and its implementation in practice.

The question is no longer whether lived experience should be valued. Most organisations now agree that it should.

The more difficult question is what happens when people with lived experience disagree with the system that invited them in.

I discuss these events and issues more on my YouTube channel and in my book, Androids DO Dream.