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Liz Fletcher: Sport for confidence

Liz Fletcher is Occupational Therapist Educational Lead at Sport For Confidence. She shares how her experiences of working in mental health have led her to this role, and why physical activity is so important to wellbeing. 


Everyone’s physical activity experience is different. Listening and the sharing of lived experiences will be key to helping health professionals integrate meaningful physical activity into daily practice.

I began my 20 year’s working in mental health services as a healthcare assistant in a psychiatric unit. My experience in this unit both shocked and motivated me.

At the time, I was 20 years old, full of passion and determination to provide ‘health’ and ‘care’ as per my label. The reality was very different to my naïve, idealistic perception. I observed a culture of deficit-based care, a flawed system ‘perfectly designed to get the results it gets’ (E Deming), the sounds of the ‘pull’ alarm often an hourly occurrence, staff with the hackles out ready to use control and restraint, a ‘them and us’ culture at its best.

Fortunately, a key part of my role  was to spend time listening to ‘patients’ as they were called in this unit, I would talk with them whilst engaging in a range of activities including walking, playing badminton, plaiting hair and even smoking in the smoking room! I loved listening to the stories I had the privilege of hearing which still inspire me today.

I was in a  position of trust and people would often share experiences of trauma, neglect, shattered hope and, occasionally, personal goals of success.  There was one chap I will never forget. I admired his determination to attend college, desperately trying to make something of his life. Every day he hid his identity from his college peers and lecturers. They had no idea of his living environment or his diagnosis of paranoid schizophrenia. I doubt he mentioned to his college friends that an occupational therapist had supported him every step of the way. His time at college was layered with segments of life most of us cannot even imagine. He taught me the meaning of the words commitment and determination. I have no idea whether he completed his course but I really hope that he did.

My biggest lesson from the last 20 years is the value listening. Truly listening. As healthcare professionals, we are facilitators; we share our knowledge with an awareness that this knowledge might not be right for the person with lived experience of mental health difficulties or disability.

The Quirk et al (2020) paper caught my eye because of its focus on the views of people with lived experience and physical activity. I work for Sport For Confidence CIC, an award winning organisation that places occupational therapists in leisure centres. Working alongside specialist coaches, the occupational therapists provide those who face barriers to participation with an opportunity to take part in adapted, meaningful and fully inclusive physical activity sessions to access the social, mental and physical benefits of being active. The research articulated exactly what I have observed in my experience, the need to listen to people, find out about their lived experience and the relationship this could have with being active. We need to listen and gain an understanding of what each individual values and explore the role of these values in relation to physical activity. We all have a different relationship with being active  and we need to truly adopt a personalised participant-centred approach.

 As healthcare professionals, we have an important role to play when enabling and empowering people to becoming more active. However, the siloed and fragmented health and sports services make a personalised approach extremely difficult. The health and sport sectors are making strides to address this and there is hope in Sport England’s new 10 year strategy – Uniting The Movement, which has a vision to transform lives and communities through sport and physical activity.

I am proud to say I now work for a service which has the balance right, check out Sport for Confidence (@sportforconf), an organisation which has found a way to put people at the heart of its delivery.

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