Peter Wilson understands what it’s like to live with a life-changing disability. He also knows about the power of having fun when you have a disability.
Peter conceptualised Determined2 as a way of getting people with disability underwater… and watched in amazement as their enjoyment turned into major health benefits and improvements in their day-to-day lives.
He talks about the power of water and his non-negotiables that put people with disability at the very centre of Determined2.
In 2007, when I was 27 years old, I was involved in a serious workplace accident. Witnesses on the scene thought I was dead. When I arrived at the emergency room and they were prepping me for surgery, they told my wife to say goodbye to me.
When I survived, I was in critical care for about two weeks with only a 20 per cent chance of survival, and I still had people visiting to say goodbye. Our son was five and our daughter was 18 months old, and they came in to say goodbye.
But then, when I didn’t die, they said I wouldn’t walk again, or I’d be permanently disabled. All up it was three months that I couldn’t move, I had to lie flat while my pelvis and spine healed. I transitioned to rehab and then to home with support from the Royal District Nursing Service and my amazing wife. It took about a year to get back to standing up.
Mine is a workplace injury, so I continue to be supported by ReturnToWorkSA (formerly WorkCover) and now claims like mine, which are catastrophic in nature, are managed through a team called Enable. My supports now are very similar to an NDIS participant. But it wasn’t always like it is now.
I thought I’d be able to go back to work, but returning to the motor industry didn’t go that well. By 2015 I was in a severe, depressed state. My biggest challenges were mental. With WorkCover, I had no choice and control, all the power sat with the insurer. I was in a pretty dark place, and that was the turning point for me.
I’d started scuba diving after my accident and it was difficult for me to get involved in, specifically around the medical requirements. But I found it beneficial in a bunch of ways and I wondered if I could use it to help people with injuries like me. There was no one else doing it, which meant I didn’t need a uni degree to do it – I left school in Year 9. Then ReturnToWorkSA was able to support me as I went about setting up Determined2.
We found people injured at work weren’t that interested in accessing the program, but people with disability were. And I’d never met someone with disability – even though I am a person with a disability! We were doing callouts and I rang my Occupational Therapist (OT), who connected me with people. I asked for someone who had significant disabilities, someone who would challenge our program, the doctors and our design, because if we can make it work for them, we can make it work for anyone.
And that’s how we met Ben. The same day I’d called my OT, he’d rolled up to one of the staff in the Hampstead Rehabilitation Centre and said: “Do you know anyone who could help get me back in the water?”.
Ben changed my whole world. I’d lived in this bubble of workers’ compensation, and I felt so sorry for myself. Ben was this kid who was 20 years old, a quadriplegic, who would go on to live in his own home, no partner, no kids… and he was so happy. So bright. His footy club had done fundraising for him to get a wheelchair. This was 2015 – he inspired me to look at my own situation.
It took us three months to get there, to get the insurance in place and the doctors in place. Initially, no pool would let us in, but we found one that would let us use it when everyone else had gone home.
The night we first tried what would become immersion therapy was Ben’s 21st birthday. When Ben got out, he was glowing. There were 20 people in the room, all crying. I said: “This is what I’ve got to do.”. It’s why I survived.
And from there we got to work, and then very quickly won the National Disability Award from the Commonwealth Government. One second this was a scribble in a book, then six months later we were in Canberra with the Prime Minister at an awards night… and we won. That opened the door and people started enquiring – people with more challenges than Ben.
It will always be about having fun. I don’t believe therapy has to be boring or vanilla!
In the beginning we had people around us, including doctors with underwater medicine specialities overseeing the medical part of what we were doing. The people in the pool were dive instructors or professional divers. Everyone was safe. Everyone was having fun. Participants were talking about a sense of freedom and confidence. And then people started getting better. More mobility, increased flexibility, happier and healthier – all things that any health service should be doing.
That’s when we first asked the question: “Could this actually be a therapy?”.
One of our team members came up with the name immersion therapy. He was the second person to go in the pool, Paralympic gold medallist Tim Maloney OAM. He’s now on our advisory committee.
Anyway, we were always careful not to position ourselves as therapists – while we had underwater medicine doctors involved, we weren’t therapists.
We had to investigate our hunch, whether immersion therapy could actually be a therapy. We were pretty sure it was – that’s what our participants were telling us.
Of course, research needs funding dollars, so along with ReturnToWorkSA, we also had the Lifetime Support Authority (LSA) as one of the first funding bodies to endorse and fund our service. The LSA supports people who’ve been seriously injured in road accidents.
Through the LSA we applied for a research grant and our doctors connected the University of South Australia (UniSA) and an exercise physiologist, Karlee, looking to do her Masters by research and she investigated: “Could this be therapy?”. You can find her thesis here.
Parallel to that, there was a qualitative study, which included about 60 participants and their support workers and families. I really liked the idea of this research because I always believed what was missing in my recovery was my voice, and so hearing from the participants about what they thought immersion therapy was really gave the whole picture of what was going on underwater.
The qualitative research was really cool, because the researchers thought the biggest benefit of immersion therapy would be the physically obvious – the ability to move underwater, for people who find it difficult to move on land. But the largest consistent theme was an improvement in their mental health and self confidence. Their physical improvement was, in most cases, a pleasant byproduct of doing something they enjoyed.
Now, as part of our seven-year relationship with UniSA, we’re entering the next phase of research with clinical trials. We continue to put forward Honours research projects each year and we currently have five underway, which is awesome because we get to include students in our work and, in return, they bring fresh eyes and ideas to the table to make what we do even better!
Where we’ve evolved to is incredible, and I am very proud of where the service is today.
Once we realised the potential, we knew that we couldn’t deliver it any more – as divers. Instead, we recruited allied health professionals with no scuba experience, and trained them under the expertise of diving doctors, along with the model and standards we had developed during the previous four years to deliver the service.
We had to check – did therapists suck the psychosocial fun out of the activity and turn it clinical? I honestly thought they would, it was one of my greatest fears taking this step.
But we found no, not only could you retain the fun, but we could dramatically increase the physical outputs for participants, now that the people delivering the program were allied health professionals who understood how to maximise those physical benefits.
The mounting evidence is pointing towards immersion therapy being a truly evidenced-based biopsychosocial therapy that nearly anyone can do. It can support your body, your mind, and how you see yourself – it's truly holistic. It doesn’t matter if you live with a profound disability or a back injury, you can do immersion therapy.
We’re all equal under the surface of the water.
People that have restrictions with mobility talk about how under the water they are free. There’s no worry about falling over because the whole body is supported – unlike hydrotherapy, which is partial support. With immersion therapy you have an air supply, so you don’t need to know how to swim.
People with communication challenges find under the water it’s just calm. People with Tourette’s and tics find they disappear under the water. People with chronic pain are pain-free under the water.
Immersion therapy is like the fourth dimension. It’s a totally new environment.
The first is people think it’s just scuba diving in a pool – that’s false. We use some common scuba equipment, as well as modified equipment we’ve developed with our doctors, so people have access to air while being fully immersed.
The other misconception is people think they couldn’t do it, it’s beyond their capabilities, you need to be wild and adventurous. Not true. We have people who need support 24/7 and we can support them in the water. We have people who are petrified of water – including a man who nearly drowned when he was 10 and had to be resuscitated, so he never went in the water again. He acquired a disability and, after a long time, he tried immersion therapy and now he’s gone to snorkelling independently and he’s going to Fiji.
Our participants include children with autism, right through to elderly people post-stroke, a broad spectrum of people.
We had to build a business model that was trainable, scalable, and repeatable, assessed to be appropriate and backed by research. We know the service is life changing and we wanted the most efficient way to get it to people.
Since 2015 we have had one simple vision – immersion therapy for all – and that vision is about to become a reality.
About three years ago we started conversations with potential partners and their first question was always about the return on investment and commercial terms. These conversations didn’t last long.
Dr Jeff Walkley from Belgravia Leisure had a different question: “How does immersion therapy help people?”. We know they’ll be an organisation that can rise to the occasion and meet our values, and they have the resources and capability to deliver. We are excited to see where they can take immersion therapy.
Put lived experience at the centre. Make sure you have people with disability in your company. There’s the great saying ‘nothing about us without us’. That’s not about getting a bunch of people with disability, taking their advice and not paying them, because that’s not co-design. Include people with disability, not just in the advice, but in the company in key roles.
Make sure you are being safe. Make sure you have insurance for what you are doing. Make sure you have the qualifications – or bring qualified people in. Doing something like this takes a lot of resources and commitment, so be ready for the long haul. It takes hard work and a bit of luck, and I think we have had the right combination of both.
If you are a person with disability, look into supports like micro-enterprise, there are lots of new and excellent way to support people with lived experience to set up and run their own gig. Don’t stress about the things you might not be good at or find hard to do, it is about having the right people around you to bring your vision and passion to life.
Ask for the person’s qualifications, registration, and insurance – then look at the testimony. Do it in that order. “How long have you been doing this?”. “What are your qualifications?”. “What is your insurance?”. “How have you helped other people?”. If you are happy with the answers, go and have a look and don’t be afraid to go slowly.
We have some people in our service who take nine sessions before they get in the water for the first time. It’s about your choice and your control.
Yes, I’d encourage you to push yourself, but you should feel the provider has the flexibility to hear you, see you, understand you, and know your limits and not take you beyond them.
We can adapt our service to meet almost any goal. You’re the expert and we’ll work it out with you. If you have funding for Improved Daily Living, or any allied health, you can choose to do our service. We are also registered with ReturnToWorkSA, LSA, and the Department of Veterans’ Affairs. We’ve even had people access our services under their aged care package, and we also support people without funding through a pro bono program.
We also provide land-based exercise physiology and hydrotherapy programs for people who feel going underwater might be a step too far out of their comfort zone. And we are based in a community aquatic centre, so it can be a really easy transition to mainstream programs for our participants looking to make that transition.
For immersion therapy, the process is booking a meet and greet online, calling, or shooting us an email – you can leave your bathers at home for this! Come and have a chat and a look, then get checked over by one of our doctors. There are a few medical exclusions, but not many. And if you’re safe and happy, we can start. Anyone can take that journey with us.
I can’t choose, there are too many. We’ve delivered 10,000 sessions of immersion therapy, and in partnership with Belgravia Leisure, we’re going to deliver 36,000 sessions a year in five years.
The thing I love most, hands down, about Determined2 is our sense of community. It’s my most favourite, no matter what else is going on.
We’ve been so fortunate to have been supported by a huge community of people – too many to name – but our staff, the students who do placements with us, our team of expert doctors, the research team at UniSA, and my own family, my personal mentors, coaches and supporters. And, of course, the hundreds of participants who have gone underwater with us.
I feel truly blessed to be part of something this special.
