Life On The Psych Ward (Forensic Psychiatry Patients Documentary) | Real Stories

[Music] they made it clear that i was different unusual strange and that my differences were almost unacceptable i think also a lot of it is about choice and i made the decision to go into the pub to get the drink to pay for it and drink again to drink again and drink and drink and drink i made that choice i made the choice to go to the kitchen to get a knife to attack the person because i didn't have a solution it just didn't occur to me i wish i had it didn't rarely seen little known the world of forensic psychiatry is a mystery to most of us we deal with the most complex and risky individuals in our country work in one of the most dangerous parts of the nhs treating extreme paranoia i've said nicely please please please get me mad you're gonna make me lose the plot and violence what are you gonna do on a daily basis if i don't change i'm gonna drink and if i drink i'm going to reoffend these patients have committed some very violent crimes i set about carving the geezer up with a razor blade you have to learn to live with what you've done and most are here because they've been judged too mentally ill to be in prison has a long history of violence when he's psychotic he's really being very threatening very aggressive but how do you contain people who pose such a threat to the public [Music] can you make them well again i've just got a you know show you know daddy's not angry that anymore he's um he's getting better and is it possible for some of the most dangerously unwell people in britain ever to rejoin the outside world they want to see me go out there because they know what i'm like outside i can understand why certain elements of society just don't want to give people like me another chance the bethlehem royal in south london houses 120 mentally disordered offenders a bed here costs four times more than one in prison so we're in effect really working with patients who are mentally sick and have been involved in serious crime we're not talking about minor offending but major acts of violence such as homicide serious sexual violence and patients are complicated further by having very complex emotional and mental health issues 250 staff work on these wards and their aim is to reduce the patient's risk to a level where one day they can be safely discharged [Music] a great majority of offenders will be discharged at some point but the time taken to achieve that discharge might be one of a few months through to even perhaps many years even a decade james came to the bethlehem royal from prison two and a half years ago for the last month he's been allowed to venture outside the locked doors of the wards this is river house this holds about eight wards six to eight wards all different illnesses cute and all different you know what i mean yeah you know you gotta be uh on buddy you're not a mania you've gotta be on a tag tagging system for like uh i don't know six months to eight months you know it's baby steps at a time but it's all progression you know a couple of months could be up the high road with an escort you know looking for voluntary work in the community you know the words my oyster is what i make of it [Music] james is serving a life sentence for committing a violent attack while in prison he's been diagnosed with borderline personality disorder and has been undergoing long-term psychological therapy a lot of this is like you know therapy work folders and folders and folders and this is all about my history where i've gone wrong you know what i'm saying yeah it's just working you know he's just working through things to uh help me improve my chances of uh making it out there do you know what i mean yeah so he's completed the main treatment program on the unit although he's made quite a lot of good progress and he certainly has been involved in quite a few incidents in the ward um been verbally abusive made threats to kill um really quite serious incidents i'll give you i'll give you a shot when we need to lock it here and i think the difficulty that we have is trying to reconcile the fact that he's saying he wants to change and that he's keen to continue to work with the fact that he's continuing to engage in that kind of anti-social behavior lovely mike cheers anti-social behavior to me i'm 45 so let's just say i've had the age of 15 i've had three decades of it that's not something you can just discard and put away overnight room weren't built in a day you know what i mean yeah anti-social at the time behavior to me was my identity it was about who i was you know what i mean yeah to put it down and just say well i'm not gonna i'm not gonna be this way anymore it don't it don't happen that way do you plan to get out of here yeah absolutely you know what i mean yeah uh this this this painting here which i finished a couple of days ago so there was two titles the first one was been double in anguish like a tree in a storm or sometimes a river and i opted for sometimes a river it was it was easier to manage john has been in secure institutions for 22 years growing up in zimbabwe he had corrective surgery for a rare birth defect i mean a lot of my friends just accepted me but there was a minority who didn't they made it clear that i was different unusual strange and that played on my confidence and my self-esteem really you know and one of the ways that i thought i'd combat the feelings that that produced later on was to drink and that that just magnified some of those feelings that i already had john has a personality disorder and when he drinks he can be unpredictably violent this is the timeline so these are historical events significant events in my life that may have uh had a psychological emotional impact on me in some way this is this forms part of the violent reduction program so these are highs and lows um so a low for example would be as a child being bullied uh some some sexual abuse and um this is my index offense it's the primary offense i stabbed a man several times i spent the night drinking with him i was drinking out of a can in his lounge and i and i said could i get a glass from for the um for the beer and he directed me to the kitchen and when i went to the kitchen i started opening up the cupboards but i completely forgot why i was in the kitchen and i saw a block of knives and i came back out with a carving knife and i uh and i attacked him [Music] they can do a huge amount of therapy understanding their offending history their offense their risk profile but at some point you've got to test it out with reality you've got to be outside the hospital to see how you manage with community life the stresses the challenges of being in a big city like london today john is facing those challenges after decades inside he has permission to go into the local community without a member of staff [Music] it's really quite exhilarating [Music] being unaccompanied being on my [Music] it own quite liberating [Music] everyone's fascinated by the concept of extreme violence murder mental illness [Music] the sort of terminology that the news of the world always used was the stop phrase scum of the earth it's a very powerful statement isn't it scum of the earth they're they're very conscious of that our patients obviously want to return back to the community in a safe and successful way i suspect often the public would wish they stayed here perhaps indefinitely most of them would see them as sick dangerous and nasty individuals we have to in many ways persuade them that what we're doing is safe thought through and very responsible [Music] i might experience anxiety and i do every day but there are varying intensities and depth to that and most of the time it's just you know it's manageable it's just you know it's okay i'm okay if i'm okay you're okay we're okay we're all right random things will happen that's life it just feels it feels unmanageable that's me my mind playing tricks on me so i don't engage with them stick to my plan what everyone else is doing that's their time my plan is different my plan is look after me one of his problems is that when things don't go according to plan or when others make mistakes or when things are unpredictable he gets very stressed very anxious and in the past he has coped by drinking alcohol taking illicit drugs that would lead to a risk of violence to others when i was a child and i did something wrong i was very aware that i've done something wrong if you have that sense of i'm in trouble and i've been i've been in situations where i've had a sense of being in trouble or done something wrong or panic that i have to phone somebody and uh invariably what i do is i phone the police john phoned the police in 1998 after he stabbed a man he'd been drinking with he was found guilty of attempted murder at the time when the police officer arrested me asked me how many times did i stab and i in my mind it was once my mind had completely censored the whole event and that it seemed like it was only once but in actual fact it was several it was thirteen times hello okay it's helen brousseau here tony is he up and about he was supposed to be ready i think i've gotta go through his risk assessment hi mike can you just do us a favor is tony is he up about the bethlehem royal hospital treats mentally ill offenders who pose a risk of violence today ward manager helen is getting a patient ready to see his clinical team they want to decide if he's safe to go outside the hospital on his own [Music] oh this happens tony are you decent hi do you remember we spoke about it yesterday it's it's quarter past two in the afternoon just let's get up and about as i don't think it looks awfully good you're spending all day in bed really so come on let's see some action all right lovely thanks very much mike that's great tony's been in and out of secure institutions since he was 18. he's been diagnosed with a personality disorder and paranoid schizophrenia tony's got a risk of aggression and violence when he's unwell and when he's unwell he does tend to use illicit substances and so when he uses these substances he becomes even more risky he has a attack staff on the ward and then when he's out in the community previously he's attacked people when he's been unwell and under the influence of substances oh well we should all have a fight i'm not led we've got a total of 36 convictions since 1997. that's quite a high number oh yeah yeah yeah [Music] which is well going through it [Music] he's still quite a risk his parents are quite worried um about him absconding about the risk of violence and aggression the risk of him using drugs on the outside and it's only fairly recently that he's been using he's been using illicit substances here on the ward tony's recovery is at risk from the legal highs in cannabis that despite tight security are smuggled onto the ward by patients on leave tony has a great difficulty in understanding the dangers of drugs and of how those substances change his mental state and turn him into somebody who we would consider dangerous the fifa with tony he has been trying he's certainly making good improvements but i think it's just a little step too far to give him one escorted leave it a minute you could have done with a shave but never mind so why are you languishing in bed for got no toothpaste on nothing well i will get some we shall organise it why not you tell me that yesterday he has no concept of the fear that has been engendered in his family and people around him when he becomes angry or aggressive or violent let's see him then and see what he says so our job is to try and help him understand what what he needs to be before he can get that on escorted leave first of all what i'd like to say is that in general i think we're all agreed that you've been doing really well and we're all working towards you eventually being discharged from hospital but i think it's a little bit too soon to think of unescorted the best thing that you can do is carry on with your medication yeah carry on with the groups and the biggest message i can give you is to stay off the legal highs or the drugs yeah yeah all right yeah i've got to pull on through i've got to continue not to i've got to not fight no one um i've not got get myself into no bother keep myself to myself mind my own business and get along slowly but surely yeah and take it in respect that the people around me are trying to help me and i'm trying my hardest to cooperate but there is times i am turning against the staff and thinking oh well shall i do what shall i do what shall i do but when it goes quiet and no one explains to me i don't know what i don't know how to continue you know for legal problems all right well done thank you all right cheers have any of your patience ever gone on to commit serious offences again they have um and i think that's one of the most difficult parts of the job my risk assessment is clearly not an exact science and we don't always get it right and on very rare occasions patients have gone on to commit other offences so why take the risk of letting these patients out at all dr cappell i think quite strongly that they should be given the opportunity to address their very real mental health problems rather than just pretending that it's not an issue and keeping people in prison for however long it would need before the risk was reduced which in many cases would be never you ready yeah all right let's go mate because of his sentence james's first trip out of the hospital must be approved by the ministry of justice so for now he can only look at the outside world from the perimeter fence i try and go up there a couple of times a week just to sort of uh [Music] prepare myself really for maybe in a couple of weeks when uh my community leaves granted and just familiarize myself with uh just the comings and goings of uh life outside these grounds you know what i mean yeah a world carrying on you know what i mean yeah well going getting by without me in it [Music] a lot of growing up mate over the last couple years but you know it's been really hard hard actually facing up to [ __ ] that i used to make excuses for [Music] 16 years ago while serving time for armed robbery james made an unprovoked attack on a fellow inmate he was given a life sentence trying to fit in into a high security status jail feeling totally out of place i was trying to sort of uh make a point that you know i'm not here to be bullied by anyone i went in the sill with another inmate you know what i mean yeah he punched the geezer up you know what i mean yeah i set about carving the geezer up with a toothbrush and a razor blade i had a guiding system i wouldn't have been released you know i i lost everything in the process you know my ex-partner my kids loved them dearly you know i mean yeah but uh you know i was no good to them mate i was i was out of control mate you know i mean yeah i was a villain i was violent why would you want to be involved in someone like that and now i'm here i've been in two and a half years i'm on a journey to try and uh build someone i'm proud of i just don't want to go back to that old lifestyle mate you know not just get out there i deteriorate crash go back to square one again i can't do it i can't afford to do it you know what i'm saying yeah i'd rather take the solely approach and i'll get it right this time you know what i mean yeah [Music] so what have we done today to get you ready to go out um i've had a shower yep um i washed my clothes last night that's it um i've washed my hair yes um i'm good looking check check mic check check one out the version it's me my name check my one is three gets out of van sometimes what does um just my my human being you know start being [ __ ] right media that's silly and that makes me laugh just whoa for three weeks tony has avoided taking any of the legal highs that get smuggled onto the wards ready to go yeah his team has allowed him two hours out in the local community let's do this you got everything you need yeah but he won't be going on his own escorted leave is the first test of a patient's ability to cope with the outside world it's something tony has struggled with since being diagnosed with schizophrenia 18 years ago are you feeling cold not sure alright it's quite warm-ish isn't it yeah you should see so if you say so he has a long history of absconding from hospitals often making his way back to his mother's house now you know what i need one-to-one supervision you know what i mean yeah why because i wander off i go on my own missions you know someone's got to stay with me you know i don't mind it though because it still it helps me out you know yeah it's true it makes me feel ten times better about yourself you know when you feel like [ __ ] and that yeah in the past there have been physical attacks against his parents tony's turned up at three four five o'clock in the morning um started throwing things at the windows trying to gain entry into the house there's been a lot of fear a lot of anxiety and i think at the moment it's the first time that his family have felt safe knowing that he's in a secure hospital and that he he can't cause them any more distress i would have made it one once once upon a time but but i felt unwell you know yeah you're getting better now getting better yeah it'd be any time two in the morning 10 o'clock at night um early hour was tony would be walking up and down the street calling me and i used to to block it out try and block it out used to go into the kitchen and stand out in the kitchen so he couldn't have no contact of seeing me what would he show it mum help me help me help me heartbreaking heartbreaking knowing that you've done you've tried in the power to do what you can let's just start breaking doing this you're just gonna be able to tell that i'm doing all right you know yeah you are you're doing well in that schizophrenia is a chronic condition there are all sorts of psychological treatments that we can employ to try and help them live with those symptoms and cope with them as best they can but we do have to be always aware that we have our limits to um and that's that's very difficult to come to terms with but maybe we've achieved the best we can but somebody is still unwell is it all right you don't know oh no i don't eat bacon we have to continue to try but i think it's a case of balancing always the risk to the public and it may be that some people can never leave hospital this is what i have to cope with it's a drama why is that drama oh look at his boots you know what i mean that would just that's just they've got muddled over them mate from yesterday you can't wear those john's been living under lock and key for 22 years i can't wear those mate you know now he's been judged safe enough to take daily trips into the local community without an escort i mean we all struggle in this i struggle i have uh you know everyone has difficulties done we've all got difficulties [Music] because i i do have like this image thing uh difficulty with myself and um is it problematic it has been you know self-esteem confidence the you know where i perceived myself you know like in the 90s when a guy with a camera filming me in my face all our image and this was on my birthday and you know and i and i reacted quite aggressively to that i threatened him with a knife and went to the kitchen just because he was filming here not because he was filming me it was the reaction that the other people had as if like oh look at you you definitely got a funny face look at your head's like you know the men identifying faults that's what i felt i felt like you were identifying faults you were looking at you know i had problems with because i've got no knuckles do you know what i mean so i can't bend them so if i've punched somebody i you know that that thing has been broken so i've used a weapon as an extension of this or um as an extension of my my rage so i might have seen a knife as like an injecting injecting all my fear into into somebody else you know a few days after threatening the man with the camera john committed the stabbing that gave him a life sentence five years before that he used a knife on his girlfriend in a violent unprovoked attack it was a similar pattern i feel trapped and i feel i do feel a need to kind of try and protect myself because i strongly perceive a dangerous threat i attacked her and i i stabbed her and i phoned the police and the ambulance and i was arrested and i spent was sentenced to prison for six years what did you feel about what had happened i felt appalled i felt appalled and disgusted in myself the crimes our patients are involved with are very serious they're they're very tragic they're often extreme 22 22. because of the graveness of their crimes they won't achieve this thing called atonement which is almost a sense of self-forgiveness [Music] our job as a team is to somehow help them bear the enormity of what they've done and that's a really compelling but also very complicated piece of work [Music] i think it's about this process you know it's something meaningful and real has to happen you know there has to be like a genuine change there has to be some understanding about you know these these events however difficult they are and painful they are is to understand these why these things happen this is why i'm in a hospital and this is why i'm trying to you know make amends in some way the decision about whether james can start to make short trips outside the hospital has been delayed frustrated he's struggling to contain the anger that has been key to his there's a reoffending proper liberty brother you you've been in more huge weight and you've tried changing rules and all that you know what i mean it's diabolical it's about coming in alignment with what other listeners for the last four years very fine without any interference yeah now let me let me finish before he jumped on because i'm left on the wayside time and time again do you know how this reflects one of the difficult things with james is the way that he was treated in his early life i mean a really terrible history of neglect and abuse um one of the worst that i've seen my personality disorders yeah i'm not like i'm not black you know and this all feeds back into like why don't i fit in one i've been chosen he's not had opportunities in his early life to develop an idea of how to relate to people um what relationships are for and i think those difficulties have really been closely related to his offending behavior i'm surfing the urge because like internally i want to scream and shout that's like part of borderline you know it's like i'm just it's like but i'll just have to just ride ride with it you know what i mean yeah you're like a pressure cooker and this could be the slightest little thing that sets you off and and you're sort of really um rash you know it's like taking a dummy off a baby you know what i mean yeah i could uh just throw a wobbler well i don't want that setback you know what i mean yeah so i just got to refrain myself and just stay calm and just think whatever comes whatever comes comes and it i'll deal with it you know life's passing me by my you know i mean yeah you know i'm anxious to sort of just get some formal normality normal life i'm like a dog at the lead at the moment trying to you know gnaw it off mate i want to get out there and sort myself out even though i've got a lot of anxiety problems but i just want to get out there and get my life back on track you know what's up tony uh um i'm miserable i've got the amp i'm pissed off and my hormones are playing up um it's against my religion which i don't have a religion but i'm church of england i was bored want to get a move on you know make a start of things common misunderstanding is that it's an easier option being forensic psychiatric care compared to them being in prison i would argue that in fact this is the tougher option when you go to prison you have an end to the sentence the sections that the majority are on here are indefinite they will go on as long as necessary some have been in the secure psychiatric care for decades and there is no end point oh mate oh come out of here mate as far as i'm concerned that i don't even know what i'm doing here mate ain't done me no favors mate and that's why i'm losing my temper i want to get out of here mate i've got a life to live i've got a daughter to look after this is like being in the in the cemetery this is like being in the funeral piler sitting here laying and they're all looking at you thinking [ __ ] you know what's wrong with this div they want me sent back to prison they don't want to see me go out there because they know what i'm like outside i'm laying on this bed i'm laying on this bed holding my head together holding all my body together now i mean i'm suffocating i'm suffocating in the building how much more they want from me man i can't do no i can't do nothing more can i but i'm all right i'll get for it i've got me i've got my daughter there so i'll just look at the photo every day and just think to myself babes i'll be out one day i'll be out not to worry i'll get out of this i just want to get my life together mate i wish i could walk right now you know i wish i could walk [Music] [Music] he was 18 years old and it was coming up to christmas and tony had gone to was going to a party he went to the party and then it was about two three days after he'd been to the party he was acting very strange um he kept saying or weird or weird things that was happening i thought this ain't right this ain't right it's something he's took something he has definitely took something and he said all he could it was help me mum help me and he just went down on the floor help me mum help me mum sorry i said that we need to come to the hospital the hospital and so i took him up to the hospital and they sectioned him there and then for six weeks and i lost him i'd lost him tony can be very scary he is voices yeah the voices tell him what to do and he says he has to do it he said i don't want to hurt no one but they they tell me what i've got to do i had to cut tony off for his own for his own good for his own benefit and that it's very hard as a mum when you've got a shutter door on your son that is out knowing there's nothing you can do you've tried and you tried and you tried and you can't and you can't do no more he's took the fight from me the fight has gone from me do you expect children or your kids or whatever to do well but never happened in his guys today should we make a cup of tea keep it up get the pill get some piece of pill wake me up [Music] james has finally got a decision [Music] his escorted leave to the local town has been approved [Music] he hasn't been allowed outside an institution in this way since he was arrested for robbery 17 years ago yes hey feeling fast all right no problem no stress eight weeks of non-smoking you know what i mean yeah he's about to just go down the pan oh gosh generally with leaves the the concerns that you've got to take into account are the likelihood of the patient disappearing absconding with him in particular that's less of a concern the greater concern is just not really coping when he's out wanting to return very quickly panicking and becoming very emotionally aroused and just losing his confidence [Music] it's nice to be out with normality in that guy here just seeing the world go by you're not mean yeah away from the wards you're not mean yeah i love it coming up here mate bundles yeah it's just different place of life out here you know at first when i came out was quite bricking it you know felt really unusual i'm on leave i'm on tag all the different aspects to it do you know what i mean yeah it's like but you just ignore it at the end of the day nobody don't know who i am what i'm doing you know i'm just mingling in like normal people do i am normal you know what i mean yeah i've got personality disorders that doesn't mean i'm a raven lunatic do you know what i mean it's all good mate [Music] hello mate did you do any uh pork belly strips you can have a couple of them please yeah do you know what i've only lost me yeah yeah hang on a second mate yo get that bag let me check that bag you sick that's it what is it you're looking for you're watching turn it off [ __ ] all me uh want me money me cards all my id all freshly done and i thought i'd lost a lot and now i found it you know what i mean now what a relief mate i feel like i'm going to pass out i felt really stressed to know that i really did let me just get some bit of air mate because i i feel really uh you know stressed mate james left his wallet in the record shop he visited earlier in the day stress ed so i said oh gosh did you know what it was a testable test because internally i was screaming inside i was ah thanks so much mike appreciate you matey thank you yeah cheers lifesaver he's got a long way to go before i think he's ready for more extensive community leave and even beginning to think about unescorted leave um i think that's a way off he could be moving on the next year to 18 months but i think that would be best case scenario and i think sometimes underestimates how difficult it's going to be yeah he's he's not high and dry yeah i'm going back to the ward now i'm depressed i want to get back out there my real world get on with my life mate and yeah cheers for today mate and thanks for your company cheers mate as the prospect of being discharged from the bethlehem royal becomes real john has started to look for voluntary work subject [Music] volunteering dso madame i'm currently an inpatient with the bethel royal hospital i'm current i currently have extensive community leave and i'm currently looking i currently currently i'd be grateful if you could let me know of any positions you have terrible paragraph you're sincerely sent beautiful at least it's just me as a kid oh i reckon i'm thirteen and with my bowl cut but just i think it's uh i think it's sad because of like uh you know this kid uh he's not he's not smoking he's not drinking oh good to see you around how are you doing and where has life taken you see how do you answer that where do you even begin with that where'd you even start hi mate i don't even know where to start i've been in the hospital recently mate i had a few psych problems that's for the last 35 years an email letter or two how do you explain 35 years [Music] [Music] [Music] doctors are about caring and i take pride in the fact that i'm working with a group of patients who are probably the most dispossessed sideline rejected in society shame and isolation for patient increases their risk if we tackle that effectively compassionately we reduce the risk significantly we've got two options as a society we either lock up offenders with personality disorder and they're just removed from society altogether or my position which is to try and get something positive out of these horrendous incidents these individuals didn't emerge from a vacuum they came from families who lived in streets and had neighbours and they very much are a product of society too and i do think we have a responsibility to think about how we support manage understand them to me the options of doing nothing just doesn't make any sense you just got rolled in there time i know i know all right yeah just stalled don't in there yeah but you're all right yeah tony you know the rules it's once a month yeah okay all right then and i'll speak to you soon all right love y'all [Music] you

Channel: Real Stories

Views: 854,721

Keywords: Real Stories, criminal psychology, forensic psychiatry, hidden world, mental disorders, mental health care, mental health recovery, mental health support, patient empowerment, patient journeys to recovery, patient recovery journey, patient rehabilitation, patient testimonials, psychiatric care, psychiatric evaluation, psychiatric hospital, psychiatric patients, psychological trauma, real life accounts, trauma healing, violent behavior

Id: GQIrEHTUYDU

Length: 47min 7sec (2827 seconds)

Published: Sun Sep 18 2022