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Britain's mental health service crisis uncovered

10/08/2022 | Health News

‘Get off me, Get off me!’ Shocking scenes as an anorexia patient is dragged along the floor and pinned down by five carers while being secretly filmed by a three-month undercover Channel 4 investigation into Britain’s mental health service crisis

Channel 4’s Dispatches secretly filmed of the UK’s biggest mental health trusts
They filmed for 3 months at Essex Partnership University NHS Foundation Trust
The footage shows horrible abuse of vulnerable patients who are even mocked
Staff are alleged to have used excessive force and failed to supervise patients

A shocking undercover investigation has laid bare appalling failures in patient care on Britain’s mental health wards.

Reporters from Channel 4’s Dispatches programme spent three months secretly filming at one of the UK’s biggest mental health trusts – Essex Partnership University NHS Foundation Trust. Their alarming findings are to be aired tomorrow night – and The Mail on Sunday has been granted an exclusive preview.

The footage reveals horrifying abuses of vulnerable residents on two acute mental health wards. It includes patients being dragged across the floor, pinned down by staff, mocked while they are in distress and humiliated.

The damning footage raises fresh concerns about the state of treatment for the most mentally unwell in this country. While the Essex Trust is just one of 54 across England, mental health professionals and families warn that such failures are widespread

On one occasion, a patient who is at high risk of suicide and supposed to be under constant supervision is left unattended and makes an attempt on their own life. Another chaotic scene involves staff trying to locate a crucial bag of specialist cutting devices to save the life of a female patient who got hold of a ligature, after a carer failed to keep watch.

On another occasion, a patient was able to escape through a broken door. Others are put at risk by staff using disproportionate and unnecessary physical restraint to pin them down – sometimes for as long as an hour.

In one distressing example, a young woman being treated for anorexia – who is heard hyperventilating with fear – is dragged across the floor by her arms. When she is later discovered making a suicide attempt, she is pinned down by five carers for 40 minutes. As the woman lies sobbing on the floor, one of the staff members discusses the success of his latest diet. Another carer laughs as she marks the rhythm of the woman’s laboured breathing with her hands.

‘Get off me, you’re making me worse,’ the patient screams. ‘You were just talking about losing weight when I’m f****** anorexic. Why would I talk to you?’

The damning footage raises fresh concerns about the state of treatment for the most mentally unwell in this country.

Former mental health nurse Julie Repper, director of imROC, an organisation that helps improve patients’ experiences in mental health services, describes events in the film as ‘literally abusive’

While the Essex Trust is just one of 54 across England, mental health professionals and families warn that such failures are widespread.

‘I asked the peer support workers we train about their experiences of the system, and they described seeing repeated ligaturing, people being dragged by their feet and being restrained. It’s ubiquitous.

‘These units are supposed to keep people safe, but this film shows they’re not. Everybody has a stake in seeing this improve, because every single one of us may become overwhelmed at some point and find we hit a crisis.’

The film comes a month after the BBC’s Panorama uncovered allegations of bullying and abuse at the Edenfield Centre, run by Greater Manchester Mental Health NHS Foundation Trust.

Staff were filmed apparently mocking, slapping and pinching vulnerable patients in footage now being investigated by the police.

And in August, The Mail on Sunday reported concerns of experts about spiralling numbers of patients receiving inappropriate treatment in psychiatric hospitals. They also highlighted the four-fold increase in people detained under the Mental Health Act – being sectioned – over the past four decades.

When a patient is sectioned, they can be injected with medication and restrained. And for the majority of patients, this type of treatment ‘is traumatic and not beneficial’, according to Dr Jorge Zimbron, consultant psychiatrist at Fulbourn Hospital in Cambridge.

One in 20 mentally ill patients discharged from hospital are readmitted within a month, according to the mental health charity Mind.

The Dispatches footage was filmed by former police officer Dawn Goddard, who worked 13 shifts as a healthcare assistant on two adult mental health wards at Rochford Hospital and Broomfield Hospital. The Essex Trust that runs these hospitals was chosen following concerns that lessons had not been learnt following 11 suicides that happened between 2004 and 2015.

The Trust was prosecuted last year by the Government’s Health and Safety Executive for the deaths – which happened on its wards – and was fined £1.5 million.

But in February, another young woman was found to have killed herself just days after being discharged from the Trust’s care.

To investigate further, Dawn took on the job, which began with basic online training and just one week of face-to-face guidance.

This, however, is part of the problem – mental health units are struggling with recruitment and rely on poorly trained, poorly paid staff from agencies to fill vital healthcare assistant roles.

Dawn’s in-person training had focused on using restraints – something they were told was ‘a last resort’. But she found that the technique was used in most shifts she worked. Sometimes patients continued to be restrained long after they had stopped resisting.

Andrew McDonnell, a professor of clinical psychology, said of the footage: ‘I get angry when I see unnecessary use of force and restraint. There are no protocols that say you drag someone or manhandle someone in that process.’

Dawn also recorded staff asleep on duty while they were supposed to be monitoring vulnerable patients at risk of self-harm.

The documentary features the stories of those who have died while under the care of the Trust.

Abbi Smith was 23 in February when she took her own life, just days after being discharged. She was autistic and had spent a decade bouncing in and out of psychiatric units in Essex.

In one final haunting video message she recorded shortly before her release, she said: ‘Last night I was crying and crying. Couldn’t stop. Not one member of staff came in to see if I was OK. I’m checking out, when I get out of here. That’s it for me now. I love you all so much.’

Her mother, Lisa Wolffe, told the documentary: ‘It felt like once that system had Abbi, she was lost to me for ever. I was disregarded and excluded from her life.’

Shortly before she was discharged, Lisa wrote to Abbi’s psychiatrist asking him to seek advice from a specialist autism unit about how to reduce her risk of self-harm. He didn’t reply.

Two days after she was discharged, Abbi killed herself in an Essex park.

Another mum, Michelle Booroff, told how her son Jayden died aged 23 in October 2020 after he escaped from the Trust’s Linden Centre in Chelmsford.

‘He was very unwell and needed treatment, and he was sent to the right place to get treatment,’ she said. ‘And if things had been better he would still be here today.’

But none of this has come as a surprise to Melanie Leahy.

The death of her 20-year-old son Matthew on a Chelmsford ward in 2012 sparked a campaign to raise the alarm about patient safety in Essex’s mental health units. It was one of the 11 similar deaths which led to the 2021 fine and prosecution.

Melanie said: ‘I’m contacted all the time by families who are going through what we went through ten years ago. It’s heartbreaking. Matthew dies again every day in my mind because nothing has been resolved. Yet no one has been prosecuted with corporate manslaughter in the mental health system.’

Melanie’s campaigning, backed by 40 bereaved families, has led to an independent Government inquiry to investigate 1,500 unexplained or self-inflicted deaths on wards.

Initial findings have been described as ‘disturbing’ by the chairman of the inquiry.

Staff, however, are not compelled to give evidence.

‘The staff don’t care because they’re not accountable,’ Melanie said. ‘They move from one agency to another when something goes wrong, their record wiped clean.’

The families have called for the investigation to be escalated to a statutory inquiry, in which staff would be legally required to supply information.

‘We need to compel people involved in cases like Matthew’s to be held to account,’ she added. ‘That’s the only thing that can bring real change.’

Lisa Wolffe agreed: ‘There are many, many families that could be sitting here alongside me. And they would all want the same thing. They would want transparency, they would want an investigation that uncovered the truth.’

A spokesman for Essex Partnership University NHS Foundation Trust said: ‘We are taking the allegations extremely seriously and we understand how distressing this is for patients, their families and carers. We have informed our regulators and partner organisations and will work with them… on the actions we are taking as a result.’

Dispatches: Hospital Undercover is on Channel 4 tomorrow at 11.05pm.

EVE SIMMONS: I witnessed very similar horrors – the units aren’t fit for purpose

When I watched a preview of the Dispatches documentary, I was, of course, disgusted – but not shocked. Rather depressingly, I was nodding in recognition throughout.

Seven years ago, in my early 20s, I was admitted to an NHS mental health ward specialising in eating disorders. I was suffering anorexia that had spiralled out of control due to a lack of psychological support.

During the six weeks I spent on the ward, I witnessed the very same examples of malpractice exposed by the Channel 4 reporters, including women being unnecessarily restrained, nurses falling asleep on the job, leaving high-risk patients unattended, or making inappropriate comments.

On one occasion, a 19-year-old patient with anorexia was advised by a nurse not to ‘overdo it’ while she ate dinner. She cried, and begged the nurse to stop talking.

Another time, a nurse asked a patient to walk a mile out of the hospital to buy the ward’s order of daily newspapers – which the nurse had forgotten to collect.

There would be punishments should we fail to gain weight, such as being denied family visits or a walk to the hospital garden. We were treated like prisoners.

Of 12 patients on my ward, only two – including me – recovered, which is hardly surprising given the quality of care.

Clearly there is a fundamental problem with how the mentally unwell are treated that extends far beyond eating-disorder wards.

In the majority of cases I saw, hospital admission made patients worse in the long term, not better.

The main problem seems obvious: you don’t have to understand much about mental health to be allowed to care for mental health patients. While most wards have a small number of specialist nurses, the majority of staff have undergone only the most basic of mental health training, which largely focuses on physical needs and how to keep everyone safe if they become out of control.

Of 12 patients on my ward, only two – including me – recovered, which is hardly surprising given the quality of care (Picture posed by model)

Patients might see a psychologist or psychiatrist – an expert who can offer evidence-based treatments – once a week, if that.

I’ve always found it baffling that, when it comes to mental health, those who are the most sick appear to get the least specialist treatment.

So what can be done?

One obvious solution is to help staff understand mental illness.

Recent studies have shown that a major reason why mental health nurses are leaving the profession in droves is because they feel that they lack professional knowledge and expertise. Meanwhile, interventions by researchers at King’s College London found that training staff in psychological strategies to improve their patients’ mood hugely benefited both the nurses and patients – at a cost of just £10 per patient, per week.

I appreciate that highly trained staff cost more, but with rocketing cases of mental illness it is surely a worthwhile investment.

The average salary for a mental health nurse in the UK is about £34,000 a year. Paediatric nurses are paid around £38,000, while A&E and intensive care nurses are on somewhere between £43,000 and £52,000, according to the website talent.com

Some may say an overhaul of this system is, right now, a challenge too big, given the endless list of NHS problems to fix.

But surely what’s not too much to ask is to treat patients with dignity, understanding and respect.

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