Episode 5 Inside Out

Hi, I'm Elaine Dunkley, and welcome to Inside Out.

This week we've got a special selection of stories

from across England as part of a major season on mental health

on the BBC.

It's called In The mind, and it's coming up.

We reveal how mental health services are failing our

most vulnerable children.

The young carers:

We will hear from a teenager who helps look

after her father, who is bipolar and suffers from depression.

And we talk to the badminton player who's beating bulimia,

and look at the connection between eating disorders and sport.

The journey from adolescence to adulthood can be a tough one,

The journey from adolescence to adulthood can be a tough one,

particularly for children struggling with mental health problems.

During this period of transition, NHS support can make

all the difference, sometimes between life and death.

Yet, because of the way our health system is structured,

many young people with severe mental illnesses are simply falling out

of the system or being denied care all together.

Dr Ann Singh has this story, and I should just say that some

viewers may find it distressing from the start.

I just want to die.

I just can't imagine living.

I want to die like there and then.

It feels like I'm lost in a cave, there is no way out,

and every time you think there is a way out, it always

gets closed up.

I don't want to breathe, I don't want to live,

I don't want to use oxygen any more, I don't want to eat,

I don't want to talk, I just don't want anything.

I don't want life.

Growing numbers of our children are developing mental disorders,

finding themselves locked in a struggle to control

the disturbing thoughts in their minds.

In fact, in the UK, around one in ten young people are now affected

by mental illness.

That's the equivalent of three pupils in every classroom.

It's quite difficult being a young person in today's society,

there is an increased risk of mental health problems and indeed

a prevalence of mental health problems, you know,

in recent years.

Girls tend to suffer more from kind of emotional

difficulties, anxiety, depression.

Boys tend to have more kind of behavioural problems like autism

spectrum disorders or ADHD or psychotic illnesses

such as schizophrenia.

That was so funny!

I forgot I did that...

At home in Croydon, 18-year-old Nicky Mattocks and a friend

remembering the happy moments they shared growing up together.

But there have also been tough times.

For most of her life, Nicky has been mentally ill.

When I was seven I realised I felt differently to most other people,

because I told my mum that I just didn't want to be here anymore

and said, why did you give birth to me?

It's clear I'm not meant to be here.

As she moved into her teenage years, Nikki developed a phobia of people,

including her own family.

I didn't speak to anyone, I literally just hid indoors,

I wouldn't go to school, I wouldn't do anything.

It was at that time that I started to hear voices.

Do you remember what those voices said?

The voices, like, they would just be telling me to hurt myself, mainly.

Never to hurt anyone else.

And did you hurt yourself?

Yes.

I hurt myself, I've lost count of how many times I have now.

I hurt myself, I tried to kill myself, I did a lot of things.

Just before her 15th birthday, Nikki made another suicide attempt,

and was admitted to hospital.

She was assessed by the children's mental-health services,

and finally diagnosed with a number of conditions,

including borderline personality disorder.

I feel it in my head, so when I know I'm really not

in a good place, like, it just hurts, I can't move,

I can't even...

My head just feels heavy.

At just 13 years old, Stella from Lewisham began self-harming.

She was diagnosed with emerging borderline personality disorder,

and placed under the care of the children and adolescent

mental health services.

I tried loads of things.

I went onto medication, and it didn't help.

I had CBT, and it didn't help.

I had psychodynamic psychotherapy, which didn't seem to improve

anything.

Now on the cusp of turning 18, she is transitioning

to adult services.

Transitioning is essentially moving from children and young people's

care into adult care.

Now, that transition should be seamless, because it is that key

moment in a child's life.

If you don't provide the right support at that point,

very often children get much worse.

I was staying within the same Trust.

So my adult team can look at my notes and read what anybody

has written about me in the past few years.

Overall, my care has been excellent.

I was lucky that my Camhs team gave it some thought and actually put me

onto the adult waiting list in enough time so that by the time

I was 18 I could go straight into adult CBT.

Stella's transitioning process is textbook perfect.

Maintaining professional treatment of her condition into adulthood

increases her chances of staying healthy, but her experience is rare.

You're going to be famous...

A year ago, Nikki was discharged from the children's mental-health

service, leaving her to fend for herself.

What was your transition like?

It was really confusing.

You get put through so many different services you just lose

track, and you lose hope quite quickly.

I'm not in treatment, I'm on loads of different waiting lists.

I can't be bothered with the NHS any more, like...

In a personal, home-recorded diary, Nikki reveals the torment

of being trapped in the void between children's and adult

mental health services.

I'm angry that the NHS didn't help me sooner,

because I've been asking for help for ages.

For, like, it's October now, I've been asking for help

since January and I'm still waiting.

And I doubt I'm going to get anywhere, to be honest.

You feel like you're just...

You're like, behind this glass wall, and everyone else is happy

on the other side, and you're just trying to break the wall down

and you just can't, and you think, what is the point?

And it can just feel so hopeless.

Then...

Then sometimes the only option that seems like it actually

will help is suicide.

A recent study suggests that in London only 4% of mentally ill

young people moving from child to adult care experienced

a good transition.

The greater majority, 96%, end up slipping through the gap,

struggling to get the care and support they need.

I think we have huge problems right across London.

The best support is required, and actually too often children

getting the worst support, they are ending up...

Their mental health is becoming worse as a result.

Music is one of the few things that have helped 18-year-old Joshua cope

with what he describes as severe depression.

He claims not to have received any care from adult mental health

services since he turned 18.

I have moved into adulthood, but I have had really no support,

because I've been to my doctors a lot of times, and they haven't

really given me the support that I have needed.

They haven't given me counselling, they haven't given me the sessions

that I would need.

When I've tried to get support from the doctor,

they said that they would do an assessment first,

and that wasn't really carried out.

Joshua believes the lack of treatment has caused his

depression to deepen.

He is now desperate for help.

When you suffer from depression, it feels like you're walking

in the desert alone, no one is around you,

and there are no people for miles and miles and miles.

I need counselling, because if I'm not going to get counselling

it is going to get worse and worse and worse.

Because of differences in the way mental illnesses are now

categorised, some young people's cases are being rated

as less urgent.

We have certainly seen cases where young people have been deemed

to be in very serious crisis, and because they moved

through into adult care, if you like the assessment

of the particular illness is deemed lower, actually they don't get

the support that they require.

It is often because services are completely overloaded and under

pressure, so they have had to raise their thresholds over

the last year or so to cope with demand, so what happens is that

many young people will fall off a cliff because they don't

meet the criteria.

With access to adult mental health services becoming increasingly

difficult, many mentally ill young people on transition waiting lists

only receive care after their lives have been at risk.

After they have become suicidal, like Jade.

When I was 17 I had a really bad turn, I tried to get back

on with mental health services, and that took a really long time

and it was a good six months or so before I finally got to be

introduced to them, and by that point I was really bad and they just

said, OK, you need to go into hospital.

So I was in hospital for a month.

When I got out of hospital, I was directly referred

to mental health services.

Jade was fortunate.

She got help just in time, but tragically, others have actually

ended their lives after failing to successfully make the transition

to adult mental health services.

Part of my job is to attend the inquest of a child or young

person who has died.

Often, but not always, one of the contributing factors

seemed to be the experience of the young person

through the movement from children's services to rival support services,

and my appeal is wherever possible local commissioners need to find

ways of having continuity through that transition,

because that transition is itself a moment of crisis.

I go to my doctors, I say, I'm self harming, I feel suicidal.

What was the point in even asking for help?

You just think, what's the point?

What's the point in coming to the doctors when they just say,

oh, go away?

That's not their job.

People died because they don't get help when they need it.

Shortly after recording these clips, Nicky managed to secure a course

of counselling from the university she now attends in Guildford.

It's a solution, for now.

Like thousands of other young people with mental illness in the UK,

she is still counting on the NHS to provide the care

she desperately needs.

Dr Ranj Singh reporting there.

And for details of organisations offering advice and support

on mental health, you can go online to bbc.co.uk/actionline or call

the BBC Action Line to hear recorded information.

Lines are open 24 hours, and calls are free from landlines and mobiles.

Caring for a loved one can be a tough enough job for an adult.

Imagine what it's like for a teenager.

It's estimated that there are 175,000 young carers across England.

Keavy from Sussex helps look after her mum and dad.

This is her story.

It's different, but it's, like, a good kind of different,

because you are your own person, you're not like all your friends.

You kind of stand out from the crowd.

It gives you a sense of pride.

My name is Keavy, and I'm 15 years old.

Together with my sister, we helped look after our dad,

who has mental health problems.

And our mum, who uses a wheelchair.

It can be a bit hard sometimes.

This is my sister Kara.

She's nine.

Oh, and here's our dog, Woody.

I'm going to get dad's medication.

She does help me out.

If I'm a bit late on it, I start getting a bit funny,

but she just gets the tablets out.

She does that for me.

Generally she just says, come on, take your medication.

He sometimes forgets things.

You need to tell him over and over again.

I've tried to take it all on top of me, because I feel that, like,

where I'm the older one, I should be the one taking it all,

not her, because I want her to have a child had as much

as possible, and give what I didn't get properly.

I don't think I'd be here if it wasn't for her.

I'd be somewhere else.

I can imagine.

It has been my childhood since, like, the age of four,

since I have been able to start doing stuff.

For the past ten years I have been looking after...

I did look after my mum at first.

And then all this stuff with dad came, so I took that

on board as well.

Do you remember that?

I remember than that.

They say to me, you're not a normal dad, I'm not,

I just can't...

I don't know what it is, really.

I just can't handle stuff sometimes with them.

Mum is a great support to us, but there is only

so much she can do.

I was born with spina bifida, which means I'm not actually

paralysed but there is a split in my spine, but I can move my legs,

but I can't walk, obviously.

It upsets me, of course.

Because I just want him to be a normal dad and normal husband,

like you see other families out and about, laughing

and joking and that.

It's very hard.

Keavy?

Yes, Miss.

It doesn't really affect school as much as it used to do,

I remember when I first started caring for dad, it used to scare me

a bit with his moods, I didn't really understand.

20 minutes, guys, can you just be finishing off now please?

Happy with that?

Yeah.

Now, as I have gotten older and people have told me,

I can understand, so I don't really worry about what he's

like when I come home, what he's going to be like,

what his moods are going to be like.

Keavy helps him a bit more, because he gets confused

about things quite a bit.

She sits down and explains things to him.

Like, if it's on the iPad or something, he doesn't quite get

it the first couple of times, and she is very patient and will sit

there and explain it all over to him again.

The red arrow warns spectators not to endanger themselves

if the train is stopped.

My dad has bipolar, and a personality disorder.

But we're not afraid to talk about it.

I take it three times a day, once in the morning,

once at lunchtime and once in the evening.

It makes me sleep better, but...

I'm on an antidepressant in the morning as well.

It is literally through the day.

I don't think people realise, people walking down the road,

you wouldn't know the difference, you wouldn't know if it's me

or you had it.

But I don't find it difficult now, I did sometimes.

People start calling you mental, but it's just a word that

people associate you with.

A few years ago, things got so bad that we nearly lost dad.

I had enough, I had a cigarette on here, and I was hanging over

there, literally hanging over, and the next thing you know

there were three police cars coming round here.

It's silly, isn't it?

The silly things go through your head.

I couldn't do it again, no way.

A total waste.

I've got to get on with it, I have no choice.

I've got kids now, and I'm back.

Don't overload it, sweetheart.

I think people should be aware of how many young carers

there actually are.

A lot is said about adult carers, but I think young

carers are forgotten.

A lot of them are under the radar.

What kind of milkshake?

Strawberry.

I used to go to a young carers' club, but then they got cut.

Kara only has her clubs now, which I help out at.

I go every fortnight.

And I do different things, like playing and making stuff.

How do you feel when you are there?

Relaxed.

And calm.

How would you feel if you didn't have a club to go to?

Stressed out.

We just found out that from next month Kara's club

is going to be cut, too.

But at least we've still got each other.

We're like typical sisters, to be honest.

We get on, and sometimes we don't, we fight, shout at each other.

And, yeah, we just annoy each other, but that's what sisters do,

I guess.

Well, that's my family, I hope that by letting you in,

even just for a short time, will mean that more of us can talk

openly about mental health problems.

My girls are my world.

They're so, so special.

And I'm so proud to have two lovely girls that help, and I wouldn't

want to be in their position if I was their age.

I'd rather be going out doing things, instead of looking

after my mum and dad.

Somethings, yeah, I do feel like running away from it all.

But then I sit and think and look at it and realised

that there are people probably in a worse situation than me.

Thinking about it, I've got it quite lucky.

Sportsmen and women project an image of physical perfection,

but sometimes beneath the body beautiful ther can be a dangerous

mental health condition.

Jenny Wallwork from Leeds ranks among the world's top badminton

players, but last year she stunned the sporting world by revealing that

at the height of her success she had an eating disorder.

As Johnny Hansen has been finding out, she is by no means the only

athlete with this illness.

Jenny Wallwork was destined for badminton success.

You have won the under-13s national singles titles before,

how long did it take you to reach that standard?

I started when I was about eight, and I'm 13 now.

But this assured and seemingly effortless rise to the top

masked a secret.

Looking back now, I've realised, you know, from 18 years old,

I had started to put on a bit of weight, and it was a case

of training as hard as I possibly could every day, making sure I'm

burning off 1000 calories at the end of the day,

to make sure that I know that I'm not going to be putting on weight.

This obsession took hold.

Outwardly, all seemed well.

Secretly, she was taking laxatives and forcing herself to be sick.

I was struggling, I was worried that this, something that had

initially started out as a habit, was now an addiction.

And I was worried that I was going to die because of it.

There are an estimated 1.6 million people in the UK

with eating disorders.

Bulimia, one of the most common, is hardest to spot.

We have a range of factors that leave people more vulnerable

to eating disorders - things like their perfectionism,

perhaps they are high achievers, bulimia becomes a way of managing

something, a way of managing emotions by focusing on diet

and shape and weight.

Professionally, it seemed it couldn't get any better.

Jenny was ranked fifth in the world.

I had training sessions where I could feel pains

in my heart, and I, all I was thinking was,

"I'm going to have a heart attack."

I didn't know whether I was going to end up collapsing

on court at that stage.

I thought, what the hell am I doing?

To tell my parents was the hardest thing I've ever done.

Do you remember that conversation where Jenny came in and said,

"I have an eating disorder?"

Oh yes.

Yes, it was a bit of disbelief, and then a bit of fear in terms

of not being sure how to help her.

It's just a horrible thing, because, you know, you want to be

there completely for your child, no matter what age they get to.

And it was just horrible.

The next step was to seek treatment, but looking the perfect

athlete, Jenny struggled to be taken seriously.

I relapsed after I was fine for two years, then I was tired

and I relapsed again.

It is definitely a fight.

Cricketer Andrew Flintoff, hurdler Colin Jackson...

Jenny is not the only athlete to confess an eating disorder.

And distance runner and psychologist Caroline Plateau

is researching the connection.

Certain things, like having to compete in quite tight,

revealing clothing can promote body dissatisfaction

and comparison across athletes.

Also, beliefs and sporting culture that actually the thinner you are,

the leaner you are, the better your performance

is going to be.

But this adds up to an alarming statistic.

The estimate is about one in five female athletes present

with eating disorders.

In male athletes, around one in 12.

If we compare that to the general population, where we see

roughly one in 50 people, you can see it is very highly

prevalent in sportsmen and women.

So, should more be done to watch out for the danger to athletes?

In Jenny's case, for example, could it have been picked up earlier?

She was normally quite easy to read in the training hall,

and you could tell where she was in terms of her comfort

levels for the training.

So it was a total shock when I heard that she had been suffering

from that, for some time as well.

If you have no signs, and she's really hiding things very

well, still training at full levels, still winning, then, you know,

there is no question it's extremely difficult to detect.

UK Sport tell us they take this issue very seriously,

and offer a range of support services to

high-performance athletes.

A national eating disorder working group is now raising awareness,

and offers help to parents, coaches and athletes

at all levels of sport.

The taboos around sport and eating disorders makes this

a rather unusual event.

It is a badminton day to launch Jenny's foundation, set up to raise

awareness of the illness, and former England team-mates have

turned out in force.

Most athletes are born with some sort of crazy competitive nature,

and of course that's what kind of makes us go that extra distance.

I mean, this isn't a one-off situation, I think there are people

struggling with it throughout sport and life.

It's been quite emotional, actually.

I woke up this morning and I was quite upset about it,

not in a negative way, in a really positive way,

because I thought it's so nice, there are so many people out

wanting to support me.

For us it's hard, because we're looking at her, and thinking,

who is helping you?

But she's saying, by doing what she's doing, it is helping her.

It is a serious illness, and if we can create a better

understanding for people, hopefully it will help people

suffering in the future.

Well, that's it from us for this week.

If you'd like to join in the conversational mental health,

please tweet us.

Hashtag #inthemind, all one word.

Don't forget if you would like to see more stories

from your area then join our inside out teams on Monday evening

at 7:30pm on BBC One, or on the BBC iPlayer.

The weekend is looking a little bit mixed on the weather front.

For most of us it is going to be cloudy with a few spots of rain,

quite windy, too.

In one or two areas we are going to get a fair bit of wet weather.

There is a lot of cloud out there in the Atlantic