0:00:05 > 0:00:08This is the McGuinness Unit in Manchester,
0:00:08 > 0:00:11one of the largest teenage mental health units in the UK.
0:00:12 > 0:00:14ALARM SOUNDS
0:00:14 > 0:00:17It's the place of last resort for teenagers with eating disorders
0:00:17 > 0:00:19- or psychosis... - SHOUTING
0:00:19 > 0:00:21..who self-harm or have OCD.
0:00:23 > 0:00:28An in-patient facility that takes in the suicidal and disturbed
0:00:28 > 0:00:30to try and turn their lives around.
0:00:35 > 0:00:40For a year, we were given unparalleled access to film the patients...
0:00:40 > 0:00:42- NO! - Just calm down.
0:00:42 > 0:00:44..and the staff.
0:00:44 > 0:00:47In the last five minutes, I've had a cup of water poured over my head.
0:00:47 > 0:00:49- In the good times... - SHE BURPS
0:00:51 > 0:00:53..and the bad.
0:00:53 > 0:00:55SHE WEEPS
0:00:58 > 0:01:02This is the reality for some of the half a million young people
0:01:02 > 0:01:04in Britain who have to deal with mental illness.
0:01:04 > 0:01:06SHE SQUEALS
0:01:06 > 0:01:093,500 young people pass through units like this each year.
0:01:09 > 0:01:13This is the chance for some of them to tell us what it's really like
0:01:13 > 0:01:17on the inside... and how others see them on the outside.
0:01:20 > 0:01:22My brain's a bit...
0:01:22 > 0:01:24SHE LAUGHS
0:01:41 > 0:01:44There is a new patient at the McGuinness Psychiatric Unit
0:01:44 > 0:01:46at Prestwich in Manchester.
0:01:47 > 0:01:5017-year-old Beth has an eating disorder,
0:01:50 > 0:01:53is depressed and also feeling suicidal.
0:01:56 > 0:01:59When I look at that I just see all the fat on my arms,
0:01:59 > 0:02:01all the fat on my hips.
0:02:01 > 0:02:04All the fat on my arms there.
0:02:04 > 0:02:06I like to see the bone,
0:02:06 > 0:02:08the collar bone and the hip bones
0:02:08 > 0:02:11and the ribs and the thigh gap and, do you know?
0:02:11 > 0:02:16But since we don't have a full-length mirror here it's pretty hard to see all that.
0:02:16 > 0:02:19My friend put together loads of pictures,
0:02:19 > 0:02:22that one's obviously been taken at school,
0:02:22 > 0:02:24must have been year 11.
0:02:24 > 0:02:28I've had, like, an eating disorder since year nine.
0:02:28 > 0:02:31One time I was at my auntie's house down south
0:02:31 > 0:02:34and I just went to the toilet and I was sick
0:02:34 > 0:02:38and then I went downstairs and I don't know why I made myself sick, I just made myself sick.
0:02:38 > 0:02:41I went downstairs to my mum and she offered me a chocolate
0:02:41 > 0:02:43and it's like, something had got in my head saying,
0:02:43 > 0:02:45"No, you're not allowed that. Don't eat that."
0:02:45 > 0:02:47And ever since then it's just been there.
0:02:47 > 0:02:49Like, it's there all the time.
0:02:49 > 0:02:53Calls you names and calls you fat and stuff.
0:02:55 > 0:02:57It sucks.
0:03:08 > 0:03:10ALARM SOUNDS
0:03:10 > 0:03:13Beth is different to many of the patients on the ward.
0:03:13 > 0:03:16Most appear depressed and withdrawn.
0:03:24 > 0:03:26Beth seems happy and extrovert.
0:03:29 > 0:03:32But looks can be deceptive.
0:03:32 > 0:03:34Even though she's not necessarily using it,
0:03:34 > 0:03:38for her it's a comfort having something in her room
0:03:38 > 0:03:40that she can harm herself with.
0:03:40 > 0:03:44Every patient is discussed in detail during weekly staff meetings.
0:03:44 > 0:03:46Beth's psychiatrist, Dr Achoo,
0:03:46 > 0:03:50thinks that even though she's laughing and joking on the ward,
0:03:50 > 0:03:52she could still be a risk to herself.
0:03:52 > 0:03:54It's very uncommon
0:03:54 > 0:03:59but it's something that you see more in adolescent people.
0:03:59 > 0:04:03Especially adolescents who end up committing suicide.
0:04:03 > 0:04:08She's gone home last weekend and also self-harmed.
0:04:08 > 0:04:12She has the opportunity of doing something a lot more worrying.
0:04:16 > 0:04:19Beth isn't alone in self-harming.
0:04:19 > 0:04:21Many patients on the ward do it
0:04:21 > 0:04:24and staff have to confiscate anything they could use.
0:04:24 > 0:04:26Broken bits of scissors...
0:04:27 > 0:04:29..tip of a spoon,
0:04:29 > 0:04:32make-up bottles made of glass, ligature risks.
0:04:35 > 0:04:37The evidence of it can be found most mornings,
0:04:37 > 0:04:40thrown out of the patients' bedroom windows.
0:04:41 > 0:04:44We need someone to come round and clear this up, don't we?
0:04:44 > 0:04:47- Get facilities to come out and clear this up.- Tissue with blood on.
0:04:47 > 0:04:49Yeah. Right.
0:04:52 > 0:04:54- It's just ridiculous, isn't it? - Yeah, it is.
0:04:54 > 0:04:56Look at the state of it.
0:04:58 > 0:05:01They think I've got something that could harm myself
0:05:01 > 0:05:02or others in there.
0:05:03 > 0:05:06Today it's Beth's turn to have her room searched.
0:05:06 > 0:05:10It's something that staff nurse Pete Crofts has done many times.
0:05:11 > 0:05:14It could be literally anything.
0:05:15 > 0:05:19It's essentially going to be something that could be secreted somewhere.
0:05:19 > 0:05:21I mean, it's not going to be a 17-inch saw back,
0:05:21 > 0:05:23Rambo survival knife.
0:05:23 > 0:05:25It could literally be anything.
0:05:26 > 0:05:29Don't think you're getting me folding your clothes up.
0:05:29 > 0:05:31Hey, yeah. Fold my clothes back up for me!
0:05:31 > 0:05:33I don't do that.
0:05:35 > 0:05:38- Nothing there, Pete. - A little fruitless.
0:05:39 > 0:05:42- Are you happy we left your room in a fit state?- No.
0:05:42 > 0:05:46Well, come in and have a look and make sure we've not stolen anything.
0:05:56 > 0:05:58DISTANT SINGING
0:06:00 > 0:06:03# Why, why did I ever let you go?
0:06:03 > 0:06:06# Mamma mia
0:06:06 > 0:06:07# Here I go again... #
0:06:09 > 0:06:11LAUGHTER
0:06:18 > 0:06:20BELL RINGS
0:06:20 > 0:06:24The unit takes boys and girls aged 13 to 17.
0:06:24 > 0:06:26All of them are considered a danger to themselves
0:06:26 > 0:06:30and some of them have been sectioned under the Mental Health Act
0:06:30 > 0:06:32which means they are being held against their will.
0:06:35 > 0:06:38Like 16-year-old Gill, who has tried to commit suicide.
0:06:39 > 0:06:42There was quite a few problems going on at home.
0:06:42 > 0:06:45I weren't getting along well with my family,
0:06:45 > 0:06:48especially, like, my mum and my dad and we was constantly arguing
0:06:48 > 0:06:51so I was always running away from home,
0:06:51 > 0:06:55I was staying out late so I didn't have to spend so much time at home
0:06:55 > 0:06:59and mine and my mum's relationship just hit rock bottom...
0:07:00 > 0:07:02..and just feel apart.
0:07:05 > 0:07:08While being treated for depression,
0:07:08 > 0:07:10Gill had a reputation for being very volatile.
0:07:10 > 0:07:14One minute she was really pleasant to be around
0:07:14 > 0:07:16and the next she was kicking off.
0:07:17 > 0:07:19Right. We need to move. Move. Move. Move.
0:07:22 > 0:07:24Gill's assaulted 14 staff.
0:07:24 > 0:07:29She's assaulted me, like, two or three weeks ago. She bit me.
0:07:30 > 0:07:34Yeah, she just got me in this leg, but I'll be all right.
0:07:34 > 0:07:39I've got a severe injury on my finger, I think I've broke it.
0:07:39 > 0:07:43I've, I've got dented pride.
0:07:43 > 0:07:45THEY LAUGH
0:07:48 > 0:07:50Since the day Gill arrived three months ago,
0:07:50 > 0:07:53all her treatment has been geared towards her discharge,
0:07:53 > 0:07:56when she leaves the unit and goes back into the world.
0:07:58 > 0:08:01The doctors don't think she's ready to live with her mum and dad yet,
0:08:01 > 0:08:03so a room at a care home has been found.
0:08:03 > 0:08:06She leaves today.
0:08:06 > 0:08:08I want to leave because I want to get on with my life,
0:08:08 > 0:08:11but I don't know what's going to happen when I get out.
0:08:11 > 0:08:14I'm worried about getting out.
0:08:14 > 0:08:15Come here. Bye, Matty!
0:08:15 > 0:08:18See you later. Have a good life.
0:08:18 > 0:08:21Bye! Love you, Shanny fanny!
0:08:21 > 0:08:23Love you, Gilly Billy!
0:08:25 > 0:08:28All the young people want to leave the hospital,
0:08:28 > 0:08:32but after several months here it's also a daunting prospect for them.
0:08:35 > 0:08:39The man in charge of the physiological care of these patients is Dr Andy Rogers.
0:08:39 > 0:08:44We're planning for discharge almost straightaway in some ways.
0:08:44 > 0:08:47Trying to get them back out into the community as quick as possible,
0:08:47 > 0:08:48with increased support where necessary.
0:08:48 > 0:08:52All right. Say bye-bye to the ward for the last time.
0:08:52 > 0:08:55You won't be coming back.
0:08:55 > 0:08:58That's not about coming in ill and going out well.
0:08:58 > 0:09:01It's about young people feeling more in control of their lives,
0:09:01 > 0:09:04irrespective of whether they have a mental health problem.
0:09:04 > 0:09:06They'll still have blips on their road to recovery,
0:09:06 > 0:09:09they will still have periods where they're distressed.
0:09:09 > 0:09:12And actually, part of what we're trying to help them do
0:09:12 > 0:09:14is build resilience to manage distress better.
0:09:16 > 0:09:19Gaining that resilience can take a long time.
0:09:19 > 0:09:22For many young people, the stress of being on the outside world,
0:09:22 > 0:09:25away from the security of the unit, can be overwhelming.
0:09:35 > 0:09:39After only three weeks away, Gill has come back to the unit.
0:09:39 > 0:09:43She'd taken a large overdose and is brought in from A&E.
0:09:45 > 0:09:48So, one-to-one.
0:09:50 > 0:09:52New admission.
0:09:52 > 0:09:56She's put back on the section and taken down to the acute corridor,
0:09:56 > 0:09:58ECA as it's known,
0:09:58 > 0:10:00to be closely observed by a member of staff.
0:10:02 > 0:10:05I just felt like I couldn't live anymore.
0:10:06 > 0:10:09Like I didn't want to. I just wanted to be dead.
0:10:11 > 0:10:14And it was really awful to feel like that...
0:10:15 > 0:10:18..and I just tried to kill myself.
0:10:20 > 0:10:24After a few days, Gill is allowed to mix with other patients on the ward,
0:10:24 > 0:10:26but then things go wrong.
0:10:27 > 0:10:29I don't want to speak with you!
0:10:30 > 0:10:32GET OFF!
0:10:32 > 0:10:35There is an incident outside the dining room.
0:10:35 > 0:10:37GET OFF! ALARM SOUNDS
0:10:37 > 0:10:39SHOUTING
0:10:40 > 0:10:44Gill's had a little bit of a momentary lapse in her mental state
0:10:44 > 0:10:46and she's been restrained.
0:10:51 > 0:10:53GET OFF! NO! GET OFF!
0:10:53 > 0:10:57It takes four people to hold Gill down on the floor.
0:10:57 > 0:10:59SHE SHOUTS
0:10:59 > 0:11:02But she is still refusing to corporate...
0:11:03 > 0:11:06..so she is taken back down the acute corridor.
0:11:12 > 0:11:14Once again she is on one-to-one observation
0:11:14 > 0:11:16and unable to mix with the other patients.
0:11:24 > 0:11:26You need to do it in the corridor, here.
0:11:27 > 0:11:32No, no. Wait, wait, wait, wait. You do one then we'll all do one.
0:11:38 > 0:11:40THEY LAUGH
0:11:41 > 0:11:43Just walk!
0:11:54 > 0:11:56THEY SQUEAL
0:12:03 > 0:12:05This is good!
0:12:05 > 0:12:08The patients are looked after by 30 staff on the unit,
0:12:08 > 0:12:10working 24-hour shift patterns.
0:12:10 > 0:12:12Each shift has two psychiatric nurses
0:12:12 > 0:12:15and up to five support workers.
0:12:16 > 0:12:18At night, a staff member, like Claire,
0:12:18 > 0:12:22sits outside the patients' bedrooms and checks on them every 15 minutes.
0:12:22 > 0:12:24Why? What's up with it?
0:12:24 > 0:12:28It's going to make me heave though, cos I've got....
0:12:29 > 0:12:32- What is it? - Go and look!
0:12:32 > 0:12:35I can't because my stomach is really weak and I'll be sick....
0:12:35 > 0:12:37- I don't want to go now! - Is it blocked?
0:12:43 > 0:12:45Eugh.
0:12:45 > 0:12:47SHE RETCHES
0:12:50 > 0:12:52THEY LAUGH
0:12:52 > 0:12:54What was it? Eugh!
0:12:54 > 0:12:56- See if it's gone down?- No!
0:12:56 > 0:12:58I can't go in there again!
0:13:00 > 0:13:02Night! See you tomorrow.
0:13:02 > 0:13:05- Night.- Night.
0:13:06 > 0:13:09I had someone ask me not long ago about,
0:13:09 > 0:13:12"Do we lock them in the bedrooms? What if they run out at you?"
0:13:12 > 0:13:14You know, we're a hospital,
0:13:14 > 0:13:17we're nurses and it's just young people who...
0:13:17 > 0:13:20are going through adolescence which, I find,
0:13:20 > 0:13:24is a form of madness at times anyway, just being an adolescent,
0:13:24 > 0:13:27with a few extra problems on top.
0:13:27 > 0:13:30So it's not an easy time to be having as a teenager.
0:13:37 > 0:13:41The McGuinness Unit is part of Greater Manchester West NHS Trust.
0:13:41 > 0:13:46A large hospital specialising in secure psychiatric care for many different types of people,
0:13:46 > 0:13:49including drug users and young offenders.
0:13:49 > 0:13:52But on the McGuinness Unit, staff try to make the ward
0:13:52 > 0:13:55feel as normal as possible for the young patients.
0:13:55 > 0:13:58In fact, not like a hospital at all.
0:13:58 > 0:14:03MUSIC: "You're the First, the Last, My Everything" by Barry White
0:14:04 > 0:14:06You'll be fine. Don't know what you're worrying about.
0:14:06 > 0:14:09You want some Vaseline round your head?
0:14:10 > 0:14:14Every couple of weeks, the girls turn the unit into a beauty salon.
0:14:14 > 0:14:17Trying out a new look is 15-year-old Emma
0:14:17 > 0:14:20who's been at the McGuinness Unit for two weeks.
0:14:20 > 0:14:24She's been diagnosed with Obsessive Compulsive Disorder or OCD.
0:14:24 > 0:14:28It has started to make her depressed and even suicidal.
0:14:28 > 0:14:30I had to give up horse riding, which I loved,
0:14:30 > 0:14:32I had to give up drama school, which I loved,
0:14:32 > 0:14:36because I had panic attacks and it's just the constant images
0:14:36 > 0:14:39and the constant, like, hearing that voice constantly telling you
0:14:39 > 0:14:41that if you don't do this, if you don't do that,
0:14:41 > 0:14:43that's going to happen, that's going to happen.
0:14:43 > 0:14:46Seeing them images and, like, the voice will tell you
0:14:46 > 0:14:49you're worthless and stuff too, and it's not just cleaning.
0:14:51 > 0:14:53BELL RINGS
0:14:53 > 0:14:56Since arriving on the ward, Emma, like all new patients,
0:14:56 > 0:14:58has been getting used to the daily schedule.
0:14:58 > 0:15:01The patients are woken at 7:30am.
0:15:01 > 0:15:05If they are well enough, they attend the onsite college
0:15:05 > 0:15:08and when school's out they can watch TV or play pool.
0:15:09 > 0:15:11That's rude!
0:15:11 > 0:15:13Cheese sandwich?
0:15:14 > 0:15:17After dinner at 6pm, it's visiting hours.
0:15:19 > 0:15:22And most nights Emma's mum and dad come to see her.
0:15:23 > 0:15:26My room's a bit of a mess.
0:15:26 > 0:15:29That's all right. How do you do this light?
0:15:29 > 0:15:32Emma is hoping to get some leave to go home in the next few weeks.
0:15:32 > 0:15:36You're not going to, like, stay in my room the whole time
0:15:36 > 0:15:39and like proper, like, be like, "Emma! Emma! You OK, Emma? Emma!"
0:15:39 > 0:15:41Because I'll get really annoyed!
0:15:41 > 0:15:43Is it all right if your friends come round if somebody calls?
0:15:43 > 0:15:45- No.- I don't want my friends to come.
0:15:45 > 0:15:47No. It's just us. Family time, isn't it?
0:15:47 > 0:15:49And are we staying in the house or are we going out?
0:15:49 > 0:15:52It's up to you, go with the flow really.
0:15:52 > 0:15:54I just fancy going home.
0:15:54 > 0:15:57Just seeing the house and, like, eating your fridge.
0:15:57 > 0:16:00I need to stock my fridge up before you come home!
0:16:00 > 0:16:02SHE LAUGHS
0:16:03 > 0:16:06I knew that she needed help and had be safe
0:16:06 > 0:16:11and hopefully she'll get the help and the actual guidance
0:16:11 > 0:16:17and the correct medication for her to get better and move on.
0:16:30 > 0:16:32SNAP!
0:16:34 > 0:16:38For many patients, drugs are a key part of their treatment.
0:16:38 > 0:16:42It can be anything from anti-psychotics to anti-depressants
0:16:42 > 0:16:45to physical medication, analgesia.
0:16:45 > 0:16:48There's a wide variety of things that we have.
0:16:51 > 0:16:53Emma and Beth are both undergoing therapy
0:16:53 > 0:16:57as part of their treatment, and this morning they are starting
0:16:57 > 0:17:00in the group session run by Vicki Ray, the occupational therapist.
0:17:01 > 0:17:06A big part of recovery is about yourselves as individuals...
0:17:06 > 0:17:11In this session, she wants the patients to write down something positive about each other.
0:17:11 > 0:17:14Those positive qualities that you have
0:17:14 > 0:17:17and your personalities are always there,
0:17:17 > 0:17:20but sometimes they can get a little bit hidden
0:17:20 > 0:17:22under some of the other stuff that's going on.
0:17:22 > 0:17:25Beth has written about Kirbi.
0:17:25 > 0:17:28Good listener, kind, warm, sensitive, funny, caring,
0:17:28 > 0:17:30supportive, best friend.
0:17:30 > 0:17:32Kirbi has written about Beth.
0:17:32 > 0:17:35Determined, good listener, nice, friendly, supportive,
0:17:35 > 0:17:38caring, can be silly with me and funny.
0:17:38 > 0:17:40THEY LAUGH
0:17:40 > 0:17:43But Emma has insisted nobody writes anything about her.
0:17:45 > 0:17:47Emma, I appreciated you struggled a little bit.
0:17:47 > 0:17:52Is there anything you want to share or add?
0:17:52 > 0:17:54No? OK.
0:17:54 > 0:17:56- Thanks a lot, everyone. - Thank you, guys.
0:17:56 > 0:18:01It does expose them and it does, I imagine, make them feel quite vulnerable,
0:18:01 > 0:18:03to actually look at themselves.
0:18:03 > 0:18:05Cos that's what we're asking them to do,
0:18:05 > 0:18:07is look at yourself as an individual.
0:18:07 > 0:18:11So I'm not necessarily surprised that Emma struggled.
0:18:11 > 0:18:14I'm scared that they'll either not put anything
0:18:14 > 0:18:17or put something that's not... that I don't want to hear.
0:18:28 > 0:18:30Most of the young people on the ward
0:18:30 > 0:18:33are aware of negative stereotypes attached to mental illness.
0:18:35 > 0:18:38Being able to laugh at themselves often helps with their recovery.
0:18:38 > 0:18:40I want to make an announcement.
0:18:40 > 0:18:44I'm not normal! I'm weird and I love it!
0:18:44 > 0:18:47And it also helps to talk about things together.
0:18:47 > 0:18:50People are like, "Ah! I'm depressed today."
0:18:50 > 0:18:52Trying to get attention.
0:18:52 > 0:18:55And you don't get depressed for a day, it's not how it works, like.
0:18:55 > 0:18:58It's the same with OCD, people are always like,
0:18:58 > 0:19:00"I like things clean, I've got OCD."
0:19:00 > 0:19:04But OCD is where you get a thought that you think,
0:19:04 > 0:19:07like, a bad thought in your head that you don't want.
0:19:07 > 0:19:11Then you think that you have to perform an action or compulsion
0:19:11 > 0:19:15in order to stop the bad thought from happening, if that makes sense?
0:19:15 > 0:19:20- People just don't understand it cos they can't actually physically see there's something wrong.- Yeah.
0:19:20 > 0:19:24They think that everyone who has mental health comes from a bad home,
0:19:24 > 0:19:29but I come from a really good home and I've still ended up like this.
0:19:29 > 0:19:32It's like, if someone had a cold or something you wouldn't go,
0:19:32 > 0:19:34"Why have you got a cold? You've got no reason to have one."
0:19:34 > 0:19:36THEY LAUGH
0:19:43 > 0:19:48It's room search time again, and for someone with Emma's condition, OCD,
0:19:48 > 0:19:50that can be particularly upsetting.
0:19:51 > 0:19:53You've messed it all up!
0:19:53 > 0:19:57Sorry, we need to go through your things, Emma, unfortunately.
0:20:00 > 0:20:02The staff are not putting things back as Emma had them.
0:20:08 > 0:20:12The search ends with the confiscation of a mobile phone,
0:20:12 > 0:20:14but that is the least of Emma's worries.
0:20:15 > 0:20:18I was up till two o'clock in the morning
0:20:18 > 0:20:20straightening some stupid CDs last night,
0:20:20 > 0:20:23for them to just go and mess it up.
0:20:23 > 0:20:25I had to have them straight
0:20:25 > 0:20:28or something's going to happen to my mum and now they've messed it up.
0:20:28 > 0:20:30So something's going to happen to my mum
0:20:30 > 0:20:32and I'm not going to have a mum and it's all their fault.
0:20:39 > 0:20:41Can I ring my mum, please?
0:20:41 > 0:20:43MUSIC: "Wildest Moments" by Jessie Ware
0:20:43 > 0:20:45# From the outside
0:20:45 > 0:20:47# From the outside
0:20:47 > 0:20:50# Everyone must be wondering why we try
0:20:51 > 0:20:54# Why do we try
0:20:56 > 0:20:58# Baby, in our wildest moments
0:20:58 > 0:21:01# We could be the greatest We could be the greatest
0:21:01 > 0:21:04# Baby, in our wildest moments
0:21:05 > 0:21:07# We could be the worst of all... #
0:21:07 > 0:21:09SHE LAUGHS
0:21:09 > 0:21:12So, we're going to listen to Bethany's presentation.
0:21:12 > 0:21:16Now, the criteria that I'm making against are on these tick sheets.
0:21:16 > 0:21:19The patients can't go to their regular schools
0:21:19 > 0:21:21while they are being treated.
0:21:21 > 0:21:23Beth, are you all set up ready to go?
0:21:23 > 0:21:26So that they don't miss out on their education
0:21:26 > 0:21:29they go to the hospital's onsite college, Cloughside.
0:21:29 > 0:21:32I'm doing the presentation on...
0:21:32 > 0:21:34Oh, crap...gymnastics.
0:21:34 > 0:21:37Before she became ill, Beth won prizes in gymnastics
0:21:37 > 0:21:39and dance competitions.
0:21:39 > 0:21:41There's four different apparatus.
0:21:41 > 0:21:44You've got the floor, the beam, the bars and the vault.
0:21:44 > 0:21:47The staff at the unit want to draw on Beth's experience
0:21:47 > 0:21:50as a gymnast and a dancer to help with her recovery.
0:21:52 > 0:21:54How old were you when you started...
0:21:54 > 0:21:59Today, Beth is going back to a dance hall in Prestwich that holds happy memories for her.
0:21:59 > 0:22:02She's with occupational therapist Matt Murphy.
0:22:02 > 0:22:06Only a few months ago, Beth competed in a dance competition
0:22:06 > 0:22:08in the main hall here.
0:22:08 > 0:22:13These sessions are relaxed, but Beth is being closely observed by Matt
0:22:13 > 0:22:16to see how she copes with being outside the hospital.
0:22:16 > 0:22:18It feels weird being back here.
0:22:18 > 0:22:20How does it make you feel? Good weird or bad weird?
0:22:20 > 0:22:23- How do you mean? - Good weird, yeah.
0:22:23 > 0:22:25- Do you want to go in?- Yeah.
0:22:28 > 0:22:30I might put them off! MUSIC PLAYS
0:22:30 > 0:22:34That's the stage and they always have the trophies along.
0:22:34 > 0:22:36So when you're doing your actual dance stuff,
0:22:36 > 0:22:37is that on this dance floor?
0:22:37 > 0:22:39Yeah, it's on the dance floor.
0:22:39 > 0:22:42- Like, the chairs only go up to where the carpet ends.- Right, OK.
0:22:42 > 0:22:45And then there's these steps here that you always...
0:22:45 > 0:22:47Go on, show us what's up here.
0:22:47 > 0:22:51I've actually stood in this exact place before, like, exactly here.
0:22:52 > 0:22:56That's my old outfit, that's when I first started losing weight, though.
0:22:56 > 0:23:00- So how long ago was that one taken? - About three years ago
0:23:00 > 0:23:02- How does that make you feel?- Fat.
0:23:04 > 0:23:07I got rid of three bin bags full of trophies.
0:23:07 > 0:23:12I think it was that one that I won at the British when I did my solo...
0:23:13 > 0:23:17..and I think that one's the second place one.
0:23:17 > 0:23:19- Brilliant.- And that big one...
0:23:19 > 0:23:22I was going to say, what's the big one? That must be a special one.
0:23:22 > 0:23:25That's second at the Europeans, that one.
0:23:26 > 0:23:29- Does it make you feel a bit sad... - It makes me feel a bit sad.
0:23:29 > 0:23:31- Bit emotional?- Yeah.
0:23:31 > 0:23:35But that's the thing, you know, you can start up your dancing
0:23:35 > 0:23:37and everything like that again, can't you?
0:23:37 > 0:23:41Get yourself right, move on from the McGuinness Unit, yeah?
0:23:41 > 0:23:43And get back out there.
0:23:59 > 0:24:01Gill is the most volatile patient on the ward,
0:24:01 > 0:24:04but recently she's been quite stable.
0:24:05 > 0:24:08I used to be a really happy child when I was a lot younger
0:24:08 > 0:24:11and I just want to go back to being that happy child again,
0:24:11 > 0:24:15rather than being all sad all the time and distant from my family.
0:24:20 > 0:24:23Because she has been quite calm, Gill has been allowed
0:24:23 > 0:24:26out of the acute corridor and can take part in group activities.
0:24:28 > 0:24:31- Do you want me to get yours? - That was skill.
0:24:33 > 0:24:35I put ham, chicken, pepperoni, more cheese.
0:24:38 > 0:24:41But Gill's behaviour can change in an instant.
0:24:45 > 0:24:47Gill! Gill! NO!
0:24:49 > 0:24:51I've nearly got it. Help me.
0:24:51 > 0:24:55In a light-hearted moment, she tries to get hold of a doctor's keys.
0:24:55 > 0:24:57Someone get it off him!
0:24:57 > 0:25:01What begins as a bit of fun quickly threatens to get out of hand.
0:25:02 > 0:25:05- GILL! - SHE SCREAMS
0:25:07 > 0:25:09- ALARM SOUNDS - Hey! Stop that now.
0:25:14 > 0:25:16RAISED VOICES
0:25:17 > 0:25:19You come with me. Gill.
0:25:19 > 0:25:21Come up there for me, please.
0:25:21 > 0:25:23Gill. Gill.
0:25:23 > 0:25:27I just feel like I just can't control myself.
0:25:27 > 0:25:31Like, when it's got to that point, I don't listen to the staff,
0:25:31 > 0:25:37to what they're saying, and it just gets a bit carried away
0:25:37 > 0:25:40and everything ends up going downhill from there.
0:25:41 > 0:25:43- Gill, we're going.- No! No!
0:25:43 > 0:25:46Right, if you want to sit on the floor that's fine. OK?
0:25:46 > 0:25:48- No!- Do not kick me!
0:25:48 > 0:25:51- Get off!- Right.
0:25:51 > 0:25:53- SHE SHOUTS - Gill. Last time, OK?
0:25:55 > 0:25:57SHE WHINES
0:26:00 > 0:26:03Once again, Gill finds herself back down the acute corridor
0:26:03 > 0:26:05on one-to-one observation with a member of staff.
0:26:07 > 0:26:09It's becoming an unhealthy cycle.
0:26:09 > 0:26:11I can't really begin to understand
0:26:11 > 0:26:15why she kicks off as often as she does, if I'm perfectly honest.
0:26:15 > 0:26:17I mean, she needs, she needs help, really,
0:26:17 > 0:26:21so, in order to help her progress. And at the moment
0:26:21 > 0:26:24she's just not progressing with the help that we're giving her.
0:26:31 > 0:26:35# Is this the way to Amarillo
0:26:35 > 0:26:39# Every night I'm hugging my pillow
0:26:39 > 0:26:41# Dreaming dreams of Amarillo
0:26:41 > 0:26:44# Where sweet Maria waits for me... #
0:26:44 > 0:26:47In the lounge, the patients are in high spirits.
0:26:47 > 0:26:50Unlike Gill, these young people aren't sectioned,
0:26:50 > 0:26:52so they can technically discharge themselves.
0:26:52 > 0:26:55They don't need to be observed so closely.
0:26:58 > 0:27:01They say you're staying here for a day.
0:27:01 > 0:27:03It turns out to be a month and we're still here!
0:27:03 > 0:27:06- One month! - THEY LAUGH
0:27:07 > 0:27:08But while on the unit,
0:27:08 > 0:27:11Beth's already unhealthy relationship with food
0:27:11 > 0:27:13is becoming more pronounced.
0:27:14 > 0:27:18She's started a diary documenting her attempts to not eat.
0:27:18 > 0:27:22I've put, like, today I've gone 100 hours with no food or drink.
0:27:22 > 0:27:25It makes me feel like the pain of, like,
0:27:25 > 0:27:28the hunger pains just make you feel happy.
0:27:28 > 0:27:30It sounds deluded that, doesn't it?
0:27:32 > 0:27:35No, but sometimes purging's not enough,
0:27:35 > 0:27:37making yourself sick isn't enough
0:27:37 > 0:27:40cos it only removes about, at the best of times,
0:27:40 > 0:27:42only, like, 50% of the calories that you've ate.
0:27:42 > 0:27:44So then you've got to exercise as well.
0:27:45 > 0:27:49And then it got to 121 hours and then 133 hours.
0:27:50 > 0:27:53Please can I just have some mashed potato and ketchup?
0:27:56 > 0:27:59The staff are becoming increasingly concerned about Beth's refusal to eat.
0:28:01 > 0:28:04She won't even go into the dining room.
0:28:06 > 0:28:10Come in the dining room and just spend ten minutes.
0:28:16 > 0:28:18You can have a piece of fruit.
0:28:20 > 0:28:24Out of the 15 patients on the ward, at any one time,
0:28:24 > 0:28:27there will always be two or three with an eating disorder.
0:28:27 > 0:28:30The unit has a special dietician who helps anorexic
0:28:30 > 0:28:32and bulimic patients fight the disease.
0:28:32 > 0:28:36So, she's tending to miss a lot of meals completely.
0:28:36 > 0:28:40So I was quite concerned about her nutritional intake.
0:28:40 > 0:28:43That, if anything, it seems to have got worse
0:28:43 > 0:28:46compared with when she first came.
0:28:46 > 0:28:49In terms of the eating disorder pathway,
0:28:49 > 0:28:52what difference would it make to her?
0:28:52 > 0:28:54If she is to go down that route?
0:28:54 > 0:28:56She would have the supervision at mealtimes
0:28:56 > 0:29:00and after mealtimes as part of the Rainbow programme.
0:29:00 > 0:29:04Maybe that might be the time to go down that route.
0:29:06 > 0:29:08The time for gentle encouragement is over.
0:29:08 > 0:29:11It's Anne from the McGuinness Unit.
0:29:12 > 0:29:16It's just regarding Bethany's leave. She hasn't been given it....
0:29:16 > 0:29:20Beth won't be getting any home leave until she starts eating.
0:29:20 > 0:29:23Staff nurse Anne rings her mum to let her know.
0:29:23 > 0:29:27We've decided to put her on what we call the Rainbow programme.
0:29:29 > 0:29:32The unit needs to take a harder line on Beth now,
0:29:32 > 0:29:34and Anne and Matt must break the news to her.
0:29:37 > 0:29:40- Just listen to Anne, OK? - Oh, why?
0:29:40 > 0:29:43Just listen to Anne. If you have any questions we can discuss it.
0:29:43 > 0:29:45- My leave, have I got it? - The overnight is no.
0:29:47 > 0:29:49Purely because you're not eating.
0:29:50 > 0:29:52And I know you're having the odd ad hoc
0:29:52 > 0:29:55because I've phoned your mum up and told your mum
0:29:55 > 0:29:58and she's said about what you've had, you know,
0:29:58 > 0:30:01whenever it were last time you went out, yeah?
0:30:01 > 0:30:04- But unfortunately it's not enough to sustain.- It is.
0:30:04 > 0:30:06No, it isn't.
0:30:06 > 0:30:09You need to give us some of that control now.
0:30:09 > 0:30:12It means you'll have somebody with you at mealtimes one-to-one.
0:30:12 > 0:30:14Oh, no. Please.
0:30:15 > 0:30:17You need to let us help you.
0:30:19 > 0:30:22- There's nothing wrong. - There's nothing wrong?
0:30:22 > 0:30:24- What did you have for your dinner? - Nothing.
0:30:24 > 0:30:27- What did you have for breakfast? - Nothing
0:30:27 > 0:30:31You won't let us weigh you. That will be changing.
0:30:32 > 0:30:36Why? What's your biggest fear?
0:30:38 > 0:30:41That I'll have put on weight since I've been in here anyway.
0:30:43 > 0:30:46- Because I know I have. - How do you know?
0:30:46 > 0:30:48- I can just tell.- Why?
0:30:50 > 0:30:53Somebody will actually...
0:30:54 > 0:30:56..pick your meal for you.
0:30:56 > 0:30:59No-one else is putting it in.
0:30:59 > 0:31:02I have to pick it up and put it in my mouth and I can say "no" to that.
0:31:02 > 0:31:05- Yeah, but if we're telling you to do it...- I can still say no.
0:31:17 > 0:31:19She's still in denial.
0:31:19 > 0:31:21She's not ready to change,
0:31:21 > 0:31:25not ready to accept that she has got something wrong with her.
0:31:25 > 0:31:27I think deep down she does know she's got a problem
0:31:27 > 0:31:30because she's not willing to get on the scales.
0:31:30 > 0:31:32You know, that's where her honest answer will lie.
0:31:32 > 0:31:35She'll be a challenge, they all are.
0:31:35 > 0:31:38Because they're in control.
0:31:38 > 0:31:41But as you've just heard with Beth, she's not in control.
0:31:42 > 0:31:45I'm mashing it up a little bit, so you can get plenty of juice,
0:31:45 > 0:31:48there's not as much juice as there usually is.
0:31:48 > 0:31:52The Rainbow programme offers a set meal system.
0:31:52 > 0:31:55Now, if the young person is really struggling with solid food
0:31:55 > 0:31:58they can always fall back on a supplement drink.
0:31:58 > 0:32:01A very high calorific drink, so you might have
0:32:01 > 0:32:04150 or 180mls of this supplement,
0:32:04 > 0:32:08which basically substitutes a full meal.
0:32:09 > 0:32:11But the Rainbow plan will only work
0:32:11 > 0:32:14if Matt can actually persuade Beth to enter the dining room.
0:32:16 > 0:32:19No, no. Matt, just go away.
0:32:19 > 0:32:22Right, we need to at least go in the dining room
0:32:22 > 0:32:24- and try and make a start, OK?- No.
0:32:25 > 0:32:29Think, Beth. This could be the start of you turning your life around.
0:32:29 > 0:32:33Otherwise you're just going to go down and down and down
0:32:33 > 0:32:36and it's going to more difficult for you to come up.
0:32:42 > 0:32:45I can't. I can't.
0:32:46 > 0:32:48If she carries on refusing to eat,
0:32:48 > 0:32:52the next stage could be to section Beth under the Mental Health Act.
0:33:11 > 0:33:15Emma's now been at the unit for four weeks, being treated for OCD.
0:33:15 > 0:33:18Last night, she had an anxiety attack.
0:33:19 > 0:33:21How come you ripped up all your college work?
0:33:21 > 0:33:24It's not as if I'm even going to get into college.
0:33:24 > 0:33:27- When's your review?- Today.
0:33:27 > 0:33:28So you'll know today.
0:33:28 > 0:33:33I don't know, like, if they'll let me, though, because of last night.
0:33:35 > 0:33:37Emma didn't just trash her room.
0:33:37 > 0:33:41She was found by another patient with shoelaces around her neck.
0:33:41 > 0:33:43It was just horrible.
0:33:43 > 0:33:45I just want to go back to school.
0:33:47 > 0:33:50I think she basically wants to remain here,
0:33:50 > 0:33:54however, go from the unit to go to her own school.
0:33:54 > 0:33:58We've tried to say to her that's not really something
0:33:58 > 0:34:03that can happen, but she's still requesting to do the same thing.
0:34:03 > 0:34:07After the meeting, it's up to staff nurse Pete
0:34:07 > 0:34:08to tell Emma what has been decided.
0:34:10 > 0:34:15You asked for school leave. Right, unfortunately that's not happened.
0:34:15 > 0:34:17I really wanted school leave.
0:34:17 > 0:34:19I know, but it's the decision of the team
0:34:19 > 0:34:23that that's just not appropriate at this moment in time. OK?
0:34:24 > 0:34:26- OK.- OK.
0:34:31 > 0:34:36# Don't worry about a thing
0:34:38 > 0:34:42# Cos every little thing is gonna be all right... #
0:34:46 > 0:34:48Thanks, Kirbi.
0:34:49 > 0:34:51It's quarter to ten on the ward
0:34:51 > 0:34:54and that means all the patients must be in bed in the next 15 minutes.
0:34:54 > 0:34:56Emma is feeling agitated.
0:34:59 > 0:35:02Now my thoughts are racing and I can't catch up with them
0:35:02 > 0:35:04and they're all there and that happens all day.
0:35:04 > 0:35:06And then I can't get to sleep cos all my thoughts are racing,
0:35:06 > 0:35:09racing and I don't have time to catch up with them.
0:35:09 > 0:35:11And they're all just horrible.
0:35:11 > 0:35:14SHE STAMPS HER FOOT
0:35:17 > 0:35:19I don't even know what causes it.
0:35:19 > 0:35:21I just want to go back to my school.
0:35:24 > 0:35:29I want to be like whatever other normal teenagers my age is doing.
0:35:29 > 0:35:31SHE TAPS HER FEET
0:35:40 > 0:35:42It just really annoys me.
0:36:06 > 0:36:09Beth has been on the Rainbow programme for a week.
0:36:09 > 0:36:12She is still being supervised every mealtime.
0:36:12 > 0:36:15I think my room door's already open, Mel.
0:36:16 > 0:36:18Yeah, it's open.
0:36:18 > 0:36:20But she's rebelling against the staff.
0:36:24 > 0:36:27- What's that there, Beth? - Diet Coke.
0:36:29 > 0:36:32I've been banned from having it.
0:36:33 > 0:36:35I use it as a meal supplement so I get filled up
0:36:35 > 0:36:37and I don't have to eat, basically,
0:36:37 > 0:36:39cos I'm too full.
0:36:55 > 0:36:57Exercise is another form of rebellion.
0:36:59 > 0:37:02She has been walking up and down the corridor
0:37:02 > 0:37:03for half an hour to burn calories.
0:37:07 > 0:37:10Still reporting that she wants to die and saying it will be easier
0:37:10 > 0:37:13that way, then no-one has to worry.
0:37:13 > 0:37:15The review team are increasingly concerned
0:37:15 > 0:37:17about Beth's lack of progress.
0:37:17 > 0:37:20She's not complying with the Rainbow plan,
0:37:20 > 0:37:24limited intake, trying to hide food in tissues.
0:37:24 > 0:37:27Continues to refuse to have blood tests
0:37:27 > 0:37:29and continues to refuse to be weighed.
0:37:31 > 0:37:35- Dr Achoo?- She said that she would never, ever eat again.
0:37:35 > 0:37:37We might have to request,
0:37:37 > 0:37:41I think we will just request for a Mental Health Act assessment.
0:37:41 > 0:37:45A mental health assessment could lead to Beth being sectioned.
0:37:45 > 0:37:49They keep warning me with sectioning, but it won't happen.
0:37:49 > 0:37:51They're just trying to scare me.
0:37:54 > 0:37:56Under section two and three,
0:37:56 > 0:37:58young people are detained against their will.
0:37:58 > 0:38:01That's the reason why it's a legal process.
0:38:01 > 0:38:05Under a section three, treatment is compulsory.
0:38:05 > 0:38:09They can be given medication, or whatever that treatment may be,
0:38:09 > 0:38:11against their will.
0:38:22 > 0:38:24SHE WHINES
0:38:24 > 0:38:26I can't sit down cos I feel like
0:38:26 > 0:38:28if I sit down I'll have to get back up again.
0:38:28 > 0:38:31You're only going to make your legs feel worse,
0:38:31 > 0:38:33pacing around like that, aren't you?
0:38:33 > 0:38:37Gill is on a section because she's a danger to herself.
0:38:37 > 0:38:39You're only going to make your legs feel worse,
0:38:39 > 0:38:41pacing around like that, aren't you?
0:38:41 > 0:38:44- Right. - SHE GIGGLES
0:38:44 > 0:38:47Even though the McGuinness is not high security, doors are kept locked
0:38:47 > 0:38:51and sectioned patients like Gill are not free to move around at will.
0:38:52 > 0:38:54ALARM SOUNDS
0:38:59 > 0:39:01But two patients have escaped.
0:39:06 > 0:39:08One of them is Gill.
0:39:08 > 0:39:10You need to turn it off now.
0:39:10 > 0:39:12Is it Gill?
0:39:12 > 0:39:14Staff give chase.
0:39:14 > 0:39:17I think they've just kicked the door open at the side.
0:39:17 > 0:39:19The police have been called immediately.
0:39:19 > 0:39:20There's staff down there.
0:39:20 > 0:39:22There's not very many staff left on the ward
0:39:22 > 0:39:25- so I'm going to hang around here. - Right.
0:39:25 > 0:39:28Two young people have actually kicked their way through the door
0:39:28 > 0:39:31and jumped over this, just a fence, here.
0:39:31 > 0:39:35You can see it's just kind of come out, basically.
0:39:35 > 0:39:39Umm...that bit there sits in there.
0:39:42 > 0:39:48One of the escaped girls has been found hiding under a bush not far from the hospital.
0:39:48 > 0:39:50But Gill is still missing.
0:39:50 > 0:39:53It's been over two hours since she ran away.
0:39:53 > 0:39:56The police are now joining in the search.
0:39:56 > 0:39:59After three hours, there is a sighting.
0:39:59 > 0:40:02I'm just letting you know that one of our members of staff
0:40:02 > 0:40:05has seen Gillian on the motorway bridge
0:40:05 > 0:40:07near the roundabout in Prestwich.
0:40:07 > 0:40:08Some of our staff have gone up,
0:40:08 > 0:40:11but obviously I need to make yourselves aware as well.
0:40:13 > 0:40:17Because Gill is on a section, she needs to be found quickly.
0:40:17 > 0:40:20But when staff reach the motorway bridge, she is nowhere to be found.
0:40:30 > 0:40:33Gill has now been missing for over eight hours.
0:40:33 > 0:40:36Staff and patients are getting increasingly worried.
0:40:36 > 0:40:39The last time she was out in the community,
0:40:39 > 0:40:41she took a large overdose.
0:40:41 > 0:40:43I've just had contact from some relatives
0:40:43 > 0:40:48regarding some potential addresses she may be at in the Gorton area,
0:40:48 > 0:40:50so I just wanted to give you those addresses.
0:40:50 > 0:40:54They wouldn't be in here and they wouldn't be on a section of the Mental Health Act
0:40:54 > 0:40:56if there wasn't a great, you know, great risk
0:40:56 > 0:40:59involved with that young person.
0:41:01 > 0:41:05An hour later, Pete gets the call everyone has been waiting for.
0:41:06 > 0:41:09Whereabouts is she in the hospital? Is she in A&E?
0:41:09 > 0:41:12She's on the children's ward.
0:41:12 > 0:41:14Right, bye-bye.
0:41:14 > 0:41:18She's been found either having either attempted to
0:41:18 > 0:41:22or alleged to have taken another overdose.
0:41:28 > 0:41:31As the patients on the ward prepare to go to bed,
0:41:31 > 0:41:32at a hospital in Manchester,
0:41:32 > 0:41:35Gill will be under constant supervision through the night
0:41:35 > 0:41:38to make sure she doesn't abscond again.
0:41:48 > 0:41:50The next morning, Gill is brought back to the unit,
0:41:50 > 0:41:53laughing and smiling.
0:41:53 > 0:41:56Once again, she is taken down to the acute corridor
0:41:56 > 0:41:59to be closely monitored by two members of staff.
0:42:08 > 0:42:10Gill's escape is a rare event,
0:42:10 > 0:42:14but the McGuinness Unit was only ever built as a temporary measure
0:42:14 > 0:42:19and it was never designed to deal with teenagers when they get violent and distressed.
0:42:19 > 0:42:22All round the unit we've got little boards
0:42:22 > 0:42:26and other pieces of wood kind of stuck on the wall.
0:42:26 > 0:42:30If you push against it they move the plaster.
0:42:30 > 0:42:34Where this big piece of wood is, there was, like,
0:42:34 > 0:42:37young people had kicked big holes in the wall.
0:42:37 > 0:42:41Boards up here, little bits there, little bits there.
0:42:41 > 0:42:45We've got a fresh one here which kind of happened yesterday.
0:42:45 > 0:42:48Bit of a typical hiding place, we had to have this put on
0:42:48 > 0:42:51cos they figured out how to get in the laundry cupboard.
0:42:51 > 0:42:53So you'd come in here and there'd be, like,
0:42:53 > 0:42:57young people hiding in the cupboard.
0:42:57 > 0:43:01Looking back, it is actually quite a funny hiding place, but...
0:43:04 > 0:43:07All this should become a thing of the past in a few months,
0:43:07 > 0:43:10when a new purpose-built ward opens just a few metres away.
0:43:18 > 0:43:21- I think that's quite a good one, personally.- Yeah.
0:43:21 > 0:43:23Emma is continuing to improve.
0:43:23 > 0:43:26She has had some day leave in recent weeks,
0:43:26 > 0:43:29but now, for the first time, is going home for a whole weekend.
0:43:29 > 0:43:32I'm scared that if things get too much
0:43:32 > 0:43:35then I'll end up right back where I started.
0:43:38 > 0:43:40I think that's my mum.
0:43:47 > 0:43:50Mum, can we drive the way that goes past my school?
0:43:50 > 0:43:52Cos I want to see my school.
0:43:52 > 0:43:54That sounds really sad, but I do.
0:43:54 > 0:43:56Well, we can see the school later, can't we?
0:44:02 > 0:44:05Arriving home is exciting for Emma,
0:44:05 > 0:44:09although she doesn't want any of her school friends to see her.
0:44:09 > 0:44:11- Has he gone?- No.
0:44:11 > 0:44:14- Do not open this door. - I know, it's OK.
0:44:14 > 0:44:16All right.
0:44:19 > 0:44:22- This is a little weird. - SHE GIGGLES
0:44:24 > 0:44:26- Where are you? Get out! - Shut the door!
0:44:26 > 0:44:29- Stop shouting, you'll draw attention to me.- Draw attention to you?
0:44:29 > 0:44:32Shut the door, then people can't see me, for God's sake!
0:44:32 > 0:44:35Ow! Fucking hell!
0:44:37 > 0:44:38Ah, my head!
0:44:38 > 0:44:41I love you too.
0:44:41 > 0:44:43Don't bite me!
0:44:43 > 0:44:46My dad's stuck a sign on my door that says,
0:44:46 > 0:44:49"Do not disturb. Already disturbed."
0:44:49 > 0:44:53And there's my wall of handprints that I did.
0:44:54 > 0:44:57Emma has been in hospital for five weeks,
0:44:57 > 0:45:01but she is now managing to control her OCD impulses more and more.
0:45:01 > 0:45:05Say I was in the lounge, I'd have to do seven steps across the lounge,
0:45:05 > 0:45:07seven steps down the hall and then seven steps to my bed
0:45:07 > 0:45:11and if I couldn't make it in them seven steps I'd have to start again.
0:45:11 > 0:45:14And then once I was in bed I had to touch one side seven times,
0:45:14 > 0:45:17another side seven times, turn over seven times,
0:45:17 > 0:45:19touch the wall seven times.
0:45:23 > 0:45:25I've seen a difference in you.
0:45:25 > 0:45:28- I know it's not perfect... - There's ups and downs..
0:45:28 > 0:45:30Yeah. And I think, you know,
0:45:30 > 0:45:33when you come home there will be ups and downs all the way, you know.
0:45:33 > 0:45:39But, er...it is difficult, you know, cos tensions can be very high...
0:45:39 > 0:45:41Can I say something, though?
0:45:41 > 0:45:44OCD doesn't, like, define who I am.
0:45:44 > 0:45:47All right, I've got it but...um...
0:45:47 > 0:45:51But I like music, I like playing the guitar,
0:45:51 > 0:45:56I like bands and I like the colour yellow,
0:45:56 > 0:45:59I like chocolate.
0:45:59 > 0:46:01But I don't like all them things cos I've got OCD,
0:46:01 > 0:46:03I like all them things cos I'm Emma,
0:46:03 > 0:46:06and it doesn't define me as a person.
0:46:06 > 0:46:08Just because I'm going through it right now
0:46:08 > 0:46:12and it's a part of me right now, it doesn't define me as a person.
0:46:15 > 0:46:19Emma returned to the unit after a successful home leave
0:46:19 > 0:46:22and that means her discharge may not be far away.
0:46:25 > 0:46:28A girl who's become good friends with Beth is leaving today.
0:46:36 > 0:46:39And when someone leaves it's always an emotional time
0:46:39 > 0:46:41for those that are left behind.
0:46:46 > 0:46:49She's still not complying with the meal plans,
0:46:49 > 0:46:51she still won't have her bloods done,
0:46:51 > 0:46:53she still won't jump on the scales.
0:46:53 > 0:46:55She has been given until Monday
0:46:55 > 0:47:00or they will be seriously considering a section.
0:47:07 > 0:47:10Beth has been in the unit for two months.
0:47:10 > 0:47:12Time is running out for her and she seems aware of it.
0:47:14 > 0:47:17But even so, it takes her several minutes to eat two pieces of carrot.
0:47:21 > 0:47:23I'm not eating any more.
0:47:23 > 0:47:26- Try a bit of the rice.- No.
0:47:26 > 0:47:29Try some of the rice, some of the protein.
0:47:29 > 0:47:32No, I just can't do it. I'm not. I'm not. I'm not.
0:47:32 > 0:47:36- What's to say you can't do it? - I just, no. I can't. I won't.
0:47:37 > 0:47:39Matt won't let her give up.
0:47:39 > 0:47:41If she won't eat her meal,
0:47:41 > 0:47:44he will get the equivalent calories in a fruit drink for her.
0:47:44 > 0:47:48- How many calories are in it? - It doesn't matter how many calories are in it, right?
0:47:48 > 0:47:50I'm not even going to get into that with you.
0:47:50 > 0:47:53It's exactly the same as what that would be.
0:47:54 > 0:47:56I'm going to say you had half the vegetables.
0:47:56 > 0:47:59- I had more than half the vegetables. - No, you had the carrots.
0:47:59 > 0:48:01- I won't argue with you. You had half.- I did eat it.
0:48:01 > 0:48:05- You ate some of it... - But I'm not having, no...
0:48:06 > 0:48:09- Right. I'm going to halve that. 15mls.- I'm not having it at all.
0:48:09 > 0:48:12And if I'm being honest I'm being generous now.
0:48:12 > 0:48:14No, I'm not having it.
0:48:14 > 0:48:17There's been so many young people with eating difficulties, yeah?
0:48:17 > 0:48:20And I now that the first time for them is the hardest.
0:48:20 > 0:48:24But with support of staff and supervision, it is made easier
0:48:24 > 0:48:27and I promise you that, it will get easier.
0:48:35 > 0:48:39The hardest part is taking hold of it...
0:48:39 > 0:48:42- No.- You need to hold it, OK? That's the most difficult part, OK?
0:48:49 > 0:48:51What we've found with young people in the past
0:48:51 > 0:48:53is ignore the negative voice, yeah?
0:48:53 > 0:48:56The one that's saying, "Don't do it."
0:48:56 > 0:48:59And listen right back there, yeah,
0:48:59 > 0:49:03to the little voice of Beth saying, "Go on, do it."
0:49:03 > 0:49:05Because really, you know you need to do it, don't you?
0:49:05 > 0:49:07Yeah, OK?
0:49:13 > 0:49:16Just think of this as you getting back out there.
0:49:16 > 0:49:19Going out, getting up with your dance and your gymnast.
0:49:19 > 0:49:24Think of how happy it will make your parents, yeah?
0:49:28 > 0:49:33Just saying, "Yeah, I am on the meal plan at this moment in time, but I'm cracking on with it.
0:49:33 > 0:49:35"I'm finding it quite difficult, but I'm doing it."
0:49:37 > 0:49:40Come on, take hold of it.
0:49:40 > 0:49:45I'm not going to make a big ordeal about, you know,
0:49:45 > 0:49:47if you drink it all.
0:49:47 > 0:49:51I'm not going to make a big song and dance about it, all right?
0:50:27 > 0:50:30OK. Keep hold of it.
0:50:30 > 0:50:35That, what you've just done there, is the hardest bit, OK?
0:50:35 > 0:50:38- Yeah, take hold of it again. - I'm not doing any more.
0:50:39 > 0:50:42- So is that it?- Yeah.- Hang on!
0:50:44 > 0:50:47One sip took Beth over 20 minutes.
0:50:49 > 0:50:53How much would you say was in a sip? About 5mls?
0:50:53 > 0:50:57- Is that all she had? - It's a start.
0:50:59 > 0:51:01It's like every little piece of you
0:51:01 > 0:51:04in your body is telling you not to eat it.
0:51:04 > 0:51:08"Don't do it, you'll get fat. Don't do it, don't do it,"
0:51:08 > 0:51:11and you've got people actually in reality saying,
0:51:11 > 0:51:15"Eat, eat," and you've just got an argument in your head.
0:51:15 > 0:51:17The way things are going with Beth,
0:51:17 > 0:51:22I'm thinking this girl is going to be with us for quite a while.
0:51:22 > 0:51:27Anorexics do get hungry, but we just learn to ignore it
0:51:27 > 0:51:32and fight it off and then food just becomes the enemy.
0:51:32 > 0:51:34There is little chance
0:51:34 > 0:51:36of Beth getting discharged in the near future.
0:51:36 > 0:51:40But because Emma's home leave has been a success,
0:51:40 > 0:51:43after six weeks, she could be about to leave for good.
0:51:43 > 0:51:47- So in terms of discharge, are we happy...- Yes!
0:51:47 > 0:51:49THEY LAUGH
0:51:52 > 0:51:55Are we happy for Emma to be discharged today?
0:51:55 > 0:51:58- Are you happy to have Emma? - Yes, yes, very much so. Yeah.
0:52:00 > 0:52:02Yeah. Thank you all for coming today.
0:52:02 > 0:52:05- Can I say goodbye to everybody? - Course you can!
0:52:05 > 0:52:09- Here are the contact numbers, in case.- Thanks a lot.
0:52:11 > 0:52:14Obviously, I'm delighted that she's coming home.
0:52:14 > 0:52:17I'm getting all emotional! Sorry!
0:52:19 > 0:52:23I've met some really important people to me.
0:52:23 > 0:52:27And I think it is important, it helps you grow as a person
0:52:27 > 0:52:31and the people here have helped me grow as a person...
0:52:31 > 0:52:35Ah, Lisa! Smell ya soon!
0:52:35 > 0:52:37Smell ya soon!
0:52:37 > 0:52:40We came in here, and for the first two or three days
0:52:40 > 0:52:44when we were driving home we were just crying,
0:52:44 > 0:52:47driving home, weren't we?
0:52:47 > 0:52:52But you get used to it and accept it. And the thing is,
0:52:52 > 0:52:55we knew she had to be in, there was no alternative.
0:52:57 > 0:52:59And it will be tough, you know, when we go home,
0:52:59 > 0:53:03but hopefully we'll be strong enough to get through it.
0:53:04 > 0:53:08Emma will still have sessions with a psychiatrist when she gets home.
0:53:08 > 0:53:11But her life is returning to normal
0:53:11 > 0:53:15and, importantly, she can start back at school.
0:53:15 > 0:53:17It's just a case of loading up, isn't it?
0:53:21 > 0:53:23Patients like Emma arrive at the McGuinness Unit
0:53:23 > 0:53:26at one of their lowest points in their lives.
0:53:27 > 0:53:30But while here, they can also enjoy some good times.
0:53:40 > 0:53:42Gillian!
0:53:43 > 0:53:45I'm going to miss you so much.
0:53:45 > 0:53:47I'm going to miss you loads too.
0:53:50 > 0:53:53As well as the therapy and medication, it's these friendships
0:53:53 > 0:53:56that play a critical role on their road to recovery.
0:53:58 > 0:54:01- Bye!- See you!- Bye!
0:54:05 > 0:54:07Look after yourself!
0:54:07 > 0:54:09- You too! Mwah!- Mwah!
0:54:12 > 0:54:14Good luck at school tomorrow!
0:54:20 > 0:54:23- I hate saying bye to people. - Why's that?
0:54:23 > 0:54:26Knowing they can actually leave now and you're stuck in here.
0:54:26 > 0:54:28It's not nice.
0:54:36 > 0:54:40When people leave, it can be very unsettling for those left behind.
0:54:44 > 0:54:47I want to go home, but I can't
0:54:47 > 0:54:51and then there's all these people leaving and I just got upset.
0:54:51 > 0:54:54In the days after Emma's discharge,
0:54:54 > 0:54:58Gill takes solace in an old but unhealthy coping mechanism.
0:55:00 > 0:55:01I had to go hospital
0:55:01 > 0:55:04because I had the end of a pen stuck in my arm.
0:55:04 > 0:55:06You know the metal bit?
0:55:06 > 0:55:10I deliberately put it in so I had to go hospital and get it removed.
0:55:14 > 0:55:16Beth continues to refuse to eat
0:55:16 > 0:55:19and is summoned to a meeting behind closed doors.
0:55:23 > 0:55:25She never believed it would happen to her,
0:55:25 > 0:55:28but now she's been sectioned under the Mental Health Act.
0:55:28 > 0:55:32Now they can physically pick me up
0:55:32 > 0:55:34and restrain me and put me on the scales.
0:55:34 > 0:55:39They can do whatever they want and whatever they can to get it.
0:55:39 > 0:55:43Cos apparently it's in my best interests and cos I'm too ill,
0:55:43 > 0:55:47I can't see what's right for me, or something like that.
0:55:49 > 0:55:51Which sucks.
0:55:57 > 0:55:59Emma has returned to school and is doing well,
0:55:59 > 0:56:03but for Gill and Beth, their struggles go on.
0:56:03 > 0:56:06My week's been shit,
0:56:06 > 0:56:10my leave has been cancelled and I'm very sad.
0:56:10 > 0:56:14I need my mum now more than ever, really.
0:56:14 > 0:56:15THEY SQUEAL
0:56:15 > 0:56:18And there are new patients on the ward.
0:56:18 > 0:56:21There's Seven, and she's the little girl I see.
0:56:21 > 0:56:23They're, like, my best friends.
0:56:23 > 0:56:25- A baby puppy! - A what?- A baby puppy!
0:56:25 > 0:56:27- Oh, really? Where?- There.
0:56:29 > 0:56:31MUSIC: "Shelter" by The XX
0:56:31 > 0:56:34# I find shelter in this way
0:56:36 > 0:56:41# Undercover hide away
0:56:43 > 0:56:48# Can you hear when I say
0:56:49 > 0:56:54# I have never felt this way... #
0:56:54 > 0:56:57Subtitles by Red Bee Media Ltd