Episode 1 Don't Call Me Crazy

This is the McGuinness Unit in Manchester,

one of the largest teenage mental health units in the UK.

ALARM SOUNDS

It's the place of last resort for teenagers with eating disorders

-or psychosis...

-SHOUTING

..who self-harm or have OCD.

An in-patient facility that takes in the suicidal and disturbed

to try and turn their lives around.

For a year, we were given unparalleled access to film the patients...

-NO!

-Just calm down.

..and the staff.

In the last five minutes, I've had a cup of water poured over my head.

-In the good times...

-SHE BURPS

..and the bad.

SHE WEEPS

This is the reality for some of the half a million young people

in Britain who have to deal with mental illness.

SHE SQUEALS

3,500 young people pass through units like this each year.

This is the chance for some of them to tell us what it's really like

on the inside... and how others see them on the outside.

My brain's a bit...

SHE LAUGHS

There is a new patient at the McGuinness Psychiatric Unit

at Prestwich in Manchester.

17-year-old Beth has an eating disorder,

is depressed and also feeling suicidal.

When I look at that I just see all the fat on my arms,

all the fat on my hips.

All the fat on my arms there.

I like to see the bone,

the collar bone and the hip bones

and the ribs and the thigh gap and, do you know?

But since we don't have a full-length mirror here it's pretty hard to see all that.

My friend put together loads of pictures,

that one's obviously been taken at school,

must have been year 11.

I've had, like, an eating disorder since year nine.

One time I was at my auntie's house down south

and I just went to the toilet and I was sick

and then I went downstairs and I don't know why I made myself sick, I just made myself sick.

I went downstairs to my mum and she offered me a chocolate

and it's like, something had got in my head saying,

"No, you're not allowed that. Don't eat that."

And ever since then it's just been there.

Like, it's there all the time.

Calls you names and calls you fat and stuff.

It sucks.

ALARM SOUNDS

Beth is different to many of the patients on the ward.

Most appear depressed and withdrawn.

Beth seems happy and extrovert.

But looks can be deceptive.

Even though she's not necessarily using it,

for her it's a comfort having something in her room

that she can harm herself with.

Every patient is discussed in detail during weekly staff meetings.

Beth's psychiatrist, Dr Achoo,

thinks that even though she's laughing and joking on the ward,

she could still be a risk to herself.

It's very uncommon

but it's something that you see more in adolescent people.

Especially adolescents who end up committing suicide.

She's gone home last weekend and also self-harmed.

She has the opportunity of doing something a lot more worrying.

Beth isn't alone in self-harming.

Many patients on the ward do it

and staff have to confiscate anything they could use.

Broken bits of scissors...

..tip of a spoon,

make-up bottles made of glass, ligature risks.

The evidence of it can be found most mornings,

thrown out of the patients' bedroom windows.

We need someone to come round and clear this up, don't we?

-Get facilities to come out and clear this up.

-Tissue with blood on.

Yeah. Right.

-It's just ridiculous, isn't it?

-Yeah, it is.

Look at the state of it.

They think I've got something that could harm myself

or others in there.

Today it's Beth's turn to have her room searched.

It's something that staff nurse Pete Crofts has done many times.

It could be literally anything.

It's essentially going to be something that could be secreted somewhere.

I mean, it's not going to be a 17-inch saw back,

Rambo survival knife.

It could literally be anything.

Don't think you're getting me folding your clothes up.

Hey, yeah. Fold my clothes back up for me!

I don't do that.

-Nothing there, Pete.

-A little fruitless.

-Are you happy we left your room in a fit state?

-No.

Well, come in and have a look and make sure we've not stolen anything.

DISTANT SINGING

# Why, why did I ever let you go?

# Mamma mia

# Here I go again... #

LAUGHTER

BELL RINGS

The unit takes boys and girls aged 13 to 17.

All of them are considered a danger to themselves

and some of them have been sectioned under the Mental Health Act

which means they are being held against their will.

Like 16-year-old Gill, who has tried to commit suicide.

There was quite a few problems going on at home.

I weren't getting along well with my family,

especially, like, my mum and my dad and we was constantly arguing

so I was always running away from home,

I was staying out late so I didn't have to spend so much time at home

and mine and my mum's relationship just hit rock bottom...

..and just feel apart.

While being treated for depression,

Gill had a reputation for being very volatile.

One minute she was really pleasant to be around

and the next she was kicking off.

Right. We need to move. Move. Move. Move.

Gill's assaulted 14 staff.

She's assaulted me, like, two or three weeks ago. She bit me.

Yeah, she just got me in this leg, but I'll be all right.

I've got a severe injury on my finger, I think I've broke it.

I've, I've got dented pride.

THEY LAUGH

Since the day Gill arrived three months ago,

all her treatment has been geared towards her discharge,

when she leaves the unit and goes back into the world.

The doctors don't think she's ready to live with her mum and dad yet,

so a room at a care home has been found.

She leaves today.

I want to leave because I want to get on with my life,

but I don't know what's going to happen when I get out.

I'm worried about getting out.

Come here. Bye, Matty!

See you later. Have a good life.

Bye! Love you, Shanny fanny!

Love you, Gilly Billy!

All the young people want to leave the hospital,

but after several months here it's also a daunting prospect for them.

The man in charge of the physiological care of these patients is Dr Andy Rogers.

We're planning for discharge almost straightaway in some ways.

Trying to get them back out into the community as quick as possible,

with increased support where necessary.

All right. Say bye-bye to the ward for the last time.

You won't be coming back.

That's not about coming in ill and going out well.

It's about young people feeling more in control of their lives,

irrespective of whether they have a mental health problem.

They'll still have blips on their road to recovery,

they will still have periods where they're distressed.

And actually, part of what we're trying to help them do

is build resilience to manage distress better.

Gaining that resilience can take a long time.

For many young people, the stress of being on the outside world,

away from the security of the unit, can be overwhelming.

After only three weeks away, Gill has come back to the unit.

She'd taken a large overdose and is brought in from A&E.

So, one-to-one.

New admission.

She's put back on the section and taken down to the acute corridor,

ECA as it's known,

to be closely observed by a member of staff.

I just felt like I couldn't live anymore.

Like I didn't want to. I just wanted to be dead.

And it was really awful to feel like that...

..and I just tried to kill myself.

After a few days, Gill is allowed to mix with other patients on the ward,

but then things go wrong.

I don't want to speak with you!

GET OFF!

There is an incident outside the dining room.

GET OFF! ALARM SOUNDS

SHOUTING

Gill's had a little bit of a momentary lapse in her mental state

and she's been restrained.

GET OFF! NO! GET OFF!

It takes four people to hold Gill down on the floor.

SHE SHOUTS

But she is still refusing to corporate...

..so she is taken back down the acute corridor.

Once again she is on one-to-one observation

and unable to mix with the other patients.

You need to do it in the corridor, here.

No, no. Wait, wait, wait, wait. You do one then we'll all do one.

THEY LAUGH

Just walk!

THEY SQUEAL

This is good!

The patients are looked after by 30 staff on the unit,

working 24-hour shift patterns.

Each shift has two psychiatric nurses

and up to five support workers.

At night, a staff member, like Claire,

sits outside the patients' bedrooms and checks on them every 15 minutes.

Why? What's up with it?

It's going to make me heave though, cos I've got....

-What is it?

-Go and look!

I can't because my stomach is really weak and I'll be sick....

-I don't want to go now!

-Is it blocked?

Eugh.

SHE RETCHES

THEY LAUGH

What was it? Eugh!

-See if it's gone down?

-No!

I can't go in there again!

Night! See you tomorrow.

-Night.

-Night.

I had someone ask me not long ago about,

"Do we lock them in the bedrooms? What if they run out at you?"

You know, we're a hospital,

we're nurses and it's just young people who...

are going through adolescence which, I find,

is a form of madness at times anyway, just being an adolescent,

with a few extra problems on top.

So it's not an easy time to be having as a teenager.

The McGuinness Unit is part of Greater Manchester West NHS Trust.

A large hospital specialising in secure psychiatric care for many different types of people,

including drug users and young offenders.

But on the McGuinness Unit, staff try to make the ward

feel as normal as possible for the young patients.

In fact, not like a hospital at all.

MUSIC: "You're the First, the Last, My Everything" by Barry White

You'll be fine. Don't know what you're worrying about.

You want some Vaseline round your head?

Every couple of weeks, the girls turn the unit into a beauty salon.

Trying out a new look is 15-year-old Emma

who's been at the McGuinness Unit for two weeks.

She's been diagnosed with Obsessive Compulsive Disorder or OCD.

It has started to make her depressed and even suicidal.

I had to give up horse riding, which I loved,

I had to give up drama school, which I loved,

because I had panic attacks and it's just the constant images

and the constant, like, hearing that voice constantly telling you

that if you don't do this, if you don't do that,

that's going to happen, that's going to happen.

Seeing them images and, like, the voice will tell you

you're worthless and stuff too, and it's not just cleaning.

BELL RINGS

Since arriving on the ward, Emma, like all new patients,

has been getting used to the daily schedule.

The patients are woken at 7:30am.

If they are well enough, they attend the onsite college

and when school's out they can watch TV or play pool.

That's rude!

Cheese sandwich?

After dinner at 6pm, it's visiting hours.

And most nights Emma's mum and dad come to see her.

My room's a bit of a mess.

That's all right. How do you do this light?

Emma is hoping to get some leave to go home in the next few weeks.

You're not going to, like, stay in my room the whole time

and like proper, like, be like, "Emma! Emma! You OK, Emma? Emma!"

Because I'll get really annoyed!

Is it all right if your friends come round if somebody calls?

-No.

-I don't want my friends to come.

No. It's just us. Family time, isn't it?

And are we staying in the house or are we going out?

It's up to you, go with the flow really.

I just fancy going home.

Just seeing the house and, like, eating your fridge.

I need to stock my fridge up before you come home!

SHE LAUGHS

I knew that she needed help and had be safe

and hopefully she'll get the help and the actual guidance

and the correct medication for her to get better and move on.

SNAP!

For many patients, drugs are a key part of their treatment.

It can be anything from anti-psychotics to anti-depressants

to physical medication, analgesia.

There's a wide variety of things that we have.

Emma and Beth are both undergoing therapy

as part of their treatment, and this morning they are starting

in the group session run by Vicki Ray, the occupational therapist.

A big part of recovery is about yourselves as individuals...

In this session, she wants the patients to write down something positive about each other.

Those positive qualities that you have

and your personalities are always there,

but sometimes they can get a little bit hidden

under some of the other stuff that's going on.

Beth has written about Kirbi.

Good listener, kind, warm, sensitive, funny, caring,

supportive, best friend.

Kirbi has written about Beth.

Determined, good listener, nice, friendly, supportive,

caring, can be silly with me and funny.

THEY LAUGH

But Emma has insisted nobody writes anything about her.

Emma, I appreciated you struggled a little bit.

Is there anything you want to share or add?

No? OK.

-Thanks a lot, everyone.

-Thank you, guys.

It does expose them and it does, I imagine, make them feel quite vulnerable,

to actually look at themselves.

Cos that's what we're asking them to do,

is look at yourself as an individual.

So I'm not necessarily surprised that Emma struggled.

I'm scared that they'll either not put anything

or put something that's not... that I don't want to hear.

Most of the young people on the ward

are aware of negative stereotypes attached to mental illness.

Being able to laugh at themselves often helps with their recovery.

I want to make an announcement.

I'm not normal! I'm weird and I love it!

And it also helps to talk about things together.

People are like, "Ah! I'm depressed today."

Trying to get attention.

And you don't get depressed for a day, it's not how it works, like.

It's the same with OCD, people are always like,

"I like things clean, I've got OCD."

But OCD is where you get a thought that you think,

like, a bad thought in your head that you don't want.

Then you think that you have to perform an action or compulsion

in order to stop the bad thought from happening, if that makes sense?

-People just don't understand it cos they can't actually physically see there's something wrong.

-Yeah.

They think that everyone who has mental health comes from a bad home,

but I come from a really good home and I've still ended up like this.

It's like, if someone had a cold or something you wouldn't go,

"Why have you got a cold? You've got no reason to have one."

THEY LAUGH

It's room search time again, and for someone with Emma's condition, OCD,

that can be particularly upsetting.

You've messed it all up!

Sorry, we need to go through your things, Emma, unfortunately.

The staff are not putting things back as Emma had them.

The search ends with the confiscation of a mobile phone,

but that is the least of Emma's worries.

I was up till two o'clock in the morning

straightening some stupid CDs last night,

for them to just go and mess it up.

I had to have them straight

or something's going to happen to my mum and now they've messed it up.

So something's going to happen to my mum

and I'm not going to have a mum and it's all their fault.

Can I ring my mum, please?

MUSIC: "Wildest Moments" by Jessie Ware

# From the outside

# From the outside

# Everyone must be wondering why we try

# Why do we try

# Baby, in our wildest moments

# We could be the greatest We could be the greatest

# Baby, in our wildest moments

# We could be the worst of all... #

SHE LAUGHS

So, we're going to listen to Bethany's presentation.

Now, the criteria that I'm making against are on these tick sheets.

The patients can't go to their regular schools

while they are being treated.

Beth, are you all set up ready to go?

So that they don't miss out on their education

they go to the hospital's onsite college, Cloughside.

I'm doing the presentation on...

Oh, crap...gymnastics.

Before she became ill, Beth won prizes in gymnastics

and dance competitions.

There's four different apparatus.

You've got the floor, the beam, the bars and the vault.

The staff at the unit want to draw on Beth's experience

as a gymnast and a dancer to help with her recovery.

How old were you when you started...

Today, Beth is going back to a dance hall in Prestwich that holds happy memories for her.

She's with occupational therapist Matt Murphy.

Only a few months ago, Beth competed in a dance competition

in the main hall here.

These sessions are relaxed, but Beth is being closely observed by Matt

to see how she copes with being outside the hospital.

It feels weird being back here.

How does it make you feel? Good weird or bad weird?

-How do you mean?

-Good weird, yeah.

-Do you want to go in?

-Yeah.

I might put them off! MUSIC PLAYS

That's the stage and they always have the trophies along.

So when you're doing your actual dance stuff,

is that on this dance floor?

Yeah, it's on the dance floor.

-Like, the chairs only go up to where the carpet ends.

-Right, OK.

And then there's these steps here that you always...

Go on, show us what's up here.

I've actually stood in this exact place before, like, exactly here.

That's my old outfit, that's when I first started losing weight, though.

-So how long ago was that one taken?

-About three years ago

-How does that make you feel?

-Fat.

I got rid of three bin bags full of trophies.

I think it was that one that I won at the British when I did my solo...

..and I think that one's the second place one.

-Brilliant.

-And that big one...

I was going to say, what's the big one? That must be a special one.

That's second at the Europeans, that one.

-Does it make you feel a bit sad...

-It makes me feel a bit sad.

-Bit emotional?

-Yeah.

But that's the thing, you know, you can start up your dancing

and everything like that again, can't you?

Get yourself right, move on from the McGuinness Unit, yeah?

And get back out there.

Gill is the most volatile patient on the ward,

but recently she's been quite stable.

I used to be a really happy child when I was a lot younger

and I just want to go back to being that happy child again,

rather than being all sad all the time and distant from my family.

Because she has been quite calm, Gill has been allowed

out of the acute corridor and can take part in group activities.

-Do you want me to get yours?

-That was skill.

I put ham, chicken, pepperoni, more cheese.

But Gill's behaviour can change in an instant.

Gill! Gill! NO!

I've nearly got it. Help me.

In a light-hearted moment, she tries to get hold of a doctor's keys.

Someone get it off him!

What begins as a bit of fun quickly threatens to get out of hand.

-GILL!

-SHE SCREAMS

-ALARM SOUNDS

-Hey! Stop that now.

RAISED VOICES

You come with me. Gill.

Come up there for me, please.

Gill. Gill.

I just feel like I just can't control myself.

Like, when it's got to that point, I don't listen to the staff,

to what they're saying, and it just gets a bit carried away

and everything ends up going downhill from there.

-Gill, we're going.

-No! No!

Right, if you want to sit on the floor that's fine. OK?

-No!

-Do not kick me!

-Get off!

-Right.

-SHE SHOUTS

-Gill. Last time, OK?

SHE WHINES

Once again, Gill finds herself back down the acute corridor

on one-to-one observation with a member of staff.

It's becoming an unhealthy cycle.

I can't really begin to understand

why she kicks off as often as she does, if I'm perfectly honest.

I mean, she needs, she needs help, really,

so, in order to help her progress. And at the moment

she's just not progressing with the help that we're giving her.

# Is this the way to Amarillo

# Every night I'm hugging my pillow

# Dreaming dreams of Amarillo

# Where sweet Maria waits for me... #

In the lounge, the patients are in high spirits.

Unlike Gill, these young people aren't sectioned,

so they can technically discharge themselves.

They don't need to be observed so closely.

They say you're staying here for a day.

It turns out to be a month and we're still here!

-One month!

-THEY LAUGH

But while on the unit,

Beth's already unhealthy relationship with food

is becoming more pronounced.

She's started a diary documenting her attempts to not eat.

I've put, like, today I've gone 100 hours with no food or drink.

It makes me feel like the pain of, like,

the hunger pains just make you feel happy.

It sounds deluded that, doesn't it?

No, but sometimes purging's not enough,

making yourself sick isn't enough

cos it only removes about, at the best of times,

only, like, 50% of the calories that you've ate.

So then you've got to exercise as well.

And then it got to 121 hours and then 133 hours.

Please can I just have some mashed potato and ketchup?

The staff are becoming increasingly concerned about Beth's refusal to eat.

She won't even go into the dining room.

Come in the dining room and just spend ten minutes.

You can have a piece of fruit.

Out of the 15 patients on the ward, at any one time,

there will always be two or three with an eating disorder.

The unit has a special dietician who helps anorexic

and bulimic patients fight the disease.

So, she's tending to miss a lot of meals completely.

So I was quite concerned about her nutritional intake.

That, if anything, it seems to have got worse

compared with when she first came.

In terms of the eating disorder pathway,

what difference would it make to her?

If she is to go down that route?

She would have the supervision at mealtimes

and after mealtimes as part of the Rainbow programme.

Maybe that might be the time to go down that route.

The time for gentle encouragement is over.

It's Anne from the McGuinness Unit.

It's just regarding Bethany's leave. She hasn't been given it....

Beth won't be getting any home leave until she starts eating.

Staff nurse Anne rings her mum to let her know.

We've decided to put her on what we call the Rainbow programme.

The unit needs to take a harder line on Beth now,

and Anne and Matt must break the news to her.

-Just listen to Anne, OK?

-Oh, why?

Just listen to Anne. If you have any questions we can discuss it.

-My leave, have I got it?

-The overnight is no.

Purely because you're not eating.

And I know you're having the odd ad hoc

because I've phoned your mum up and told your mum

and she's said about what you've had, you know,

whenever it were last time you went out, yeah?

-But unfortunately it's not enough to sustain.

-It is.

No, it isn't.

You need to give us some of that control now.

It means you'll have somebody with you at mealtimes one-to-one.

Oh, no. Please.

You need to let us help you.

-There's nothing wrong.

-There's nothing wrong?

-What did you have for your dinner?

-Nothing.

-What did you have for breakfast?

-Nothing

You won't let us weigh you. That will be changing.

Why? What's your biggest fear?

That I'll have put on weight since I've been in here anyway.

-Because I know I have.

-How do you know?

-I can just tell.

-Why?

Somebody will actually...

..pick your meal for you.

No-one else is putting it in.

I have to pick it up and put it in my mouth and I can say "no" to that.

-Yeah, but if we're telling you to do it...

-I can still say no.

She's still in denial.

She's not ready to change,

not ready to accept that she has got something wrong with her.

I think deep down she does know she's got a problem

because she's not willing to get on the scales.

You know, that's where her honest answer will lie.

She'll be a challenge, they all are.

Because they're in control.

But as you've just heard with Beth, she's not in control.

I'm mashing it up a little bit, so you can get plenty of juice,

there's not as much juice as there usually is.

The Rainbow programme offers a set meal system.

Now, if the young person is really struggling with solid food

they can always fall back on a supplement drink.

A very high calorific drink, so you might have

150 or 180mls of this supplement,

which basically substitutes a full meal.

But the Rainbow plan will only work

if Matt can actually persuade Beth to enter the dining room.

No, no. Matt, just go away.

Right, we need to at least go in the dining room

-and try and make a start, OK?

-No.

Think, Beth. This could be the start of you turning your life around.

Otherwise you're just going to go down and down and down

and it's going to more difficult for you to come up.

I can't. I can't.

If she carries on refusing to eat,

the next stage could be to section Beth under the Mental Health Act.

Emma's now been at the unit for four weeks, being treated for OCD.

Last night, she had an anxiety attack.

How come you ripped up all your college work?

It's not as if I'm even going to get into college.

-When's your review?

-Today.

So you'll know today.

I don't know, like, if they'll let me, though, because of last night.

Emma didn't just trash her room.

She was found by another patient with shoelaces around her neck.

It was just horrible.

I just want to go back to school.

I think she basically wants to remain here,

however, go from the unit to go to her own school.

We've tried to say to her that's not really something

that can happen, but she's still requesting to do the same thing.

After the meeting, it's up to staff nurse Pete

to tell Emma what has been decided.

You asked for school leave. Right, unfortunately that's not happened.

I really wanted school leave.

I know, but it's the decision of the team

that that's just not appropriate at this moment in time. OK?

-OK.

-OK.

# Don't worry about a thing

# Cos every little thing is gonna be all right... #

Thanks, Kirbi.

It's quarter to ten on the ward

and that means all the patients must be in bed in the next 15 minutes.

Emma is feeling agitated.

Now my thoughts are racing and I can't catch up with them

and they're all there and that happens all day.

And then I can't get to sleep cos all my thoughts are racing,

racing and I don't have time to catch up with them.

And they're all just horrible.

SHE STAMPS HER FOOT

I don't even know what causes it.

I just want to go back to my school.

I want to be like whatever other normal teenagers my age is doing.

SHE TAPS HER FEET

It just really annoys me.

Beth has been on the Rainbow programme for a week.

She is still being supervised every mealtime.

I think my room door's already open, Mel.

Yeah, it's open.

But she's rebelling against the staff.

-What's that there, Beth?

-Diet Coke.

I've been banned from having it.

I use it as a meal supplement so I get filled up

and I don't have to eat, basically,

cos I'm too full.

Exercise is another form of rebellion.

She has been walking up and down the corridor

for half an hour to burn calories.

Still reporting that she wants to die and saying it will be easier

that way, then no-one has to worry.

The review team are increasingly concerned

about Beth's lack of progress.

She's not complying with the Rainbow plan,

limited intake, trying to hide food in tissues.

Continues to refuse to have blood tests

and continues to refuse to be weighed.

-Dr Achoo?

-She said that she would never, ever eat again.

We might have to request,

I think we will just request for a Mental Health Act assessment.

A mental health assessment could lead to Beth being sectioned.

They keep warning me with sectioning, but it won't happen.

They're just trying to scare me.

Under section two and three,

young people are detained against their will.

That's the reason why it's a legal process.

Under a section three, treatment is compulsory.

They can be given medication, or whatever that treatment may be,

against their will.

SHE WHINES

I can't sit down cos I feel like

if I sit down I'll have to get back up again.

You're only going to make your legs feel worse,

pacing around like that, aren't you?

Gill is on a section because she's a danger to herself.

You're only going to make your legs feel worse,

pacing around like that, aren't you?

-Right.

-SHE GIGGLES

Even though the McGuinness is not high security, doors are kept locked

and sectioned patients like Gill are not free to move around at will.

ALARM SOUNDS

But two patients have escaped.

One of them is Gill.

You need to turn it off now.

Is it Gill?

Staff give chase.

I think they've just kicked the door open at the side.

The police have been called immediately.

There's staff down there.

There's not very many staff left on the ward

-so I'm going to hang around here.

-Right.

Two young people have actually kicked their way through the door

and jumped over this, just a fence, here.

You can see it's just kind of come out, basically.

Umm...that bit there sits in there.

One of the escaped girls has been found hiding under a bush not far from the hospital.

But Gill is still missing.

It's been over two hours since she ran away.

The police are now joining in the search.

After three hours, there is a sighting.

I'm just letting you know that one of our members of staff

has seen Gillian on the motorway bridge

near the roundabout in Prestwich.

Some of our staff have gone up,

but obviously I need to make yourselves aware as well.

Because Gill is on a section, she needs to be found quickly.

But when staff reach the motorway bridge, she is nowhere to be found.

Gill has now been missing for over eight hours.

Staff and patients are getting increasingly worried.

The last time she was out in the community,

she took a large overdose.

I've just had contact from some relatives

regarding some potential addresses she may be at in the Gorton area,

so I just wanted to give you those addresses.

They wouldn't be in here and they wouldn't be on a section of the Mental Health Act

if there wasn't a great, you know, great risk

involved with that young person.

An hour later, Pete gets the call everyone has been waiting for.

Whereabouts is she in the hospital? Is she in A&E?

She's on the children's ward.

Right, bye-bye.

She's been found either having either attempted to

or alleged to have taken another overdose.

As the patients on the ward prepare to go to bed,

at a hospital in Manchester,

Gill will be under constant supervision through the night

to make sure she doesn't abscond again.

The next morning, Gill is brought back to the unit,

laughing and smiling.

Once again, she is taken down to the acute corridor

to be closely monitored by two members of staff.

Gill's escape is a rare event,

but the McGuinness Unit was only ever built as a temporary measure

and it was never designed to deal with teenagers when they get violent and distressed.

All round the unit we've got little boards

and other pieces of wood kind of stuck on the wall.

If you push against it they move the plaster.

Where this big piece of wood is, there was, like,

young people had kicked big holes in the wall.

Boards up here, little bits there, little bits there.

We've got a fresh one here which kind of happened yesterday.

Bit of a typical hiding place, we had to have this put on

cos they figured out how to get in the laundry cupboard.

So you'd come in here and there'd be, like,

young people hiding in the cupboard.

Looking back, it is actually quite a funny hiding place, but...

All this should become a thing of the past in a few months,

when a new purpose-built ward opens just a few metres away.

-I think that's quite a good one, personally.

-Yeah.

Emma is continuing to improve.

She has had some day leave in recent weeks,

but now, for the first time, is going home for a whole weekend.

I'm scared that if things get too much

then I'll end up right back where I started.

I think that's my mum.

Mum, can we drive the way that goes past my school?

Cos I want to see my school.

That sounds really sad, but I do.

Well, we can see the school later, can't we?

Arriving home is exciting for Emma,

although she doesn't want any of her school friends to see her.

-Has he gone?

-No.

-Do not open this door.

-I know, it's OK.

All right.

-This is a little weird.

-SHE GIGGLES

-Where are you? Get out!

-Shut the door!

-Stop shouting, you'll draw attention to me.

-Draw attention to you?

Shut the door, then people can't see me, for God's sake!

Ow! Fucking hell!

Ah, my head!

I love you too.

Don't bite me!

My dad's stuck a sign on my door that says,

"Do not disturb. Already disturbed."

And there's my wall of handprints that I did.

Emma has been in hospital for five weeks,

but she is now managing to control her OCD impulses more and more.

Say I was in the lounge, I'd have to do seven steps across the lounge,

seven steps down the hall and then seven steps to my bed

and if I couldn't make it in them seven steps I'd have to start again.

And then once I was in bed I had to touch one side seven times,

another side seven times, turn over seven times,

touch the wall seven times.

I've seen a difference in you.

-I know it's not perfect...

-There's ups and downs..

Yeah. And I think, you know,

when you come home there will be ups and downs all the way, you know.

But, er...it is difficult, you know, cos tensions can be very high...

Can I say something, though?

OCD doesn't, like, define who I am.

All right, I've got it but...um...

But I like music, I like playing the guitar,

I like bands and I like the colour yellow,

I like chocolate.

But I don't like all them things cos I've got OCD,

I like all them things cos I'm Emma,

and it doesn't define me as a person.

Just because I'm going through it right now

and it's a part of me right now, it doesn't define me as a person.

Emma returned to the unit after a successful home leave

and that means her discharge may not be far away.

A girl who's become good friends with Beth is leaving today.

And when someone leaves it's always an emotional time

for those that are left behind.

She's still not complying with the meal plans,

she still won't have her bloods done,

she still won't jump on the scales.

She has been given until Monday

or they will be seriously considering a section.

Beth has been in the unit for two months.

Time is running out for her and she seems aware of it.

But even so, it takes her several minutes to eat two pieces of carrot.

I'm not eating any more.

-Try a bit of the rice.

-No.

Try some of the rice, some of the protein.

No, I just can't do it. I'm not. I'm not. I'm not.

-What's to say you can't do it?

-I just, no. I can't. I won't.

Matt won't let her give up.

If she won't eat her meal,

he will get the equivalent calories in a fruit drink for her.

-How many calories are in it?

-It doesn't matter how many calories are in it, right?

I'm not even going to get into that with you.

It's exactly the same as what that would be.

I'm going to say you had half the vegetables.

-I had more than half the vegetables.

-No, you had the carrots.

-I won't argue with you. You had half.

-I did eat it.

-You ate some of it...

-But I'm not having, no...

-Right. I'm going to halve that. 15mls.

-I'm not having it at all.

And if I'm being honest I'm being generous now.

No, I'm not having it.

There's been so many young people with eating difficulties, yeah?

And I now that the first time for them is the hardest.

But with support of staff and supervision, it is made easier

and I promise you that, it will get easier.

The hardest part is taking hold of it...

-No.

-You need to hold it, OK? That's the most difficult part, OK?

What we've found with young people in the past

is ignore the negative voice, yeah?

The one that's saying, "Don't do it."

And listen right back there, yeah,

to the little voice of Beth saying, "Go on, do it."

Because really, you know you need to do it, don't you?

Yeah, OK?

Just think of this as you getting back out there.

Going out, getting up with your dance and your gymnast.

Think of how happy it will make your parents, yeah?

Just saying, "Yeah, I am on the meal plan at this moment in time, but I'm cracking on with it.

"I'm finding it quite difficult, but I'm doing it."

Come on, take hold of it.

I'm not going to make a big ordeal about, you know,

if you drink it all.

I'm not going to make a big song and dance about it, all right?

OK. Keep hold of it.

That, what you've just done there, is the hardest bit, OK?

-Yeah, take hold of it again.

-I'm not doing any more.

-So is that it?

-Yeah.

-Hang on!

One sip took Beth over 20 minutes.

How much would you say was in a sip? About 5mls?

-Is that all she had?

-It's a start.

It's like every little piece of you

in your body is telling you not to eat it.

"Don't do it, you'll get fat. Don't do it, don't do it,"

and you've got people actually in reality saying,

"Eat, eat," and you've just got an argument in your head.

The way things are going with Beth,

I'm thinking this girl is going to be with us for quite a while.

Anorexics do get hungry, but we just learn to ignore it

and fight it off and then food just becomes the enemy.

There is little chance

of Beth getting discharged in the near future.

But because Emma's home leave has been a success,

after six weeks, she could be about to leave for good.

-So in terms of discharge, are we happy...

-Yes!

THEY LAUGH

Are we happy for Emma to be discharged today?

-Are you happy to have Emma?

-Yes, yes, very much so. Yeah.

Yeah. Thank you all for coming today.

-Can I say goodbye to everybody?

-Course you can!

-Here are the contact numbers, in case.

-Thanks a lot.

Obviously, I'm delighted that she's coming home.

I'm getting all emotional! Sorry!

I've met some really important people to me.

And I think it is important, it helps you grow as a person

and the people here have helped me grow as a person...

Ah, Lisa! Smell ya soon!

Smell ya soon!

We came in here, and for the first two or three days

when we were driving home we were just crying,

driving home, weren't we?

But you get used to it and accept it. And the thing is,

we knew she had to be in, there was no alternative.

And it will be tough, you know, when we go home,

but hopefully we'll be strong enough to get through it.

Emma will still have sessions with a psychiatrist when she gets home.

But her life is returning to normal

and, importantly, she can start back at school.

It's just a case of loading up, isn't it?

Patients like Emma arrive at the McGuinness Unit

at one of their lowest points in their lives.

But while here, they can also enjoy some good times.

Gillian!

I'm going to miss you so much.

I'm going to miss you loads too.

As well as the therapy and medication, it's these friendships

that play a critical role on their road to recovery.

-Bye!

-See you!

-Bye!

Look after yourself!

-You too! Mwah!

-Mwah!

Good luck at school tomorrow!

-I hate saying bye to people.

-Why's that?

Knowing they can actually leave now and you're stuck in here.

It's not nice.

When people leave, it can be very unsettling for those left behind.

I want to go home, but I can't

and then there's all these people leaving and I just got upset.

In the days after Emma's discharge,

Gill takes solace in an old but unhealthy coping mechanism.

I had to go hospital

because I had the end of a pen stuck in my arm.

You know the metal bit?

I deliberately put it in so I had to go hospital and get it removed.

Beth continues to refuse to eat

and is summoned to a meeting behind closed doors.

She never believed it would happen to her,

but now she's been sectioned under the Mental Health Act.

Now they can physically pick me up

and restrain me and put me on the scales.

They can do whatever they want and whatever they can to get it.

Cos apparently it's in my best interests and cos I'm too ill,

I can't see what's right for me, or something like that.

Which sucks.

Emma has returned to school and is doing well,

but for Gill and Beth, their struggles go on.

My week's been shit,

my leave has been cancelled and I'm very sad.

I need my mum now more than ever, really.

THEY SQUEAL

And there are new patients on the ward.

There's Seven, and she's the little girl I see.

They're, like, my best friends.

-A baby puppy!

-A what?

-A baby puppy!

-Oh, really? Where?

-There.

MUSIC: "Shelter" by The XX

# I find shelter in this way

# Undercover hide away

# Can you hear when I say

# I have never felt this way... #

Subtitles by Red Bee Media Ltd