Episode 2

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0:00:05 > 0:00:06ALARM RINGS

0:00:06 > 0:00:08This is the McGuinness Unit in Manchester,

0:00:08 > 0:00:12one of the largest teenage mental health units in the UK.

0:00:12 > 0:00:14GIRL SCREAMS

0:00:14 > 0:00:17It's the place of last resort for teenagers with eating disorders

0:00:17 > 0:00:22or psychosis, who self-harm, or have OCD -

0:00:22 > 0:00:28an in-patient facility that takes in the suicidal and disturbed

0:00:28 > 0:00:32to try and turn their lives around.

0:00:36 > 0:00:38For a year, we were given unparalleled access

0:00:38 > 0:00:39to film the patients...

0:00:39 > 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 thrown over my head.

0:00:47 > 0:00:49..in the good times...

0:00:49 > 0:00:50SHE BELCHES

0:00:50 > 0:00:51LAUGHTER

0:00:51 > 0:00:53..and the bad.

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 > 0:01:06THEY SCREAM

0:01:06 > 0:01:093,500 young people pass through units like this each year.

0:01:12 > 0:01:15This is the chance for some of them to tell us what it's really like

0:01:15 > 0:01:20on the inside and how others see them on the outside.

0:01:20 > 0:01:22Me brain's a bit...!

0:01:46 > 0:01:4814-year-old Crystal has just arrived on the ward.

0:01:48 > 0:01:51Making a mess on the floor.

0:01:51 > 0:01:54- I'm not making a mess! - You all look messy!

0:01:56 > 0:02:00She sees people and animals that no-one else can.

0:02:00 > 0:02:03They have been with her for six years.

0:02:03 > 0:02:06Most of them are her friends.

0:02:06 > 0:02:10They're the people. I'm not a very good drawer.

0:02:12 > 0:02:18That's 75, that's the dog and then that's 200 and that's the cat.

0:02:18 > 0:02:22That's the land where they live.

0:02:22 > 0:02:27And then there's Seven, and she's the little girl I see.

0:02:27 > 0:02:32But some of them are sinister and they frighten Crystal.

0:02:32 > 0:02:38That's one of the rats called Autumn and its teeth are really long.

0:02:52 > 0:02:56Recently the scary characters have been appearing more often

0:02:56 > 0:02:59and have made her feel suicidal, which is why she's been admitted.

0:03:02 > 0:03:06These characters tell Crystal to do things

0:03:06 > 0:03:09and she believes she has to obey.

0:03:11 > 0:03:15It's dinner time on the ward and the patients are in the canteen.

0:03:16 > 0:03:18But Crystal is not eating.

0:03:18 > 0:03:22She appears preoccupied, glancing back at the floor,

0:03:22 > 0:03:26looking at something the other patients cannot see.

0:03:28 > 0:03:30'I was hungry.

0:03:30 > 0:03:35'If I eat, then the rat will get mad and he can bite and scratch

0:03:35 > 0:03:39'and hurt me

0:03:39 > 0:03:41'and then he can get the other rats.'

0:03:41 > 0:03:45Scary. I don't like it.

0:03:45 > 0:03:48A patient like Crystal, who has hallucinations,

0:03:48 > 0:03:52raises particular challenges for the staff in the unit.

0:03:52 > 0:03:57They need to explore the causes and there are many possible reasons.

0:03:58 > 0:04:04On admission, the first thing we did was carry out a blood test,

0:04:04 > 0:04:07making sure that her liver, kidney,

0:04:07 > 0:04:12the thyroid glands that they're all functioning well.

0:04:12 > 0:04:15Because if there are difficulties with these areas,

0:04:15 > 0:04:19you might end up having problems with seeing things

0:04:19 > 0:04:23that are actually not there and the result of this...

0:04:23 > 0:04:26they came out as all being normal.

0:04:26 > 0:04:29Since nothing showed up in her blood test,

0:04:29 > 0:04:33it's clear that Crystal's problems are psychological.

0:04:33 > 0:04:37- Oh!- Charlotte the art therapist

0:04:37 > 0:04:41has been using drawing to find out more about Crystal's imaginary world

0:04:41 > 0:04:43and what might have caused it.

0:04:43 > 0:04:46These are kind of the good guys, aren't they?

0:04:46 > 0:04:48- Yeah, they're the good ones.- Yeah.

0:04:48 > 0:04:50We sometimes think about what happens in your world

0:04:50 > 0:04:52and what happens in this world.

0:04:52 > 0:04:56- We get confused sometimes, don't we, as well, Crystal?- Yeah.

0:04:56 > 0:05:00- This is Seven? Yeah? - Yeah, but it doesn't look like Seven.

0:05:00 > 0:05:02What was it that didn't look like Seven?

0:05:02 > 0:05:04She looks older.

0:05:04 > 0:05:06Because you wanted her to look about four, didn't you?

0:05:06 > 0:05:09- Yeah, because she is four.- Yeah.

0:05:09 > 0:05:13Crystal was also four when something significant happened to her.

0:05:13 > 0:05:15She was adopted.

0:05:15 > 0:05:17We started to think about some of the bad things

0:05:17 > 0:05:19that came in as well, do you remember?

0:05:19 > 0:05:21Like the man, he's just really scary.

0:05:21 > 0:05:25His eyes are just big, black circles, so he doesn't have eyes.

0:05:25 > 0:05:30He's just scary and he looks like my real dad as well,

0:05:30 > 0:05:32and that's a bit weird.

0:05:33 > 0:05:36Crystal is 14

0:05:36 > 0:05:41and the hearing of voices started around the age of eight.

0:05:41 > 0:05:45Every week, the senior staff meet to discuss each patent in detail.

0:05:45 > 0:05:50This is someone who had a very, very traumatic upbringing.

0:05:50 > 0:05:53She was being neglected.

0:05:53 > 0:05:59There was physical abuse going on and Social Services had to step in.

0:05:59 > 0:06:01Crystal and her younger brother,

0:06:01 > 0:06:04they were both adopted since about the age of three.

0:06:04 > 0:06:07She's gone through a lot.

0:06:07 > 0:06:09In Crystal's assessment,

0:06:09 > 0:06:14the team need to understand her past to know how to help her.

0:06:14 > 0:06:16It's very, very early stages.

0:06:16 > 0:06:19We've thought a little bit about these bad characters

0:06:19 > 0:06:24and the rats and how they relate to angry feelings

0:06:24 > 0:06:27and jealous feelings sometimes as well

0:06:27 > 0:06:30and getting between relationships.

0:06:36 > 0:06:39During her first week, Crystal's characters are with her

0:06:39 > 0:06:44from first thing in the morning to last thing at night.

0:06:44 > 0:06:46Seven's there.

0:06:52 > 0:06:56She's there. She's hugging Barlum.

0:07:00 > 0:07:06Barlum's her toy, it's a sheep and it's called Barlum

0:07:06 > 0:07:09and she holds it everywhere.

0:07:09 > 0:07:12She always wants me to read her a story.

0:07:14 > 0:07:17She says she wants a princess story.

0:07:18 > 0:07:23She said Barlum's a princess.

0:07:35 > 0:07:40The ones I can see, they sometimes have a line around them,

0:07:40 > 0:07:45like a white line that glows.

0:07:45 > 0:07:49They're always saying that they'll be there for me all the time.

0:07:49 > 0:07:55So, that's why I called them 24/7, 24 hours and Seven.

0:07:55 > 0:07:58I don't want the good things I see to go away

0:07:58 > 0:08:04because they're like my best friends and I wouldn't want them to go away.

0:08:29 > 0:08:3217-year-old Beth has been on the McGuinness Unit for three months,

0:08:32 > 0:08:35suffering from depression and an eating disorder.

0:08:35 > 0:08:36Why don't you want to do this?

0:08:36 > 0:08:38Because there's nothing wrong.

0:08:38 > 0:08:40- There's nothing wrong?- People...

0:08:40 > 0:08:42- What did you have for your dinner? - Nothing!

0:08:42 > 0:08:46- What did you have for breakfast? - Nothing!

0:08:46 > 0:08:48She was admitted voluntarily,

0:08:48 > 0:08:52but wouldn't eat for days at a time and rebelled against staff.

0:08:52 > 0:08:56All the fat on my hips, like all the fat on my arms there.

0:08:56 > 0:08:59I like to see the bone.

0:08:59 > 0:09:01Still reporting that she wants to die

0:09:01 > 0:09:04and saying it will be easier that way, then no-one has to worry.

0:09:04 > 0:09:08Her refusal to eat enough forced staff to consider drastic action.

0:09:08 > 0:09:11They keep warning me with section, but it won't happen.

0:09:11 > 0:09:14They're just trying to scare me.

0:09:14 > 0:09:17But three months after being admitted, Beth was sectioned

0:09:17 > 0:09:21under the Mental Health Act and she has lost the ability to say no.

0:09:21 > 0:09:25Now they can physically pick me up and restrain me

0:09:25 > 0:09:27and put me on the scales.

0:09:27 > 0:09:30They can do whatever they want and whatever they can.

0:09:30 > 0:09:34Apparently, it's in my best interests and because I'm too ill,

0:09:34 > 0:09:39I can't see what's right for me or something like that.

0:09:39 > 0:09:41Which sucks.

0:09:46 > 0:09:47Beth now has the choice -

0:09:47 > 0:09:51to comply with the doctor's orders or continue to rebel.

0:09:51 > 0:09:54The way things are going with Beth,

0:09:54 > 0:09:58I'm thinking that this girl is going to be with us for quite a while.

0:10:01 > 0:10:04Vegetarian... It's only half a portion, isn't it?

0:10:05 > 0:10:08- Very, very few chips.- No, no.

0:10:10 > 0:10:13Take a bit few more off... Just that...

0:10:13 > 0:10:15Yeah, that's fine.

0:10:15 > 0:10:18Just a tiny bit of peas.

0:10:18 > 0:10:21Beth's on a treatment called the Rainbow Programme,

0:10:21 > 0:10:24which means she has to consume a set amount of calories every day.

0:10:24 > 0:10:26Breakfast, lunch and dinner

0:10:26 > 0:10:29are eaten under the watchful eye of a member of staff.

0:10:29 > 0:10:32I just...I can't...

0:10:32 > 0:10:34SHE SOBS

0:10:34 > 0:10:35Come on.

0:10:38 > 0:10:40You don't feel like...?

0:11:06 > 0:11:08A few mouthfuls of peas is not a lot,

0:11:08 > 0:11:11but it's an improvement on recent weeks.

0:11:11 > 0:11:15They don't see it as progress, they just want me to eat everything

0:11:15 > 0:11:16and that's when it will be progress,

0:11:16 > 0:11:19but as soon as you start eating everything, they'll just up it

0:11:19 > 0:11:21and they'll give you more.

0:11:35 > 0:11:38You've got a choice of strawberry, vanilla or jam.

0:11:38 > 0:11:43- They're strawberry, they're vanilla and these are jam.- Strawberry.

0:11:45 > 0:11:48Lucy, do you want a cake?

0:11:48 > 0:11:51Oh...strawberry, vanilla and jam.

0:11:51 > 0:11:55It feels a bit hard, you sure it's not a rock cake?

0:11:55 > 0:11:56No, it's all right.

0:12:06 > 0:12:09THEY LAUGH

0:12:09 > 0:12:12Why do you keep laughing about what you've hidden in these cakes?

0:12:12 > 0:12:15Onions, mayonnaise...

0:12:15 > 0:12:19- Garlic...- ..toothpaste.. - ..tomato puree.

0:12:26 > 0:12:29While much of the McGuinness Unit has a relaxed atmosphere

0:12:29 > 0:12:32with patients socialising together,

0:12:32 > 0:12:33it also has an acute wing

0:12:33 > 0:12:36for its most disturbed or disruptive patients.

0:12:36 > 0:12:40Here, young people are observed by staff 24 hours a day.

0:12:40 > 0:12:43As kind of streetwise as these kids are,

0:12:43 > 0:12:44they are kids, you know,

0:12:44 > 0:12:47the average age is about 13 or 14

0:12:47 > 0:12:51and they've been left in, essentially, a strange environment

0:12:51 > 0:12:55with lots of strange people in a strange situation

0:12:55 > 0:12:58and the vast majority have no inkling

0:12:58 > 0:13:01as to how quickly they'll be able to go home,

0:13:01 > 0:13:04whether they'll be able to go home or whether they'll move on

0:13:04 > 0:13:06to another area of the service or what have you.

0:13:06 > 0:13:09So it is, it's quite a difficult...a difficult time.

0:13:14 > 0:13:1816-year-old Gill is one of the acute wing's longest-standing patients.

0:13:22 > 0:13:24She suffers from depression

0:13:24 > 0:13:27and her moods can change radically at a moment's notice.

0:13:32 > 0:13:35In the six months she's been here,

0:13:35 > 0:13:37she's been restrained countless times...

0:13:38 > 0:13:40SHE SCREAMS

0:13:40 > 0:13:41Gill!

0:13:41 > 0:13:43ALARM BLARES

0:13:43 > 0:13:45..and even managed to escape from the unit.

0:13:45 > 0:13:51She's been found having taken another overdose.

0:13:51 > 0:13:53Watch your fingers, OK?

0:13:53 > 0:13:56She spends a lot of her time kept down the acute corridor

0:13:56 > 0:13:58or ECA, as it's known.

0:13:58 > 0:14:01Right, you need to move. Move, move.

0:14:06 > 0:14:08Today, she's locked down there again.

0:14:10 > 0:14:12I cut myself last night,

0:14:12 > 0:14:15cos I was really struggling and I've not cut for ages.

0:14:15 > 0:14:16My mood just got so low

0:14:16 > 0:14:19and I was just really upset and I don't know why.

0:14:19 > 0:14:22I think I first did it when I was 12 years old.

0:14:22 > 0:14:26My mum was ill with cancer... I'm not blaming my mum,

0:14:26 > 0:14:29but I think everything just got on top of me,

0:14:29 > 0:14:31cos I was busy with school work,

0:14:31 > 0:14:34looking after my mum and my little brothers,

0:14:34 > 0:14:37just doing quite a lot for my age

0:14:37 > 0:14:39and I just couldn't cope with it.

0:14:39 > 0:14:41And then, one day, I don't know why,

0:14:41 > 0:14:44I just thought it my head, "I'll cut myself."

0:14:44 > 0:14:48Many of the patients on the unit have complicated home lives.

0:14:48 > 0:14:53Gill has not seen or spoken to her mother for six months.

0:14:53 > 0:14:56Having no contact causes Gill huge pain and distress.

0:14:59 > 0:15:02She has been rejected, I think, throughout her life.

0:15:02 > 0:15:03Her last admission here, I think,

0:15:03 > 0:15:06she had one visit from one family member.

0:15:06 > 0:15:08She was asking members of staff

0:15:08 > 0:15:10if they would think about fostering her,

0:15:10 > 0:15:13or...you know, I mean, she even asked me at one point

0:15:13 > 0:15:17and she promised me faithfully that if I would agree to...

0:15:17 > 0:15:21to give her that option and give her a chance,

0:15:21 > 0:15:24that she would promise faithfully she would never self-harm again,

0:15:24 > 0:15:26cos all that she wanted was a family.

0:15:26 > 0:15:28Somebody who could care for her and give her that normal life.

0:15:30 > 0:15:34Rebuilding her relationship with her mum is key to Gill's recovery.

0:15:36 > 0:15:39Despite their differences, both want to try again.

0:15:40 > 0:15:44It began with a phone call between the two

0:15:44 > 0:15:46and then her mum came to see her on the ward.

0:15:46 > 0:15:48Hello, Mum! Are you all right?

0:15:48 > 0:15:50Now, a few weeks later,

0:15:50 > 0:15:53the relationship is beginning to blossom.

0:15:53 > 0:15:56Today, her mother is paying another visit to the hospital.

0:15:56 > 0:15:57Whereabouts are you?

0:15:59 > 0:16:01OK, five minutes. All right, then.

0:16:01 > 0:16:04All right, brilliant, bye!

0:16:04 > 0:16:07Love you! Love you! Love you more!

0:16:07 > 0:16:09Bye!

0:16:09 > 0:16:10SHE CHUCKLES

0:16:10 > 0:16:11Bye!

0:16:14 > 0:16:19Family often are the key relationships through childhood

0:16:19 > 0:16:21that help influence

0:16:21 > 0:16:23how you understand relationships,

0:16:23 > 0:16:25how you feel about yourself,

0:16:25 > 0:16:26how you interact with others,

0:16:26 > 0:16:29how you interact with the social world.

0:16:29 > 0:16:30So our relationships with family,

0:16:30 > 0:16:34right from the moment we're born, and arguably before that,

0:16:34 > 0:16:35are absolutely fundamental.

0:16:35 > 0:16:41Helping young people understand how they relate within their family

0:16:41 > 0:16:45can often give us the best chance of positive outcomes.

0:16:45 > 0:16:47Oh, you remembered the games...

0:16:47 > 0:16:50Yes, that one is crackers.

0:16:50 > 0:16:52I can't get to grips with that one.

0:16:52 > 0:16:54So you can have fun enjoying yourself and...

0:16:54 > 0:16:56Thank you.

0:16:59 > 0:17:02There you go. How's that, babe?

0:17:02 > 0:17:04You remember when me and the kids went to Blackpool

0:17:04 > 0:17:06- and you wasn't with us?- Yeah.

0:17:11 > 0:17:12That's for you.

0:17:16 > 0:17:17Wow!

0:17:19 > 0:17:22Afterwards, Gill and her mum go for a walk though the hospital grounds.

0:17:22 > 0:17:26It's so nice to be out.

0:17:26 > 0:17:28- Oh! It's good that you're out with me as well.- Yeah.

0:17:28 > 0:17:32Next week, I've got 25 minutes and we can go up to the barrier.

0:17:33 > 0:17:36Because Gill has a history of absconding,

0:17:36 > 0:17:39the pair are not allowed to be alone.

0:17:39 > 0:17:41What time is it? Can you check what time it is?

0:17:44 > 0:17:47- You've got four minutes. - Four minutes, come on!

0:17:51 > 0:17:54If staff feel Gill and her mum are getting on well

0:17:54 > 0:17:56and Gill continues to improve on the unit,

0:17:56 > 0:17:59they may agree to some home leave in the next few weeks.

0:18:03 > 0:18:05'If she can keep her temper,'

0:18:05 > 0:18:07then, she can outdo most of her problems,

0:18:07 > 0:18:09so...do you know what I mean?

0:18:09 > 0:18:12She's great, she's such a placid kid,

0:18:12 > 0:18:14but things have got on top of her

0:18:14 > 0:18:17and when she kicks off, she kicks off.

0:18:17 > 0:18:19BELL RINGS

0:18:19 > 0:18:22Just having my mum there helped a lot.

0:18:22 > 0:18:24Cos I didn't want to run off in front of my mum,

0:18:24 > 0:18:27cos my mum would get upset worrying about me.

0:18:27 > 0:18:30I need my mum now more than ever, really.

0:18:30 > 0:18:33Because of all this, being stuck in hospital.

0:18:33 > 0:18:36So I need her now.

0:18:36 > 0:18:37And she's there for me.

0:19:11 > 0:19:15Gill has become good friends with the unit's newest patient,

0:19:15 > 0:19:1814-year-old Crystal, who has been having hallucinations.

0:19:20 > 0:19:21SHE LAUGHS

0:19:23 > 0:19:25I'm really bad at burping.

0:19:25 > 0:19:28I want to be able to burp, like, really loud.

0:19:28 > 0:19:30You know, those big, fat loud ones?

0:19:30 > 0:19:32I've got one coming, I can feel it.

0:19:32 > 0:19:35Come on, give the bottle to me, please...

0:19:35 > 0:19:37Gill, give the bottle to me, please.

0:19:39 > 0:19:40Thank you very muchly.

0:19:40 > 0:19:44Ah, I've got pains, it's the rush of caffeine through my body.

0:19:44 > 0:19:47I need to burp...

0:19:47 > 0:19:50Can someone tell me how Gillian got a full bottle of Coke?

0:19:52 > 0:19:53Who let you in?

0:19:53 > 0:19:54SHE BELCHES

0:19:54 > 0:19:56THEY LAUGH

0:19:56 > 0:19:58Who let you in, Crystal?

0:19:58 > 0:20:01I don't know, I snuck it in.

0:20:01 > 0:20:02SHE BELCHES

0:20:10 > 0:20:13Gill is making great efforts to get reacquainted with her family,

0:20:13 > 0:20:16it's something Crystal would love to do.

0:20:16 > 0:20:19She never really knew her birth parents,

0:20:19 > 0:20:22but that doesn't stop them preying on her mind.

0:20:22 > 0:20:24I get jealous of them a lot.

0:20:24 > 0:20:27There's my little sister

0:20:27 > 0:20:32and my older brother live with my real mum and dad

0:20:32 > 0:20:36and I'm kind of jealous cos I don't

0:20:36 > 0:20:39and I think I'd like to.

0:20:39 > 0:20:40It's kind of expected.

0:20:40 > 0:20:43It would be a bit weird if you weren't jealous, though.

0:20:43 > 0:20:47Because if they're your really mum and dad and they're living with them,

0:20:47 > 0:20:49you're bound to be jealous.

0:20:49 > 0:20:54We wrote to her a few years ago and then she replied

0:20:54 > 0:20:56and I was really happy about that.

0:20:56 > 0:21:01And then we wrote to her again and she didn't reply, so...

0:21:01 > 0:21:03And I got my hopes up.

0:21:09 > 0:21:12She had symptoms of depression

0:21:12 > 0:21:20and when I was little, some social worker people came to my house

0:21:20 > 0:21:25and, like, she shouted at me in front of them

0:21:25 > 0:21:29and then, when I was little, I had a bruise on my leg from her

0:21:29 > 0:21:32and that looked like a bite mark and she said I fell

0:21:32 > 0:21:36and I had a few bruises and stuff on me.

0:21:36 > 0:21:39It was like she didn't want me

0:21:39 > 0:21:43and a lot of times, I feel like I am not wanted

0:21:43 > 0:21:46and, like, I feel really bad about myself a lot.

0:21:52 > 0:21:55But Crystal has a loving adoptive family

0:21:55 > 0:21:57who have visited her every day.

0:21:57 > 0:22:01Today, she's being picked up for her first night at home in five weeks.

0:22:01 > 0:22:03Hello, darling.

0:22:03 > 0:22:05Hello, Bill.

0:22:05 > 0:22:07Right, are we ready?

0:22:07 > 0:22:09- Slippers.- Slippers.

0:22:09 > 0:22:14- This is great, this, isn't it? - I don't want my slippers.- OK.

0:22:14 > 0:22:18Right, let's shut the door. Do you want your door locked, darling?

0:22:18 > 0:22:19- I don't mind.- OK.

0:22:19 > 0:22:22- I'll lock it up afterwards. - Thank you very much.

0:22:25 > 0:22:29Bill and Helen adopted Crystal and her brother Dillon 11 years ago...

0:22:29 > 0:22:31Sit!

0:22:31 > 0:22:35..and they're excited to be taking her home again.

0:22:35 > 0:22:38Sit. He's not trained.

0:22:38 > 0:22:40I haven't planned anything,

0:22:40 > 0:22:43so I'll let Crystal decide what she wants to do and...

0:22:50 > 0:22:54On the way home, Crystal sees one of her characters.

0:22:54 > 0:22:58- 75's there.- 75's there?

0:22:58 > 0:23:00Yeah, he's chasing the car, cos he's super fast.

0:23:04 > 0:23:08At home, she sees another vision in the front garden.

0:23:09 > 0:23:10- 75's there.- OK.

0:23:12 > 0:23:15- He's asleep!- Right.

0:23:15 > 0:23:18SHE LAUGHS

0:23:18 > 0:23:19OK.

0:23:26 > 0:23:28A baby puppy!

0:23:28 > 0:23:30- A what?- A baby puppy.

0:23:30 > 0:23:32- Oh, really? Where?- There!- Right.

0:23:33 > 0:23:35It's called Ten!

0:23:35 > 0:23:37Ten? I've not heard of Ten before!

0:23:39 > 0:23:44He's white and...but he's called Ten.

0:23:44 > 0:23:48Right. OK, well, do you want to go in and see your own dog in a minute?

0:23:52 > 0:23:55Yeah, 75 wants to take Ten to Cranelli.

0:23:55 > 0:23:57OK, shall we go back inside, darling?

0:23:59 > 0:24:01- Yeah!- OK.

0:24:04 > 0:24:06Initially, it disturbed me.

0:24:06 > 0:24:11Initially, you want to say, "There's nothing there, don't be so silly."

0:24:11 > 0:24:15It's irrational, but there's no point telling her it's irrational,

0:24:15 > 0:24:18there's no point telling her to make them to go away,

0:24:18 > 0:24:20because they won't go away,

0:24:20 > 0:24:22it's as simple as that.

0:24:22 > 0:24:25Bill and Helen find it surreal talking to their daughter

0:24:25 > 0:24:28about the people and the animals that she sees.

0:24:28 > 0:24:31But they need to deal with it in a very matter-of-fact way.

0:24:31 > 0:24:34Mum, there's a new puppy.

0:24:34 > 0:24:36Yeah, called number Ten.

0:24:36 > 0:24:39Cos you've not had any new characters for a while?

0:24:39 > 0:24:42- I've had 27.- 27?

0:24:42 > 0:24:45- Yeah, the bird?- Hey?

0:24:45 > 0:24:48The bird, the black bird.

0:24:48 > 0:24:51And is 27 nice or nasty?

0:24:51 > 0:24:53- Nasty...- Oh, dear.

0:24:53 > 0:24:56It's a big, scary, black bird and it lives in the forest.

0:24:56 > 0:24:59I don't think we needed any more nasty ones.

0:25:00 > 0:25:02Her adoptive parents have no idea

0:25:02 > 0:25:05what has brought on their daughter's hallucinations,

0:25:05 > 0:25:08whether the condition has a name or even if it can be treated.

0:25:08 > 0:25:12It would be nice to be able to label it as something, you know,

0:25:12 > 0:25:14some kind of condition.

0:25:14 > 0:25:17But we haven't got a label for it yet.

0:25:17 > 0:25:20But I know that this is something quite deep-seated

0:25:20 > 0:25:23and it's not going to go away in a hurry.

0:25:27 > 0:25:29CRYSTAL SINGS ALONG TO SONG

0:25:29 > 0:25:32# But you can't hold on to water

0:25:32 > 0:25:34# It fills you up but never stays

0:25:34 > 0:25:38# It's only good to wash away today

0:25:38 > 0:25:44# And you're loving me Like water... #

0:25:44 > 0:25:46The past few weeks have been relatively calm

0:25:46 > 0:25:49on the McGuinness Unit, even harmonious.

0:25:49 > 0:25:52- Shall we sing our song to her?- Yeah.

0:25:52 > 0:25:56# I love you, you love me We're a mental family

0:25:56 > 0:26:01# In a mental home at Prestwich and it's called the McGuinness Unit. #

0:26:01 > 0:26:03We made that up.

0:26:03 > 0:26:05Right, it's really good, apart from the end bit.

0:26:05 > 0:26:07You need like a bit of action.

0:26:07 > 0:26:09It's good wording, though.

0:26:09 > 0:26:12- M...Mc, like...- M-C-G...

0:26:14 > 0:26:15It's like...

0:26:24 > 0:26:28It's five o'clock - dinner time on the ward.

0:26:28 > 0:26:31Since she was put on a section, Beth has started to comply a bit more,

0:26:31 > 0:26:35she's beginning to eat at meal times.

0:26:35 > 0:26:38They think one of the reasons why I've got an eating disorder

0:26:38 > 0:26:41in the first place was cos I try to control things in my life

0:26:41 > 0:26:45and now they're taking the control of food away from me...

0:26:46 > 0:26:51..I, you know...I don't like it.

0:26:52 > 0:26:56Beth may be eating more, but it's making her feel guilty.

0:26:56 > 0:26:59So she's developed a way of punishing herself.

0:27:01 > 0:27:04I cut when I've eaten as a punishment.

0:27:04 > 0:27:08That's when the voice is more in control.

0:27:08 > 0:27:11It makes me feel better because it's like...

0:27:13 > 0:27:15..it's all just coming out in the blood,

0:27:15 > 0:27:17all the thoughts are just coming out in the blood

0:27:17 > 0:27:19that comes out of your body.

0:27:21 > 0:27:24One day, I walked into the room and she was cutting herself

0:27:24 > 0:27:27and I took it off her to stop her cutting herself.

0:27:27 > 0:27:29I'm such a good friend.

0:27:29 > 0:27:32I did thank her the day after, I hated her that day.

0:27:32 > 0:27:35But they day after, I did thank her.

0:27:35 > 0:27:39Around one in 12 young people deliberately self-harm,

0:27:39 > 0:27:42around 25,000 are admitted to hospital every year

0:27:42 > 0:27:44due to the severity of their injuries.

0:27:46 > 0:27:50It's a continuous problem for staff on the McGuinness Unit.

0:27:50 > 0:27:53As soon as they confiscate something the patients could self-harm with,

0:27:53 > 0:27:56the young people find new ways of hiding them.

0:27:56 > 0:28:00The most sort of common things are sharpener blades,

0:28:00 > 0:28:02razor blades...

0:28:04 > 0:28:08Make sure nothing's been concealed anywhere.

0:28:08 > 0:28:10The young people sort of think

0:28:10 > 0:28:11that we're not that clued up,

0:28:11 > 0:28:14so, you know, you'll come to do

0:28:14 > 0:28:16a search of a poster

0:28:16 > 0:28:19and you'll get a piece of Blu-Tack and have a look through

0:28:19 > 0:28:23and you'll find like a blade stuck inside it.

0:28:23 > 0:28:27So I think now they're not actually allowed Blu-Tack in the bedrooms.

0:28:27 > 0:28:30We encourage them to use sort of sticky tape.

0:28:36 > 0:28:38When I'm in the outside world,

0:28:38 > 0:28:40I do anything to hide my scars.

0:28:40 > 0:28:44Like, I wouldn't even get changed in front of everyone.

0:28:44 > 0:28:47When we was getting changed for practical at college

0:28:47 > 0:28:49in case anyone saw it...

0:28:50 > 0:28:53That helps it fade.

0:28:53 > 0:28:56I had that bandage today and that's all there is to it today.

0:28:58 > 0:28:59It's fine now.

0:28:59 > 0:29:01'It feels more normal in here.'

0:29:01 > 0:29:05Like, literally everyone has done it.

0:29:05 > 0:29:06They don't judge you.

0:29:06 > 0:29:11People on the outside, they judge you on the way you look.

0:29:11 > 0:29:13Like, if they saw me,

0:29:13 > 0:29:15sitting here like this, they'd probably say,

0:29:15 > 0:29:18"You're too fat to have an eating disorder,"

0:29:18 > 0:29:20like cos I am, I'm...I'm fat. I'm...

0:29:23 > 0:29:25I'm just fat.

0:29:28 > 0:29:30I just don't think that'll ever change.

0:29:32 > 0:29:34And now I've got to go and eat dinner.

0:29:36 > 0:29:39Here, she says she hates herself

0:29:39 > 0:29:43and she definitely believes that she will end her life,

0:29:43 > 0:29:45that that will be the only way out.

0:29:45 > 0:29:48And nobody actually understands her.

0:29:48 > 0:29:50Nobody.

0:29:50 > 0:29:55The senior team are meeting to discuss new fears for Beth's safety.

0:29:55 > 0:29:58She's written a letter to staff that has made alarm bells ring.

0:29:58 > 0:30:00And...and she says,

0:30:00 > 0:30:02"I really do need to die.

0:30:02 > 0:30:06"I just really don't know how to do it in this place.

0:30:06 > 0:30:08"Overdosing," she says, "didn't work.

0:30:08 > 0:30:11"Using ligature didn't work.

0:30:11 > 0:30:15"Using sharp objects has not worked."

0:30:15 > 0:30:20You know, she says all these terrible things about herself,

0:30:20 > 0:30:25but if you observe her, you don't get that sense

0:30:25 > 0:30:30that she's going through a lot of this, you don't get it at all.

0:30:30 > 0:30:32But once we discharge her,

0:30:32 > 0:30:37then she will do something terrible whilst out in the community.

0:30:39 > 0:30:42It's a very sad letter. Very, very sad.

0:30:43 > 0:30:48We'll sit down with her, try to review her antidepressants

0:30:48 > 0:30:53and the sleeping tablets with a view to increasing it.

0:30:57 > 0:31:00Just like Beth has a price to pay for eating her meal,

0:31:00 > 0:31:04so does the ward's youngest patient, 14-year-old Crystal.

0:31:13 > 0:31:15Some of her imaginary characters, the rats,

0:31:15 > 0:31:17are not happy when she eats dinner.

0:31:24 > 0:31:28The rats, you see, told me not to eat and I've been eating,

0:31:28 > 0:31:33so they'll come and be mean and they'll hurt me a lot.

0:31:34 > 0:31:37Those are the recent ones

0:31:37 > 0:31:40and the rats were trying to get me to scratch,

0:31:40 > 0:31:43so I scratched through a vein,

0:31:43 > 0:31:46but it didn't really work

0:31:46 > 0:31:51and then, on my other arm, I did most of that yesterday.

0:31:51 > 0:31:53And then, I did that a few days ago.

0:31:55 > 0:31:58But Crystal doesn't just want to harm herself.

0:31:58 > 0:32:03She's told staff at the unit that her imaginary characters, the rats,

0:32:03 > 0:32:07want her to kill her adoptive father, Bill.

0:32:07 > 0:32:09I don't know how it came about,

0:32:09 > 0:32:13but she...she said she felt like killing me sometimes.

0:32:13 > 0:32:15She felt like killing me.

0:32:15 > 0:32:18My fears are it's schizophrenia.

0:32:18 > 0:32:21- I don't think at the moment she would do something.- No.

0:32:21 > 0:32:24But, sometimes, I don't know if it's a look on her face

0:32:24 > 0:32:27that makes me feel, "No, you're not being silly here,

0:32:27 > 0:32:30"this is actually quite sinister."

0:32:30 > 0:32:34And then it'll pass and it's almost like that person's gone again

0:32:34 > 0:32:36and she's...Crystal's back.

0:32:39 > 0:32:42My dad gets scared of them sometimes.

0:32:42 > 0:32:49They make me feel like I want to kill him and stuff, even if I don't.

0:32:49 > 0:32:51But, like, they make me feel like I do.

0:32:55 > 0:32:57She's very settled on the ward at the minute,

0:32:57 > 0:32:59she spends time in communal areas with others.

0:32:59 > 0:33:01The unit's senior staff are concerned

0:33:01 > 0:33:03about Crystal's change in behaviour.

0:33:03 > 0:33:07Perceptual, er...disturbances.

0:33:07 > 0:33:10Art therapist Charlotte reports back on something

0:33:10 > 0:33:12that came out of their sessions.

0:33:12 > 0:33:14Her hamster died at the weekend.

0:33:14 > 0:33:16Crystal actually got the clay

0:33:16 > 0:33:19and was stamping it and saying, "That's like my dead hamster,"

0:33:19 > 0:33:22and she laughed about it and was saying

0:33:22 > 0:33:26that it was funny when people...when her hamster died, really,

0:33:26 > 0:33:30and talking about ideas of people being harmed

0:33:30 > 0:33:32and it's all right for people to be harmed

0:33:32 > 0:33:34and we tried to explore that a little bit

0:33:34 > 0:33:36in terms of, perhaps, her own experiences,

0:33:36 > 0:33:41thinking that she's been hurt and that it's OK for others to be hurt.

0:33:41 > 0:33:44But her reaction to it was quite incongruent, really.

0:33:44 > 0:33:49I just wanted to mention that. But, otherwise, work sort of is ongoing.

0:33:50 > 0:33:52It's not just the art therapist Charlotte

0:33:52 > 0:33:55who is trying to work with Crystal on her aggression,

0:33:55 > 0:33:57the occupational therapists Vicky and Matt

0:33:57 > 0:34:01talk to her about wanting to kill her adoptive dad.

0:34:01 > 0:34:05I said I don't like my dad because I don't get along with my dad.

0:34:06 > 0:34:10And I think...I think there's some concerns about...

0:34:10 > 0:34:13- I said I want to kill him.- Yeah.

0:34:13 > 0:34:17I want to love my dad and get along with him,

0:34:17 > 0:34:19but, like, my voices won't let me.

0:34:21 > 0:34:25So is a lot of it driven by the voices, do you think?

0:34:25 > 0:34:26- Yeah.- Yeah?

0:34:26 > 0:34:29It's about how we can support you to keep you safe,

0:34:29 > 0:34:32but also to keep your dad safe as well.

0:34:39 > 0:34:42Crystal is on another weekend visit home.

0:34:43 > 0:34:44I've got two guinea pigs.

0:34:46 > 0:34:48But I don't like them.

0:34:49 > 0:34:52That one's the oldest.

0:34:52 > 0:34:56Cos, like, we had that one and another one

0:34:56 > 0:34:59and then the other one died and then we got another one

0:34:59 > 0:35:03and that one died and then we got her and she's...alive.

0:35:14 > 0:35:16Crystal's latest changes in behaviour

0:35:16 > 0:35:18are causing tensions with her mother, Helen.

0:35:18 > 0:35:20Give it to me now.

0:35:20 > 0:35:21Give what to you?

0:35:21 > 0:35:25The hair clip that you've pulled the plastic off and it's now sharp.

0:35:25 > 0:35:28- It never had plastic on it. - Give it to me.

0:35:28 > 0:35:30- Give what to you?- The hair clip. - I've not got anything.

0:35:30 > 0:35:33- It's in your hand, Crystal, give it to me, please.- I've not got hands.

0:35:35 > 0:35:37No...

0:35:37 > 0:35:41- Crystal, open your hand.- No. - Look at this, look.

0:35:41 > 0:35:42You did that months ago

0:35:42 > 0:35:44and you've still got marks.

0:35:44 > 0:35:45Thank you.

0:35:49 > 0:35:54Without an answer, it's very difficult to get help and support.

0:35:54 > 0:35:57With an answer, that's the only reason, really. With an answer,

0:35:57 > 0:36:00with something that you can put a name to,

0:36:00 > 0:36:03comes the support and the extra help.

0:36:03 > 0:36:05- Why are you doing that, Crystal? - I don't know.

0:36:05 > 0:36:09And we've gone through the gamut now of not eating,

0:36:09 > 0:36:13well, you can see the evidence of the self-harm.

0:36:13 > 0:36:16So it's quite scary at the moment.

0:36:17 > 0:36:19I don't sleep very well at night.

0:36:28 > 0:36:30Winter is drawing in.

0:36:35 > 0:36:37Inside the McGuinness Unit,

0:36:37 > 0:36:4115 young people are spending weeks or even months of their lives

0:36:41 > 0:36:44trying to find a way to deal with their illnesses.

0:36:55 > 0:36:58My week's been shit, I've not got discharged,

0:36:58 > 0:37:04my leave has been cancelled and I'm very sad.

0:37:06 > 0:37:07You can tell this place is mental

0:37:07 > 0:37:10when there's people lying on the floor.

0:37:11 > 0:37:13You got me a pressie?

0:37:13 > 0:37:17My mum's amazing, she brings me in loads of stuff.

0:37:20 > 0:37:21- Oh, yeah.- Yeah?

0:37:21 > 0:37:24Gill is continuing to make good progress.

0:37:24 > 0:37:28She has had more visits from her mum and they are getting on well.

0:37:28 > 0:37:29Thank you.

0:37:29 > 0:37:32Oh! Thank you! I needed one of these.

0:37:34 > 0:37:37And now I want you to gently bring your attention to your breathing...

0:37:39 > 0:37:41..and the sensations in your body.

0:37:41 > 0:37:43She's also no longer being restrained,

0:37:43 > 0:37:47thanks, in part, to what's called mindfulness therapy.

0:37:47 > 0:37:50Just notice what's taking your mind away.

0:37:50 > 0:37:51Let it be...

0:37:52 > 0:37:56..and gently bring your attention back to the breath.

0:38:00 > 0:38:03I had a very insightful day the other day,

0:38:03 > 0:38:06I just realised that I just need to concentrate on myself

0:38:06 > 0:38:09and getting myself better and getting myself out of here.

0:38:09 > 0:38:12I think seeing my mum more helps.

0:38:12 > 0:38:16I'm never, ever going back to 24 hours on the ECA.

0:38:16 > 0:38:18I'm determined not to go back to that.

0:38:18 > 0:38:21I just need to keep on the right track.

0:38:23 > 0:38:25The review team have given Gill a leave plan,

0:38:25 > 0:38:28which allows her increasing amounts of time in the hospital grounds

0:38:28 > 0:38:30as long as everything goes well.

0:38:33 > 0:38:38It started yesterday, when I had five minutes out and again today

0:38:38 > 0:38:40and then tomorrow I've got another five minutes,

0:38:40 > 0:38:44but then, on Thursday, it goes up to ten minutes.

0:38:44 > 0:38:48Then next week, on Monday and Tuesday, I get 20 minutes.

0:38:48 > 0:38:51Then, Wednesday and Thursday, I get 25.

0:38:51 > 0:38:53Friday and Saturday, I get 30 minutes

0:38:53 > 0:38:57and then, hopefully, I'll be able to go home for Christmas.

0:38:58 > 0:39:00PIANO PLAYING

0:39:03 > 0:39:06# Rocking around the Christmas tree

0:39:06 > 0:39:09# At the Christmas party hop... #

0:39:09 > 0:39:11At this time of year, the staff go to great lengths

0:39:11 > 0:39:13to make the ward feel festive for the inpatients.

0:39:17 > 0:39:19In the week before Christmas,

0:39:19 > 0:39:23there are a number of events organised on the unit.

0:39:23 > 0:39:26# All is calm

0:39:26 > 0:39:29# All is bright... #

0:39:29 > 0:39:33In the art class, there is an award ceremony for the patients.

0:39:33 > 0:39:37One of the prizes is for the best writing in an English class.

0:39:37 > 0:39:39The person who did win it, overall, is here

0:39:39 > 0:39:41and that was Gillian, well done!

0:39:45 > 0:39:46I got a pen!

0:39:48 > 0:39:50That's rather funky, that

0:39:50 > 0:39:53and then chocolate, you can tell that's chocolate. Feel it!

0:39:56 > 0:40:00While Gill is enjoying herself at the Christmas concert,

0:40:00 > 0:40:01the review team is deciding

0:40:01 > 0:40:03whether she'll be allowed home on Christmas day.

0:40:03 > 0:40:08Risk to self - there was a self-harm incident over the weekend

0:40:08 > 0:40:11where she got a needle from the clinic room and self-harmed.

0:40:11 > 0:40:14Because the last review was a bit more positive,

0:40:14 > 0:40:16including from college as well, isn't it?

0:40:16 > 0:40:19So this is a week period almost where we had...

0:40:19 > 0:40:21It's deteriorated rapidly...

0:40:21 > 0:40:24Yeah, and it's triggered by Christmas coming up

0:40:24 > 0:40:25and of feeling that...

0:40:25 > 0:40:29I think she probably knows we're not going to give her leave.

0:40:38 > 0:40:40- I don't care!- I do.

0:40:43 > 0:40:46The risk has been deemed too high

0:40:46 > 0:40:48for Gill to leave the unit on Christmas Day.

0:41:01 > 0:41:04ALL: Bye!

0:41:04 > 0:41:06But it's not bad news for everyone.

0:41:06 > 0:41:08Crystal has been allowed home leave

0:41:08 > 0:41:10for the whole of the Christmas period

0:41:10 > 0:41:12and she's heading off this afternoon.

0:41:21 > 0:41:25No-one wants to spend Christmas Day on a psychiatric ward.

0:41:25 > 0:41:28But eight young people are waking up to this one on the McGuinness Unit,

0:41:28 > 0:41:31away from their families, and that includes Beth.

0:41:33 > 0:41:34It's stupid!

0:41:39 > 0:41:43It don't really feel like it's Christmas, because, at Christmas,

0:41:43 > 0:41:45you're supposed to be at home

0:41:45 > 0:41:47and stay in bed all day, like, with your pyjamas on

0:41:47 > 0:41:49and spend it with your family.

0:41:49 > 0:41:53Run downstairs in the morning and just, like, jump on your parents.

0:41:53 > 0:41:55You feel more lonely because

0:41:55 > 0:41:58you know other people have gone to see their families

0:41:58 > 0:42:03and enjoy Christmas as it is, not just sitting here, waiting.

0:42:03 > 0:42:06Oh, this is wicked! Merry Christmas!

0:42:09 > 0:42:11THEY LAUGH

0:42:23 > 0:42:27This time last year, I was running away from home.

0:42:27 > 0:42:29But this time, it's like, yay!

0:42:29 > 0:42:32I've got my family back, we're all talking again and it's brilliant.

0:42:34 > 0:42:36- I love you.- I love you too.

0:42:45 > 0:42:49Just after Christmas, a friend of Gill's sadly dies.

0:42:49 > 0:42:53It has a profound effect on her, but the tragedy inspires Gill

0:42:53 > 0:42:56to stop self-harming and look to the future.

0:42:56 > 0:43:00Yeah, I've got this bobble and when I feel like doing it,

0:43:00 > 0:43:02- I'll just do that...- Ping it.

0:43:02 > 0:43:05Ping it and it reminds me of her

0:43:05 > 0:43:07- and not to do it for her.- Yeah.

0:43:07 > 0:43:11- I need to live the life that she's not got any more.- Yeah.

0:43:13 > 0:43:15- It was very distressing, wasn't it?- Yeah.

0:43:15 > 0:43:18So, for me, you're in a very good place at the moment.

0:43:18 > 0:43:22Do you kind of feel that you're now probably engaging more and...?

0:43:22 > 0:43:24Yeah, yeah, I am trying a lot more.

0:43:30 > 0:43:32For the patients on the McGuinness Unit,

0:43:32 > 0:43:34it's the beginning of a new year.

0:43:36 > 0:43:39Kim, is there a chicken tikka on there?

0:43:39 > 0:43:42I'll put both out and then you can decide.

0:43:43 > 0:43:48Beth is continuing to comply with the eating plan,

0:43:48 > 0:43:52although she may still hide the odd piece of food at meal times.

0:43:56 > 0:44:00They don't know, but I break it up,

0:44:00 > 0:44:03put it in my hand and then put it in my pocket when they don't look

0:44:03 > 0:44:07and I'll hide it underneath more food.

0:44:07 > 0:44:09Because that way, they're getting what they want

0:44:09 > 0:44:11and I'm getting what I want, so everyone's happy.

0:44:13 > 0:44:14We have to speed up a bit.

0:44:14 > 0:44:17- Zip.- Boing.

0:44:17 > 0:44:19- Zip.- Zig...boing.

0:44:19 > 0:44:20- Zip.- Boing.

0:44:20 > 0:44:22- Zip.- Boing.

0:44:22 > 0:44:24Zip. Boing.

0:44:24 > 0:44:25Zip.

0:44:25 > 0:44:28- Zip.- Boing.

0:44:28 > 0:44:31- Zip.- Zip.- Zip.- Zip.

0:44:31 > 0:44:34Ever since she arrived at the McGuinness Unit eight weeks ago,

0:44:34 > 0:44:37Crystal's doctors have been trying to establish

0:44:37 > 0:44:40whether her visions are caused by psychosis.

0:44:40 > 0:44:43- Zip.- Zip.- Boing.

0:44:43 > 0:44:44- Boing.- Zip.

0:44:44 > 0:44:47Boing. I'm wondering when this game finishes...

0:44:47 > 0:44:49THEY LAUGH

0:45:05 > 0:45:08That assessment is complete

0:45:08 > 0:45:10and her adoptive parents, Bill and Helen,

0:45:10 > 0:45:13will shortly find out the reality of Crystal's condition.

0:45:15 > 0:45:20As long as she could come home and live a reasonably normal life -

0:45:20 > 0:45:24the worst-case scenario is that she can't manage

0:45:24 > 0:45:28and that she would either be institutionalised

0:45:28 > 0:45:33or she wouldn't manage life on the outside at all

0:45:33 > 0:45:35and the worst of the worst would happen.

0:45:37 > 0:45:41They have been called to a meeting with Dr Acho,

0:45:41 > 0:45:42Crystal's psychiatrist.

0:45:44 > 0:45:46Since her early life, you know,

0:45:46 > 0:45:50she's experienced this neglect, physical abuse.

0:45:50 > 0:45:55She's always been feeling worthless and unwanted.

0:45:55 > 0:45:58She has then developed some protective strategies

0:45:58 > 0:46:03to help her and stop her from feeling lonely and unloved.

0:46:03 > 0:46:06In terms of child development,

0:46:06 > 0:46:09it's something that we all went through.

0:46:09 > 0:46:13At a point in our life, we live in fantasy world.

0:46:13 > 0:46:17Usually, between the ages of three and five,

0:46:17 > 0:46:22but for some children, it becomes bigger and bigger

0:46:22 > 0:46:26and they tend to lose that sense of reality.

0:46:26 > 0:46:30Are we looking at her following any medication?

0:46:30 > 0:46:33She is not psychotic,

0:46:33 > 0:46:37- this is her way of coping...- Yeah.

0:46:37 > 0:46:42..and that she could, with time, be able to destroy those characters,

0:46:42 > 0:46:45because it's something that she has created

0:46:45 > 0:46:50and it's something which she can work towards getting rid of.

0:46:50 > 0:46:53- OK, thank you very much, doctor. - Cheers.- Thank you.

0:46:53 > 0:46:55Thanks for coming.

0:46:58 > 0:47:00Huge relief, there's nothing worse

0:47:00 > 0:47:03than knowing a little bit about something,

0:47:03 > 0:47:05cos you tend to build it up in your own mind.

0:47:05 > 0:47:11So all we want is for her to come home and be able to manage happily

0:47:11 > 0:47:13and go back to school and be happy at school.

0:47:13 > 0:47:16- Maybe I'm expecting too much there. - Yeah.

0:47:16 > 0:47:19- Hi!- Hello, darling! Are you OK?

0:47:19 > 0:47:21Look, Look!

0:47:21 > 0:47:24Kirsty did that before she left and I found it in...

0:47:24 > 0:47:26- Oh, that's nice! - I found it in maths.

0:47:26 > 0:47:28"To Crystal. Love, Kirsty."

0:47:28 > 0:47:30- Oh!- That's really nice, that.

0:47:36 > 0:47:37Ugh!

0:47:37 > 0:47:39THEY LAUGH

0:47:39 > 0:47:41I won't actually do it, you know.

0:47:41 > 0:47:42# Nah-nah-nah-nah-nah-nah! #

0:47:42 > 0:47:45THEY LAUGH

0:48:14 > 0:48:16- Hiya!- You all right?

0:48:16 > 0:48:18- Yeah, are you?- Yeah.

0:48:18 > 0:48:20When a friend visits Beth later in January,

0:48:20 > 0:48:24she has made a big improvement in terms of her eating plan.

0:48:24 > 0:48:26It was my CPA yesterday

0:48:26 > 0:48:30and they said they're going to keep reviewing my section every week,

0:48:30 > 0:48:33so maybe in the next few weeks, I'll be taken off that.

0:48:33 > 0:48:35That's good, then.

0:48:35 > 0:48:38Yeah, and my meal plan's been increased again.

0:48:38 > 0:48:40And I've moved from... I'll show you.

0:48:49 > 0:48:54I've moved from the anorexia nervosa band to the underweight band.

0:48:54 > 0:48:56Where did you start off?

0:48:56 > 0:48:59In the green band - anorexia nervosa,

0:48:59 > 0:49:01now I'm just the underweight!

0:49:01 > 0:49:03So what's after that?

0:49:05 > 0:49:06Fat!

0:49:06 > 0:49:07THEY LAUGH

0:49:07 > 0:49:10It's not fat after that, though, is it?

0:49:10 > 0:49:12- It is!- No, it isn't!- Yes.

0:49:12 > 0:49:15- Well, I'm happy you're getting better, anyway!- Oh, Gabby!

0:49:19 > 0:49:22- Oh, I've missed you, I actually have. - I've missed you too.

0:49:22 > 0:49:25- Everyone at college misses you as well.- Do they?- Yeah.

0:49:29 > 0:49:32Beth believes she has made so much progress in the last few weeks,

0:49:32 > 0:49:34she should be allowed to go home,

0:49:34 > 0:49:37but she cannot leave while she is still sectioned.

0:49:37 > 0:49:39So she's taking the matter to a tribunal.

0:49:39 > 0:49:42You can also get discharged there as well,

0:49:42 > 0:49:45so that's what I'm hoping will happen.

0:49:45 > 0:49:47I really want to go home,

0:49:47 > 0:49:49so I'm packing now.

0:49:52 > 0:49:55The law allows patients to appeal against sections

0:49:55 > 0:49:57if they feel they have a case.

0:50:00 > 0:50:03I don't really want to kill myself any more.

0:50:03 > 0:50:06There's things everywhere that you can actually self-harm with.

0:50:06 > 0:50:08Like, you can self-harm with this.

0:50:10 > 0:50:13I'm not really that desperate to do it any more.

0:50:20 > 0:50:23Beth cannot leave of her own free will,

0:50:23 > 0:50:27but Crystal is being discharged today.

0:50:27 > 0:50:31Now, I feel that I can talk to my mum and dad more and...

0:50:31 > 0:50:34I can tell them when I've been having a bad day.

0:50:34 > 0:50:38And I can, like, trust them to not get mad.

0:50:38 > 0:50:41I used to never tell them anything.

0:50:44 > 0:50:48The doctors are confident she does not have a psychotic illness,

0:50:48 > 0:50:50which means she is not a threat to herself or others

0:50:50 > 0:50:52and can go home.

0:50:52 > 0:50:55- You're just excited to go home, I hope.- No!

0:50:55 > 0:50:57- Pardon?- No!- No? Yeah.

0:51:01 > 0:51:04She and her parents understand what's going on inside her head

0:51:04 > 0:51:07and now know how to manage it.

0:51:07 > 0:51:09I'm actually going to have a future.

0:51:11 > 0:51:15Like, I do think more of the future now, like,

0:51:15 > 0:51:18when I first came in here, I just thought that was it

0:51:18 > 0:51:22and I was never going to get better and I'd be in here forever

0:51:22 > 0:51:24and I just wanted to die.

0:51:24 > 0:51:28I think it's a case of coming to terms

0:51:28 > 0:51:32and learning to live with stuff - it doesn't go away.

0:51:33 > 0:51:35It's just about coping.

0:51:35 > 0:51:37When you can't cope, you tell people.

0:51:43 > 0:51:46- Bye, Crystal!- Bye!

0:51:46 > 0:51:47Bye!

0:51:58 > 0:52:00Gill has made a remarkable breakthrough.

0:52:00 > 0:52:03She's finally been moved off the acute corridor

0:52:03 > 0:52:06and now has a room on the general ward with all the other patients.

0:52:06 > 0:52:10Mind the mess. I'm a bit untidy.

0:52:10 > 0:52:13One minute.

0:52:13 > 0:52:15Dirty clothes, dirty clothes,

0:52:15 > 0:52:18clean clothes in the dirty wash basket.

0:52:20 > 0:52:23Yeah, and just a heap of junk on there.

0:52:23 > 0:52:26SHE CHUCKLES

0:52:26 > 0:52:27For the past six weeks,

0:52:27 > 0:52:30Gill has been slowly building up her leave away from the ward.

0:52:30 > 0:52:33- What's in it? Hydrogen peroxide? - Uh-huh.

0:52:34 > 0:52:38It may have started only as five minutes in the hospital grounds...

0:52:38 > 0:52:39What do you think? Let me see.

0:52:39 > 0:52:42..but now Gill is preparing to go out into the community

0:52:42 > 0:52:44for the first time in six months.

0:52:48 > 0:52:50On a trip with Vicky and Matt,

0:52:50 > 0:52:53she is trying to show she is well enough to be taken off her section,

0:52:53 > 0:52:55and eventually be discharged from the unit.

0:52:57 > 0:52:59It's really good, cos I get time off the unit

0:52:59 > 0:53:02and I can, like, just be out with normal people.

0:53:04 > 0:53:06Cos, like, when you're out,

0:53:06 > 0:53:09people don't know that you're in, like, a unit or anything.

0:53:09 > 0:53:13So, like, it's a bit strange sometimes, cos it's like,

0:53:13 > 0:53:16"Oh, my gosh, I have to go back there, don't I?"

0:53:16 > 0:53:19This trip is meant to be fun and relaxed,

0:53:19 > 0:53:23but Vicky and Matt are watching Gill closely to see how she behaves.

0:53:23 > 0:53:25Chicken, bacon and mozzarella.

0:53:25 > 0:53:27Treatment at the McGuinness Unit

0:53:27 > 0:53:30is less about finding a cure for the patient

0:53:30 > 0:53:34and more about helping them to find ways of coping in the outside world.

0:53:34 > 0:53:37Any typical adolescent will become distressed at times

0:53:37 > 0:53:40and our task is not to make the perfect adolescent,

0:53:40 > 0:53:44it's actually to support young people to build resilience,

0:53:44 > 0:53:47to build confidence, that when they become distressed, actually,

0:53:47 > 0:53:50they're able to manage it more effectively.

0:53:50 > 0:53:52They're able to feel confident in themselves

0:53:52 > 0:53:56and they can go on and live their life with its ups and downs,

0:53:56 > 0:54:01without some of the negative consequences of...of that distress.

0:54:01 > 0:54:04First, I'd prefer it to be in white...hmm...

0:54:06 > 0:54:08SHE LAUGHS

0:54:11 > 0:54:14Today, Beth's future is going to be decided.

0:54:14 > 0:54:17She has appealed against her section

0:54:17 > 0:54:19and this afternoon a tribunal will decide

0:54:19 > 0:54:21if she's well enough to be taken off it.

0:54:21 > 0:54:23I could ultimately be discharged,

0:54:23 > 0:54:26but I'd need to be taken off my section today.

0:54:26 > 0:54:31It's basically just a court and you've got three independent people

0:54:31 > 0:54:34and they all basically assess you

0:54:34 > 0:54:37and tell you whether you're well enough to go home or whatever,

0:54:37 > 0:54:41but...I think I'm well enough to go home now.

0:54:41 > 0:54:42Good luck!

0:54:45 > 0:54:47If the decision goes her way,

0:54:47 > 0:54:50she could be going home after the meeting.

0:54:52 > 0:54:53Are you coming through?

0:55:04 > 0:55:07The tribunal lasts two and a half hours.

0:55:15 > 0:55:17It's not good news for Beth -

0:55:17 > 0:55:20she must remain on her section and in the hospital.

0:55:23 > 0:55:24On the same afternoon,

0:55:24 > 0:55:27feelings could not be more different for Gill,

0:55:27 > 0:55:29who has reason to celebrate.

0:55:29 > 0:55:31I'm coming off my section tomorrow!

0:55:31 > 0:55:34- You what?- I'm coming off my section tomorrow!

0:55:34 > 0:55:36BOTH: Yeah!

0:55:36 > 0:55:39The first call she makes is to her mum.

0:55:39 > 0:55:41I'm getting taken off it tomorrow.

0:55:46 > 0:55:48I'm so happy!

0:55:49 > 0:55:51One afternoon,

0:55:51 > 0:55:53two completely different decisions.

0:55:57 > 0:56:00Dismay for one patient and joy for another.

0:56:00 > 0:56:03I'm getting taken off my section!

0:56:09 > 0:56:12Crystal returned to school and is doing well.

0:56:12 > 0:56:14For Beth, her struggle goes on.

0:56:14 > 0:56:16Tomorrow's ages away,

0:56:16 > 0:56:19when you've been stuck in here almost six fucking months!

0:56:20 > 0:56:23- No!- Just calm down.

0:56:23 > 0:56:25But she's not the only one with anger issues.

0:56:25 > 0:56:28Just do it. You should kill yourself.

0:56:29 > 0:56:30HE GRUNTS

0:56:31 > 0:56:33Oh! Fucking hell!

0:56:33 > 0:56:35I hate it.

0:56:36 > 0:56:38Really hate it.

0:56:38 > 0:56:39What a tit!

0:57:05 > 0:57:08Subtitles by Red Bee Media Ltd