Episode 2 Don't Call Me Crazy

ALARM RINGS

This is the McGuinness Unit in Manchester,

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

GIRL SCREAMS

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

or psychosis, 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 thrown over my head.

..in the good times...

SHE BELCHES

LAUGHTER

..and the bad.

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

in Britain who have to deal with mental illness.

THEY SCREAM

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.

Me brain's a bit...!

14-year-old Crystal has just arrived on the ward.

Making a mess on the floor.

-I'm not making a mess!

-You all look messy!

She sees people and animals that no-one else can.

They have been with her for six years.

Most of them are her friends.

They're the people. I'm not a very good drawer.

That's 75, that's the dog and then that's 200 and that's the cat.

That's the land where they live.

And then there's Seven, and she's the little girl I see.

But some of them are sinister and they frighten Crystal.

That's one of the rats called Autumn and its teeth are really long.

Recently the scary characters have been appearing more often

and have made her feel suicidal, which is why she's been admitted.

These characters tell Crystal to do things

and she believes she has to obey.

It's dinner time on the ward and the patients are in the canteen.

But Crystal is not eating.

She appears preoccupied, glancing back at the floor,

looking at something the other patients cannot see.

'I was hungry.

'If I eat, then the rat will get mad and he can bite and scratch

'and hurt me

'and then he can get the other rats.'

Scary. I don't like it.

A patient like Crystal, who has hallucinations,

raises particular challenges for the staff in the unit.

They need to explore the causes and there are many possible reasons.

On admission, the first thing we did was carry out a blood test,

making sure that her liver, kidney,

the thyroid glands that they're all functioning well.

Because if there are difficulties with these areas,

you might end up having problems with seeing things

that are actually not there and the result of this...

they came out as all being normal.

Since nothing showed up in her blood test,

it's clear that Crystal's problems are psychological.

-Oh!

-Charlotte the art therapist

has been using drawing to find out more about Crystal's imaginary world

and what might have caused it.

These are kind of the good guys, aren't they?

-Yeah, they're the good ones.

-Yeah.

We sometimes think about what happens in your world

and what happens in this world.

-We get confused sometimes, don't we, as well, Crystal?

-Yeah.

-This is Seven? Yeah?

-Yeah, but it doesn't look like Seven.

What was it that didn't look like Seven?

She looks older.

Because you wanted her to look about four, didn't you?

-Yeah, because she is four.

-Yeah.

Crystal was also four when something significant happened to her.

She was adopted.

We started to think about some of the bad things

that came in as well, do you remember?

Like the man, he's just really scary.

His eyes are just big, black circles, so he doesn't have eyes.

He's just scary and he looks like my real dad as well,

and that's a bit weird.

Crystal is 14

and the hearing of voices started around the age of eight.

Every week, the senior staff meet to discuss each patent in detail.

This is someone who had a very, very traumatic upbringing.

She was being neglected.

There was physical abuse going on and Social Services had to step in.

Crystal and her younger brother,

they were both adopted since about the age of three.

She's gone through a lot.

In Crystal's assessment,

the team need to understand her past to know how to help her.

It's very, very early stages.

We've thought a little bit about these bad characters

and the rats and how they relate to angry feelings

and jealous feelings sometimes as well

and getting between relationships.

During her first week, Crystal's characters are with her

from first thing in the morning to last thing at night.

Seven's there.

She's there. She's hugging Barlum.

Barlum's her toy, it's a sheep and it's called Barlum

and she holds it everywhere.

She always wants me to read her a story.

She says she wants a princess story.

She said Barlum's a princess.

The ones I can see, they sometimes have a line around them,

like a white line that glows.

They're always saying that they'll be there for me all the time.

So, that's why I called them 24/7, 24 hours and Seven.

I don't want the good things I see to go away

because they're like my best friends and I wouldn't want them to go away.

17-year-old Beth has been on the McGuinness Unit for three months,

suffering from depression and an eating disorder.

Why don't you want to do this?

Because there's nothing wrong.

-There's nothing wrong?

-People...

-What did you have for your dinner?

-Nothing!

-What did you have for breakfast?

-Nothing!

She was admitted voluntarily,

but wouldn't eat for days at a time and rebelled against staff.

All the fat on my hips, like all the fat on my arms there.

I like to see the bone.

Still reporting that she wants to die

and saying it will be easier that way, then no-one has to worry.

Her refusal to eat enough forced staff to consider drastic action.

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

They're just trying to scare me.

But three months after being admitted, Beth was sectioned

under the Mental Health Act and she has lost the ability to say no.

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.

Apparently, it's in my best interests and because I'm too ill,

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

Which sucks.

Beth now has the choice -

to comply with the doctor's orders or continue to rebel.

The way things are going with Beth,

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

Vegetarian... It's only half a portion, isn't it?

-Very, very few chips.

-No, no.

Take a bit few more off... Just that...

Yeah, that's fine.

Just a tiny bit of peas.

Beth's on a treatment called the Rainbow Programme,

which means she has to consume a set amount of calories every day.

Breakfast, lunch and dinner

are eaten under the watchful eye of a member of staff.

I just...I can't...

SHE SOBS

Come on.

You don't feel like...?

A few mouthfuls of peas is not a lot,

but it's an improvement on recent weeks.

They don't see it as progress, they just want me to eat everything

and that's when it will be progress,

but as soon as you start eating everything, they'll just up it

and they'll give you more.

You've got a choice of strawberry, vanilla or jam.

-They're strawberry, they're vanilla and these are jam.

-Strawberry.

Lucy, do you want a cake?

Oh...strawberry, vanilla and jam.

It feels a bit hard, you sure it's not a rock cake?

No, it's all right.

THEY LAUGH

Why do you keep laughing about what you've hidden in these cakes?

Onions, mayonnaise...

-Garlic...

-..toothpaste..

-..tomato puree.

While much of the McGuinness Unit has a relaxed atmosphere

with patients socialising together,

it also has an acute wing

for its most disturbed or disruptive patients.

Here, young people are observed by staff 24 hours a day.

As kind of streetwise as these kids are,

they are kids, you know,

the average age is about 13 or 14

and they've been left in, essentially, a strange environment

with lots of strange people in a strange situation

and the vast majority have no inkling

as to how quickly they'll be able to go home,

whether they'll be able to go home or whether they'll move on

to another area of the service or what have you.

So it is, it's quite a difficult...a difficult time.

16-year-old Gill is one of the acute wing's longest-standing patients.

She suffers from depression

and her moods can change radically at a moment's notice.

In the six months she's been here,

she's been restrained countless times...

SHE SCREAMS

Gill!

ALARM BLARES

..and even managed to escape from the unit.

She's been found having taken another overdose.

Watch your fingers, OK?

She spends a lot of her time kept down the acute corridor

or ECA, as it's known.

Right, you need to move. Move, move.

Today, she's locked down there again.

I cut myself last night,

cos I was really struggling and I've not cut for ages.

My mood just got so low

and I was just really upset and I don't know why.

I think I first did it when I was 12 years old.

My mum was ill with cancer... I'm not blaming my mum,

but I think everything just got on top of me,

cos I was busy with school work,

looking after my mum and my little brothers,

just doing quite a lot for my age

and I just couldn't cope with it.

And then, one day, I don't know why,

I just thought it my head, "I'll cut myself."

Many of the patients on the unit have complicated home lives.

Gill has not seen or spoken to her mother for six months.

Having no contact causes Gill huge pain and distress.

She has been rejected, I think, throughout her life.

Her last admission here, I think,

she had one visit from one family member.

She was asking members of staff

if they would think about fostering her,

or...you know, I mean, she even asked me at one point

and she promised me faithfully that if I would agree to...

to give her that option and give her a chance,

that she would promise faithfully she would never self-harm again,

cos all that she wanted was a family.

Somebody who could care for her and give her that normal life.

Rebuilding her relationship with her mum is key to Gill's recovery.

Despite their differences, both want to try again.

It began with a phone call between the two

and then her mum came to see her on the ward.

Hello, Mum! Are you all right?

Now, a few weeks later,

the relationship is beginning to blossom.

Today, her mother is paying another visit to the hospital.

Whereabouts are you?

OK, five minutes. All right, then.

All right, brilliant, bye!

Love you! Love you! Love you more!

Bye!

SHE CHUCKLES

Bye!

Family often are the key relationships through childhood

that help influence

how you understand relationships,

how you feel about yourself,

how you interact with others,

how you interact with the social world.

So our relationships with family,

right from the moment we're born, and arguably before that,

are absolutely fundamental.

Helping young people understand how they relate within their family

can often give us the best chance of positive outcomes.

Oh, you remembered the games...

Yes, that one is crackers.

I can't get to grips with that one.

So you can have fun enjoying yourself and...

Thank you.

There you go. How's that, babe?

You remember when me and the kids went to Blackpool

-and you wasn't with us?

-Yeah.

That's for you.

Wow!

Afterwards, Gill and her mum go for a walk though the hospital grounds.

It's so nice to be out.

-Oh! It's good that you're out with me as well.

-Yeah.

Next week, I've got 25 minutes and we can go up to the barrier.

Because Gill has a history of absconding,

the pair are not allowed to be alone.

What time is it? Can you check what time it is?

-You've got four minutes.

-Four minutes, come on!

If staff feel Gill and her mum are getting on well

and Gill continues to improve on the unit,

they may agree to some home leave in the next few weeks.

'If she can keep her temper,'

then, she can outdo most of her problems,

so...do you know what I mean?

She's great, she's such a placid kid,

but things have got on top of her

and when she kicks off, she kicks off.

BELL RINGS

Just having my mum there helped a lot.

Cos I didn't want to run off in front of my mum,

cos my mum would get upset worrying about me.

I need my mum now more than ever, really.

Because of all this, being stuck in hospital.

So I need her now.

And she's there for me.

Gill has become good friends with the unit's newest patient,

14-year-old Crystal, who has been having hallucinations.

SHE LAUGHS

I'm really bad at burping.

I want to be able to burp, like, really loud.

You know, those big, fat loud ones?

I've got one coming, I can feel it.

Come on, give the bottle to me, please...

Gill, give the bottle to me, please.

Thank you very muchly.

Ah, I've got pains, it's the rush of caffeine through my body.

I need to burp...

Can someone tell me how Gillian got a full bottle of Coke?

Who let you in?

SHE BELCHES

THEY LAUGH

Who let you in, Crystal?

I don't know, I snuck it in.

SHE BELCHES

Gill is making great efforts to get reacquainted with her family,

it's something Crystal would love to do.

She never really knew her birth parents,

but that doesn't stop them preying on her mind.

I get jealous of them a lot.

There's my little sister

and my older brother live with my real mum and dad

and I'm kind of jealous cos I don't

and I think I'd like to.

It's kind of expected.

It would be a bit weird if you weren't jealous, though.

Because if they're your really mum and dad and they're living with them,

you're bound to be jealous.

We wrote to her a few years ago and then she replied

and I was really happy about that.

And then we wrote to her again and she didn't reply, so...

And I got my hopes up.

She had symptoms of depression

and when I was little, some social worker people came to my house

and, like, she shouted at me in front of them

and then, when I was little, I had a bruise on my leg from her

and that looked like a bite mark and she said I fell

and I had a few bruises and stuff on me.

It was like she didn't want me

and a lot of times, I feel like I am not wanted

and, like, I feel really bad about myself a lot.

But Crystal has a loving adoptive family

who have visited her every day.

Today, she's being picked up for her first night at home in five weeks.

Hello, darling.

Hello, Bill.

Right, are we ready?

-Slippers.

-Slippers.

-This is great, this, isn't it?

-I don't want my slippers.

-OK.

Right, let's shut the door. Do you want your door locked, darling?

-I don't mind.

-OK.

-I'll lock it up afterwards.

-Thank you very much.

Bill and Helen adopted Crystal and her brother Dillon 11 years ago...

Sit!

..and they're excited to be taking her home again.

Sit. He's not trained.

I haven't planned anything,

so I'll let Crystal decide what she wants to do and...

On the way home, Crystal sees one of her characters.

-75's there.

-75's there?

Yeah, he's chasing the car, cos he's super fast.

At home, she sees another vision in the front garden.

-75's there.

-OK.

-He's asleep!

-Right.

SHE LAUGHS

OK.

A baby puppy!

-A what?

-A baby puppy.

-Oh, really? Where?

-There!

-Right.

It's called Ten!

Ten? I've not heard of Ten before!

He's white and...but he's called Ten.

Right. OK, well, do you want to go in and see your own dog in a minute?

Yeah, 75 wants to take Ten to Cranelli.

OK, shall we go back inside, darling?

-Yeah!

-OK.

Initially, it disturbed me.

Initially, you want to say, "There's nothing there, don't be so silly."

It's irrational, but there's no point telling her it's irrational,

there's no point telling her to make them to go away,

because they won't go away,

it's as simple as that.

Bill and Helen find it surreal talking to their daughter

about the people and the animals that she sees.

But they need to deal with it in a very matter-of-fact way.

Mum, there's a new puppy.

Yeah, called number Ten.

Cos you've not had any new characters for a while?

-I've had 27.

-27?

-Yeah, the bird?

-Hey?

The bird, the black bird.

And is 27 nice or nasty?

-Nasty...

-Oh, dear.

It's a big, scary, black bird and it lives in the forest.

I don't think we needed any more nasty ones.

Her adoptive parents have no idea

what has brought on their daughter's hallucinations,

whether the condition has a name or even if it can be treated.

It would be nice to be able to label it as something, you know,

some kind of condition.

But we haven't got a label for it yet.

But I know that this is something quite deep-seated

and it's not going to go away in a hurry.

CRYSTAL SINGS ALONG TO SONG

# But you can't hold on to water

# It fills you up but never stays

# It's only good to wash away today

# And you're loving me Like water... #

The past few weeks have been relatively calm

on the McGuinness Unit, even harmonious.

-Shall we sing our song to her?

-Yeah.

# I love you, you love me We're a mental family

# In a mental home at Prestwich and it's called the McGuinness Unit. #

We made that up.

Right, it's really good, apart from the end bit.

You need like a bit of action.

It's good wording, though.

-M...Mc, like...

-M-C-G...

It's like...

It's five o'clock - dinner time on the ward.

Since she was put on a section, Beth has started to comply a bit more,

she's beginning to eat at meal times.

They think one of the reasons why I've got an eating disorder

in the first place was cos I try to control things in my life

and now they're taking the control of food away from me...

..I, you know...I don't like it.

Beth may be eating more, but it's making her feel guilty.

So she's developed a way of punishing herself.

I cut when I've eaten as a punishment.

That's when the voice is more in control.

It makes me feel better because it's like...

..it's all just coming out in the blood,

all the thoughts are just coming out in the blood

that comes out of your body.

One day, I walked into the room and she was cutting herself

and I took it off her to stop her cutting herself.

I'm such a good friend.

I did thank her the day after, I hated her that day.

But they day after, I did thank her.

Around one in 12 young people deliberately self-harm,

around 25,000 are admitted to hospital every year

due to the severity of their injuries.

It's a continuous problem for staff on the McGuinness Unit.

As soon as they confiscate something the patients could self-harm with,

the young people find new ways of hiding them.

The most sort of common things are sharpener blades,

razor blades...

Make sure nothing's been concealed anywhere.

The young people sort of think

that we're not that clued up,

so, you know, you'll come to do

a search of a poster

and you'll get a piece of Blu-Tack and have a look through

and you'll find like a blade stuck inside it.

So I think now they're not actually allowed Blu-Tack in the bedrooms.

We encourage them to use sort of sticky tape.

When I'm in the outside world,

I do anything to hide my scars.

Like, I wouldn't even get changed in front of everyone.

When we was getting changed for practical at college

in case anyone saw it...

That helps it fade.

I had that bandage today and that's all there is to it today.

It's fine now.

'It feels more normal in here.'

Like, literally everyone has done it.

They don't judge you.

People on the outside, they judge you on the way you look.

Like, if they saw me,

sitting here like this, they'd probably say,

"You're too fat to have an eating disorder,"

like cos I am, I'm...I'm fat. I'm...

I'm just fat.

I just don't think that'll ever change.

And now I've got to go and eat dinner.

Here, she says she hates herself

and she definitely believes that she will end her life,

that that will be the only way out.

And nobody actually understands her.

Nobody.

The senior team are meeting to discuss new fears for Beth's safety.

She's written a letter to staff that has made alarm bells ring.

And...and she says,

"I really do need to die.

"I just really don't know how to do it in this place.

"Overdosing," she says, "didn't work.

"Using ligature didn't work.

"Using sharp objects has not worked."

You know, she says all these terrible things about herself,

but if you observe her, you don't get that sense

that she's going through a lot of this, you don't get it at all.

But once we discharge her,

then she will do something terrible whilst out in the community.

It's a very sad letter. Very, very sad.

We'll sit down with her, try to review her antidepressants

and the sleeping tablets with a view to increasing it.

Just like Beth has a price to pay for eating her meal,

so does the ward's youngest patient, 14-year-old Crystal.

Some of her imaginary characters, the rats,

are not happy when she eats dinner.

The rats, you see, told me not to eat and I've been eating,

so they'll come and be mean and they'll hurt me a lot.

Those are the recent ones

and the rats were trying to get me to scratch,

so I scratched through a vein,

but it didn't really work

and then, on my other arm, I did most of that yesterday.

And then, I did that a few days ago.

But Crystal doesn't just want to harm herself.

She's told staff at the unit that her imaginary characters, the rats,

want her to kill her adoptive father, Bill.

I don't know how it came about,

but she...she said she felt like killing me sometimes.

She felt like killing me.

My fears are it's schizophrenia.

-I don't think at the moment she would do something.

-No.

But, sometimes, I don't know if it's a look on her face

that makes me feel, "No, you're not being silly here,

"this is actually quite sinister."

And then it'll pass and it's almost like that person's gone again

and she's...Crystal's back.

My dad gets scared of them sometimes.

They make me feel like I want to kill him and stuff, even if I don't.

But, like, they make me feel like I do.

She's very settled on the ward at the minute,

she spends time in communal areas with others.

The unit's senior staff are concerned

about Crystal's change in behaviour.

Perceptual, er...disturbances.

Art therapist Charlotte reports back on something

that came out of their sessions.

Her hamster died at the weekend.

Crystal actually got the clay

and was stamping it and saying, "That's like my dead hamster,"

and she laughed about it and was saying

that it was funny when people...when her hamster died, really,

and talking about ideas of people being harmed

and it's all right for people to be harmed

and we tried to explore that a little bit

in terms of, perhaps, her own experiences,

thinking that she's been hurt and that it's OK for others to be hurt.

But her reaction to it was quite incongruent, really.

I just wanted to mention that. But, otherwise, work sort of is ongoing.

It's not just the art therapist Charlotte

who is trying to work with Crystal on her aggression,

the occupational therapists Vicky and Matt

talk to her about wanting to kill her adoptive dad.

I said I don't like my dad because I don't get along with my dad.

And I think...I think there's some concerns about...

-I said I want to kill him.

-Yeah.

I want to love my dad and get along with him,

but, like, my voices won't let me.

So is a lot of it driven by the voices, do you think?

-Yeah.

-Yeah?

It's about how we can support you to keep you safe,

but also to keep your dad safe as well.

Crystal is on another weekend visit home.

I've got two guinea pigs.

But I don't like them.

That one's the oldest.

Cos, like, we had that one and another one

and then the other one died and then we got another one

and that one died and then we got her and she's...alive.

Crystal's latest changes in behaviour

are causing tensions with her mother, Helen.

Give it to me now.

Give what to you?

The hair clip that you've pulled the plastic off and it's now sharp.

-It never had plastic on it.

-Give it to me.

-Give what to you?

-The hair clip.

-I've not got anything.

-It's in your hand, Crystal, give it to me, please.

-I've not got hands.

No...

-Crystal, open your hand.

-No.

-Look at this, look.

You did that months ago

and you've still got marks.

Thank you.

Without an answer, it's very difficult to get help and support.

With an answer, that's the only reason, really. With an answer,

with something that you can put a name to,

comes the support and the extra help.

-Why are you doing that, Crystal?

-I don't know.

And we've gone through the gamut now of not eating,

well, you can see the evidence of the self-harm.

So it's quite scary at the moment.

I don't sleep very well at night.

Winter is drawing in.

Inside the McGuinness Unit,

15 young people are spending weeks or even months of their lives

trying to find a way to deal with their illnesses.

My week's been shit, I've not got discharged,

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

You can tell this place is mental

when there's people lying on the floor.

You got me a pressie?

My mum's amazing, she brings me in loads of stuff.

-Oh, yeah.

-Yeah?

Gill is continuing to make good progress.

She has had more visits from her mum and they are getting on well.

Thank you.

Oh! Thank you! I needed one of these.

And now I want you to gently bring your attention to your breathing...

..and the sensations in your body.

She's also no longer being restrained,

thanks, in part, to what's called mindfulness therapy.

Just notice what's taking your mind away.

Let it be...

..and gently bring your attention back to the breath.

I had a very insightful day the other day,

I just realised that I just need to concentrate on myself

and getting myself better and getting myself out of here.

I think seeing my mum more helps.

I'm never, ever going back to 24 hours on the ECA.

I'm determined not to go back to that.

I just need to keep on the right track.

The review team have given Gill a leave plan,

which allows her increasing amounts of time in the hospital grounds

as long as everything goes well.

It started yesterday, when I had five minutes out and again today

and then tomorrow I've got another five minutes,

but then, on Thursday, it goes up to ten minutes.

Then next week, on Monday and Tuesday, I get 20 minutes.

Then, Wednesday and Thursday, I get 25.

Friday and Saturday, I get 30 minutes

and then, hopefully, I'll be able to go home for Christmas.

PIANO PLAYING

# Rocking around the Christmas tree

# At the Christmas party hop... #

At this time of year, the staff go to great lengths

to make the ward feel festive for the inpatients.

In the week before Christmas,

there are a number of events organised on the unit.

# All is calm

# All is bright... #

In the art class, there is an award ceremony for the patients.

One of the prizes is for the best writing in an English class.

The person who did win it, overall, is here

and that was Gillian, well done!

I got a pen!

That's rather funky, that

and then chocolate, you can tell that's chocolate. Feel it!

While Gill is enjoying herself at the Christmas concert,

the review team is deciding

whether she'll be allowed home on Christmas day.

Risk to self - there was a self-harm incident over the weekend

where she got a needle from the clinic room and self-harmed.

Because the last review was a bit more positive,

including from college as well, isn't it?

So this is a week period almost where we had...

It's deteriorated rapidly...

Yeah, and it's triggered by Christmas coming up

and of feeling that...

I think she probably knows we're not going to give her leave.

-I don't care!

-I do.

The risk has been deemed too high

for Gill to leave the unit on Christmas Day.

ALL: Bye!

But it's not bad news for everyone.

Crystal has been allowed home leave

for the whole of the Christmas period

and she's heading off this afternoon.

No-one wants to spend Christmas Day on a psychiatric ward.

But eight young people are waking up to this one on the McGuinness Unit,

away from their families, and that includes Beth.

It's stupid!

It don't really feel like it's Christmas, because, at Christmas,

you're supposed to be at home

and stay in bed all day, like, with your pyjamas on

and spend it with your family.

Run downstairs in the morning and just, like, jump on your parents.

You feel more lonely because

you know other people have gone to see their families

and enjoy Christmas as it is, not just sitting here, waiting.

Oh, this is wicked! Merry Christmas!

THEY LAUGH

This time last year, I was running away from home.

But this time, it's like, yay!

I've got my family back, we're all talking again and it's brilliant.

-I love you.

-I love you too.

Just after Christmas, a friend of Gill's sadly dies.

It has a profound effect on her, but the tragedy inspires Gill

to stop self-harming and look to the future.

Yeah, I've got this bobble and when I feel like doing it,

-I'll just do that...

-Ping it.

Ping it and it reminds me of her

-and not to do it for her.

-Yeah.

-I need to live the life that she's not got any more.

-Yeah.

-It was very distressing, wasn't it?

-Yeah.

So, for me, you're in a very good place at the moment.

Do you kind of feel that you're now probably engaging more and...?

Yeah, yeah, I am trying a lot more.

For the patients on the McGuinness Unit,

it's the beginning of a new year.

Kim, is there a chicken tikka on there?

I'll put both out and then you can decide.

Beth is continuing to comply with the eating plan,

although she may still hide the odd piece of food at meal times.

They don't know, but I break it up,

put it in my hand and then put it in my pocket when they don't look

and I'll hide it underneath more food.

Because that way, they're getting what they want

and I'm getting what I want, so everyone's happy.

We have to speed up a bit.

-Zip.

-Boing.

-Zip.

-Zig...boing.

-Zip.

-Boing.

-Zip.

-Boing.

Zip. Boing.

Zip.

-Zip.

-Boing.

-Zip.

-Zip.

-Zip.

-Zip.

Ever since she arrived at the McGuinness Unit eight weeks ago,

Crystal's doctors have been trying to establish

whether her visions are caused by psychosis.

-Zip.

-Zip.

-Boing.

-Boing.

-Zip.

Boing. I'm wondering when this game finishes...

THEY LAUGH

That assessment is complete

and her adoptive parents, Bill and Helen,

will shortly find out the reality of Crystal's condition.

As long as she could come home and live a reasonably normal life -

the worst-case scenario is that she can't manage

and that she would either be institutionalised

or she wouldn't manage life on the outside at all

and the worst of the worst would happen.

They have been called to a meeting with Dr Acho,

Crystal's psychiatrist.

Since her early life, you know,

she's experienced this neglect, physical abuse.

She's always been feeling worthless and unwanted.

She has then developed some protective strategies

to help her and stop her from feeling lonely and unloved.

In terms of child development,

it's something that we all went through.

At a point in our life, we live in fantasy world.

Usually, between the ages of three and five,

but for some children, it becomes bigger and bigger

and they tend to lose that sense of reality.

Are we looking at her following any medication?

She is not psychotic,

-this is her way of coping...

-Yeah.

..and that she could, with time, be able to destroy those characters,

because it's something that she has created

and it's something which she can work towards getting rid of.

-OK, thank you very much, doctor.

-Cheers.

-Thank you.

Thanks for coming.

Huge relief, there's nothing worse

than knowing a little bit about something,

cos you tend to build it up in your own mind.

So all we want is for her to come home and be able to manage happily

and go back to school and be happy at school.

-Maybe I'm expecting too much there.

-Yeah.

-Hi!

-Hello, darling! Are you OK?

Look, Look!

Kirsty did that before she left and I found it in...

-Oh, that's nice!

-I found it in maths.

"To Crystal. Love, Kirsty."

-Oh!

-That's really nice, that.

Ugh!

THEY LAUGH

I won't actually do it, you know.

# Nah-nah-nah-nah-nah-nah! #

THEY LAUGH

-Hiya!

-You all right?

-Yeah, are you?

-Yeah.

When a friend visits Beth later in January,

she has made a big improvement in terms of her eating plan.

It was my CPA yesterday

and they said they're going to keep reviewing my section every week,

so maybe in the next few weeks, I'll be taken off that.

That's good, then.

Yeah, and my meal plan's been increased again.

And I've moved from... I'll show you.

I've moved from the anorexia nervosa band to the underweight band.

Where did you start off?

In the green band - anorexia nervosa,

now I'm just the underweight!

So what's after that?

Fat!

THEY LAUGH

It's not fat after that, though, is it?

-It is!

-No, it isn't!

-Yes.

-Well, I'm happy you're getting better, anyway!

-Oh, Gabby!

-Oh, I've missed you, I actually have.

-I've missed you too.

-Everyone at college misses you as well.

-Do they?

-Yeah.

Beth believes she has made so much progress in the last few weeks,

she should be allowed to go home,

but she cannot leave while she is still sectioned.

So she's taking the matter to a tribunal.

You can also get discharged there as well,

so that's what I'm hoping will happen.

I really want to go home,

so I'm packing now.

The law allows patients to appeal against sections

if they feel they have a case.

I don't really want to kill myself any more.

There's things everywhere that you can actually self-harm with.

Like, you can self-harm with this.

I'm not really that desperate to do it any more.

Beth cannot leave of her own free will,

but Crystal is being discharged today.

Now, I feel that I can talk to my mum and dad more and...

I can tell them when I've been having a bad day.

And I can, like, trust them to not get mad.

I used to never tell them anything.

The doctors are confident she does not have a psychotic illness,

which means she is not a threat to herself or others

and can go home.

-You're just excited to go home, I hope.

-No!

-Pardon?

-No!

-No? Yeah.

She and her parents understand what's going on inside her head

and now know how to manage it.

I'm actually going to have a future.

Like, I do think more of the future now, like,

when I first came in here, I just thought that was it

and I was never going to get better and I'd be in here forever

and I just wanted to die.

I think it's a case of coming to terms

and learning to live with stuff - it doesn't go away.

It's just about coping.

When you can't cope, you tell people.

-Bye, Crystal!

-Bye!

Bye!

Gill has made a remarkable breakthrough.

She's finally been moved off the acute corridor

and now has a room on the general ward with all the other patients.

Mind the mess. I'm a bit untidy.

One minute.

Dirty clothes, dirty clothes,

clean clothes in the dirty wash basket.

Yeah, and just a heap of junk on there.

SHE CHUCKLES

For the past six weeks,

Gill has been slowly building up her leave away from the ward.

-What's in it? Hydrogen peroxide?

-Uh-huh.

It may have started only as five minutes in the hospital grounds...

What do you think? Let me see.

..but now Gill is preparing to go out into the community

for the first time in six months.

On a trip with Vicky and Matt,

she is trying to show she is well enough to be taken off her section,

and eventually be discharged from the unit.

It's really good, cos I get time off the unit

and I can, like, just be out with normal people.

Cos, like, when you're out,

people don't know that you're in, like, a unit or anything.

So, like, it's a bit strange sometimes, cos it's like,

"Oh, my gosh, I have to go back there, don't I?"

This trip is meant to be fun and relaxed,

but Vicky and Matt are watching Gill closely to see how she behaves.

Chicken, bacon and mozzarella.

Treatment at the McGuinness Unit

is less about finding a cure for the patient

and more about helping them to find ways of coping in the outside world.

Any typical adolescent will become distressed at times

and our task is not to make the perfect adolescent,

it's actually to support young people to build resilience,

to build confidence, that when they become distressed, actually,

they're able to manage it more effectively.

They're able to feel confident in themselves

and they can go on and live their life with its ups and downs,

without some of the negative consequences of...of that distress.

First, I'd prefer it to be in white...hmm...

SHE LAUGHS

Today, Beth's future is going to be decided.

She has appealed against her section

and this afternoon a tribunal will decide

if she's well enough to be taken off it.

I could ultimately be discharged,

but I'd need to be taken off my section today.

It's basically just a court and you've got three independent people

and they all basically assess you

and tell you whether you're well enough to go home or whatever,

but...I think I'm well enough to go home now.

Good luck!

If the decision goes her way,

she could be going home after the meeting.

Are you coming through?

The tribunal lasts two and a half hours.

It's not good news for Beth -

she must remain on her section and in the hospital.

On the same afternoon,

feelings could not be more different for Gill,

who has reason to celebrate.

I'm coming off my section tomorrow!

-You what?

-I'm coming off my section tomorrow!

BOTH: Yeah!

The first call she makes is to her mum.

I'm getting taken off it tomorrow.

I'm so happy!

One afternoon,

two completely different decisions.

Dismay for one patient and joy for another.

I'm getting taken off my section!

Crystal returned to school and is doing well.

For Beth, her struggle goes on.

Tomorrow's ages away,

when you've been stuck in here almost six fucking months!

-No!

-Just calm down.

But she's not the only one with anger issues.

Just do it. You should kill yourself.

HE GRUNTS

Oh! Fucking hell!

I hate it.

Really hate it.

What a tit!

Subtitles by Red Bee Media Ltd