Episode 3 Don't Call Me Crazy

SIREN RINGS

This is the McGuinness Unit in Manchester,

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

GIRL YELLS

It's the place of last resort

for teenagers with eating disorders or psychosis,

who self-harm or have OCD.

Shut up!

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...

BELCHING AND LAUGHTER

..and the bad.

SOBBING

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

who have to deal with mental illness.

GIRL SCREAMS

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...

LAUGHTER

17-year-old Matty has just been admitted to the McGuinness Psychiatric Unit.

-That's cooked.

-It's not.

-It is. That is done.

Matty suffers severe depression,

and experiences psychotic episodes, hearing voices in his head.

'I've had suicidal thoughts and I've attempted suicide numerous times.'

I've stabbed myself, hanged myself.

And that's it.

Matty's voices say that someone will kill him on his 18th birthday,

which is only six weeks away.

These paranoid thoughts have been so strong

that he has considered taking his own life.

'I was actually planning to buy a gun on my 18th birthday.

'Instead of someone else doing it to me, I'll do it myself.'

Matty, admitted into hospital as he was seen by a lecturer at college,

he was writing down on the internet thoughts of wanting to end his life,

so the lecturer brought him to A&E,

and he was transferred here later when a bed became available.

Matty complained of experiencing depressive symptoms for over a year.

We know he talked about experiencing voices, but those,

rather than being psychotic, were more related to trauma

and he experienced those voices when he was experiencing any distress.

Matty has been attending some of the group counselling sessions.

This one is art therapy,

and the young people are using photographs to help explore their conditions.

Images can make you think all different sorts of things.

What do you think about the pictures that you've chosen?

This one reminds me of, like, all the voices.

-All my voices...

-OK.

-..locked in separate boxes.

Brilliant, OK.

And... that one's obviously about my thoughts,

-like my past and stuff.

-Mm-hmm.

And that's it, really.

So that one's really interesting,

especially given that you said when you were walking around...

The problem for Matty is the voices can strike at any time,

day or night.

Shit.

-Do you want me to take you back through, Matty?

-Yes, please.

-OK.

MATTY BREATHES SLOWLY

The voices cause Matty so much distress he turns violent,

and has already punched holes in the walls of his room.

'I hear around 50 voices.

'They're all shouting at me, talking over each other.

'What I do, I write stuff what they say to me.'

Like, I've written some down there, and drew some pictures.

"Just do it. Kill yourself."

"Black Matty." That was my nickname.

"Diary. Bang, and he's gone."

That just says, "Fuck my life."

When I do write it down,

I can tell, like, the nurse or the doctor and give it to them.

"I don't give a shit about them.

"I hope they get fucking slaughtered, and I will kill."

The 15 teenagers on the ward are not just treated with therapy and drugs.

Physical exercise is also a key part of helping them get better.

Today, a dance instructor has been brought in.

One, two, down.

And wait. This time, go back.

Two, three, four.

This afternoon, Matty is feeling a bit better.

There are no voices disturbing him.

Even so, this kind of dancing in front of other patients is a step too far.

And backwards.

Forwards.

Skip.

I can't dance with other people.

I can dance by myself.

He knows what I'm saying.

MUSIC: "Cha Cha Slide" by DJ Casper

I can do all that!

It's just with other people, I can't do it.

All the patients on the McGuinness Unit

are here because they're considered a danger to themselves.

It's a mixed ward of boys and girls aged 13 to 17,

but there are usually two girls to every boy.

We have a male corridor that has got one, two...

that's got four beds on it, and there's 11 female beds.

Males find it difficult to talk about the problems that they're having.

'A bloke's more likely to disappear and keep himself to himself.

'The females are more likely to talk to people.'

Four days ago, a new boy arrived on the unit.

'Since I've started with my depression,

'I've had a couple of suicide attempts,'

which is the first way to deal with it.

And I just didn't see any other way of coping with it.

16-year-old George is a very talented rugby player,

and he won a prestigious scholarship to a top boarding school in Cumbria.

I'm there, wearing someone else's shirt.

But, while there, over 200 miles from his home in the South,

he developed severe depression, and tried to kill himself.

This is from my house at school, Sedgwick House.

Er... They all signed it.

There's a picture of the boys.

"I wish you the very best of luck. I hope you get better soon.

"My thoughts will be with you.

"You're a very special member of this House,

"and you will be deeply missed. Much love, Tom."

'A lot of my mates wonder why I'm here,

and it was quite hard for them, I think, to understand

why I was getting taken away and put into a unit like this.

'I decided to write them a letter for my schoolmaster to read out.'

I just told them...

that I have got a mental problem at the moment,

and I need a bit of help.

And they all were, apparently, quite touched by that, my letter,

and apparently there were a few tears in the boys' house,

which you don't normally get.

It was nice to hear how concerned people were.

And, erm...

Yeah, I'm getting a lot of support from my school.

It's not just his school that is supporting him.

Once a week, George's father, Mark,

drives up from the family home in Essex to spend time with his son.

He's brought some pictures for George to put in the scrapbook that he's been making.

What do you use it for?

I just look at it when I'm feeling a bit shitty.

There's a nice one of you and Mum, look. Portugal that was.

Oh, my word, look at my nose!

-There's Granddad.

-Granddad Bill.

-Ayesha. Granddad Bill.

That was two years ago.

And that was October, November time, as well.

It just seems like a long time ago now.

'I remember the first game I watched him,'

I got a train up to Macclesfield. You didn't know I was there,

I was standing behind a tree, and it was pouring with rain,

-and then he...

-I scored four tries.

-He scored four tries.

I didn't know he'd been made captain, either,

so there was people going, "Who's that?"

And I was sort of saying, "He's my son," you know?

So it's... Very proud.

To get a phone call near to midnight

saying that your son's had a severe incident of depression

and thinking, you know,

what's going on in his mind...

Erm, quite frightening. Very frightening.

Some upsetting things, wasn't it?

Psychiatrist Dr Acho has been looking after George

since he was admitted.

He would like to become a professional rugby player

and he's very competitive,

and this has created a lot of pressure on him

'and feeling depressed,'

and then made up his mind to end his life by hanging himself.

Fucking bullshit, love.

Boys like George and Matty often arrive on the unit angry,

violent and aggressive.

'We probably find that males, in general,'

get to more of a crisis point,

whereas with females, because they do like to talk about things,

it will come up in conversation

and people will sort of see

that there may be problems a little bit earlier.

'A bloke's more likely to be quite aggressive, quite hostile,'

hitting out, punching things, needing to blow off steam, as it were.

Matty has been on the ward for two weeks,

but the voices are still with him.

Shut up! Shut up.

HE EXHALES

Fuck off. Shut up, shut up, shut up.

HE GRUNTS

Shut up. Shut up.

'I don't know exactly, like, when this started,

'but I started hearing three or four years ago.'

They told me that everything was going to be all right

if I listened to them. They could help me.

If anyone tries to get in your way, hurt 'em.

'Like, sometimes I get proper agitated about 'em.'

I don't even see how it can... I don't even see how it can happen.

It's madness.

It's not normal.

And I don't like it.

Matty's been having home leave every week,

but last night the voices in his head became so unbearable that,

for only the second time since he's been on the unit,

he self-harmed.

The review team meet to discuss whether he's safe enough for his home leave today.

I met him with Dr Acho on Monday.

He was talking about saving up money to buy a gun,

so he knows that the gun costs about £250 and they sell it in Manchester city centre,

so we were wondering if he wanted the gun to keep himself safe

with the paranoid thoughts he expressed

or he had intentions to end his life.

He said initially it was for both the purposes.

I think he's getting worse, to be honest. I am worried about it.

I mean, I'm concerned that we don't really know a sufficient amount

in terms of the risk he presents to others.

That is concerning to me, so it's how we can get a clearer picture of that.

It's down to staff nurse Pete to tell Matty what's been decided.

We've obviously just had your meeting with regards to leave plans, etc.

Based on your presentation for the last couple of days,

and the difficulties that you've had, you won't be going home today,

but what I've suggested is that somebody, such as myself,

escorts you home

and spends some time with you at home.

And what are you going to do today if you start having difficulties?

I think you know what you need to do

if you start having difficulties today based on this bad news.

All right?

Bad news can trigger anxiety in a patient,

and Matty looks like his mood might escalate.

HE YELLS

'Just keeping an eye out, really.

'I mean, obviously, a bit of bad news,'

so I just want to make sure that nothing inappropriate happens.

But the unit is starting to have a positive effect on him,

and today he seeks help to cope with his emotions.

Pete, will we be able to go outside?

Yeah, why not, mate? Not a problem.

Erm, let me just make sure there's somebody in that lounge.

I've got the keys, have you got the kit?

-What do you need?

-A lighter.

-Lighter?

Just simply talking to someone is a key step in Matty's recovery.

A bit cheesed off?

If I spoke to someone last night, I would have been able to go.

And I know that for myself.

Well, there is that,

so it's a kind of a lesson learned on that score.

And that's a much better way of dealing with it, isn't it?

Listening to music.

It's one of your things of how to deal with things

when you're on your own, isn't it?

SINGS: It's my aeroplane!

You know I've got a tattoo on my back like Anthony Kiedis,

the lead singer?

I used to have Spanish galleon at the bottom, as well.

Can you still see it?

Er, no.

Oh, it must've sank!

MATTY CHUCKLES

Ha-ha-ha! I knew we'd get a smile out of him eventually.

Look at that!

Dr Pete.

We don't need no tablets. We don't need no tablets!

SPORT ON TV

No. Fuck's sake.

He's already committed.

For fuck's sake.

What a tit.

Matty isn't the only one struggling with anger on the unit.

Oh! Fucking hell.

Fuck off!

Selfish bastard.

-Was that you?

-Yeah.

-What did you do, punch it?

-Yeah.

They restrained me into this corner, but I ended up punching the wall.

-I'm only joking.

-And then got put in seclusion.

Did you get put in seclusion? Was you secluded? Was you locked in?

Why?

And they gave me two diazepam.

Like cardboard.

KNOCKING AT DOOR

'It's not me when I'm angry. It's someone else sometimes.

'That's what it feels like.'

I can't really think for myself, my anger thinks for me.

Which probably sounds really weird, but that's just how it feels.

And... I can't really do anything about it once I get there.

It just sort of happens.

George's anger is often prompted by a voice in his head.

Like Matty, George takes anti-psychotic and anti-depressant drugs,

and has regular sessions with psychiatrists to discuss his progress.

-You're looking quite well today, actually.

-You are looking well.

When I saw you on Monday, you were feeling...

It was half-half, wasn't it?

Yeah, I was pretty shitty.

I was fine, and then, after breakfast, I went in for a shower,

got changed, and then suddenly I just...

Something came over me, I suppose, and I started to feel really crappy.

What about this issue of the voices? Is that a lot better now?

No, they're still there. They're still there a lot.

A lot at night, but sometimes during the day.

And now I hear things and see things when I'm not depressed.

I still see them when I am depressed,

but now I see them now when I'm not depressed, as well.

And the paranoia got a lot worse. A lot worse.

The head of psychology at the McGuinness Unit is Dr Andy Rogers.

For him and his staff, young people hearing voices is a common problem.

'One of the triggers can be an increase in stress or anxiety,'

and, with anxiety, their thoughts race

so they're thinking about things and feeling anxious a lot of the time.

'They then start to question what's real and what's not real.'

These things creep up over time, often, that's what young people say.

It's not that they wake up one day...

And there's usually a story around their experiences,

and helping to understand what that story is,

and helping them understand,

actually can then help them manage it, manage the symptoms better.

The voice in George's head is a man who tells him he is worthless

and should quit rugby.

'It does scare me.'

I shake and I cry, and that's when my anxiety gets worse, I suppose.

'A couple of nights ago, I had my worst episode of it.'

I called my dad, cos I was really scared,

cos he was saying horrible things, really derogatory things,

asked me questions, telling me what people thought.

I can't live like this.

I do it all the time.

It's a burden, almost.

I hate it.

Really hate it.

-Cheers.

-All right.

Like most people on the unit,

Matty and George are voluntary patients.

They've agreed to be there.

But others have been sectioned under the Mental Health Act,

which means that they don't have a choice.

Like Beth, who has to stay on the ward.

I'm 17...

..and they fit me.

Beth was admitted four months ago

with an eating disorder and depression.

She would not eat for days at a time.

Today, I've gone 100 hours with no food or drink.

She wouldn't comply with staff, and self-harmed regularly.

That helps it fade.

I had that band yesterday and that steri-strip today.

You won't let us weigh you, that'll be changing.

No, it won't.

What's your biggest fear?

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

Cos I know I have.

That was three months ago.

Since then, Beth's condition has improved.

She's started eating at meal times, and is self-harming less.

Being on a section means she must comply with her treatment.

She has finally started to be weighed.

This is the first time Beth has allowed the cameras to film her on the scales.

51.

Are you getting ready, or are you going back in?

Going back to bed.

Since she was sectioned, her food intake has increased,

meaning her weight today is 51kg.

But this is still under her target weight of 57.

I think it was more anxiety before,

because I was really unsure of my weight,

and I thought it would be like, put on 20 million stone.

But I've not.

They've got to weigh me anyway, so I can be discharged.

I still get scared because I don't want to put on weight

but you've got to.

It's the illness that's telling you not to put on weight.

'She slept before midnight,'

and she slept all the way through to past seven o'clock in the morning.

Medication can be an effective way of managing a patient's condition.

But over-reliance on some drugs can become a problem.

She's sleeping all the way through up till eight.

Today, the review team are going to change Beth's sleeping medication.

Because if you're staying asleep and your sleep is not interrupted,

I don't know what are zopiclone going to do?

The most effective thing is really the sleep hygiene to get her to sleep

or melatonin.

George, Gill, do you mind giving us some privacy, please?

Beth might be getting better,

but being told that her drugs are going to be changed

is making her stressed.

SHE SNIFFS

There's got to be some positives, though, hasn't there?

Like what? Being stuck in hospital with everybody just letting you down?

But look how much progression you've made since admission.

You know, and one of the things that can reflect that is you leave.

And what do you want?

You tell me what, cos I can't just get it, can I?

I need to tell her what you want.

-I just want you to write me up for that.

-For zopiclone?

Yeah, and take me off melatonin.

OK. I'll go and give her a ring and see if we can find something out.

-You're very demanding aren't you?

-Yeah, because nothing gets done.

Right, let me just find who's got the keys.

She's gone home.

Fuck!

Tonight, we're not going to be able to get you anything, all right?

-Listen...

-No!

-Just calm down,

because this isn't going to get us anywhere, is it?

I know you think we're all crap, but we do do our best.

I know it doesn't feel like that, but...

Will you leave me on my own, please?

Yeah.

-Right, you just want some time to calm down?

-Yeah.

Don't wind yourself up, all right?

And we'll do everything that we can to sort it out.

'She's not very happy.'

-I think she'll be all right, but it's just to be wary that she could...

-All right.

'Hopefully, she'll be able to put things into perspective,

'and see what we're doing and how we're trying to help.'

She didn't think people cared, nobody was doing anything for her,

whereas we are, but, because she's in a distressed state,

she's not seeing the true picture.

Where could they be? I have no idea!

GIGGLING

-Ah! God!

-Did you actually know we were in there?

Is there anyone else in here?

Right, Janine, get out of there now.

Tinsel!

I've got a cowboy hat on!

THEY LAUGH

Matty has now been on the ward for four weeks,

but he is still hearing voices in his head,

and fears that when he turns 18 in just two weeks,

someone will kill him.

Last night, he had an angry outburst, threw a chair at the wall,

and had to be restrained.

I was trying to calm down,

but I was hearing voices and got really, really angry,

started hitting myself, and then the closest thing to me was that.

'What they do, they put you in a headlock, and my head was killing.'

I'm glad that they did it, to take me down there,

because I had time to myself to calm down.

That's basically what it's for.

Yeah, it was all right.

Well, it weren't all right, but it was all right.

Because Matty was restrained, his case manager, Maureen, needs to speak to him.

She's keen to find out what lies behind his anger.

You got wound up about things, the voices.

It's hard for me to speak to people. Usually, I just can't speak to them.

Do you often experience anger?

Yeah.

I've had, like, when I was in secondary school,

I had anger management,

but it just made me angry, to tell you the truth.

MAUREEN LAUGHS

Sitting in a room full of angry people, talking about angry stuff.

-Yeah.

-It doesn't work at all.

I think, for you, it's more about how you manage anxiety and stresses,

and your interpretation of things, you know?

I think that's probably more the path than just anger management, per se.

Matty has been finding group sessions difficult to deal with,

and usually leaves abruptly halfway through.

And sometimes it can feel as though you're on your own,

and it can feel as though you don't have anybody to support you.

Today's session is with Vicki, the occupational therapist.

What I want you to do is just take a couple of minutes

to have a think about who are the people that support you?

Your family, it can be friends. Whoever it might be.

Matty?

Maybe one person.

Apart from that, I don't think... No-one else.

OK. And do you feel able to access the support

from that particular person if you need to?

Erm...

-Not always.

-Not always?

This is the first time Matty has stayed to the end of this type of group activity.

It marks a massive step forward.

It's very exciting, this group!

Aren't you glad you stayed?

-Not really.

-No? Oh, no!

-Thank you.

-Cheers.

Just towards the end there, he had, by the end of it,

written I think five names of people who are there to support him.

He able to think about it and reflect on it,

and write those things down, so that's really positive as well,

and even if he takes away nothing else from today,

but he takes away the fact that, actually, he does have people,

because, initially, he wrote "No-one."

I used to just bottle it all up,

but it's just helped me speaking to people.

Like, they will listen,

and some of them will actually understand what I'm saying.

Basically, all we're doing first is measuring out 150 grams into your bowl.

HE LAUGHS

The McGuinness Unit has both boys and girls

because the doctors want it to feel as close to the outside world as possible.

But that can bring about its own complications.

THEY LAUGH

A flirtation has developed between two patients on the ward.

Any form of romance is strictly forbidden.

He's the type of guy that I would go for on the outside.

Oh, for God's sake. I'm giving up.

Erm, but, like... I feel like I've gone red.

Yeah, me and Beth are really close now.

Erm...

Er...

Yeah, we're pretty close.

Oh, my God!

We just get along really well, when he's not being a dick.

Oh!

He knows how to wind me up.

And I guess I know how to wind him up, so...

Why are your slippers there?

'We have kind of hinted at each other that we do kind of like each other,

'but it's the wrong circumstances,'

because we're in a psychiatric hospital.

Like, what can you do in a psychiatric hospital?

Everyone's in a vulnerable state,

so it could... If you ended up having an argument,

it could affect your recovery

To say sorry to George for throwing his slippers out of the window,

Beth makes him a pancake in the cookery class.

-What a shitty pancake!

-Oh, shut up.

It looks like potato.

< Is there paper plates in here?

Oh, that stinks!

Ta-da! See, it now looks like a pancake

But George is not that impressed with Beth's offering.

I'm definitely not fucking touching it.

What's that white shit around it?

It's home-made! Oh, that's minging.

Patients' moods change daily, sometimes hourly,

so they have regular mental health assessments.

These give the staff and young people

a clearer picture of what's going on inside the patient's head.

Earlier this week, I got my first report back

from my case manager and my psychologist.

But I didn't think I'd get statistics like these, really, like the percentage.

For instance, anxiety, I scored 97%,

depression 95.8,

anger 96.8,

disruptive behaviour 90.

And they're all extremely elevated, which isn't... isn't good.

I never thought they were going to be that high, really.

All the things I'm worried about,

like voices and all those sorts of things,

just in one document, which is pretty useful to have

because know I can see it in paper,

and I know all the issues and problems without guessing.

This information helps George understand his problems better,

and the time on the unit gives him space to reflect on his situation.

Fucking free.

It's like a safety blanket, really.

I feel more secure and more safe here than I did before.

I'm with people that understand me.

Over a game of pool with the student nurse, Ross,

he begins to open up his feelings towards rugby,

the sport he's always loved,

and that he'd hoped would be his profession.

It's hard to talk about, really.

Yeah. If you don't want to talk about it, that's absolutely fine.

No, no, it's fine. It's just hard to.

No man likes talking about how they feel.

Well, I've lost interest in rugby quite a bit,

because of all my issues. I haven't had time concentrate on it as much.

But that's another reason why I'm here, to find that interest again,

so I can enjoy that a bit more again.

You know, you've got your whole life ahead of you, haven't you?

But obviously none of us can make that decision for you.

All we can do is help you.

Cos that's what I want to do, make the right decision.

The decision George makes about his future

could affect the rest of his life.

For the past two years, he has been on a rugby scholarship

at a boarding school in Cumbria, living his dream.

But as he struggled to cope so far from home,

it's made him question what is best for him and his recovery.

Ohhh!

We're going to talk a bit about the future...

Three weeks later, during a session with Dr Paul,

George makes his decision.

It's just the fact that I'm not going back to my boarding school

cos boarding school isn't the right place for me at the moment.

Yeah, it is quite hard to swallow, but that is the right decision.

In terms of friends and stuff, what have you got down there?

Have you got a lot of friends still from school time?

Yeah, I've got a few.

Having decided to leave his boarding school

and go back to live with his family in Essex,

George will be moved to another psychiatric unit closer to home

but only when a bed becomes available.

Hello!

Hello!

Hello!

In recent weeks,

Beth, who is sectioned under the mental health act,

has been making progress.

For the first time in two months, she is allowed to eat on her own.

Over the past few weeks, I've been taken off supervision for my snacks,

I've got more leave. It's been good spending the time with my family.

It's been weird and it's scary,

but it's just cos I've been stuck in here for loads of time.

Being in hospital has meant Beth has had to give up

some of the things she loves most.

Before she was admitted,

she had taken part in many dance competitions

and won lots of trophies.

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

-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.

But due to her eating disorder,

she is not allowed to exercise because she'd lose weight.

So that is still the case,

compliance with weight monitoring and meal plan remains improved?

Now the staff must decide if Beth has made enough progress

to return to dancing.

She's going to be burning off energy, is her weight going to plummet because of this?

Activity levels in relation to her diet, isn't it?

So where we are, in terms of how much she can tolerate, there isn't as such.

This leave remains contingent on the present issue.

-So it'd be like at nurses' discretion?

-It is on that, but...

It's been a long five months,

but Beth is finally back on the dance floor.

'Just seeing everyone and how everyone's missed me,'

I'm just really glad to be back, cos I thought I'd never be let back

once I'd been put in the unit.

The dance class shows just how far Beth has come in her recovery,

and she's even started writing a book

about her experiences with mental illness.

"Mental health is so common, yet there is so much stigma surrounding it.

"We are all just normal everyday people.

"In fact, walking along a busy street today,

"you probably passed over 150 people with some form or severity of mental health.

"I have a mental illness. Am I ashamed? Not any more.

"I admit, yeah, I did used to hide and lie about my illness,

"but, now, why should I have to lie about something

"that has made me grow into a stronger and overall better person?

"Why hide something that makes me unique?"

Fantastic. I mean, that just gives people a tremendous insight

into what it's like to be you, really, and what it's like to suffer from such a horrible condition.

All the nurses from the examination.

-This is over the past week, though, isn't it?

-Past two weeks.

-Fortnight.

-So have we had any incident or any concerns for the past two weeks?

-No.

The review team is discussing Beth's diet.

Despite her recent steps towards recovery,

she still has goals to achieve with her eating plan.

I think she's in quite a big rush to move on and get discharged.

All the indications are that things are moving rather fast,

and, if anything, people want her to move even faster,

which makes it a bit of a challenge, really,

from the eating side of things for that speed to be matched up

when she gets discharged from here.

But it seems like there is a clear shortfall in the calories

which needs to be made up before she gets discharged.

There is a week to go before Matty turns 18.

He has always found it difficult to open up,

but today his best friend, Ryan, is coming to visit him

-Yeah, it's Matthew.

-Yes, Ryan, how you doing?

-You good?

-Yeah, man.

-Sweet.

And it's chance for Matty to talk about what he's been going through.

A few years ago, I wasn't hearing nothing like this,

and now it's just happened. It's not real, you get me?

When they let me down here, socialising with everybody,

I tried hanging myself in the bathrooms over there.

Why were you feeling like that when they moved you down here?

Cos...

I was just, like, depressed that day, and...

I just didn't want to stay any more.

The best option for me was to go.

And that was the way I was going to go.

You seem a bit happier now, though, you seem a bit more...

A bit more you, if that makes sense?

Getting back to the Matty I used to know.

Sweet.

'I noticed he was getting down and he weren't interacting well.'

I'd say something and he'd just be like, "What did you say?"

It's like, you know, the paranoia, I noticed the paranoia coming in.

A lot of people have a stigma about it,

and sometimes even stereotype people having depression.

I do understand why people could be a bit nervous,

but I'm all right with it. I'm always here.

Matty has taken big steps forward in the unit

but with his 18th birthday imminent,

it means he will have to leave the ward.

'When a young person turns 18,'

although from being 17 one day to 18 the next day,

doesn't matter for us clinically,

what it means legally is that they are an adult

'and what that means is that you have an adult on a children's ward,'

and that raises lots of legal and safeguarding issues.

The search is underway to find Matty a bed on an adult ward somewhere in the region,

but beds can be hard to come by.

We have to walk to the side, Doctor please. Thank you very much.

Everybody has to walk like this so you don't mess my floor up.

A good shake. This is good for the hips.

You could do a dance with it, if you wanted to.

Oh, I'm sweating now.

MUSIC: "Superstition" by Stevie Wonder

George is still waiting to find out when he will be transferred

to a psychiatric hospital closer to his home in the South.

Over the past two weeks, he has started to improve,

returning to the things he once did,

taking part in more group activities.

Even though he doesn't want to go back to his prestigious boarding school,

he now knows that he wants to return to the sport he loves.

I'm there, at the back.

'I'm on my way to getting a scholarship'

at a school closer to home.

'A lot of the work I've done is looking at things in perspective.

'If one thing goes wrong, not everything's going to go wrong,

'and that's what I used to get anxious about.'

I think the one big thing that's changed is my mindset.

'I'm probably more mentally tough than I have been,

'and I think that's a big factor.'

I just can't wait to get back out there and do some people proud.

After ten weeks on the unit, George is leaving today,

moving to a hospital closer to his home in Essex.

No! Are you going?

Oh, my God!

-So, have things improved while you've been here?

-Yeah.

-Yeah.

Bit nervous about moving on?

Yeah, a bit. A little bit.

Well, keep up the hard work. Well done.

I probably won't see you again.

'It's obviously a very difficult morning for him,'

and he's a lad, he doesn't really want to show it,

but you can clearly tell he's quite nervous about it.

'But hopefully he won't be at the new place for too long,

'because he's took massive steps while he's been with us.'

But it will obviously be very difficult for him.

-Group hug, everyone.

-Group hug.

George leaving makes Beth even more determined to get home.

Beep beep. Coming through.

What is that?

Watch your feet.

Beth is one of the unit's longest-standing residents.

It's actually really nice.

Beth is now starting to look to the future for the first time.

When I get discharged from here, I'm going to go home,

sleep in a nice comfy bed with new bedding,

new duvet cover, new pillows.

'I still want things to go faster than they're going,

'but things are going really fast now.'

Like, my weight's more stable now,

and I've got more, I've got the energy to actually do things.

The last three readings should all have been rounded to 51.5.

It's maintained, it's not dipped again.

The trend of two readings that we saw was the initial sort of aim, really, wasn't it?

The review team is pleased with her progress,

but need to ensure she continues to gain weight.

We're looking at a leave date being around the 25th.

This is the last bit of her recovery

that she really needs to achieve while she's still with us,

and it's a difficult one for her.

And we have to concentrate on the fact that we need to achieve it this week, really,

for her then to focus her mind towards discharge.

After nearly six months in the unit, the end is in sight.

It's now up to her to prove she's ready to go.

But, last night, she self-harmed.

A search is now underway for a razor in her bedroom

or outside her window.

She's used it and then she's threw it out,

and that's the bit she's used, there.

That's the bit she's self-harmed with.

Now her room is being turned upside down by staff

to ensure there are no other blades,

and the doctor has come to say her home leave is being cancelled.

Is there no chance I can go home?

We do agree that your leave has been really, really good

and it has helped you,

and stopping you from going on leave is not as a punishment

because you self-harmed, OK?

-It is, though.

-But we want to make sure that you are safe.

I am safe. What have I done on leave that's prevented me from going,

except a little stupid thing that I did on the unit last night?

But that was last night, that's not today.

-So you accept it was a stupid thing to do?

-Yeah!

I don't want arms like this, do I?

SHE SNIFFS

All I'm saying is....

Wait until tomorrow?

You don't understand, though. None of you do in here.

You all think, "Oh, it'll be fine tomorrow, we'll just sort it out tomorrow."

But tomorrow's ages away when you've been stuck in here almost six fucking months.

-So I'll speak to you tomorrow then?

-No!

You can speak to Dr Imran tomorrow if you want?

All right, whatever. Just please get out of my room.

You don't even know what you're on about.

All right. Thanks, Beth. Thanks for speaking to me.

No, don't even talk to me. Just go away.

Do you want to go and get yourself a tissue while I search your chair?

The staff did not find any other blades,

and, despite the set back,

it's actually made Beth aware of how much progress she has been making.

In the past when I self-harmed,

it used to make me feel really good, really better. It didn't even hurt.

But this time it was just, like, annoying,

because I just kept getting annoyed because it wouldn't stop bleeding,

and then I thought, "Shit, I need to get it seen to," and I just...

I don't know, it just doesn't work the same any more.

I hate the fact that it didn't really work for me this time.

I think it just shows that I am getting better now.

'I think one of the things that we notice and we sort of expect'

is that, as young people come up for discharge, their anxiety builds,

because, in effect, they're going back out to their life and their experience,

'and so it wouldn't be unusual for young people have a blip,

'or seem like they're taking a step back.'

And it's about supporting them through that process.

I guess it would be unusual not to expect a young person to be more anxious.

When people hear the word "recovery," what comes to mind?

When you're mental and then you're not mental.

SHE LAUGHS

OK, how do we feel about the word "mental"?

That's what we are.

I don't know, really...

Just helping...

-yourself. People helping you.

-Your friends helping you.

In the six weeks that he has been on the ward,

Matty has been convinced someone will kill him on his 18th birthday.

The paranoia has been so strong

that he has considered taking his own life on the day.

The two actions points that I've got down are to contact Beth

about the progress with the ward in Oldham...

Staff now have to work on a care plan

to ensure that Matty is supported on his birthday,

whether he's on the McGuinness Unit

or is transferred to an adult ward somewhere else.

So that's what we agree,

that he will be discharged to an adult in-patient unit,

but how soon that will happen we don't know,

because they tend to have a waiting list.

If we can plan the same way as we planned on the last board review

then I think we should be OK.

Yeah, I agree, cos that's the reason that the discharge was stopped

because of the thoughts that he had,

so, yeah, as long as he's got support during that day.

The staff on the unit are hoping to find a bed for Matty at an adult hospital,

but a couple of days later, on the evening before he turns 18,

it is still not clear what is going to happen to him.

I'm still pretty worried,

and anxious and paranoid about what's happening.

I mean, it's tomorrow.

HE BELCHES

Pardon me. It starts, like, 12 o'clock tonight.

Anything could happen.

The following morning, Matty's room is empty.

He was discharged after a bed suddenly became available

at an adult psychiatric hospital closer to his home and friends.

Obviously, Matty wasn't particularly aware of it

because pretty much the staff weren't aware of it either,

so as soon as we found out that there was a bed that became available

in an adult services setting, we were right on that,

and that's why Matty was moved on as quickly as he was.

It's the morning of the weekly reviews,

and there is a sense of anticipation on the ward.

Beth has heard that the staff are discussing her possible discharge.

Stop talking about me!

But with her recent self-harming,

Beth's unsure that she's done enough to convince them she is ready to go home.

Not all three of you are talking to me, are you?

-Shall I pull out?

-Yeah.

-All right, that's fine.

I'm in CP, anyway, so if you have any questions when you get back...

Have you got a discharge date? Because that's what I want out of it.

-Have I?! Soon?!

-Yes.

Like, this week?

What's my discharge date?

What's my discharge...? Is it this week?

12 days later, and Beth is finally going home.

It's been six months since she first arrived at the McGuinness Unit.

'I got taken off my section on Thursday,'

and then today I'm going.

In some ways, it did save my life,

because I wasn't really well when I first came.

But I won't miss these hospital blankets. Disgusting!

'I'm stronger than I thought I was.'

I thought that the only way to stop all, like, things in my head

was to just give up and get rid of me, and kill myself.

But now I've learnt that you don't have to do that.

You just need to talk and be more open, and communicate with people.

And that's how you can get better.

-See you later, Beth.

-See you!

Well done!

See you out and about.

I'm going to cry.

Bye, Stephen. Try not to get killed, yeah?

I'll try, I'll try my best. I'll try my best.

Bye, guys! Bye, Michaela!

Who's looking?

Bye.

After four weeks in an adult unit,

Matty is now living at home and back at college.

George spent a short time at a unit in Surrey.

He's back at his family home,

waiting to start his new school in September,

and playing rugby again.

Beth plans to return to college,

and is back competing in dance competitions.

Although she is finding it difficult to maintain her target weight,

she has not self-harmed since leaving the unit.

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