:00:16. > :00:17.Welcome to a special edition of Reporters,
:00:18. > :00:22.examining a key area that affects all of us,
:00:23. > :00:27.We will be finding out how the latest research is improving
:00:28. > :00:30.the understanding and treatment of mental illnesses,
:00:31. > :00:32.and hearing from people who have learned to live
:00:33. > :00:47.Fergus Walsh reports on the new revolution in neuroscience.
:00:48. > :00:49.I will be explaining how scientific understanding of mental illness
:00:50. > :00:52.are being advanced by these, miniature human brains being grown
:00:53. > :00:57.Chris Buckler reports from Northern Ireland on how one
:00:58. > :00:58.of the most controversial treatments, electroconvulsive
:00:59. > :01:08.To think that this barbaric treatment still exists...
:01:09. > :01:18.Fergal Keane investigates a new study suggesting young victims
:01:19. > :01:24.of domestic violence can suffer from PTSD.
:01:25. > :01:27.It is costing society a great deal, and causing the children a huge
:01:28. > :01:36.These children can grow up into damaged adults.
:01:37. > :01:38.Talking about it and opening up about it is fairly helpful
:01:39. > :01:41.for breaking down stigma and telling people what it is really
:01:42. > :01:46.And we will be hearing from the young campaigners taking
:01:47. > :01:58.How does the brain work and why does it go wrong?
:01:59. > :02:00.These are two of the fundamental questions behind treating mental
:02:01. > :02:05.It involves our emotional, psychological and social well-being,
:02:06. > :02:09.and affects how we think, feel and act.
:02:10. > :02:12.Mental health problems are also one of the main causes of disease
:02:13. > :02:15.According to the world's top neuroscientists,
:02:16. > :02:20.our understanding of the human brain is undergoing a revolution.
:02:21. > :02:23.Advances in genetics and brain imaging are enabling researchers
:02:24. > :02:27.to discover more about mental illness.
:02:28. > :02:29.As Fergus Walsh explains, it opens up the possibilities
:02:30. > :02:35.It is a privilege to be able to examine this,
:02:36. > :02:38.the right hemisphere of the human brain.
:02:39. > :02:41.One of hundreds of brains donated in the UK for medical
:02:42. > :02:46.This delicate structure is responsible for thought,
:02:47. > :02:52.memory, language, emotion, consciousness.
:02:53. > :02:55.The very things that make us human, yet despite all of our scientific
:02:56. > :02:58.knowledge there is still a huge amount to be discovered about how
:02:59. > :03:06.the brain works and why it goes wrong.
:03:07. > :03:10.But the brain is beginning to give up its secrets.
:03:11. > :03:13.Advances in biology mean many genes implicated in mental illness have
:03:14. > :03:16.been identified, and new scanning techniques are creating something
:03:17. > :03:20.extraordinary, a complete map of the brain's intricate
:03:21. > :03:29.These coloured lines represent bundles of nerve fibres linking
:03:30. > :03:36.different parts of the brain through a number of highly connected hubs.
:03:37. > :03:39.There are parts of the brain that we can talk about as being hubs
:03:40. > :03:42.of the brain, in the same way that Heathrow is a hub
:03:43. > :03:48.Researchers have discovered that people with schizophrenia tend
:03:49. > :03:53.to have fewer hubs so their brain networks are less well-connected.
:03:54. > :03:56.Where the excitement is building at the moment is linking the network
:03:57. > :03:59.diagrams that we can get out of imaging to what we are learning
:04:00. > :04:09.If we can bring those two things together we may be able
:04:10. > :04:11.to understand more clearly whether the genetic mechanisms that
:04:12. > :04:14.drive genetic development can go off on a different path that
:04:15. > :04:22.If we can understand mechanisms, then we can design new treatments.
:04:23. > :04:25.As well as deciphering the brain's networks of connections,
:04:26. > :04:28.scientists are also learning more about the early stages
:04:29. > :04:34.of development by growing miniature brains.
:04:35. > :04:37.Known as organoids, here they are in the hands
:04:38. > :04:40.of the scientist who invented the technique.
:04:41. > :04:46.Incubated in a research lab in Cambridge, these tiny balls
:04:47. > :04:51.of tissue mimic what the infant brain is like as it grows
:04:52. > :05:03.Among people with mental illness, these brains can help explore
:05:04. > :05:08.We can then compare those brains and try to understand
:05:09. > :05:13.I think it is an early step in some great breakthroughs in what has been
:05:14. > :05:21.a desert in the field of biomedicine.
:05:22. > :05:23.Mental health disorders have been incredibly lacking in terms
:05:24. > :05:28.of new medications to treat these really devastating disorders.
:05:29. > :05:30.So when will this research pay dividends in delivering
:05:31. > :05:41.In the next five or ten years you can expect two things
:05:42. > :05:45.We will be able to use neuroscience and genetics to target treatments
:05:46. > :05:47.better for patients, and this could happen with schizophrenia.
:05:48. > :05:51.The second is that based on the knowledge we have now we can
:05:52. > :06:00.actually have new medications, not for an entire illness,
:06:01. > :06:04.Of course, mental health is determined by our life
:06:05. > :06:06.experiences as well as the genes we inherit.
:06:07. > :06:12.The more we discover about this masterpiece of evolution,
:06:13. > :06:15.the greater the chance we have of treating it when it goes wrong.
:06:16. > :06:17.We may be learning more about the brain itself,
:06:18. > :06:23.but much of mental health still remains a mystery.
:06:24. > :06:25.So how do we define mental health conditions?
:06:26. > :06:37.Neurotic conditions are extreme emotional experiences,
:06:38. > :06:48.Psychotic symptoms interfere with the perception of reality.
:06:49. > :06:49.Conditions include schizophrenia and bipolar disorder.
:06:50. > :07:01.Global figures are hard to track down, but in the UK about 20%
:07:02. > :07:03.of people will become depressed at some point in their lives.
:07:04. > :07:06.Anxiety will affect 5% of the population at any one time.
:07:07. > :07:09.Other conditions, like bipolar disorder and schizophrenia,
:07:10. > :07:13.affect about one person in every 100 people.
:07:14. > :07:17.The exact cause of most mental illnesses is not known.
:07:18. > :07:19.Many conditions, such as bipolar disorder,
:07:20. > :07:21.can run in families, which suggests a genetic link.
:07:22. > :07:24.Difficult life events can then trigger a mental illness.
:07:25. > :07:32.Stress, poverty, abuse, isolation, substance abuse,
:07:33. > :07:37.So, how are mental health problems treated?
:07:38. > :07:40.Talking treatments are often used to help, trying to break the cycle
:07:41. > :07:50.Other therapies might also delve into past experiences.
:07:51. > :07:52.Antidepressants usually ascribed for anxiety and depression,
:07:53. > :07:56.and antipsychotics, which affects chemicals in the brain,
:07:57. > :08:01.But as with everything that involves the brain,
:08:02. > :08:04.much about mental health remains a mystery.
:08:05. > :08:09.The idea of treating psychiatric illness by passing a jolt
:08:10. > :08:12.of electricity through the brain was one of the most controversial
:08:13. > :08:18.The use of electroconvulsive therapy has been condemned by critics
:08:19. > :08:22.as barbaric and ineffective, but as Chris Buckler reports,
:08:23. > :08:29.it is used often without consent, and is on the rise.
:08:30. > :08:35.Electroconvulsive therapy is often associated with a different era.
:08:36. > :08:37.But it is still used today and can be effective
:08:38. > :08:47.The person will have had a muscle relaxing and an anaesthetic
:08:48. > :09:01.This helps prevent injuries, as an epileptic seizure
:09:02. > :09:12.That can result in side effects like memory loss, but it can also help.
:09:13. > :09:15.I have looked after many individuals who have been profoundly unwell,
:09:16. > :09:18.to the point of wanting to kill themselves, not eating or or having
:09:19. > :09:20.florid delusions, who have responded completely and got completely
:09:21. > :09:26.It is accepted that ECT is not suitable for everyone who finds
:09:27. > :09:31.Michael is an artist who was given the treatment without his consent,
:09:32. > :09:43.and he says he is still having nightmares about the experience.
:09:44. > :09:45.To think that this barbaric treatment still exists.
:09:46. > :09:48.Being strapped down to a metal bed with a rubber sheet,
:09:49. > :09:53.getting an injection, and waking up, and you just...
:09:54. > :09:56.You didn't want to be in your own body, it was like this
:09:57. > :10:08.I came in here healthy, without my permission.
:10:09. > :10:12.Michael was given ECT without his consent,
:10:13. > :10:17.The Irish government is in the process of introducing
:10:18. > :10:20.legislation to stop the treatment in cases where the patient does not
:10:21. > :10:27.The idea of unwillingness is unsavoury and something that
:10:28. > :10:34.There should not be a situation where the state forces
:10:35. > :10:37.But just across the Irish border in Northern Ireland,
:10:38. > :10:40.as in the rest of the UK, consent is not always needed
:10:41. > :10:44.for a patient to be given ECT, although it happens only in extreme
:10:45. > :10:49.cases and with specific medical approval.
:10:50. > :10:52.Last year in Northern Ireland, psychiatrists made more than 50
:10:53. > :10:56.requests for people to be treated without their consent.
:10:57. > :10:59.That is an increase of almost 50% on a few years before,
:11:00. > :11:04.although it is not known if some of those requests were refused.
:11:05. > :11:08.Those figures include both people who were unable to give consent,
:11:09. > :11:11.as well as patients who simply refused to.
:11:12. > :11:14.There are some psychiatrists wary of losing the option of ECT
:11:15. > :11:28.You would be eliminating a treatment that could be life-saving.
:11:29. > :11:31.Scientists are still working to try to understand the brain,
:11:32. > :11:33.and drugs are constantly being developed to tackle depression.
:11:34. > :11:35.But until new, more effective treatments are found,
:11:36. > :11:41.that once known as electroshock therapy will still have a place
:11:42. > :11:53.One of the most comprehensive studies of mental healthcare
:11:54. > :11:57.in England ever conducted has severely criticised provision
:11:58. > :11:59.for men of African and Caribbean heritage.
:12:00. > :12:02.The mental health task force reports there is evidence of systemic
:12:03. > :12:06.failure, and that black men are nearly seven times more likely
:12:07. > :12:09.to be detained under the mental health act or admitted as inpatients
:12:10. > :12:16.Elaine Dunkley has been talking to some of those who witnessed
:12:17. > :12:28.Sean was just lying there, still, and I kissed him on his forehead,
:12:29. > :12:36.We all put our hands together on top of one another over Sean and we said
:12:37. > :12:42.the Lord's prayer and we promised we would find out what happened to him.
:12:43. > :12:53.In 2008, his death at Brixton police station exposed the disproportionate
:12:54. > :12:57.dangers faced by black men and people with mental health
:12:58. > :13:06.That is where Sean took his last breath, that is where Sean died
:13:07. > :13:15.without his family, without his mother.
:13:16. > :13:17.There were systematic failures by the mental health team.
:13:18. > :13:21.Had they done their job properly at that time Sean would never have
:13:22. > :13:28.By the time he became so psychotic that he hallucinated,
:13:29. > :13:34.Sometimes I don't like to think about that, what could have been
:13:35. > :13:39.going on in his mind at that time, and we will never know,
:13:40. > :13:49.because he never lived to tell the tale.
:13:50. > :13:51.Devon Marston also believes that his treatment was profoundly
:13:52. > :13:59.In the 1980s he was diagnosed with paranoid schizophrenia and says
:14:00. > :14:07.he was often heavily medicated and rarely given counselling.
:14:08. > :14:12.It was rife in the system when I got involved.
:14:13. > :14:16.I was so frightened, I was struggling, I had my
:14:17. > :14:29.I thought these people were going to kill me.
:14:30. > :14:31.They would inject me with that medication,
:14:32. > :14:35.I lost myself and I can't find myself again.
:14:36. > :14:39.The drugs they gave the affected me all through my life
:14:40. > :14:43.I look at drugs as something like a spiritual straitjacket
:14:44. > :14:50.A lack of trust in services and the stigma around mental health
:14:51. > :14:54.often means that people from black, Asian and minority ethnic
:14:55. > :14:58.backgrounds don't get help until it reaches crisis point.
:14:59. > :15:02.But critically, culture also plays a key role.
:15:03. > :15:04.Psychiatry is still very much a middle-class and quite white
:15:05. > :15:13.As a black person, I know that if I go into a shop,
:15:14. > :15:15.the likelihood is I will be followed around.
:15:16. > :15:18.But if I'm someone with a mental health problem and I say that
:15:19. > :15:21.to my psychiatrist, in all probability they will see
:15:22. > :15:25.that as paranoia, because they don't have the lived experience.
:15:26. > :15:31.Can men come together and have a conversation...
:15:32. > :15:33.In Birmingham, there is a simple solution in tackling
:15:34. > :15:40.It is like a weight was lifted off me the moment I said it.
:15:41. > :15:45.The recognition that those most in need of help are
:15:46. > :15:50.Because of how men have been socialised, and the added pressure
:15:51. > :15:53.of being a black man and society, this notion of showing emotion,
:15:54. > :16:01.I would say you need to foster relationships and build
:16:02. > :16:09.relationships with people who understand the community.
:16:10. > :16:12.The mental health task force report is calling for a more targeted
:16:13. > :16:14.approach in treating people from minority ethnic backgrounds,
:16:15. > :16:17.recognition that there is a need for a change in the culture
:16:18. > :16:26.It's not only adults that experience mental illness,
:16:27. > :16:33.There is growing awareness that infants are vulnerable
:16:34. > :16:35.to post-traumatic stress disorder, especially if they've witnessed
:16:36. > :16:38.Research suggests such children show similar changes in brain activity
:16:39. > :16:44.to soldiers who suffer PTSD in war zones.
:16:45. > :16:47.But as Fergal Keane reports, with therapy and good care,
:16:48. > :16:54.There are things seen in childhood we can spend a lifetime
:16:55. > :17:01.This is the story of how British scientists and therapists
:17:02. > :17:03.are pioneering change in the treatment of childhood trauma.
:17:04. > :17:06.It's estimated that about 50% of mental health problems
:17:07. > :17:13.I'm reporting this story because I've seen the effects
:17:14. > :17:19.I've experienced it myself, not just in war, but as the child
:17:20. > :17:25.Back in the '60s, the only remedy offered to me was medication.
:17:26. > :17:28.Society was a long way from accepting that children
:17:29. > :17:34.could be traumatised in the home as soldiers were at war.
:17:35. > :17:36.But now, in the 21st Century, a therapeutic revolution
:17:37. > :17:45.Eight-year-old Samuel witnessed extreme domestic violence.
:17:46. > :17:50.When he came to his new adoptive family, he was deeply traumatised.
:17:51. > :17:52.One day he said he's going to burn the house down.
:17:53. > :17:58.So he was generally quite aggressive.
:17:59. > :18:04.He couldn't see why life was the way it was.
:18:05. > :18:06.He wasn't really nice to be around, initially.
:18:07. > :18:16.We just knew he needed a second chance.
:18:17. > :18:19.That second chance came about because he had a new loving
:18:20. > :18:25.home but, critically, also through therapy.
:18:26. > :18:31.In war, children are often treated for PTSD using art and storytelling,
:18:32. > :18:37.as well as one-on-one therapy, like these in Syria.
:18:38. > :18:41.Such techniques have brought about real changes in Samuel.
:18:42. > :18:45.Less talking about the things that he'd witnessed
:18:46. > :18:55.In the science of trauma, there have also been extraordinary advances.
:18:56. > :18:59.Researchers are studying the brains of traumatised soldiers and then
:19:00. > :19:03.comparing them with children who've witnessed disturbing events.
:19:04. > :19:07.Here, for example, we see changes in brain structure.
:19:08. > :19:09.They found that part of the frontal section of the brain,
:19:10. > :19:12.which deals with emotion, thins in the same way as soldiers
:19:13. > :19:17.Children who have been exposed to domestic violence
:19:18. > :19:19.and maltreatment, we see that there is a thinner cortex
:19:20. > :19:24.Can the damage that we see be reversed?
:19:25. > :19:29.For many, there's a long-term risk, but there is evidence of recovery
:19:30. > :19:37.So although we see changes in the brain, we know the brain
:19:38. > :19:40.is an incredibly plastic organ and is able to respond and adapt
:19:41. > :19:45.to new influences and to positive influences across development.
:19:46. > :19:47.If untreated, the trauma of childhood can haunt adult life,
:19:48. > :19:49.leading to addiction, broken relationships, depression.
:19:50. > :19:54.Psychotherapist Paul Barrett helps PTSD sufferers.
:19:55. > :19:57.He was only diagnosed with the condition himself
:19:58. > :20:03.What really happened to me was, I was walking up the road one day
:20:04. > :20:06.and I started getting flashbacks from childhood.
:20:07. > :20:15.I didn't really know what was happening.
:20:16. > :20:19.I walked round with a constant feeling of fear, but never realised
:20:20. > :20:29.According to one leading charity, 70% of children with mental health
:20:30. > :20:34.problems haven't been treated at a young enough age.
:20:35. > :20:36.Experts are calling for greater focus on and funding
:20:37. > :20:43.Damaged children can grow up into damaged adults?
:20:44. > :20:46.They very much do, and of course a huge cost to society,
:20:47. > :20:48.whether it's young offenders or children causing all sorts
:20:49. > :20:59.That is costing society a great deal.
:21:00. > :21:02.Of course, it's causing those children a huge amount of harm.
:21:03. > :21:05.Samuel had the unluckiest of starts in life, but he's becoming
:21:06. > :21:15.There's a great child locked up in that body,
:21:16. > :21:22.Now, would you tell your employer if you were diagnosed
:21:23. > :21:25.We asked 1000 people across the UK, and more than two-thirds
:21:26. > :21:31.A slightly higher proportion said they would tell their friends,
:21:32. > :21:34.and more than nine in ten said they would tell their family.
:21:35. > :21:37.It is one snapshot of attitudes which appear to show that the stigma
:21:38. > :21:42.of mental health may finally be disappearing.
:21:43. > :21:44.Two women, Eden Taylor and Laura Nuttall, have
:21:45. > :21:50.recorded their thoughts on taking on one of the last medical taboos.
:21:51. > :21:52.Having a mental illness is being like a puppet,
:21:53. > :21:55.being controlled by a puppetmaster, because it is just like having your
:21:56. > :22:07.own brain taken out and someone else's brain put
:22:08. > :22:08.We are going to leave reporters there