21/02/2016 Health Check

Welcome to a special edition of Reporters,

examining a key area that affects all of us,

We will be finding out how the latest research is improving

the understanding and treatment of mental illnesses,

and hearing from people who have learned to live

Fergus Walsh reports on the new revolution in neuroscience.

I will be explaining how scientific understanding of mental illness

are being advanced by these, miniature human brains being grown

Chris Buckler reports from Northern Ireland on how one

of the most controversial treatments, electroconvulsive

To think that this barbaric treatment still exists...

Fergal Keane investigates a new study suggesting young victims

of domestic violence can suffer from PTSD.

It is costing society a great deal, and causing the children a huge

These children can grow up into damaged adults.

Talking about it and opening up about it is fairly helpful

for breaking down stigma and telling people what it is really

And we will be hearing from the young campaigners taking

How does the brain work and why does it go wrong?

These are two of the fundamental questions behind treating mental

It involves our emotional, psychological and social well-being,

and affects how we think, feel and act.

Mental health problems are also one of the main causes of disease

According to the world's top neuroscientists,

our understanding of the human brain is undergoing a revolution.

Advances in genetics and brain imaging are enabling researchers

to discover more about mental illness.

As Fergus Walsh explains, it opens up the possibilities

It is a privilege to be able to examine this,

the right hemisphere of the human brain.

One of hundreds of brains donated in the UK for medical

This delicate structure is responsible for thought,

memory, language, emotion, consciousness.

The very things that make us human, yet despite all of our scientific

knowledge there is still a huge amount to be discovered about how

the brain works and why it goes wrong.

But the brain is beginning to give up its secrets.

Advances in biology mean many genes implicated in mental illness have

been identified, and new scanning techniques are creating something

extraordinary, a complete map of the brain's intricate

These coloured lines represent bundles of nerve fibres linking

different parts of the brain through a number of highly connected hubs.

There are parts of the brain that we can talk about as being hubs

of the brain, in the same way that Heathrow is a hub

Researchers have discovered that people with schizophrenia tend

to have fewer hubs so their brain networks are less well-connected.

Where the excitement is building at the moment is linking the network

diagrams that we can get out of imaging to what we are learning

If we can bring those two things together we may be able

to understand more clearly whether the genetic mechanisms that

drive genetic development can go off on a different path that

If we can understand mechanisms, then we can design new treatments.

As well as deciphering the brain's networks of connections,

scientists are also learning more about the early stages

of development by growing miniature brains.

Known as organoids, here they are in the hands

of the scientist who invented the technique.

Incubated in a research lab in Cambridge, these tiny balls

of tissue mimic what the infant brain is like as it grows

Among people with mental illness, these brains can help explore

We can then compare those brains and try to understand

I think it is an early step in some great breakthroughs in what has been

a desert in the field of biomedicine.

Mental health disorders have been incredibly lacking in terms

of new medications to treat these really devastating disorders.

So when will this research pay dividends in delivering

In the next five or ten years you can expect two things

We will be able to use neuroscience and genetics to target treatments

better for patients, and this could happen with schizophrenia.

The second is that based on the knowledge we have now we can

actually have new medications, not for an entire illness,

Of course, mental health is determined by our life

experiences as well as the genes we inherit.

The more we discover about this masterpiece of evolution,

the greater the chance we have of treating it when it goes wrong.

We may be learning more about the brain itself,

but much of mental health still remains a mystery.

So how do we define mental health conditions?

Neurotic conditions are extreme emotional experiences,

Psychotic symptoms interfere with the perception of reality.

Conditions include schizophrenia and bipolar disorder.

Global figures are hard to track down, but in the UK about 20%

of people will become depressed at some point in their lives.

Anxiety will affect 5% of the population at any one time.

Other conditions, like bipolar disorder and schizophrenia,

affect about one person in every 100 people.

The exact cause of most mental illnesses is not known.

Many conditions, such as bipolar disorder,

can run in families, which suggests a genetic link.

Difficult life events can then trigger a mental illness.

Stress, poverty, abuse, isolation, substance abuse,

So, how are mental health problems treated?

Talking treatments are often used to help, trying to break the cycle

Other therapies might also delve into past experiences.

Antidepressants usually ascribed for anxiety and depression,

and antipsychotics, which affects chemicals in the brain,

But as with everything that involves the brain,

much about mental health remains a mystery.

The idea of treating psychiatric illness by passing a jolt

of electricity through the brain was one of the most controversial

The use of electroconvulsive therapy has been condemned by critics

as barbaric and ineffective, but as Chris Buckler reports,

it is used often without consent, and is on the rise.

Electroconvulsive therapy is often associated with a different era.

But it is still used today and can be effective

The person will have had a muscle relaxing and an anaesthetic

This helps prevent injuries, as an epileptic seizure

That can result in side effects like memory loss, but it can also help.

I have looked after many individuals who have been profoundly unwell,

to the point of wanting to kill themselves, not eating or or having

florid delusions, who have responded completely and got completely

It is accepted that ECT is not suitable for everyone who finds

Michael is an artist who was given the treatment without his consent,

and he says he is still having nightmares about the experience.

To think that this barbaric treatment still exists.

Being strapped down to a metal bed with a rubber sheet,

getting an injection, and waking up, and you just...

You didn't want to be in your own body, it was like this

I came in here healthy, without my permission.

Michael was given ECT without his consent,

The Irish government is in the process of introducing

legislation to stop the treatment in cases where the patient does not

The idea of unwillingness is unsavoury and something that

There should not be a situation where the state forces

But just across the Irish border in Northern Ireland,

as in the rest of the UK, consent is not always needed

for a patient to be given ECT, although it happens only in extreme

cases and with specific medical approval.

Last year in Northern Ireland, psychiatrists made more than 50

requests for people to be treated without their consent.

That is an increase of almost 50% on a few years before,

although it is not known if some of those requests were refused.

Those figures include both people who were unable to give consent,

as well as patients who simply refused to.

There are some psychiatrists wary of losing the option of ECT

You would be eliminating a treatment that could be life-saving.

Scientists are still working to try to understand the brain,

and drugs are constantly being developed to tackle depression.

But until new, more effective treatments are found,

that once known as electroshock therapy will still have a place

One of the most comprehensive studies of mental healthcare

in England ever conducted has severely criticised provision

for men of African and Caribbean heritage.

The mental health task force reports there is evidence of systemic

failure, and that black men are nearly seven times more likely

to be detained under the mental health act or admitted as inpatients

Elaine Dunkley has been talking to some of those who witnessed

Sean was just lying there, still, and I kissed him on his forehead,

We all put our hands together on top of one another over Sean and we said

the Lord's prayer and we promised we would find out what happened to him.

In 2008, his death at Brixton police station exposed the disproportionate

dangers faced by black men and people with mental health

That is where Sean took his last breath, that is where Sean died

without his family, without his mother.

There were systematic failures by the mental health team.

Had they done their job properly at that time Sean would never have

By the time he became so psychotic that he hallucinated,

Sometimes I don't like to think about that, what could have been

going on in his mind at that time, and we will never know,

because he never lived to tell the tale.

Devon Marston also believes that his treatment was profoundly

In the 1980s he was diagnosed with paranoid schizophrenia and says

he was often heavily medicated and rarely given counselling.

It was rife in the system when I got involved.

I was so frightened, I was struggling, I had my

I thought these people were going to kill me.

They would inject me with that medication,

I lost myself and I can't find myself again.

The drugs they gave the affected me all through my life

I look at drugs as something like a spiritual straitjacket

A lack of trust in services and the stigma around mental health

often means that people from black, Asian and minority ethnic

backgrounds don't get help until it reaches crisis point.

But critically, culture also plays a key role.

Psychiatry is still very much a middle-class and quite white

As a black person, I know that if I go into a shop,

the likelihood is I will be followed around.

But if I'm someone with a mental health problem and I say that

to my psychiatrist, in all probability they will see

that as paranoia, because they don't have the lived experience.

Can men come together and have a conversation...

In Birmingham, there is a simple solution in tackling

It is like a weight was lifted off me the moment I said it.

The recognition that those most in need of help are

Because of how men have been socialised, and the added pressure

of being a black man and society, this notion of showing emotion,

I would say you need to foster relationships and build

relationships with people who understand the community.

The mental health task force report is calling for a more targeted

approach in treating people from minority ethnic backgrounds,

recognition that there is a need for a change in the culture

It's not only adults that experience mental illness,

There is growing awareness that infants are vulnerable

to post-traumatic stress disorder, especially if they've witnessed

Research suggests such children show similar changes in brain activity

to soldiers who suffer PTSD in war zones.

But as Fergal Keane reports, with therapy and good care,

There are things seen in childhood we can spend a lifetime

This is the story of how British scientists and therapists

are pioneering change in the treatment of childhood trauma.

It's estimated that about 50% of mental health problems

I'm reporting this story because I've seen the effects

I've experienced it myself, not just in war, but as the child

Back in the '60s, the only remedy offered to me was medication.

Society was a long way from accepting that children

could be traumatised in the home as soldiers were at war.

But now, in the 21st Century, a therapeutic revolution

Eight-year-old Samuel witnessed extreme domestic violence.

When he came to his new adoptive family, he was deeply traumatised.

One day he said he's going to burn the house down.

So he was generally quite aggressive.

He couldn't see why life was the way it was.

He wasn't really nice to be around, initially.

We just knew he needed a second chance.

That second chance came about because he had a new loving

home but, critically, also through therapy.

In war, children are often treated for PTSD using art and storytelling,

as well as one-on-one therapy, like these in Syria.

Such techniques have brought about real changes in Samuel.

Less talking about the things that he'd witnessed

In the science of trauma, there have also been extraordinary advances.

Researchers are studying the brains of traumatised soldiers and then

comparing them with children who've witnessed disturbing events.

Here, for example, we see changes in brain structure.

They found that part of the frontal section of the brain,

which deals with emotion, thins in the same way as soldiers

Children who have been exposed to domestic violence

and maltreatment, we see that there is a thinner cortex

Can the damage that we see be reversed?

For many, there's a long-term risk, but there is evidence of recovery

So although we see changes in the brain, we know the brain

is an incredibly plastic organ and is able to respond and adapt

to new influences and to positive influences across development.

If untreated, the trauma of childhood can haunt adult life,

leading to addiction, broken relationships, depression.

Psychotherapist Paul Barrett helps PTSD sufferers.

He was only diagnosed with the condition himself

What really happened to me was, I was walking up the road one day

and I started getting flashbacks from childhood.

I didn't really know what was happening.

I walked round with a constant feeling of fear, but never realised

According to one leading charity, 70% of children with mental health

problems haven't been treated at a young enough age.

Experts are calling for greater focus on and funding

Damaged children can grow up into damaged adults?

They very much do, and of course a huge cost to society,

whether it's young offenders or children causing all sorts

That is costing society a great deal.

Of course, it's causing those children a huge amount of harm.

Samuel had the unluckiest of starts in life, but he's becoming

There's a great child locked up in that body,

Now, would you tell your employer if you were diagnosed

We asked 1000 people across the UK, and more than two-thirds

A slightly higher proportion said they would tell their friends,

and more than nine in ten said they would tell their family.

It is one snapshot of attitudes which appear to show that the stigma

of mental health may finally be disappearing.

Two women, Eden Taylor and Laura Nuttall, have

recorded their thoughts on taking on one of the last medical taboos.

Having a mental illness is being like a puppet,

being controlled by a puppetmaster, because it is just like having your

own brain taken out and someone else's brain put

We are going to leave reporters there