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"I want to tell you the truth about how bad things have got." | 0:00:02 | 0:00:05 | |
A cry for help from a 17-year-old | 0:00:05 | 0:00:07 | |
trapped within Britain's broken mental health service. | 0:00:07 | 0:00:11 | |
"I came into hospital with one or two suicide plans, | 0:00:11 | 0:00:15 | |
"but now I have at least five." | 0:00:15 | 0:00:17 | |
Parents separated from their children by hundreds of miles. | 0:00:18 | 0:00:22 | |
We shouldn't have to travel this far. There should be places nearby. | 0:00:22 | 0:00:26 | |
A system so dysfunctional it can't even keep track of deaths. | 0:00:28 | 0:00:33 | |
What is so shocking is that neither we | 0:00:33 | 0:00:36 | |
nor the Department of Health | 0:00:36 | 0:00:39 | |
know how many children are dying in psychiatric care. | 0:00:39 | 0:00:44 | |
Do you know how many children have died | 0:00:44 | 0:00:46 | |
in mental health units since 2010? | 0:00:46 | 0:00:49 | |
I'm advised that the number is very small. | 0:00:49 | 0:00:51 | |
-Well, do you know how many? -I don't know the number accurately. | 0:00:51 | 0:00:55 | |
How many more deaths do they need | 0:00:55 | 0:00:58 | |
before they're going to do something? | 0:00:58 | 0:01:01 | |
A bereaved mother haunted by the words of her daughter. | 0:01:02 | 0:01:06 | |
"I'm not all right. | 0:01:06 | 0:01:08 | |
"I'm broken inside." | 0:01:08 | 0:01:10 | |
Sara Green was a very bright child, | 0:01:20 | 0:01:23 | |
excited about her future. | 0:01:23 | 0:01:25 | |
All she ever wanted to do was go into a medical career, be a doctor. | 0:01:27 | 0:01:31 | |
-Just so caring, so thoughtful. -Mm. | 0:01:31 | 0:01:34 | |
You know, so much compassion for everybody else. | 0:01:34 | 0:01:37 | |
Sara, more than anything, loved to write. | 0:01:39 | 0:01:42 | |
"I'm hoping that I'll find out where I'm going soon, | 0:01:43 | 0:01:46 | |
"so I can start looking at applying to college." | 0:01:46 | 0:01:49 | |
She would write, | 0:01:49 | 0:01:51 | |
and she would sometimes show us certain pages of her diary | 0:01:51 | 0:01:54 | |
to let us know how she was feeling, | 0:01:54 | 0:01:56 | |
if she didn't feel she could express that particular thing. | 0:01:56 | 0:01:59 | |
Sara's family have allowed us to use extracts from this diary. | 0:02:01 | 0:02:05 | |
A teenager writing of a broken mental health service | 0:02:05 | 0:02:09 | |
and her supposed place of safety, | 0:02:09 | 0:02:11 | |
the hospital where she was to die. | 0:02:11 | 0:02:14 | |
"I cried so much today, | 0:02:14 | 0:02:15 | |
"and I know tomorrow will be worse." | 0:02:15 | 0:02:18 | |
For this film, her sister Stacey chose to read Sara's words. | 0:02:20 | 0:02:23 | |
No-one could ever tell on the phone who was who. | 0:02:25 | 0:02:28 | |
They'd have to say, "Is that Sara or is that Stacey?" | 0:02:28 | 0:02:31 | |
Aged 11, Sara's difficulties began. | 0:02:37 | 0:02:40 | |
She started developing mental health problems. | 0:02:40 | 0:02:43 | |
By the time she was 14, Sara had an eating disorder | 0:02:44 | 0:02:47 | |
and was locked into obsessive behaviour. | 0:02:47 | 0:02:50 | |
One evening, she confided in Stacey. | 0:02:51 | 0:02:55 | |
We were in our bedroom, and she told me that she self-harms. | 0:02:55 | 0:03:00 | |
And I didn't... | 0:03:01 | 0:03:02 | |
It was late at night, and I didn't... | 0:03:02 | 0:03:06 | |
I tried not to react, really. I just listened. | 0:03:06 | 0:03:09 | |
And I did say to her, | 0:03:11 | 0:03:12 | |
"Well, obviously, I'm going to have to tell Mum." | 0:03:12 | 0:03:17 | |
But I told her that I was glad she told me. | 0:03:17 | 0:03:19 | |
Sara, like many teenagers, used self harm to show her distress. | 0:03:21 | 0:03:25 | |
It led to her first brush with disaster. | 0:03:27 | 0:03:30 | |
She took an overdose of antidepressants. | 0:03:32 | 0:03:35 | |
"I'm not accepted at school. | 0:03:37 | 0:03:39 | |
"There are only so many insults a person can take. | 0:03:39 | 0:03:42 | |
"I'm hated for who I am, | 0:03:42 | 0:03:44 | |
"but the truth is, I hate myself. | 0:03:44 | 0:03:46 | |
"I can't believe I let them get to me like this." | 0:03:46 | 0:03:50 | |
The family caught her just in time. | 0:03:51 | 0:03:54 | |
They found a note. She felt bullied. | 0:03:54 | 0:03:57 | |
"I want to tell you the truth about how bad things have got. | 0:03:57 | 0:04:01 | |
"I'm not all right. | 0:04:01 | 0:04:03 | |
"I'm broken inside." | 0:04:03 | 0:04:05 | |
It's estimated nearly half of all children have been bullied. | 0:04:13 | 0:04:16 | |
These days, after school ends, there's no respite. | 0:04:18 | 0:04:21 | |
What we've seen is an explosion, really, around bullying. | 0:04:22 | 0:04:27 | |
Cyber-bullying means that young people are exposed to bullying | 0:04:27 | 0:04:31 | |
24 hours a day. | 0:04:31 | 0:04:34 | |
They don't escape it at all. | 0:04:34 | 0:04:36 | |
You don't come home from school and leave those people behind. | 0:04:36 | 0:04:39 | |
They are still there, on your phone. | 0:04:39 | 0:04:41 | |
It's having an enormous impact on young people's mental health. | 0:04:41 | 0:04:45 | |
In the summer of the 2013, | 0:04:47 | 0:04:49 | |
the family were living in Scunthorpe, | 0:04:49 | 0:04:51 | |
and Sara was under the care of CAMHS. | 0:04:51 | 0:04:54 | |
CAMHS is the Child and Adolescent Mental Health Service, | 0:04:56 | 0:05:00 | |
and across England, it's in crisis. | 0:05:00 | 0:05:02 | |
The Scunthorpe CAMHS office | 0:05:04 | 0:05:06 | |
wasn't able to give Sara the home support she needed. | 0:05:06 | 0:05:10 | |
The advice was, take her home, | 0:05:10 | 0:05:13 | |
lock the windows, lock the doors, | 0:05:13 | 0:05:16 | |
and if she absconds, ring the police. | 0:05:16 | 0:05:18 | |
Sara took another overdose. | 0:05:20 | 0:05:22 | |
Now CAMHS decided she needed hospital treatment. | 0:05:22 | 0:05:26 | |
But in the whole of Humber and Yorkshire, | 0:05:26 | 0:05:29 | |
there were only 30 child psychiatric beds. | 0:05:29 | 0:05:32 | |
None were available. | 0:05:32 | 0:05:34 | |
So for three nights, Sara was shunted between adult NHS units. | 0:05:34 | 0:05:39 | |
You received a phone call, didn't you, | 0:05:41 | 0:05:43 | |
giving you 20 minutes' notice that | 0:05:43 | 0:05:45 | |
they were picking Sara up in a taxi from Scunthorpe | 0:05:45 | 0:05:49 | |
and then going to the Priory, Cheadle Royal. | 0:05:49 | 0:05:53 | |
-That's the other side of the country. -Yeah. -Yeah. | 0:05:53 | 0:05:56 | |
Nearly half of all adolescent mental health patients | 0:05:58 | 0:06:01 | |
are sent by the NHS to private hospitals, | 0:06:01 | 0:06:04 | |
at an average cost of £800 a night. | 0:06:04 | 0:06:07 | |
The Priory group, the largest provider, | 0:06:09 | 0:06:11 | |
renowned for celebrity rehab, | 0:06:11 | 0:06:13 | |
gets 85% of its funding from the public sector. | 0:06:13 | 0:06:17 | |
On July 17th 2013, | 0:06:18 | 0:06:21 | |
Sara Green was admitted to the Priory in Cheadle, Manchester. | 0:06:21 | 0:06:25 | |
Now 100 miles from home and family, she turned to her diary. | 0:06:26 | 0:06:30 | |
"I want to go home. | 0:06:30 | 0:06:33 | |
"I just hope that Mum and Stace will be able to visit soon, | 0:06:33 | 0:06:36 | |
"because it's making me feel worse not being able to see them." | 0:06:36 | 0:06:39 | |
Faced with the expense of a 200-mile round trip across England, | 0:06:41 | 0:06:45 | |
her family had to scrimp to see her once a fortnight. | 0:06:45 | 0:06:48 | |
There was one week we lived on tuna sandwiches, | 0:06:48 | 0:06:51 | |
and that is just how it was. | 0:06:51 | 0:06:53 | |
That ordeal is bleakly familiar to Tara Palin. | 0:06:56 | 0:06:59 | |
We met Tara this winter, | 0:07:02 | 0:07:04 | |
crossing the country from Lancashire to Newcastle, | 0:07:04 | 0:07:07 | |
a 300-mile round trip, | 0:07:07 | 0:07:09 | |
to see her 15-year-old daughter, Rachel. | 0:07:09 | 0:07:12 | |
We've tried all kinds of ways. Travelling by coach, train. | 0:07:13 | 0:07:17 | |
Just... There's no real easy way. | 0:07:17 | 0:07:20 | |
It's horrible. | 0:07:20 | 0:07:21 | |
Rachel was a happy child. | 0:07:24 | 0:07:26 | |
-Hip-hip... -Hurray! | 0:07:26 | 0:07:28 | |
-Hip-hip... -Hurray! | 0:07:28 | 0:07:30 | |
But like one in ten of all youngsters, | 0:07:31 | 0:07:33 | |
she began having mental health problems. | 0:07:33 | 0:07:36 | |
Tara, from Chorley, is one of hundreds of parents | 0:07:41 | 0:07:44 | |
who must travel long distances to see their children. | 0:07:44 | 0:07:47 | |
Where's she been so far, then? | 0:07:47 | 0:07:49 | |
She's been to Warrington, which was not too bad. | 0:07:49 | 0:07:53 | |
It felt like it was miles away, | 0:07:53 | 0:07:55 | |
but it's nothing compared to now. | 0:07:55 | 0:07:58 | |
And then, after that, she got moved to Stafford, | 0:07:58 | 0:08:00 | |
about two-and-a-half hours away. | 0:08:00 | 0:08:03 | |
And then she got moved to Middlesbrough. | 0:08:03 | 0:08:05 | |
So three, three-and-a-half hours. | 0:08:05 | 0:08:07 | |
-And now, well, this journey... -It's about five, isn't it? | 0:08:07 | 0:08:10 | |
Yeah, takes about five hours, all in all. | 0:08:10 | 0:08:12 | |
So it's getting further and further away. | 0:08:12 | 0:08:14 | |
Yeah, further and further away. | 0:08:14 | 0:08:16 | |
The distance leaves Tara's daughter Rachel, | 0:08:17 | 0:08:20 | |
like Sara and many others before her, | 0:08:20 | 0:08:23 | |
without the family support crucial to recovery. | 0:08:23 | 0:08:27 | |
It's essential to try and keep young people connected | 0:08:27 | 0:08:30 | |
to their communities, their families, their friends. | 0:08:30 | 0:08:33 | |
That actually helps their recovery. | 0:08:33 | 0:08:35 | |
CAMHS is always a Cinderella service. | 0:08:35 | 0:08:38 | |
It only, even now, will be receiving 0.7% | 0:08:38 | 0:08:43 | |
-of the total NHS budget. -0.7%? -Indeed, | 0:08:43 | 0:08:47 | |
of the total NHS budget. | 0:08:47 | 0:08:49 | |
So we're really concerned | 0:08:49 | 0:08:50 | |
that we're facing a lost generation of young people here. | 0:08:50 | 0:08:54 | |
This journey isn't smooth. | 0:08:56 | 0:08:58 | |
An hour's delay at Manchester - Tara is used to it. | 0:09:01 | 0:09:05 | |
Tara accepts Rachel needs hospital treatment, | 0:09:08 | 0:09:12 | |
but fears she's becoming institutionalised. | 0:09:12 | 0:09:14 | |
She's getting worse. | 0:09:16 | 0:09:17 | |
I see her with marks that she's never had before. | 0:09:17 | 0:09:20 | |
Learned behaviour. That's never happened. | 0:09:20 | 0:09:22 | |
Marks round her neck | 0:09:22 | 0:09:24 | |
where she's tried to make ligatures. It's learned behaviour. | 0:09:24 | 0:09:27 | |
Learned from being in these places, | 0:09:27 | 0:09:29 | |
learned off other children, that they're doing it. | 0:09:29 | 0:09:31 | |
# Happy birthday, dear Sara | 0:09:37 | 0:09:39 | |
# Happy birthday to you! # | 0:09:39 | 0:09:41 | |
Six weeks after admission to the Priory, | 0:09:41 | 0:09:44 | |
close to the time when she should have been discharged, | 0:09:44 | 0:09:46 | |
Sara Green was allowed home for her 17th birthday, | 0:09:46 | 0:09:50 | |
her hair dyed red for the party. | 0:09:50 | 0:09:53 | |
Make a wish. | 0:09:53 | 0:09:54 | |
Make a wish. | 0:09:54 | 0:09:56 | |
But then it was back to the Priory. | 0:09:59 | 0:10:01 | |
Sara had been told she'd be there | 0:10:03 | 0:10:04 | |
no more than eight weeks for initial assessment. | 0:10:04 | 0:10:08 | |
"I've been in hospital for weeks now, | 0:10:08 | 0:10:10 | |
"but I don't think that people fully understand my problems." | 0:10:10 | 0:10:14 | |
But there was no move, | 0:10:15 | 0:10:17 | |
and it fed her anxiety. | 0:10:17 | 0:10:19 | |
"I cried so much today, | 0:10:19 | 0:10:21 | |
"and I know tomorrow will be worse." | 0:10:21 | 0:10:24 | |
Soon after, Sara says there was a huge letdown. | 0:10:24 | 0:10:28 | |
She'd been looking forward to a break at home. | 0:10:28 | 0:10:32 | |
"What a crap few days. | 0:10:32 | 0:10:34 | |
"Friday, I was all ready to go home, | 0:10:34 | 0:10:36 | |
"then I got told I wasn't going because there weren't any staff. | 0:10:36 | 0:10:40 | |
"I absolutely hate it here." | 0:10:40 | 0:10:42 | |
You don't promise a child, | 0:10:43 | 0:10:45 | |
you don't let them get packed up ready to go home, | 0:10:45 | 0:10:48 | |
and then just before you're ready to leave, say, | 0:10:48 | 0:10:50 | |
"No, you're not going home." | 0:10:50 | 0:10:52 | |
By October 2013, after two-and-a-half months in the Priory, | 0:10:54 | 0:10:58 | |
all sides agreed Sara should be closer to home. | 0:10:58 | 0:11:01 | |
But nothing happened. | 0:11:03 | 0:11:05 | |
Sara's fixations became much worse. | 0:11:05 | 0:11:08 | |
"If anything, I have worse thoughts of suicide now | 0:11:10 | 0:11:13 | |
"than I did when I first came in. | 0:11:13 | 0:11:15 | |
"These are getting increasingly bad at the moment." | 0:11:15 | 0:11:18 | |
Sara was plagued by notions of self-destruction. | 0:11:20 | 0:11:24 | |
She started having more incidents. | 0:11:24 | 0:11:27 | |
-Self-harming? -Yeah. | 0:11:27 | 0:11:29 | |
And more severe incidents as well. | 0:11:29 | 0:11:32 | |
At case meetings, the family would be told of fruitless attempts | 0:11:34 | 0:11:38 | |
by CAMHS and NHS England | 0:11:38 | 0:11:40 | |
to get Sara a bed closer to home. | 0:11:40 | 0:11:43 | |
Each time it was different excuses. | 0:11:43 | 0:11:46 | |
They'd say a bed was becoming available, | 0:11:46 | 0:11:48 | |
we're just waiting for another child to be discharged, things like that. | 0:11:48 | 0:11:52 | |
And then there'd be some excuse | 0:11:52 | 0:11:54 | |
why it wasn't happening. | 0:11:54 | 0:11:56 | |
She felt she was just being lied to all the time. | 0:11:56 | 0:11:59 | |
The family say there was palpable tension between the Priory | 0:12:02 | 0:12:06 | |
and the child mental health service CAMHS, | 0:12:06 | 0:12:09 | |
as they discussed what should happen next. | 0:12:09 | 0:12:11 | |
In these meetings, Sara was pretty much made to sit there | 0:12:13 | 0:12:16 | |
and listen to CAMHS and the Priory debating between themselves | 0:12:16 | 0:12:20 | |
who's going to provide funding. | 0:12:20 | 0:12:22 | |
-In front of the child, the patient? -In front of Sara. | 0:12:22 | 0:12:25 | |
Christmas is tough for the 1,000 or so children who are inpatients. | 0:12:27 | 0:12:32 | |
Rachel Palin has now spent her second Christmas detained, | 0:12:32 | 0:12:35 | |
or sectioned, under the Mental Health Act. | 0:12:35 | 0:12:39 | |
150 miles away, at home, | 0:12:39 | 0:12:41 | |
her mother Tara safety-proofs the presents. | 0:12:41 | 0:12:45 | |
I bought her part of a tracksuit, | 0:12:45 | 0:12:47 | |
and when I wrap it up, I'll have to pull this out. | 0:12:47 | 0:12:50 | |
The drawstring will have to come out, | 0:12:50 | 0:12:52 | |
because she will just tie it round her neck, | 0:12:52 | 0:12:54 | |
and that'll be quite hard to get off her. | 0:12:54 | 0:12:57 | |
Tara goes to extraordinary lengths to protect Rachel from herself. | 0:12:57 | 0:13:00 | |
I'm scared that I'm going to, potentially, be responsible | 0:13:03 | 0:13:06 | |
for giving her something to hurt herself with and harm herself with. | 0:13:06 | 0:13:10 | |
These same worries troubled Sara's mum Jane | 0:13:13 | 0:13:16 | |
when Sara was in the Priory. | 0:13:16 | 0:13:18 | |
In the run-up to Christmas 2013, | 0:13:20 | 0:13:22 | |
four-and-a-half months into her stay, | 0:13:22 | 0:13:24 | |
the Priory lent Sara a craft book for making bracelets. | 0:13:24 | 0:13:28 | |
It was bound with wire. | 0:13:28 | 0:13:31 | |
See, the thing with Sara, | 0:13:31 | 0:13:33 | |
if she had an idea in her mind of something to harm herself, | 0:13:33 | 0:13:37 | |
she would feel she'd have to act on it. | 0:13:37 | 0:13:40 | |
She couldn't just sort of erase it from her mind. | 0:13:41 | 0:13:45 | |
She felt that in order to do that, | 0:13:45 | 0:13:47 | |
she would have to act out whatever it was she was thinking. | 0:13:47 | 0:13:52 | |
Sara's mother and sister say a member of the Priory staff | 0:13:54 | 0:13:58 | |
made an ill-judged comment about the wire binding. | 0:13:58 | 0:14:01 | |
A nurse had come in the room and said to Sara, | 0:14:01 | 0:14:04 | |
"You'll be all right with this, Sara? | 0:14:04 | 0:14:07 | |
"You won't do owt with this, would you?" | 0:14:07 | 0:14:09 | |
-You won't do anything with this? -Mm. -Meaning what? | 0:14:09 | 0:14:12 | |
Use it for anything. | 0:14:12 | 0:14:14 | |
And after the nurse had left the room, | 0:14:14 | 0:14:17 | |
Sara said, "Well, you know, I hadn't thought of that before... | 0:14:17 | 0:14:21 | |
-BOTH: -"..but I have now." | 0:14:21 | 0:14:24 | |
The Priory says it does not believe this conversation happened. | 0:14:25 | 0:14:29 | |
Sara was allowed home leave for Christmas, | 0:14:30 | 0:14:33 | |
but on Christmas Day she was anxious at the impending departure | 0:14:33 | 0:14:38 | |
of her local CAMHS caseworker. | 0:14:38 | 0:14:40 | |
"From the moment I got home, | 0:14:42 | 0:14:44 | |
"all I have thought about is self-harming. | 0:14:44 | 0:14:47 | |
"To top it off, it looks like I'll be getting another worker. | 0:14:47 | 0:14:50 | |
"She says she will still be seeing me, but I'm annoyed. | 0:14:50 | 0:14:53 | |
"The whole point of her was to have one consistent worker | 0:14:53 | 0:14:56 | |
"because I have been through so many." | 0:14:56 | 0:14:59 | |
January 2014 was a dreadful month. | 0:15:01 | 0:15:04 | |
Back in the Priory, Sara tried self-strangulation, ligatures, | 0:15:06 | 0:15:10 | |
eight separate times. | 0:15:10 | 0:15:12 | |
She told her mother she was frightened staff might not | 0:15:12 | 0:15:16 | |
find her in time and that her self-harming could end in tragedy. | 0:15:16 | 0:15:20 | |
Jane wrote a two-page letter to the Priory, | 0:15:23 | 0:15:26 | |
listing a number of serious complaints. | 0:15:26 | 0:15:28 | |
"There have been several incidents involving ligatures..." | 0:15:28 | 0:15:31 | |
"Becoming increasingly distressed and... | 0:15:31 | 0:15:33 | |
"I feel my daughter's safety and wellbeing | 0:15:33 | 0:15:36 | |
"is consistently seriously compromised." | 0:15:36 | 0:15:39 | |
She didn't receive a reply for three months | 0:15:39 | 0:15:42 | |
and by then, it was too late. | 0:15:42 | 0:15:44 | |
Sara's departing CAMHS caseworker | 0:15:47 | 0:15:49 | |
also put her concerns in an e-mail to her bosses. | 0:15:49 | 0:15:52 | |
"We feel that Sara is no longer being appropriately risk managed." | 0:15:54 | 0:15:59 | |
Some days later, Jane received a late-night phone call | 0:16:03 | 0:16:06 | |
from the Priory saying they'd forcibly cut Sara's hair | 0:16:06 | 0:16:10 | |
because she was threatening to ligature with it. | 0:16:10 | 0:16:14 | |
Sara was devastated. | 0:16:14 | 0:16:17 | |
"There's no need to hack it off whilst I'm in restraint. | 0:16:17 | 0:16:20 | |
"And my hair wasn't even around my neck at that point. | 0:16:20 | 0:16:23 | |
"How is that any different to assault?" | 0:16:23 | 0:16:25 | |
And Sara actually told us they'd pinned her up against the wall | 0:16:25 | 0:16:29 | |
and hacked it off with ligature cutters. | 0:16:29 | 0:16:32 | |
The member of staff basically said, | 0:16:32 | 0:16:34 | |
"We cannot let her control like that, she has to learn." | 0:16:34 | 0:16:38 | |
The Priory told Panorama | 0:16:40 | 0:16:42 | |
staff had no option but to cut her hair to ensure her safety, | 0:16:42 | 0:16:47 | |
following repeated attempts to ligature with it. | 0:16:47 | 0:16:50 | |
Sara, unwell and struggling, was still able to make | 0:16:53 | 0:16:56 | |
an acute assessment of how the system was failing her. | 0:16:56 | 0:17:00 | |
She, better than anyone, understood. | 0:17:00 | 0:17:04 | |
"My community team are clueless, | 0:17:04 | 0:17:06 | |
"and the staff here have different opinions on what to do with me. | 0:17:06 | 0:17:10 | |
"I'm just kind of stuck in the middle | 0:17:10 | 0:17:12 | |
"between my CAMHS team that wants me in this unit, | 0:17:12 | 0:17:15 | |
"but failing to offer enough support in the community. | 0:17:15 | 0:17:18 | |
"It's making me question if anyone actually knows what | 0:17:18 | 0:17:21 | |
"they are talking about." | 0:17:21 | 0:17:23 | |
On the last day of January, Sara took the wire binding | 0:17:26 | 0:17:30 | |
from the Priory's craft book and tried to strangle herself. | 0:17:30 | 0:17:34 | |
She was saved but it was close. She needed oxygen. | 0:17:34 | 0:17:37 | |
A few weeks later she wrote... | 0:17:39 | 0:17:42 | |
"I don't like not knowing where I am going next | 0:17:42 | 0:17:45 | |
"and not knowing anything about it. | 0:17:45 | 0:17:47 | |
"Not knowing when and where makes me feel really uncertain | 0:17:47 | 0:17:50 | |
"about everything, and out of control, which I absolutely hate." | 0:17:50 | 0:17:54 | |
Then Sara is given hope. | 0:17:57 | 0:18:00 | |
A caseworker, commissioned by NHS England, | 0:18:00 | 0:18:03 | |
shows her brochures of therapeutic units. | 0:18:03 | 0:18:06 | |
They talk of sending her to a new one near Leeds, | 0:18:06 | 0:18:10 | |
still 50 miles from home but close enough for regular family visits. | 0:18:10 | 0:18:15 | |
"I'm glad that things have moved in terms of finding me a placement. | 0:18:15 | 0:18:19 | |
"I'm hoping that I'll find out where I'm going soon | 0:18:19 | 0:18:22 | |
"so I can start looking at applying to college." | 0:18:22 | 0:18:25 | |
What Sara didn't know is the new unit wouldn't even be open | 0:18:33 | 0:18:36 | |
for another six months. | 0:18:36 | 0:18:39 | |
NHS England didn't know this either. | 0:18:39 | 0:18:41 | |
No-one made the basic check, a phone call, to find out. | 0:18:41 | 0:18:46 | |
There was no place to go to... | 0:18:46 | 0:18:48 | |
so why tell us there was? Why build Sara's hopes up? | 0:18:48 | 0:18:53 | |
Sara's last home visit was in March 2014. | 0:18:55 | 0:18:59 | |
She was depressed at the prospect of returning to the Priory | 0:18:59 | 0:19:03 | |
but her mum says they had no option. | 0:19:03 | 0:19:06 | |
She didn't want to go back. | 0:19:07 | 0:19:09 | |
I didn't want her to go back, I didn't... | 0:19:09 | 0:19:12 | |
I didn't want her to go back, but I knew what would happen if... | 0:19:12 | 0:19:15 | |
-If she didn't. -They would section her. | 0:19:15 | 0:19:17 | |
And they'd made that quite clear over the period of time | 0:19:17 | 0:19:21 | |
she was in there. | 0:19:21 | 0:19:23 | |
On March 18th 2014, | 0:19:25 | 0:19:27 | |
the day after she went back to the Priory, | 0:19:27 | 0:19:30 | |
Sara Green made a second wire ligature. | 0:19:30 | 0:19:33 | |
This time she wouldn't be saved. | 0:19:35 | 0:19:37 | |
At half past ten she was pronounced dead. | 0:19:41 | 0:19:45 | |
She had used a wire... | 0:19:45 | 0:19:46 | |
..from a spiral book... | 0:19:49 | 0:19:51 | |
..and taken her own life. | 0:19:53 | 0:19:55 | |
The coroner at Sara's inquest was heavily critical of the Priory. | 0:20:06 | 0:20:10 | |
He concluded she hadn't intended to die, it wasn't suicide, | 0:20:10 | 0:20:14 | |
she was self-harming, | 0:20:14 | 0:20:15 | |
her anxiety having worsened because of her unacceptably | 0:20:15 | 0:20:19 | |
prolonged stay here in the Priory, | 0:20:19 | 0:20:22 | |
a hospital 100 miles from her home. | 0:20:22 | 0:20:25 | |
The coroner said the ward manager's evidence | 0:20:29 | 0:20:32 | |
that Sara's first wire binding ligature wasn't "a serious incident" | 0:20:32 | 0:20:36 | |
was a staggering admission. | 0:20:36 | 0:20:39 | |
The Priory's record-keeping was | 0:20:40 | 0:20:42 | |
"deplorable, so inadequate as to risk future deaths. | 0:20:42 | 0:20:46 | |
"Sara would have been safer at home." | 0:20:46 | 0:20:49 | |
The Priory told Panorama the safety of patients was its first concern. | 0:20:51 | 0:20:55 | |
Sara Green's death should never have happened. | 0:21:16 | 0:21:18 | |
The fact that it did is absolutely appalling. | 0:21:18 | 0:21:21 | |
For our society, in this day and age, | 0:21:21 | 0:21:24 | |
for a young person to be in inpatient care, | 0:21:24 | 0:21:28 | |
where she should be getting the best of care, to help her recover, | 0:21:28 | 0:21:33 | |
to take her own life is just awful. | 0:21:33 | 0:21:36 | |
And what this indicates is a whole system in collapse. | 0:21:36 | 0:21:40 | |
The verdict at Sara's inquest was that both CAMHS and NHS England | 0:21:41 | 0:21:45 | |
had given confusing and contradictory evidence | 0:21:45 | 0:21:49 | |
and had no clear plan to get Sara out of the Priory. | 0:21:49 | 0:21:53 | |
The coroner blamed the entire system for Sara's death. | 0:21:54 | 0:21:57 | |
CAMHS in Scunthorpe is run by an NHS Trust. | 0:21:59 | 0:22:03 | |
In Sara's case, she was supposed to be in this hospital | 0:22:03 | 0:22:06 | |
for six to eight weeks. She was there for nine months. | 0:22:06 | 0:22:08 | |
There was no way for her to get out because you had no facilities here. | 0:22:08 | 0:22:12 | |
Absolutely. And that is absolutely to be regretted. | 0:22:12 | 0:22:16 | |
There was nowhere appropriate for her to go that would have met | 0:22:16 | 0:22:18 | |
her needs at the time. I fully accept that. | 0:22:18 | 0:22:21 | |
Because she couldn't just be transferred | 0:22:21 | 0:22:23 | |
to a normal CAMHS service locally - it would require a specialist level | 0:22:23 | 0:22:26 | |
of input that was not available locally - | 0:22:26 | 0:22:29 | |
hence other units were being sought out. | 0:22:29 | 0:22:31 | |
-And none found. -Not at that point. | 0:22:31 | 0:22:34 | |
Since Sara Green's death, | 0:22:36 | 0:22:38 | |
a legal campaigning group has been working with her family. | 0:22:38 | 0:22:42 | |
What has been really shocking is how difficult it is to find out | 0:22:42 | 0:22:47 | |
the true picture of the number of children who are dying | 0:22:47 | 0:22:49 | |
in psychiatric care. We asked a parliamentary question | 0:22:49 | 0:22:53 | |
to the previous Minister, Norman Lamb, | 0:22:53 | 0:22:56 | |
who told us that there had been no deaths between 2010 | 0:22:56 | 0:23:00 | |
and between 2014. And yet we knew from our casework | 0:23:00 | 0:23:03 | |
that of course there had been deaths. | 0:23:03 | 0:23:06 | |
We then were forced to conduct Freedom of Information requests, | 0:23:06 | 0:23:10 | |
which have subsequently found out that there have been nine deaths. | 0:23:10 | 0:23:14 | |
But, of course, Freedom of Information does not apply | 0:23:14 | 0:23:17 | |
-to private providers. -So you think there could be even more deaths? | 0:23:17 | 0:23:20 | |
My fear is that there could be more deaths. | 0:23:20 | 0:23:22 | |
But what is so shocking is that neither we | 0:23:22 | 0:23:26 | |
nor the Department of Health know how many children are dying | 0:23:26 | 0:23:30 | |
in psychiatric care. | 0:23:30 | 0:23:32 | |
Do you know how many children have died in mental health units | 0:23:32 | 0:23:36 | |
since 2010? | 0:23:36 | 0:23:38 | |
-I'm advised that the number is very small. -Do you know how many? | 0:23:38 | 0:23:41 | |
I don't know the number accurately beyond... | 0:23:41 | 0:23:44 | |
Your predecessor said none had died. | 0:23:44 | 0:23:47 | |
-Right. -We've been told by the charity Inquest | 0:23:47 | 0:23:49 | |
they've established at least nine have died. | 0:23:49 | 0:23:52 | |
Well, my understanding is, actually, it was fewer than that. | 0:23:52 | 0:23:57 | |
Should you not, as the minister responsible, know how many? | 0:23:57 | 0:24:00 | |
I was advised it was less than that number. | 0:24:00 | 0:24:03 | |
The minister later said they'd records of four deaths since 2010, | 0:24:03 | 0:24:08 | |
and now they'd explore Inquest's figure of nine. | 0:24:08 | 0:24:11 | |
He stated... | 0:24:11 | 0:24:12 | |
Rachel's mum Tara is determined the system must change. | 0:24:30 | 0:24:34 | |
She started an online petition for more localised care | 0:24:34 | 0:24:39 | |
and has collected over 100,000 signatures. | 0:24:39 | 0:24:41 | |
It's just amazing, we were overwhelmed by it. | 0:24:43 | 0:24:46 | |
And that means you have the possibility | 0:24:46 | 0:24:48 | |
of a parliamentary debate. | 0:24:48 | 0:24:49 | |
Yeah, I think you need over 100,000 to be considered for a debate | 0:24:49 | 0:24:53 | |
in Parliament, yeah. | 0:24:53 | 0:24:55 | |
These poor children are being kept so far away from their families, | 0:24:55 | 0:24:58 | |
and it doesn't help recovery, it's not helpful at all. | 0:24:58 | 0:25:02 | |
It's not good for them, it's not good for the family. | 0:25:02 | 0:25:05 | |
In February, a long-awaited NHS task force reported that | 0:25:08 | 0:25:12 | |
England's mental health services have been chronically underfunded. | 0:25:12 | 0:25:17 | |
The minister says he wants that to change. | 0:25:17 | 0:25:21 | |
We're trying to increase the amount both of community provision | 0:25:21 | 0:25:24 | |
and specialised care. We now have 1,400 acute beds available | 0:25:24 | 0:25:28 | |
for children and young people, that's the most we've ever had. | 0:25:28 | 0:25:31 | |
We've added 50 since I became the minister. | 0:25:31 | 0:25:34 | |
At the same time, we have an investment of £1.4 billion | 0:25:34 | 0:25:38 | |
into children's and young people's services. | 0:25:38 | 0:25:40 | |
Sara Green's death carries many lessons. | 0:25:43 | 0:25:46 | |
I want you to give this person a compliment, OK? When I say... | 0:25:46 | 0:25:49 | |
If we're falling short in caring for the mentally ill, | 0:25:49 | 0:25:52 | |
what's to be done? | 0:25:52 | 0:25:54 | |
Off you go. Give each other a compliment. | 0:25:54 | 0:25:57 | |
Schools are now on the front line, handling mental health problems. | 0:25:57 | 0:26:01 | |
Three-quarters of mental health trusts in England cut or froze | 0:26:01 | 0:26:05 | |
their CAMHS teenage mental health spending last year. | 0:26:05 | 0:26:09 | |
The responsibility's been put onto schools to tackle problems | 0:26:09 | 0:26:13 | |
before they take hold. | 0:26:13 | 0:26:15 | |
Teachers are very well placed to actually spot | 0:26:15 | 0:26:18 | |
when children are in distress or where there is change | 0:26:18 | 0:26:22 | |
which might indicate a mental health problem. | 0:26:22 | 0:26:24 | |
So what we have done is start a new type of programme called | 0:26:24 | 0:26:29 | |
Academic Resilience. | 0:26:29 | 0:26:30 | |
And this is about helping schools help the mental health | 0:26:30 | 0:26:34 | |
of their pupils, and it's a completely brand-new approach. | 0:26:34 | 0:26:38 | |
So when Lara logged on and she saw those comments, | 0:26:38 | 0:26:41 | |
how would that have made her feel? | 0:26:41 | 0:26:43 | |
The school piloting the programme was Hove Park Secondary in Sussex. | 0:26:43 | 0:26:47 | |
She started to regret it, yep, she started to regret it. | 0:26:47 | 0:26:50 | |
And why do you think...? | 0:26:50 | 0:26:51 | |
They're talking about bullying, | 0:26:51 | 0:26:53 | |
a torment for Sara Green, Rachael Palin and millions of others. | 0:26:53 | 0:26:58 | |
Yeah, so it could lead to depression and self-harm. | 0:26:58 | 0:27:00 | |
In what ways do you think it might...? | 0:27:00 | 0:27:03 | |
Rates of teenage depression have doubled since the 1980s. | 0:27:03 | 0:27:07 | |
On average, three in every classroom | 0:27:07 | 0:27:10 | |
will have some kind of mental health problem. | 0:27:10 | 0:27:13 | |
At Hove Park it means around 160 pupils will need help. | 0:27:13 | 0:27:17 | |
Self-harming, have you had any experience of that | 0:27:18 | 0:27:21 | |
or do you know any friends who self-harm? | 0:27:21 | 0:27:24 | |
The school employs three full-time non-teaching staff, | 0:27:24 | 0:27:28 | |
the care team, for counselling. | 0:27:28 | 0:27:31 | |
It's really sad to say but I think it's become quite normal now. | 0:27:31 | 0:27:35 | |
The majority of people I know personally self-harm. | 0:27:35 | 0:27:39 | |
-Make a wish. -I made a wish. | 0:27:47 | 0:27:50 | |
Sara Green died because she was let down | 0:27:51 | 0:27:54 | |
by a broken mental health service. | 0:27:54 | 0:27:57 | |
The family, in their grief, know, like Sara knew, | 0:27:57 | 0:28:01 | |
she would have been far safer at home. | 0:28:01 | 0:28:04 | |
Sara was frightened, you could see it in her... | 0:28:08 | 0:28:11 | |
Because she knew what was going on. | 0:28:11 | 0:28:14 | |
And that's what makes it really, really hard as well. | 0:28:14 | 0:28:17 | |
Because she knew... | 0:28:17 | 0:28:19 | |
what was happening and she couldn't do anything about it and... | 0:28:19 | 0:28:23 | |
neither could anybody else. | 0:28:23 | 0:28:25 | |
"Fall the floor | 0:28:28 | 0:28:30 | |
"Close the door | 0:28:30 | 0:28:32 | |
"I don't want to be me | 0:28:32 | 0:28:33 | |
"I want to be free | 0:28:33 | 0:28:35 | |
"I need some relief from all this grief | 0:28:35 | 0:28:38 | |
"I know I smile | 0:28:38 | 0:28:40 | |
"But I haven't felt happy for a while." | 0:28:40 | 0:28:43 |