Revealed: Britain's Mental Health Crisis Panorama

Tonight on Panorama,

we reveal the shocking rise of nearly 50%

in unexpected deaths of mental health patients...

I literally am sitting on the chair that my son died in.

..and how, despite five years of Government promises...

If you suffer from mental health problems,

there's not enough help to hand.

I believe we can lead a revolution in mental health treatment

in Britain.

..funding for NHS mental health trusts has in fact

dropped by £150 million...

What is tragic is that it's the time when we have been promised

increased funding and there is

no doubt that this is not being seen on the ground.

..and we investigate the human cost at what's been England's

worst-performing mental health trust.

Can you imagine waking up every day and almost tossing a coin to go

upstairs to see whether your own flesh and blood is still alive?

On the 14th of November, Sheila Preston's

son Leo was found dead following a suspected accidental overdose.

I met her on her first visit to his flat just four days later.

This is Leo.

This is Leo here.

He was probably 12 years old there.

And he was the most beautiful, kind, loving son.

And I was proud of him.

-SHE SIGHS

-And he should still be here

in this flat today.

I wanted to save him.

-Look at this.

-SHE SOBS

The 39-year-old had been treated for schizophrenia

for the last two decades.

Look at all this.

Sophie, look at that. Look.

Look at that.

Would you want to cook on that?

Leo had been a patient

of the Norfolk and Suffolk Foundation Trust,

the only mental health trust to be placed in special measures

in the history of the NHS.

I begged.

I begged the trust to help him

but they thought he was living well, he was, you know, he was managing.

But I knew that he wasn't.

I knew that he would just get iller and iller and iller.

And he died.

And when they came to tell me, I was not surprised.

I was expecting it.

The NHS produces very little national data about

the performance of our mental health services.

So we decided to do some research of our own.

Every mental health trust in England was asked for their figures

on unexpected patient deaths over the last three years.

They're recorded when there's

no obvious sign of a natural cause of death, so they can include

suicide, accidental overdoses, and also neglect.

We have results from 33 of the 57 trusts.

The data is complex because different parts of

the country collect it in slightly different ways,

but what our figures show is a clear trend suggesting that

unexpected deaths have risen by nearly half in the last three years.

That's 1,000 additional deaths last year in those 33 trusts alone.

These horrifying figures come

despite years of Government pledges to prioritise mental health.

Just last month,

Theresa May gave a major speech promising to revolutionise care.

I want us to employ the power of Government as

a force for good to transform the way we deal with

mental health problems, right across society and at every stage of life.

No matter what pledges are made by central government,

it's local areas that decide where to spend the bulk of the money.

The difficulty is making the connection between

announcements at national level and money actually showing up

at local level to buy more staff,

to buy more care and really for patients to see the difference.

And with the whole NHS under unprecedented pressure,

many areas have decided they can't afford to put it into mental health.

To make ends meet, trusts are now undertaking major restructures.

One of our concerns around mental health is just how radical

many of those transformations are

but with very little information about were they were a good

idea for patients and what kind of impact they're having.

Quite a few of them seem to be about saving money.

The Norfolk and Suffolk Foundation Trust was one of the first to

attempt a wholesale restructuring of its services.

In 2013, faced with cuts of 20%, the trust introduced

a series of dramatic changes.

Front-line community teams were disbanded,

experienced staff laid off and case loads rocketed.

Since then, unexpected deaths have nearly doubled,

rising to 157 last year.

Sheila's son Leo was one of those deaths.

Before the changes, Leo was seen at least once a week.

After the changes,

I asked his nurse and she hadn't seem him for four weeks.

A 2016 inspection of the trust found that staffing levels were

"not always sufficient in community teams",

with one lead care professional being allocated 95 patients.

The idea that people would be better living in the community is

a very good idea

but the support is not there to help them maintain their health.

I literally am sitting on the chair that my son died in.

And I know, I know that my son, and I know that people in the trust,

good people in the trust, know that my son could've been saved.

At the time the trust introduced the changes, Emma Corlett had

worked as a mental health nurse in Norfolk for 17 years,

while Terry Skyrme had been a social worker in the area

for nearly two decades.

Both were also union reps.

They were forced to make cuts by the NHS.

We had a homeless team in Norwich that was closed immediately.

And instead of outreach teams, they were specialist teams that were

set up in the mid-90s because of all the problems in mental health,

very serious specialist teams,

they decided to close both of them down, immediately.

Yeah. So they were the teams that supported people probably with

the greatest level of vulnerability and greatest level of risk.

And this is a risk in the community, is it?

Or is this in hospital?

It's both. We lost beds and cut community services.

And because of the budget pressures everything just ended up being

done really, really quickly.

We had people turning up at office asking to see their worker,

not realising that their worker had gone.

So it was a recipe for disaster right from the start.

No more cuts! No more deaths!

After more than a year of raising concerns through official

channels, Terry and Emma formed what claims to be the largest grass-roots

local mental health campaign in the country, with over 2,300 supporters.

Whose NHS? Our NHS!

The trust followed the activities of the campaign closely.

They put so much effort into trying to silence us and discredit the

campaign that they should have been putting into keeping people safe.

Do you have evidence of that?

We've got a series of e-mails.

There's this one here saying, "The chief executive and I had

"a brief discussion last week and I think it would be helpful to

"talk about Terry Skyrme and his current actions.

"I don't see how we can continue to leave him in post."

Some people in management think like that, don't they?

They think, you know, you're supposed to do as you're told,

not protest, not stand out and certainly not publicise things.

-It fits with the culture of the organisation.

-Yeah. Yeah.

Terry left the trust in 2014,

while Emma stayed on in her post until April of last year.

You know, we had three years of trying to improve things.

-And also, nursing's a great career.

-SHE SIGHS

But you only get one life.

So I just decided to leave.

In 2015, the Norfolk and Suffolk Trust was put into

special measures after inspectors raised concerns over safety,

staffing shortages and a lack of beds.

Over the two years I've been investigating this story, numerous

health professionals have told me of their concerns about bed shortages.

Most are reluctant to go on record, fearing possible consequences.

However, one front-line mental health professional agreed to talk

to me on condition of strict anonymity.

There's been a huge rise in unexpected deaths across the area

and no-one seems willing to acknowledge

it's a result of the cuts.

Can you tell me, what has happened with hospital beds?

A few years ago, it was possible most of the time to access

a local bed.

But that's not the case now.

And it hasn't been the case for three or four years.

If there are not beds, then there's no purpose in attending the

address and agitating the person by carrying out an assessment.

So I'm asking relatives to carry on looking after someone under

great stress with the possibility

that if that person is suicidal,

they may complete a suicide while they're waiting for a bed,

which is very distressing for the carers and for me as a worker.

So, overall, how do you feel about the trust's services it's providing?

I would say they're inadequate,

unsafe and a disgrace to a so-called civilised society.

Recently the Norfolk and Suffolk Trust came out of special measures

despite the numbers of unexpected deaths continuing to rise.

Between 2012 and 2016 the trust closed 136 psychiatric beds,

a cut of about a quarter, even though demand continued to rise.

Norwich residents Alison and Simon Gathercole discovered how difficult

it is to get an emergency bed from the trust just a few weeks ago.

Their 20-year-old daughter Sophie has been diagnosed

with a personality disorder, anxiety and has visual hallucinations.

Shortly before Christmas, her self-harming escalated in

a horrifying cutting incident in the family bathroom.

So she opened the door and I was confronted for the very first

time with a bloodbath.

Simon photographed the scene to show just how bad things had got.

And that one moment, I think,

above all the things that I thought,

changed my perception.

In what way?

Seeing somebody you love...

..in a hopeless state.

And not really being able to help.

Then on New Year's Eve, Sophie cut her wrists and was rushed by

ambulance to A&E.

She was sent home with the promise the mental health crisis team

would see her in the morning.

Alison hoped that would mean a safe bed in a hospital.

Got up the next morning, debated with Simon as to who was

going to go up and see if Sophie was still alive.

Can you imagine waking up every day and almost tossing a coin to

go upstairs to see whether your own flesh and blood is still alive?

It's just a living nightmare.

Sophie did survive the night, but there were

no plans in place for her to see the crisis team.

Trying to remain calm, Alison contacted the out of hours GP.

By the time they arrived at his surgery,

Sophie had self-harmed again, cutting her leg.

So he gets on the phone to the crisis team

and a lady answers the phone

and he explains the situation to this lady

and the lady point-blank turned round and said,

"No, we're not seeing Sophie."

The GP's only option was to send her to A&E

to treat her now heavily bleeding leg.

In through these curtains swished a lady and she said,

"I'm the mental health nurse, I've come to see Sophie

"but, oh, I know you, Sophie, don't I? I've met you many times

"and we know you're not psychotic and we know you're not ill

"and you just need to be patched up with your leg and to go home."

Sophie just absolutely went berserk.

She got off the bed,

she started trying to steal needles out of trolleys,

she stole an EpiPen and was trying to stab herself with it

and within minutes I had three security guards in the room with me.

Yet this lady was saying, "She can go home."

I was distraught.

And the charge nurse came and he said, "Don't worry,"

he said, "We'll try and sort this out."

And he did, thankfully.

The nurse in A&E kept Sophie in overnight

on a ward in the General Hospital.

The following morning,

the mental health crisis team agreed to see her -

36 hours after she first slashed her wrists.

They phoned us about 9:30 and said,

"OK, we've assessed Sophie, we're going to send her home."

And at that point Simon and I both looked at one another and said,

"There's no way we can keep her safe."

Can't cope with it any more.

Finally, after four desperate pleas for help, the crisis team

found Sophie a psychiatric bed at the trust's Hellesdon Hospital.

The national picture is just as bleak.

The number of psychiatric beds in the UK

has almost halved since 2000 - a cut of about 25,000 beds.

And it's not just beds.

New analysis on funding, for Panorama, explains why

so many mental health trusts, which provide most of the care,

are struggling.

Over the last four years, the amount that we spend on health care in

England has increased by about £8 billion.

But mental health trusts have received none of that increase.

In fact, when you allow for inflation,

their funding has actually fallen by £150 million.

So, you're saying they weren't prioritised?

So, they've actually got a falling share of the cake.

The NHS has not set out to cut mental health services

but what they've found is as they've got rising patient demand elsewhere

they've had to look for cuts to make up that budget shortfall

and often it is mental health services that have borne the brunt

of those cuts.

Mental illness causes about a quarter of our burden of

disease, yet receives only 11% of NHS funding.

The impact on trusts, where most of the money is spent, can be

that clinically proven treatments are not available to patients.

22-year-old student Kerry Hunter took her own life last spring.

Her father, Adam, and her brother, James, feel that

the Norfolk and Suffolk Trust could've done much more to help her.

I met them at the park which was once one of her favourite places.

We just used to come all the time.

She liked the outdoors.

When she was younger.

I mean, she became more reclusive

with the mental health problems.

I remember her as a bubbly, caring,

loving girl that all she ever wanted to do was help people.

It wasn't just losing my sister.

To me, it was losing one of my closest friends.

Kerry had a borderline personality disorder, or BPD,

but was never offered the specialist talking therapy that NICE,

the Government health advisory body,

recommends for her condition.

How do you feel about the level of mental health care

that she received?

What mental health care?

Erm...

No matter how many times she tried to hurt herself,

you know, the only things that she was ever offered were things she'd

already tried unsuccessfully.

They actually fund for people to go to Norfolk and get the correct

treatment for BPD.

But my sister was not deemed severe enough,

even after multiple attempts on her own life.

When mental health services are severely stretched, there's a

fear people can fall through the net and end up living on the streets.

It's estimated that four in ten people sleeping rough in

England have mental health problems.

Here in Ipswich, the number of rough sleepers

has more than trebled in three years.

Local churches have stepped into the breach, offering 12 homeless

people shelter and a warm meal every night for three months this winter.

About half of their guests have diagnosed mental health problems.

Many feel they've been abandoned by the NHS.

Mental Health Service in Ipswich might as well be none, zero.

No help, no support.

There's plenty of people out there with mental health problems

but there's no help out there for them.

That's why people are in homeless situations,

or whatever they're in, cos nobody is there to help them.

It took me overdosing, trying to take my own life,

for a psychiatric appointment

to actually become available to myself.

The Reverend Canon Paul Daltry set up this scheme in 2011.

Have you seen a change in mental health services

over the past few years?

What I would say is that the guests that we get into the

shelter are indicative of the problems that we've got

through the health system and our own system. It's not just health.

The numbers are going up, there are people falling through the nets and

it's showing that there's something not really working.

We have no contact with anybody from the mental health service,

so if something happens here, we've got no contact.

So we've got a set of wonderful volunteers, who we do give some

training for, but all they've got, all that they can do is ring 999.

And there's no other links that they can go to,

other advice they can go to.

We're not the professionals, we are volunteers.

And so that is a very, very real problem.

And if the system isn't improved, what is the danger?

We're going to see more people dying,

we're going to see more people on our streets,

we're going to see a gradual breakdown in those who are

most marginalised in our country.

There are thousands of people with mental health problems

sleeping rough across the UK

but charities simply don't have the resources to offer all of

them the kind of support available to this small group in Ipswich.

Coming here's helped a lot.

I am completely on that level now where I am stable, I'm not up,

I'm not down, I'm just on that level path

and I can now start to sort my life out again.

It's not just about coming here, having a roof over your head

so you can sleep and hot food in your belly, it's the fact that

the staff here, they support you. If you're having issues,

all you've got to do is pull one of them aside.

Mental health services in Ipswich are provided

by the Norfolk and Suffolk Trust,

where Michael Scott was appointed chief executive

nearly three years ago.

I met him, armed with figures which had been leaked to

me from the most recent board meeting.

They prove that the rate of unexpected deaths

compared to the number of patients is still rising.

Well, five years ago before I joined the trust, the trust was under

financial pressure. There's no doubt about that.

And it had to respond to that financial pressure by changing

the way it ran its services.

And my personal view is I think mistakes were made in that period.

-And now you say you've got it right, do you?

-I'm not saying that at all.

I'm saying we're on a journey of improvement.

How can this be a journey of improvement

if more and more of your patients are dying?

What the facts actually show is that one of the reasons that those

numbers are changing is that we are providing more services than

we ever did before and we're seeing more and more people.

Sadly, some of those die, but you really can't compare the years

before to the years now.

I mean, you'll recognise this document because it's actually from

your latest board meeting.

And in it, it has a graph

and you've adjusted the patient numbers per 100,000.

And you can see the red line.

The numbers of unexpected deaths have continued to rise,

so it's not about the patient population, is it?

It's about the services we provide and the way we provide new services.

But we've acknowledged that people are dying.

What's important is that we understand the causes.

You feel the trust learns lessons and listens to its critics?

I mean, we've spoken to a number of people who consider themselves to be

whistle-blowers who say that the trust hasn't listened,

that it's tried to discredit them.

It's not a picture I recognise and it's not one that I think

the majority of our staff would recognise.

Are you getting all the money that you need?

Five years ago we were not getting the money we needed -

before I was with the trust.

That is now changing, so new money is coming through specifically

for mental health, and we welcome that.

We welcome the new focus on mental health. It's long overdue.

The Department of Health says...

"Just this year, mental health spending by clinical commissioning

"groups has gone up by £342 million,

"which is on top of an extra £1.4 billion

"allocated in this Parliament.

"This increase in the number of deaths is to be expected because the

"NHS is very deliberately improving the way such events are recorded

"and investigated, following past failings."

NHS England says improvements in care are already underway as

part of a nationwide plan.

But that's made little difference to Simon and Alison Gathercole.

They have made regular visits to their daughter, Sophie, since

she was allocated a psychiatric bed after their nightmare over New Year.

The day she was admitted into the hospital,

I did feel that huge relief

because I felt the responsibility of keeping Sophie safe had been

taken away from me and somebody else was responsible.

Currently, at the moment,

the staff at the hospital are doing everything they can for her

and we can't fault what they're doing.

-I mean, they're quite attentive, aren't they? You know.

-Yep.

But it's almost a little bit too late, if you know what I mean?

Nearly every mental health trust in the country is currently in

the process of restructuring their services.

There are fears they may follow the same path as Norfolk and Suffolk.

This is really a warning, both to mental health, but also to the NHS

more widely, about when you make major change.

Make sure you've got your evidence-base solid

and that you're monitoring progress as you go along.

And despite the soaring numbers of unexpected deaths among

mental health patients, there are worrying signs that

front-line services around the country face further cuts.

I've been in meetings with chief execs and chairs of

trusts who are openly talking about that they'll have to

decommission services next year.

But what is, I think, tragic is that it's the time when we have been

promised increased funding, and there is

no doubt this is not getting to where it is intended.

It's great to hear the Prime Minister

talking about mental health,

but a system that cannot fulfil those promises is

a system that is not working to the advantage of those with

mental disorders and their families.

Somewhere along the line, somebody needs to sit down with these

people and say, "Look, these are the issues,

"let's actually do something about it."

Because there's a long line of my daughters out there,

all waiting to do the same thing.