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tv   Breaking Point  BBC News  July 14, 2018 2:30pm-3:00pm BST

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afternoon. let's find out if the weather is going to be fine. it's going to be and sticky debt wimbledon for the men's final and ladies final. —— a sticky day. for most of us, dry, blue sky and sunshine, especially in england and wales. parts of scotland and northern ireland clouding from the west. some spots of rain in the far north—west, dry and settled for the evening, and we are in for a warm and uncomfortable night, with temperatures in the mid teens for most places. it will feel quite humid to start sunday morning. tomorrow, similar to today, especially in england and wales. more blue sky warm sunshine, but more cloud for scotland and northern ireland, with a few splashes of rain at times. things stay dry the further south and east you are, with temperatures up to 29 or 30, low to mid 20s in the north—west. for next week, gradually things will start to feel all of us. still plenty of sunshine but, if you are crossing
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your fingers sunshine but, if you are crossing yourfingers for a bit sunshine but, if you are crossing your fingers for a bit of rain for your fingers for a bit of rain for your garden, you might well see it at times next week. president trump is in scotland to wind down and play golf after completing his two—day working trip to the uk. thousands take part in protests on the streets of edinburgh in a second day of rallies against donald trump's uk visit. an explosive device has been thrown at the former sinn fein leader gerry adams‘ house in west belfast. nobody was hurt in the attack. a large—scale investigation continues in wiltshire after police identify the source of the nerve agent novichok. it was found in side the house of one of the victims. now on bbc news, fiona walker investigates a mental health unit at breaking point, where patients say they have been bullied and illegal drugs are rife. when your mental health
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has hit rock—bottom, hospital should be a place of safety. he lifted his hand and slapped me really hard on my thigh. it's assault. but we've heard a very different story about one mental health hospital. i couldn't walk for a week, the week after, because the amount of pressure they put on my hip. the nurses were pushing david down on the bed and this gentleman was saying, "you psychotic bustard." a toxic culture where illegal drugs are rife. were you offered them? yeah, everyone was offered them. experts say what patients describe would be abuse. what really concerns me, if it persisted, this unit,
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it would represent a continuing scandal in mental health care. so should it be closed down? i think it should be closed down. adele douglas is from forfar and is a youth worker. like a growing number of young people, she has mental health issues. last year, she was in a dark place, wrangling with depression and anorexia. it's like you're not in the world, you know, you'rejust sitting in a bubble, and there's nothing around you. you don't know how to get yourself out of this dark area that you're in, and maybe sometimes you get a bit too proud and you don't want to ask for help, but it got to the point
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where i had to. adele was admitted to an nhs psychiatric hospital in dundee. it's called carseview. as a patient there, adele was determined to kill herself. staff needed to watch her 2a hours a day to prevent her from taking her own life. i was on constant observation, so a nurse was sitting outside my room, and i had my mattress on the floor, all my sheets were everywhere, my clothes were thrown about, my curtains were shut, and i think i remember somehow getting a sheet into my bathroom, and i think it got to the point where i was so anxious and i was so, "i don't want to be
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here any more," kind of thing. that day, adele made a serious attempt at suicide. staff came rushing in, and she says they got her to the ground. i was face down, my hand was like this up behind my back, both hands, my head was held down. it had to be held down to the ground because i was physically smashing my head off the ground. i don't know what i was trying to do. maybe knock myself unconscious or something. i don't know. it can't be easy for staff when someone is determined to harm themselves. physically restraining a patient is allowed when it's necessary, and in adele's case, there is no doubt they had to intervene. but she says this didn't feel like care, it felt like assault. my legs were held but my knee
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was in a funny position. it's like he was hitting my knee to the floor, and i kept shouting at him, "you're hurting my knee. "i've had an operation on my knee. you're hurting it. "stop leaning on it so hard." and at this point i was going absolutely mad and then he lifted his hand and slapped me really hard on my thigh and after that... when he slapped me, he said, "that's enough of that." the guy was really rough with me. it's like he was taking his frustration out on me. this is the bruising and swelling adele said was caused to her knee by the way she was held down. i said, "i can't breathe, i can't breathe. " and they said, "well, stop moving, stop struggling." "stop this, stop that." i'm like, well, "stop the men yanking my legs, "you know, slapping me, pulling me about the place.
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"stop that and i'll calm down." she said a nurse later told her how long she'd been held down for. i was there for about 45 minutes to an hour and it was to the point where they were doing my obs, blood pressure, everything, on the floor. i was down for a long time. adele says some of the staff were very professional but she was pinned down in this way three times. so what are the rules about how to restrain a patient? nhs tayside follows a range of guidelines on restraint, including those by the national institute for health and care excellence, or nice. they recommend facedown restraint should last no longer than ten minutes. and the mental welfare commission also says restraint should only be used as a last resort. i want to show our evidence to someone completely independent of carseview. professor tyrer chaired the group which wrote the nice guidelines. like he was taking his
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frustration out on me. adele is a young woman with asthma. should they be restraining her in the way she describes? i couldn't understand why, in fact, there's any reason at all to keep that person, that poor girl, in a position where, in fact, it's highly dangerous. i mean, you've noticed that she has problems with asthma. the major problem with holding people facedown is that they can actually die from respiratory obstruction. carseview is the biggest mental health unit in tayside, with around 80 beds over five wards. hundreds of patients a year are treated there. but we've discovered adele's experience is one of many. during this investigation, we've spoken to 23 people who have been patients at carseview over the past five years. each one of them went there for treatment, to be looked after, yet they say,
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in some ways, it made them worse. there was one woman with learning difficulties. they would say, "get back to your room or you'll get the needle." they would just stay and sedate her. it is punishment, frightening. all the patients were on edge, scared. a patient was restrained for spitting his tea back into his mug. a member of staff called him a dirty pig and lifted him out of his chair, dragging him to his room. these allegations are of restraint mostly happening behind closed doors, often in the rooms of patients who are mentally unwell. guidelines on restraint are clear that before restraint is considered, staff should talk to the patient to try to calm them down. the guidelines are there for good reason but not every situation on the wards is predictable, so i'm in manchester to meet an expert in best practice.
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i ask her, how much force is too much? restraint is used in emergency situations and is used as a last resort in order to try and prevent a person from becoming more upset, agitated or violent. i mean, these are patients, these are individuals with mental health problems and it's felt it's totally inappropriate in this day and age to be inflicting pain on vulnerable individuals. carseview is meant to be a safe, compassionate place. are the staff providing that place of safety? this young woman has told us she struggled with her mental health since she was raped when she was 17. it was after the abuse happened. i just started falling right downhill. it wasn't being picked up
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cos i wouldn't tell anybody, and i dealt with it myself for quite a few months. well, years, i would say, i dealt with it myself. and then ijust went completely into complete crisis. at her lowest point, she tried to kill herself. she doesn't want to be recognisable to those who don't know her so chooses not to show her face on camera. she only left carseview a couple of months ago. she says one staff member really helped her through it but others made her much worse. at home, her mum felt helpless as she read her daughter's texts from the ward. did you ever feel like you might lose her? yes. that was a constant thought. you were constantly worried about her. she was just blank, she wasn't even talking. you would just sit in the dining room, she'd be sitting colouring in. there was no communication.
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racquel hoped her daughter would be treated with compassion. given that she was a rape victim, her mum was astounded to hear her daughter say she'd been pinned facedown five or six times by staff. when you say they restrained you, what do you mean? they... ..kind of grab you and they throw you to the floor. somebody actually sat on me, on my back. somebody sat on your back? yeah. i could barely get my head up cos i was right to the ground. and i asked them to relieve the pressure and they says that until i stopped fighting them they won't relieve the pressure. when you say you were fighting them, do you mean struggling, or was there any kind of aggression? i was struggling to get them to get the pressure off me, because the pressure they were putting on me was seriously hurting myjoints, cos i have rheumatoid arthritis. she says the memories of the rape came flooding back.
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it kind of brought me back to that time when it happened, when i was 17, of being forced into the floor and not being able to move, like you're paralysed because you physically can't move. so it did bring quite a lot of trauma, being restrained so many times. are there particular concerns with people who have experienced rape or sexual assault in the past? yes, definitely, because of course this is precisely the sort of circumstance that she must have been through in the past. and, of course, it's hardly surprising that this is rekindled by having that sort of... ..violence perpetrated in hospital. and, of course, in those circumstances, you should be doing everything possible to avoid any form of violence like that, and it doesn't look as though that was even contemplated. it's interesting
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you call it violence. yes, it is violence. imean... ..we call it restraint and we call it control, but these are euphemisms for violence. the people we've met so far have been recent patients, but we've uncovered evidence that this culture stretches back at least five years. this photo is from 2013. david fong says this was a result of being restrained in carseview. while i was pinned down by, again, about five, six people, one of the nurses put his hand on the back of my head and just ground my face into the carpet on the floor. that took the skin off my face,
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like the side of the forehead and down the side of my face. david is settled now, but five years ago it was very different. he spent a month in carseview with psychosis. it was a month he says had a lasting impact. you're hardened by the events that happen to you in life. you're not scared. you've had, like, the worst happen to you that you can imagine. david claims staff used restraint violently and repeatedly over his time there and complained about it. what this tells us is that nhs tayside have known about allegations of abuse of restraint for five years. his mum says she witnessed it too.
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because he kept saying, "mum, just take me home," this gentleman cut the visit short, and i was sort of escorted one way and david was escorted the other way. i went to where david's bedroom was, outside in the car park, i went to david's room, outside david's room, and the nurses were pushing david down on the bed and this gentleman was saying, "you psychotic bustard," and just pushing david down on the thing. and all the things that he was saying... "you evil, psychotic maniac." aye, uh—huh, yeah. but there was about four or five people down on the thing, and ijust said, "you stop saying that to my son, and you leave my son alone." david had been in another hospital, where he felt he was treated with respect. although staff had used restraint techniques there, he said what happened in carseview felt quite different. the restraints in carseview definitely did feel like punishments. the nurses wanted to maintain
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their authority above patients, so maybe they were trying to maintain this air of power, that they could maybe keep people in control. when you look at those, what's your first impression? pretty shocking, actually. burn marks such as that have clearly arisen from friction. rubbing of the face into a carpet is certainly not an acceptable approach and would never be taught as part of prevention and management of violence and aggression. whenever a restraint does happen, it's meant to be recorded. but i found something else — the nhs figures for carseview don't seem to add up. it's something i need to check with david fong. let me show you this. this is information that has been posted by nhs tayside themselves. it comes to the year where you were in carseview. here's carseview. it says that there were fewer than five incidents of restraint...
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yes. ..in that entire year for all patients... all patients. 0k. ..in carseview. how come, when your records...? in my notes we have hard written evidence that there is at least, well, five restraints happened tojust me alone. right. and you believe it's more than that. yes. how do you react to their claim? it's disgraceful. 0bviously, there's been things going on that haven't been recorded, people that have been doing these incidents or carrying out these incidents have basically been... if they're saying less than five, have been covering up what's really been going on. in fact, david's nhs medical notes record six restraint incidents in one month, yet this isn't reflected in officialfigures. if carseview is not handling difficult situations correctly, then is there a different way? a hospital in liverpool has won awards for the way they're trying to avoid restraint wherever possible. i want to know how they do it,
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and i'm hoping they'll give me an idea of the best way to hold patients facedown for their own safety. so take the elbows in, yeah? but i'm in for a surprise. any form of restraint is dangerous but particularly facedown restraint. it turns out they don't train their staff to use facedown restraint because it is so potentially harmful. we no longer train staff in the deliberate use of facedown restraint. but what we acknowledge is that you may end up in that position, so what we do train our staff in is the safe management of it. but if i was really, really resisting... we would try to avoid facedown restraint at all costs. even these hands—on techniques are a last resort. what we'd be thinking about is reassurance and support. just let me go home. move out my way. you're in my way. i'm sorry. get out of my way! i don't want to get in your way at all. i'm sorry.
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this nurse is showing us how to do exactly that before the situation gets too far. it must be terrible to feel stuck in here. it is. i really understand that. it's horrible. he's demonstrating with a patient who works with the team here to reduce restraint. going to inject me next, are you, on the floor? are you? it takes time, but the way the nurse talks to a patient is the key to this hospital's "no force first" programme. are you ok for me to stick around for a bit? we've managed to reduce physical restraint on our wards and also assaults on staff by about a third over the last couple of years, so it shows that actually this is a much safer approach because they've not experienced the re—trauma of having been restrained, but it's also safer for staff. it sounds like mersey care trust is trying to develop a culture which puts compassion at its heart. it's very different to what we've been told about the culture at carseview. over the past 18 months, around two dozen people have spoken
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to us with concerns about restraint, about staff apathy and bullying. there is this one nurse who wields the needle of power. he holds that over us to behave and do what we're told, or getjagged. the staff were using patients for their own entertainment. the staff were on their phones, laughing and joking in the nurses‘ station all the time. it's like the patients are an inconvenience. i got better support from the cleaners, who'd at least talk to you, than some of the staff. carseview is meant to be a hospital to help heal the mind away from the difficulties of life outside, but as well as those incidents of restraint we've heard about, the alleged bullying, the apathy of some of the staff, there's another big problem — many of the patients we've spoken to have said illegal drugs were rife inside the hospital.
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no. this college lecturer from dundee turned to carseview for help when everything got too much for her. i've had mental health issues diagnosed from about 15. it's always been cycles of a couple of years everything's good, and then it'll be a couple of years everything's really, really bad. got more serious after a serious assault when i was 21. yeah, i wrote a diary. marnie stirling had two stays in carseview with anxiety and depression. she couldn't believe what it was like. did you see illegal drugs on the ward? yeah. all the time. it was rife. cannabis was the easiest one to get. speed was quite common. valium. and were you offered them? yeah, everyone was offered them. and did you ever take them? no. so were they selling them to patients? yeah.
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and there's patients selling them to patients? yeah. within the actual ward? yeah. it was really obvious that people were getting high. and marnie's not the only one who says she's seen this. did you witness any illegal drugs on the wards? yes. a lot. mm—hm. a lot. especially two patients, constantly dealing, handing out... some of them were prescription medication. there was weed, or cannabis, and i know two people that were taking coke as well. so they were actually taking them on the ward? yes, they were. how did that affect your recovery? i was scared. cos you don't know how people are when they're on drugs. i don't know. i felt a bit threatened. it's just i don't want to get involved in that. a unit which has that degree of...
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..drug use going on between patients in a ward is a hospital that's out of control. quite apart from anything else, if you're taking prescribed drugs and the people you're seeing are taking illegal drugs, there's a real danger because of interactions between them, and so you can actually have all sorts of problems of people thinking that they're giving too high a dose when in fact they're not giving too high a dose, it's because they're already taking an illegal drug. so in fact you're dealing with a dangerous situation. so there are allegations of illegal drug—taking, bullying and abuse of restraint. if this is the case, how can all this have been going on over at least five years in an nhs hospital? the mental welfare commission monitors psychiatric hospitals. they recently visited carseview
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but didn't hear the allegations we've heard from patients. we told them what we found. they say they're concerned and will follow up as necessary. the restraint experts we spoke to haven't been inside carseview. this very much seems reflective of an institution in crisis that needs to look at the culture and address the fact that force appears to be getting overused. if you were giving them marks for good practice, what mark would you give them? that's a difficult one, really. if you were saying "poor, good, excellent, very good" or whatever, i mean, i would certainly put this at the poor end, if not even abusive. professor tyrer goes further. "abuse" is a slightly overused term, but i think it'sjustified.
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what really concerns me, if it persisted, this unit, it would represent a continuing scandal in mental health care. so should it be closed down? i think it should be closed down. we asked nhs tayside if carseview should be shut down. they didn't answer that or any of the detailed points we put to them. they said they cannot discuss individual cases due to patient confidentiality and would not be interviewed. nhs tayside say they are concerned by the nature of the allegations and would like to include them in an independent inquiry into mental health services in tayside that's already ongoing. the patients we've spoken to the experience of carseview stays with them. i would definitely call it a crime.
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they were doing things that shouldn't be done. that if they'd happened outwith in society, then it would've been classed as assault. so definitely, 100%, i would class them as crimes. the only thing carseview is good for is medicating people. there's no care in any other way. i think i'm going to cry, cos ijust get so upset about it. i wish i could go to some of them face—to—face and say, "you haven't beat me, i'm still here." good afternoon, a few sharp showers and thunderstorms around yesterday, but dry today, some places have seen barely any rain in the past six weeks or so. england and wales dry and sunny, up to 28 degrees, northern ireland and scotland clouding over gradually later from the north—west. this evening and
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overnight, lashes of rain across northern ireland and the western half of scotland, elsewhere staying dry, quite warm and humid once again overnight, temperatures holding up in the mid—teens for most of us, a sticky start on sunday, and similar to today, particularly in england, wales and eastern scotland, lots of sunshine on offer, hotter temperatures than this afternoon, so by tomorrow afternoon 29 or 30 degrees in the south—east. further north, 17—23 for scotland and northern ireland. to next week, the fresher feel will stretch across all of the country, still spells of sunshine, but we have got a chance of seeing a bit of useful rain. this is bbc news. i'm chris rogers. the headlines at 3pm. you can just about make them out. playing through the boos — the "working" part of the trip is now over and president trump
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is playing a round of golf in turnberry. thousands take part in protests on the streets of edinburgh in a second day of rallies against donald trump's uk visit. in other news, investigations continue in wiltshire after a bottle containing novichok is found at the home of charlie rowley, one of the victims poisoned by the nerve agent. england face belgium in their world cup third place clash. harry kane is chasing the golden boot as england aim for their highest world cup finish since 1966.
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