'Stacey Dooley: On The Psych Ward' - A snapshot of the UK’s mental health challenges

Stacey Dooley’s BBC Three documentary, produced in collaboration with South West London and St George’s Mental Health Trust, explores the pressures people at crisis point and the mental health services endure

'Stacey Dooley: On The Psych Ward' lasts barely fifty minutes, but in that time it touches upon some of the greatest issues facing our mental health services. This includes looking at the wellbeing of individuals who are so desperately in need of support, and the dedication of clinical staff who are also impacted by dwindling resources within mental health care services.

Having filmed a large number of documentaries throughout her career, as well as programmes about the NHS, Stacey is experienced at navigating situations outside of her personal experience. Throughout this documentary and having never been inside a mental health services ward, Stacey acts as a representative of a large percentage of the watching public who may not have first-hand knowledge of what it means to live with, and be treated for a mental illness, long term or at crisis point.

Based at Springfield Hospital in London, one of the oldest psychiatric hospitals in the country, Stacey’s latest documentary sees her shadowing the NHS mental health services team across four wards, meeting multiple patients along the way.

In her new documentary for @BBCThree, @StaceyDooley experiences the pressure of life on the frontline of UK mental health services.

Stacey Dooley: On The Psych Ward | Streaming now on @bbciplayer 👉 https://t.co/1eznmgDh2G pic.twitter.com/Wo1fAtc606

— BBC (@BBC) February 19, 2020

Please note, the article and programme may be triggering as there are explicit conversations regarding anorexia, suicide, psychosis and emotionally unstable personality disorder, also known as borderline personality disorder, and self-harm.

The programme contains strong language and some upsetting scenes.

The first patient Stacey meets is Laura, in the 136 Suite. This serves as a safe and secure space for police to bring vulnerable people who have been detained under Section 136 of the Mental Health Act, having put themselves or others in danger due to their mental health conditions.

Talking with Stacey, Laura speaks plainly about the plan to take her own life, which saw her detained by police; as well as her ongoing struggle with anorexia, an illness she’s been in treatment for since the age of 11.

“Living with anorexia is like living with this big monster,” Laura reflects three months after the initial filming at the hospital took place. “It makes you feel so low and so self-critical. It’s like torture.

“With adult services, things have to get a lot worse before they decide to help you and by the time things get worse, you don’t want the help,” she shares.

Many of the people brought to the 136 Suite, Stacey explains, have attempted to take their life. 'On the Psych Ward' explores how staff support patients at this critical time. Healthcare Assistant Guan discusses how he tries to enter their world, have empathy for their situation and bring conversations around to the immediate moment and their needs.

Stacey also meets Kyle on her visit to the hospital’s drop-in Lotus Assessment Suite, a ward specially set up to provide support for patients facing a mental health crisis. Explaining that he’s been anxious since Year Five at school, Kyle has come voluntarily to the suite as an informal patient, for support around depression and suicidal ideation. The ward offers him a 48 hour stay.

“For people like Kyle to come here, just to take a moment to exhale, to take a minute to pause and reflect and try and figure out what they want to do next...

“You can not understimate this place,” Stacey says to the camera, also sharing her deep concerns about his state of mind after their discussion.

Mental health nurse Rosie expands on the role of the ward for the people who refer themselves. “Coming here, it’s like we contain the crisis, and in that time many people feel better because they feel safe.

That crisis of having suicidal thoughts, having those plans to end their life can be contained, but that doesn’t mean that they’re gone completley

“That crisis of having suicidal thoughts, having those plans to end their life can be contained, but that doesn’t mean that they’re gone completley. It doesn’t work like that.”

Later, reflecting on their conversation in a piece to camera, Rosie shares the impact of working with people in crisis and having concerns about the action they wil take once out of the ward. “The hardest part of this job is making decisions about people’s care, because you can never be certain.

“I've gone home from work on occasions when I’ve been quite upset by something I’ve been faced with, it does happen. It’s part of the job.”

The reality of what it means to work in a mental health hospital is a strong theme throughout the documentary, as teams discuss last resort restrictive practice (having to restrain or tranquilise), dealing with physical violence and verbal abuse and how they manage the impact of the job on their own mental health.

Resources are also a continual conversation throughout and a subject raised by both those in care at the hopital and its staff. 29 year-old Rachelle, who was sectioned seven months beforehand, is an inpatient living with emotionally unstable personality disorder. She believes that hospitalisation is not helping her. Her desire is for therapy in the community, and treatment at a EUPD clinic though she remains under section while waiting to hear news of funding.

The hardest thing that overides everything is probably the NHS being underfunded, as common as that sounds

As the documentary draws to a close, Suite 136 team member Steph shares her own resource frustrations following the loss of a bed for a patient in crisis. “The hardest thing that overides everything is probably the NHS being underfunded, as common as that sounds,” she says.

“There’s no beds, there’s a whole other queue of people waiting, and the pressure that has on us, A&E, community services - I can’t even describe it. It’s hard on us.”

There’s a sense throughout the documentary that mental health care at crisis point is hard all around - but also that the people at the front line are deeply committed to delivering the very best they can, with what they have.

For the people who need that care, and for those who love them, there are a large number of hurdles to jump. The biggest hurdle is getting access to therapy and support in the community at the first point of needing it, rather than at crisis point - something that’s seemingly impossible in the current funding climate.

So many of the people I’ve met have experienced some form of trauma that hasn’t been dealt with at the time

“So many of the people I’ve met have experienced some form of trauma that hasn’t been dealt with at the time,” Stacey concludes. “As they approach their early adult years, it all starts unravelling and there’s this sense of not being able to cope and they hit crisis point and they find themselves in a place like this.

“And of course everyone’s rallying around and trying to do their best and help these people but the truth is, the level of demand is totally unmanageable. And it does beg the question, if people like Laura and Rachelle had been given the right help at the time in the community, would they be sat here now?”

The making of 'Stacey Dooley: On The Psych Ward'

As with any documentary featuring people at a vulnerable time in their lives, questions have been asked about the appropriateness of filming conversations that, at another time, participants may not have been willing to engage in so publicly.

Stacey responded to social media queries, explaining about consent prior to, during and after filming. “We use ‘rolling consent’ which means they are allowed to withdraw at any time," she wrote about the films' participants. "Even months after. Which one contributor did. And is now no longer part of the film. Totally their choice, and a decision we fully respected.”

“We constantly check in with the mental health experts, doctors, psychiatrist, and if appropriate their family members. My hand on my heart, I feel we approached this as ethically as possible. This is not sensationalist. It’s important conversations re (sic) hopefully reducing stigma."

I so hope it helps.

I’ve had hundreds of messages over the years from people asking me to cover this.
One lady said ‘just because we are ill, doesn’t mean we don’t deserve to be heard or represented’

So even though it’s v difficult territory, I think it’s needed x https://t.co/ScNrNPIEMI

— Stacey Dooley (@StaceyDooley) February 18, 2020

Stacey’s sentiments were echoed by Vanessa Ford, Chief of South West London and St George’s Mental Health Trust, who praised those who participated. “I would like to sincerely thank the service users, carers and staff who were filmed in this documentary, as well as those who supported behind the scenes, all of which made it possible for us to show how we work together to support 20,000 patients every year with mental health conditions.”

“The Trust and production company worked closely with patients and service users, their families and carers, throughout the filming, and ensured they were happy for the filming and the broadcast to take place.”

Vanessa is proud of the Trust’s involvement with the programme and believes it can have a positive impact on those who view it. “It’s a great ambition of ours to reduce the stigma of mental health conditions, and we hope very much that this intimate portrayal of the care we provide helps people to talk more openly and honestly about mental health conditions and prompts them to seek help where it is needed,” she explained.

'Stacey Dooley: On The Psych Ward' is available on BBC Iplayer now