Episode 3: Behind Closed Wards

This is a true crime podcast and is not suitable for all audiences. Please use discretion. This episode contains descriptions of emergency medical situations, suicide, eating disorders, and sexual assault. Please take extra care whilst listening. This is episode three of a ten-part series. If you haven't listened to the first two episodes, please go back to the beginning so you can follow along. In the first two episodes of this podcast, you heard two mothers who had lost their children, you heard their experiences and their son's experiences of their life in an Essex mental health unit which led to their deaths. Today's episode cannot be described as anything other than deeply upsetting and utterly heartbreaking. In this episode, we're going to hear what happened when an undercover journalist went to work in a mental health unit in Essex and some of the behaviour from staff towards the impatience is shocking, disgraceful, and criminal. This episode needs a firm warning because it's one that can never be unheard, but this is the reality. I'm Naomi Channel and this is Investigating Essex, dying to be saved. From the moment mental health institutions materialised, they were featured in countless media and entertainment. They've been the punchline of jokes, the scene of grizzly horror films, often cundering up images of patients in straight jackets, prison-like wards, with the sounds of screaming, heavy doors slamming, padded cells, and the people in them are often depicted as scary, creepy, and sometimes even evil. On Halloween, it's likely that it won't take you too long to find someone who's dressed as an escapee from a mental asylum or something to do with one. If you've had a loved one admitted to a mental health hospital, it's likely to be very painful. If you've spent time in one yourself, then I'm certain it's incredibly painful. But what I have discovered is that actually the reality of some, not all, of these mental health units and the staff that work in them can be much scarier than a scene in a horror film. In 2022, Channel 4 commissioned an episode of Dispatches called Hospital Undercover, are they safe? If you aren't familiar with Dispatches, it's an award-winning investigative current affairs programme in the UK. They have exposed huge failings in our society. They've been undercover to expose the abuse dementia patients were receiving from staff in care homes. They looked into the safety of the COVID vaccines and the connection between Prince Andrew and the pedophile, Jeffrey Epstein. But in the hospital undercover episode, they looked into what was really going on in UK's mental health units and one of their team went undercover. She was a retired police officer called Dawn Goddard. She had applied to become a health care assistant and she was accepted. She worked 13 shifts across mental health units in two hospitals, Rochford Hospital and Brumfield Hospital. Both of them are in Essex and both are under EPUT. Remember, EPUT stands for the Essex Partnership University NHS Foundation Trust. The reason the producers wanted her to film there were down to concerns that the trust has not learnt lessons and responded to safety recommendations after 11 suicides happened in their hospitals between 2004 and 2015. Each time another life was lost, the inquests showed repeated failings from EPUT and the managers in charge. Dawn was given online training to complete and then a week of face-to-face training. The training was in line with the requirements and guidelines set out by EPUT. After that, she was put onto the wards to work face-to-face with patients with serious mental health issues. She wore a secret body camera and filmed her time on the wards. First off, she started working on the Willow wards in Rochford Hospital. She started there in April 2022. This wards is specifically for adult women. On her first shift, she's given some extra training from one of the nurses on shift. They tell her that one of the biggest risks on their ward is patients attempting to take their own life with a ligature. In the footage, the nurse shows her a plastic wallet that is kept in the staff office. It contains a variety of different tools to help cut a variety of different types of ligatures. Dawn is told that if an alarm sounds and a patient has been found with a ligature around their neck, then they need to grab the whole folder in case one of the tools isn't sharp enough or doesn't work, then they have other options. Before I started researching this series, I had no idea how often this happened on wards. I had honestly thought it was something that happened very rarely, after all, I, like many other people, thought that the staff on the wards made it extremely hard to give the patients access to things they could harm themselves with, but I was wrong. I'm going to go deeper with the statistics later on, but in Dawn's case, the first attempted suicide by ligature happened just two hours after her shift started. I'm now going to play a clip from that time. The voices have been disguised and the names of these staff members were never made public. For context, a woman has been found in the bathroom of her room, on the ward that she stays in, and a serious incident alarm has been activated. The alarm alerts any available staff members to rush to the scene to assist. She's been found hanging. I'm going to play a clip from that time. There are multiple people now in the women's bathroom trying to cut her down, all members of staff. Just like in standard hospitals, if somebody gets critically ill, a rapid response must come in, knowing there is a serious threat to life. The nurse arrives with some ligature scissors, but they're not the right tool to cut down this type of ligature, which is a scarf. She should have brought the whole folder, just like Dawn was told by her two hours prior. Just to make those last few sentences clear. The nurse says a scarf, where did that come from? Then they said let's get all this stuff out of here. And then the nurse looks down onto the floor, where the woman who has just tried to take her own life is lying, shocked and confused, and says, "All over a vape, I'm shocked at you." I want to give you some more information regarding that incident now. So the nurse arrived with the ligature scissors, as I said, they weren't the right tool to cut them down. Now the trust says it should take just 10 seconds to get the ligature folder to a serious incident. In this case, it took almost two minutes. The patient in question was on a one-to-one observation. On this level of observation are a known serious risk to themselves and to others. She had a male member of staff watching her, and she told that member of staff that she needed to use her bathroom, and he let her. According to their policy, he should have then called a female member of staff to accompany her to the bathroom. But he failed to do so. And while she was alone in the bathroom, that was when she attempted to take her own life with a scarf. It's incredible to think that she had access to a scarf, a very, very clear ligature risk. But that was just the start of the horror that dawn would witness over her 13 ships. The next clips I'm about to play are to be quite honest, cold and cruel. I'll set the scene. A female patient is trying to leave the mental health unit. Again, voices have been distorted. She's being restrained by staff and held against the two glass doors that act as the main entrance. Outside is the car park. That's dawn arriving on the scene. She's there with a nurse, and she's also there with the patient. The patient is not acting out, but she is trying to leave the facility. A patient is only just an adult. She's vulnerable and she has an eating disorder. This is still a manageable situation, though the patient is getting more agitated because the member of staff is telling her that they won't be allowed to go outside anymore in the bathroom. The patient is now being forced inside the unit beyond the double doors. There are now five members of staff there. The patient is restrained for 20 minutes on the floor. She's then let go, and at that point she gets into a fight with two other inpatients. They're all separated and they're all restrained. But the lady that they initially dealt with with the eating disorder is now being dragged by two members of staff to her room. When I say dragged, I mean dragged. Through corridors, through double doors. She's constantly getting caught between doors. And then she's finally put into her room. But on the next shift, dawn attends, and alarm goes off again for the same patient. This time, the patient has a ligature around her neck. She's now actively trying to take her own life. The patient has been freed from her ligature. She's shocked. She's exhausted, and she's hyperventilating. And the nurse says, "Do you want some sedative?" And when she doesn't answer, the nurse says, "I'll take that as a no then." [Music] In case that audio was unclear, one of the five people restraining her, one of the nurses says she is sweating and jokes that it's a peril of being a bigger woman. Someone asks her how her diet's going. She says she's lost two and a half pounds this week. And then someone else says, well why don't we get KFC for lunch? And they all start laughing. This patient has an eating disorder. [Music] As the woman hyperventilates and gets more distressed, the plus-size nurse who was just talking about her diet is now mocking the woman by dancing in time to the noises of her hyperventilating. As she holds her down, she bobs her head from side to side to the beat of this woman's panic and distressed breathing patterns. She then starts tapping the surface next to her in time with her breathing, like she's tapping along to music playing. And it's horrific to watch. Finally, a patient can't take it anymore. [Music] Just so you know, the woman said, you're making me worse. You know banging triggers me. You know talking about diet and losing weight triggers me. All you do is fucking trigger me. Staff just make it worse. You were just talking about losing weight when I'm fucking anorexic. Why would I talk to you? On her next shift, Dawn is stationed to be the observer of the same patient. Dawn talks to her and the patient then tells her that she wants to show her something. She has shown her footage of one of the members of staff that has been recorded on her mobile phone, a member of staff who was supposed to be observing her after she attempted to take her own life. And they're asleep. Fully asleep. Dawn reports this at a staff meeting and very little noise is made about it. But the person chairing the meeting just reminds staff casually, not to be caught using their mobile phones on wards. Footage from Dawn's body camera shows many images of different staff members on their phones texting on social media and typing whilst conducting one-to-one observations. Some important information to put this into context. Many of these staff earn on average 12 pound an hour. It's a job that often sees very little reward. This batch is reported that from June 2021 to June 2022, EPUT used agency staff for over 4,000 ships. This means that they are often placed in different centres, different hospitals and different units, and there is often very little consistency in the shift patterns. This reveals what many of us already know. There are serious worries when it comes to the amount of NHS staff across the board, who are consistently in one place, and how low wages and low job satisfaction can prevent people from wanting to undertake these crucial and important roles. I'm giving absolutely no excuses for the behaviour of these staff members. What I saw was horrific, but I'm trying to offer a little bit of understanding where I can. Going back to the last two episodes, we know that both Matthew, Leahy and Ben Morris were restrained with extreme force. Remember Lisa, Ben's mother, said that she was on the phone to Ben when he was restrained, for something he had done earlier. In several of the reports I've read, regarding patients whose deaths are now being investigated as part of the Lampard inquiry, have cited that there was forcible restraint as part of their care. In many of these reports, there are phrases that pop up in the descriptions, phrases like manhandling and unnecessary force. I wanted to find out when restraints should be used, and whether this footage is deemed as a correct response in regard to this situation with the patient who was trying to abscond. That restraint, ultimately, set off a cascade of terrible, terrible events. In the footage, the patient was not seen to lash out to attempt to hurt herself or anyone else. So, should there have been another approach? When should restraint be used, and how? When Dawn was working on the Willow Ward in Rochford Hospital, she did nine shifts. On seven of those shifts, she witnessed patients being restrained. Some of those patients were restrained for almost an hour. Epits have had many warnings and recommendations via the Quality Care Commission over their frequent use of restraints. The Mental Health Charity Mind launched a campaign after hearing that many of their service users who have been in patience in a mental health facility were traumatised and harmed after being restrained. I said, quote, "We believe that the use of control and physical restraint needs urgent repraisal, and that the use of face down physical restraint should be ended. We are calling for established national standards on the use of physical restraint and accredited training for health care staff in England." Some of the hospitals under EPIT have taken action against these recommendations. In 2018, EPIT put together a report called Reducing Restrictive Practice, a story of change. Ultimately, the report was put together to document how they were now talking to patients before using restraints, attempting to de-escalate situations that may have previously chosen restraints as a way of trying to handle the problem in hand. They covered a number of wards in the reports, but one was mentioned more than others. The Fuji Ward, in Brockfield House, it's a mental health unit in Wichford Essex. This ward is a female medium secure ward, and it was consistently one of the wards that had the highest number of restraining incidents in the trust. From April 2014 to March 2015, there were over 400 incidents where restraints were being used. The exact number of beds on Fuji Ward alone is unclear, but for context, there were 97 beds in the whole hospital, and there shared across seven wards. Four of the wards are for males. Two of them, including Fuji, are female, and one is a mixed ward. By talking to the patients, they managed to de-escalate situations, and for that, made the total number of restraints on the Fuji Ward to approximately 40 in the year 2017 to 2018. I do have to, of course, say that these are the documented restraints. When the Channel 4 Dispatches Show came out, and other allegations started to circle online, a spokesperson for Essex Partnership, University NHS Trust, said, quote, "The care and safety of patients is our number one priority. We are taking the allegations raised extremely seriously, and we understand how to stress this is for patients, their families, and carers." When we were contacted about these issues, we took immediate action to protect patient safety and commissioned a full investigation. We have informed our regulators, safeguarding partners and partner organisations, and will continue to work with them and keep them updated on the actions we are taking as a result. Next time, we're going to hear from a mother whose son's death is being investigated by the Lampard inquiry, a mother who begged Essex mental health services to look after her autistic son, who was having severe mental health difficulties, and the outcome is one of the most tragic things I've ever heard. But it transpired that they were well away who was going to die in the day before he did suicide, they were all saying, between them, in their internal emails, "God forbid," in the morning quote, "we don't hand up in the coroner's court with this one." Episode 4 is out and available to listen to now. I'm Naomi Channel, and this is Investigating Essex, dying to be saved. Thank you. [BLANK_AUDIO]