The term ‘Forensic psychiatry’ tends to conjure up images of white coats and crime scenes, and I’m embarrassed to admit my knowledge of this area of psychiatry didn’t extend very much further at the time of my first visit to the Bethlem Royal Hospital back in spring 2015.
My first experience in the forensic services was sitting in on a ward round – a weekly event where all of the patients are called in to see their clinical team – made up of psychiatrists, psychologists, doctors, social workers, nursing staff and occupational therapists. It was by turns eye opening, uncomfortable, amusing, and raw. This is a place where the full spectrum of human experience is brought into very sharp focus. And while the staff and patients made me feel immediately welcome, no doubt there were a few raised eyebrows on the ward at the prospect of a Channel 4 documentary.
'Why do you want to put us on TV?' Was the question most regularly directed at us by patients. It’s a cliché when you begin in journalism that everyone has a story to tell. But within the walls of the forensic psychiatric wards at the Bethlem Royal - where specialist staff treat male and female offenders with mental disorders - the words ring very true. Everyone has a background, everyone has a story, a set of experiences that has led them to where they are today. The forensic service may be the sharp end of mental health, but mental illness affects virtually every one of us in some way, and it doesn't discriminate.
One of my preconceptions when I first arrived in the service, was that I had expected a more simple link between mental illness and offending. What I encountered was infinitely more complex; myriad shades of grey, complicated by abuse, neglect or drug use. Many patients are victims as well as creating victims. It’s impossible to spend time in the service without coming away with a different view of both mental disorder and offending.
On the rollercoaster of ups and downs, a highlight for me of our time at the trust was observing part of a pilot restorative justice programme. On completion of the programme patients were invited to light a candle and make a gift of restitution to their victim. It was enormously moving, and two of the patients have since made steps to contact their victims with the help of experienced facilitators.
The challenges of filming here meanwhile were numerous. Not least how to navigate this highly sensitive environment without impacting patients, some of whom were very unwell. Balancing the ethics of filming with such a vulnerable group of patients required a constant dialogue, between us, the clinical teams, the trust and our legal advisors.
But we also felt hugely supported. Not only by Rare Day and Channel 4, but by an incredible team at SLaM. Having decided to open their doors to us, nothing was too much trouble, and we cannot thank or praise highly enough the staff who gave up so many hours of their time helping us to steer the right course.
Our presence on the wards, if not embraced by all, was certainly accepted by the vast majority of both patients and staff, who saw the benefits in sharing their experiences with us. An often unheard group of people were being given a voice, and those that chose to be a part of this embraced and relished that. They understood that insight breeds understanding, and that this above all is an area of psychiatry that needs understanding.
I hope those that took part feel the benefit of sharing their stories. I hope the public watches this with intelligence and without judgement or prejudice, or at the very least that we are able to challenge that prejudice in some small way, to dispel misconceptions, and to open people’s eyes to an often misunderstood part of our society.