Reflecting on the above documentary (which was probably the last time that the public will see it in its current form) I felt like I wanted to blog about it because mental health is a subject close to my heart.
People think that Broadmoor is a prison. It's not. It's a maximum high security hospital somewhat 40 miles from London located in a forest which was founded in 1863. It has 284 beds and 15 wards some of which are assertive, which gives the patient more freedom. The lives of people in society continue nearby. Old Victorian buildings have witnessed the troubled lives of hundered's of people in its 150 year history which has been a secretive and mysterious institution. It was first built as a lunatic asylum for the criminally insane which is now an NHS hospital.
Entry to Broadmoor takes time and strict protocol. It houses 210 patients behind its walls whom have serious mental disorders. New construction to transform the building took place in 2014 which was a £242 million pound project. Prior to this there were talks of turning it into a hotel.
800 staff work there, some of which these days they deny doing so. Everything has to be confidential.
Broadmoor is an institution which houses some of the most dangerous killers ever known. The Yorkshire ripper Peter Sutcliffe is just one of them. Patients may have background history of violence, child adversity, alcohol and substance misuse, their childhoods haven't been good, they may have been abused and run away, but some of the patient's say that it's the most stable place they have been in years and its home for some of them.
The most mentally ill patients are on an intensive care ward which takes about 6 staff just to open one person's room. There are different wards, one of which is the 'Chepstow Ward' and this is medium dependency. All wards are different and patients are put on them depending on where they need to be. There are weekly ward meetings. The 'Cranfield Ward' is for violent people. Some are high dependency wards for people that self harm and they're under 24 / 7 observation. There are seclusion areas too. The 'RSU' (Regional Secure Unit) is a way out of Broadmoor. It's not a dumping ground for society's most notorious criminals with a final destination of no hope to being released. There is hope as each ward is a staging post to ones recovery.
It takes about 10 locked doors to move a patient from one ward to another ward. Strict routine and stability is very important as is consistent interaction with others. The rooms are air locked with fingerprint identification. The cornerstone of treatment can be psychological therapies which are available. Medication can control behaviour and therapy can change it. There are other groups too like violent offenders groups for example to name a few. Some like to participate in doing art work and poetry.
The patient's can be vulnerable, anti social, segregated and paranoid. Some suffer visual and / or auditory hallucinations. They may have psychotic disorders and their reality is somewhat different to others. Some present a grave and immediate risk to the public and the crimes they have committed include arson, torture, rape and murder.
Patients can be sectioned under the mental health act against their will, for example a section 12 has to be carried out by an approved Psychiatrist.
It costs a massive £300,000.000 per year to keep just one patient in Broadmoor which equates to about £822.00 a day! This is five times more than the cost of someone in prison.
It's known as a ghost town. There are certain times and configurations in which patients can move and searches have to be done before they do so to check for weapons to disarm patients. They will use anything they can get their hands on to self harm like cutlery and even those types of items have to be accounted for. Incompatible patients don't collide so it's best they are kept away from one another to eliminate conflict. As well as this camera's record their movement in a control room.
Everyone is born with certain temperaments with certain predispositions to certain behaviours. Violence issues are rife in Broadmoor and planned intervention is needed. EG: Some patients are allowed out into the yard for 'X' amount of time. If they decline to return to their room (even if they may have been given an extra half an hour) then a restraint procedure maybe carried out which can take 8 members of staff to control the patient. They may have to go as far as getting the patient on the floor to get them into their room. One may hold their legs, another their head, the arms and so on. Once on the bed feet furthest away from the door the staff can let go on exit one by one using safe procedure. After this staff will tend to take time out to re-appraise after using force.
It sounds like patients are locked up like caged tigers and let out one by one but Broadmoor serves its purpose. There's approximately 5 physical assaults per week on staff which include punching, kicking, throwing hot liquids, urine and faeces warranting the hospital pursuing criminal charges.
Staff teams are deployed about 30 times a year. They enforce medication to dealing with full scale riots which need specialised training and equipment for.
Patients may believe that they aren't unwell and refuse to take medication, some which can cause weight gain and sedation. Anti psychotics are some and some patients are described as looking starry eyed when on them.
Patients may have internal anguish which can torment them and be debilitating, some can't communicate properly which is frustrating and they feel isolated, discomfort, depressed, distressed which can cause a lack of co-operation. As a result they will spend more time in Broadmoor. They are allowed to go to work within the hospital (they make goods for the public) and can also purchase goods from a shop. They earn less than a pound an hour. No tobacco is allowed.
When patients are due to leave Broadmoor a mental health tribunal will take place to consider conditional discharge hopefully not resulting in a recall. The average time to be in Broadmoor is 8 years but some have been in for 30 years.
There is no release date for patients. "There's time, then there's Broadmoor time"
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The information mentioned in this blog has been sourced from the TV documentary itself and also Google.