""I want to tell you the truth about how bad things have got."" "A cry for help from a 17-year-old trapped within Britain's broken mental health service." ""I came into hospital with one or two suicide plans," ""but now I have at least five."" "Parents separated from their children by hundreds of miles." "We shouldn't have to travel this far." "There should be places nearby." "A system so dysfunctional it can't even keep track of deaths." "What is so shocking is that neither we nor the Department of Health know how many children are dying in psychiatric care." "Do you know how many children have died in mental health units since 2010?" "I'm advised that the number is very small." " Well, do you know how many?" " I don't know the number accurately." "How many more deaths do they need before they're going to do something?" "A bereaved mother haunted by the words of her daughter." ""I'm not all right." ""I'm broken inside."" "Sara Green was a very bright child, excited about her future." "All she ever wanted to do was go into a medical career, be a doctor." " Just so caring, so thoughtful." " Mm." "You know, so much compassion for everybody else." "Sara, more than anything, loved to write." ""I'm hoping that I'll find out where I'm going soon," ""so I can start looking at applying to college."" "She would write, and she would sometimes show us certain pages of her diary to let us know how she was feeling, if she didn't feel she could express that particular thing." "Sara's family have allowed us to use extracts from this diary." "A teenager writing of a broken mental health service and her supposed place of safety, the hospital where she was to die." ""I cried so much today," ""and I know tomorrow will be worse."" "For this film, her sister Stacey chose to read Sara's words." "No-one could ever tell on the phone who was who." "They'd have to say, "Is that Sara or is that Stacey?"" "Aged 11, Sara's difficulties began." "She started developing mental health problems." "By the time she was 14, Sara had an eating disorder and was locked into obsessive behaviour." "One evening, she confided in Stacey." "We were in our bedroom, and she told me that she self-harms." "And I didn't..." "It was late at night, and I didn't..." "I tried not to react, really." "I just listened." "And I did say to her," ""Well, obviously, I'm going to have to tell Mum."" "But I told her that I was glad she told me." "Sara, like many teenagers, used self harm to show her distress." "It led to her first brush with disaster." "She took an overdose of antidepressants." ""I'm not accepted at school." ""There are only so many insults a person can take." ""I'm hated for who I am," ""but the truth is, I hate myself." ""I can't believe I let them get to me like this."" "The family caught her just in time." "They found a note." "She felt bullied." ""I want to tell you the truth about how bad things have got." ""I'm not all right." ""I'm broken inside."" "It's estimated nearly half of all children have been bullied." "These days, after school ends, there's no respite." "What we've seen is an explosion, really, around bullying." "Cyber-bullying means that young people are exposed to bullying 24 hours a day." "They don't escape it at all." "You don't come home from school and leave those people behind." "They are still there, on your phone." "It's having an enormous impact on young people's mental health." "In the summer of the 2013, the family were living in Scunthorpe, and Sara was under the care of CAMHS." "CAMHS is the Child and Adolescent Mental Health Service, and across England, it's in crisis." "The Scunthorpe CAMHS office wasn't able to give Sara the home support she needed." "The advice was, take her home, lock the windows, lock the doors, and if she absconds, ring the police." "Sara took another overdose." "Now CAMHS decided she needed hospital treatment." "But in the whole of Humber and Yorkshire, there were only 30 child psychiatric beds." "None were available." "So for three nights, Sara was shunted between adult NHS units." "You received a phone call, didn't you, giving you 20 minutes' notice that they were picking Sara up in a taxi from Scunthorpe and then going to the Priory, Cheadle Royal." " That's the other side of the country." " Yeah." " Yeah." "Nearly half of all adolescent mental health patients are sent by the NHS to private hospitals, at an average cost of £800 a night." "The Priory group, the largest provider, renowned for celebrity rehab, gets 85% of its funding from the public sector." "On July 17th 2013," "Sara Green was admitted to the Priory in Cheadle, Manchester." "Now 100 miles from home and family, she turned to her diary." ""I want to go home." ""I just hope that Mum and Stace will be able to visit soon," ""because it's making me feel worse not being able to see them."" "Faced with the expense of a 200-mile round trip across England, her family had to scrimp to see her once a fortnight." "There was one week we lived on tuna sandwiches, and that is just how it was." "That ordeal is bleakly familiar to Tara Palin." "We met Tara this winter, crossing the country from Lancashire to Newcastle, a 300-mile round trip, to see her 15-year-old daughter, Rachel." "We've tried all kinds of ways." "Travelling by coach, train." "Just..." "There's no real easy way." "It's horrible." "Rachel was a happy child." " Hip-hip..." " Hurray!" " Hip-hip..." " Hurray!" "But like one in ten of all youngsters, she began having mental health problems." "Tara, from Chorley, is one of hundreds of parents who must travel long distances to see their children." "Where's she been so far, then?" "She's been to Warrington, which was not too bad." "It felt like it was miles away, but it's nothing compared to now." "And then, after that, she got moved to Stafford, about two-and-a-half hours away." "And then she got moved to Middlesbrough." "So three, three-and-a-half hours." " And now, well, this journey..." " It's about five, isn't it?" "Yeah, takes about five hours, all in all." "So it's getting further and further away." "Yeah, further and further away." "The distance leaves Tara's daughter Rachel, like Sara and many others before her, without the family support crucial to recovery." "It's essential to try and keep young people connected to their communities, their families, their friends." "That actually helps their recovery." "CAMHS is always a Cinderella service." "It only, even now, will be receiving 0.7%" " of the total NHS budget." " 0.7%?" " Indeed, of the total NHS budget." "So we're really concerned that we're facing a lost generation of young people here." "This journey isn't smooth." "An hour's delay at Manchester" " Tara is used to it." "Tara accepts Rachel needs hospital treatment, but fears she's becoming institutionalised." "She's getting worse." "I see her with marks that she's never had before." "Learned behaviour." "That's never happened." "Marks round her neck where she's tried to make ligatures." "It's learned behaviour." "Learned from being in these places, learned off other children, that they're doing it." "# Happy birthday, dear Sara" "# Happy birthday to you!" "#" "Six weeks after admission to the Priory, close to the time when she should have been discharged," "Sara Green was allowed home for her 17th birthday, her hair dyed red for the party." "Make a wish." "Make a wish." "But then it was back to the Priory." "Sara had been told she'd be there no more than eight weeks for initial assessment." ""I've been in hospital for weeks now," ""but I don't think that people fully understand my problems."" "But there was no move, and it fed her anxiety." ""I cried so much today," ""and I know tomorrow will be worse."" "Soon after, Sara says there was a huge letdown." "She'd been looking forward to a break at home." ""What a crap few days." ""Friday, I was all ready to go home," ""then I got told I wasn't going because there weren't any staff." ""I absolutely hate it here."" "You don't promise a child, you don't let them get packed up ready to go home, and then just before you're ready to leave, say," ""No, you're not going home."" "By October 2013, after two-and-a-half months in the Priory, all sides agreed Sara should be closer to home." "But nothing happened." "Sara's fixations became much worse." ""If anything, I have worse thoughts of suicide now" ""than I did when I first came in." ""These are getting increasingly bad at the moment."" "Sara was plagued by notions of self-destruction." "She started having more incidents." " Self-harming?" " Yeah." "And more severe incidents as well." "At case meetings, the family would be told of fruitless attempts by CAMHS and NHS England to get Sara a bed closer to home." "Each time it was different excuses." "They'd say a bed was becoming available, we're just waiting for another child to be discharged, things like that." "And then there'd be some excuse why it wasn't happening." "She felt she was just being lied to all the time." "The family say there was palpable tension between the Priory and the child mental health service CAMHS, as they discussed what should happen next." "In these meetings, Sara was pretty much made to sit there and listen to CAMHS and the Priory debating between themselves who's going to provide funding." " In front of the child, the patient?" " In front of Sara." "Christmas is tough for the 1,000 or so children who are inpatients." "Rachel Palin has now spent her second Christmas detained, or sectioned, under the Mental Health Act." "150 miles away, at home, her mother Tara safety-proofs the presents." "I bought her part of a tracksuit, and when I wrap it up, I'll have to pull this out." "The drawstring will have to come out, because she will just tie it round her neck, and that'll be quite hard to get off her." "Tara goes to extraordinary lengths to protect Rachel from herself." "I'm scared that I'm going to, potentially, be responsible for giving her something to hurt herself with and harm herself with." "These same worries troubled Sara's mum Jane when Sara was in the Priory." "In the run-up to Christmas 2013, four-and-a-half months into her stay, the Priory lent Sara a craft book for making bracelets." "It was bound with wire." "See, the thing with Sara, if she had an idea in her mind of something to harm herself, she would feel she'd have to act on it." "She couldn't just sort of erase it from her mind." "She felt that in order to do that, she would have to act out whatever it was she was thinking." "Sara's mother and sister say a member of the Priory staff made an ill-judged comment about the wire binding." "A nurse had come in the room and said to Sara," ""You'll be all right with this, Sara?" ""You won't do owt with this, would you?"" " You won't do anything with this?" " Mm." " Meaning what?" "Use it for anything." "And after the nurse had left the room," "Sara said, "Well, you know, I hadn't thought of that before..." " BOTH:" " "..but I have now."" "The Priory says it does not believe this conversation happened." "Sara was allowed home leave for Christmas, but on Christmas Day she was anxious at the impending departure of her local CAMHS caseworker." ""From the moment I got home," ""all I have thought about is self-harming." ""To top it off, it looks like I'll be getting another worker." ""She says she will still be seeing me, but I'm annoyed." ""The whole point of her was to have one consistent worker" ""because I have been through so many."" "January 2014 was a dreadful month." "Back in the Priory, Sara tried self-strangulation, ligatures, eight separate times." "She told her mother she was frightened staff might not find her in time and that her self-harming could end in tragedy." "Jane wrote a two-page letter to the Priory, listing a number of serious complaints." ""There have been several incidents involving ligatures..."" ""Becoming increasingly distressed and..." ""I feel my daughter's safety and wellbeing" ""is consistently seriously compromised."" "She didn't receive a reply for three months and by then, it was too late." "Sara's departing CAMHS caseworker also put her concerns in an e-mail to her bosses." ""We feel that Sara is no longer being appropriately risk managed."" "Some days later, Jane received a late-night phone call from the Priory saying they'd forcibly cut Sara's hair because she was threatening to ligature with it." "Sara was devastated." ""There's no need to hack it off whilst I'm in restraint." ""And my hair wasn't even around my neck at that point." ""How is that any different to assault?"" "And Sara actually told us they'd pinned her up against the wall and hacked it off with ligature cutters." "The member of staff basically said," ""We cannot let her control like that, she has to learn."" "The Priory told Panorama staff had no option but to cut her hair to ensure her safety, following repeated attempts to ligature with it." "Sara, unwell and struggling, was still able to make an acute assessment of how the system was failing her." "She, better than anyone, understood." ""My community team are clueless," ""and the staff here have different opinions on what to do with me." ""I'm just kind of stuck in the middle" ""between my CAMHS team that wants me in this unit," ""but failing to offer enough support in the community." ""It's making me question if anyone actually knows what" ""they are talking about."" "On the last day of January, Sara took the wire binding from the Priory's craft book and tried to strangle herself." "She was saved but it was close." "She needed oxygen." "A few weeks later she wrote..." ""I don't like not knowing where I am going next" ""and not knowing anything about it." ""Not knowing when and where makes me feel really uncertain" ""about everything, and out of control, which I absolutely hate."" "Then Sara is given hope." "A caseworker, commissioned by NHS England, shows her brochures of therapeutic units." "They talk of sending her to a new one near Leeds, still 50 miles from home but close enough for regular family visits." ""I'm glad that things have moved in terms of finding me a placement." ""I'm hoping that I'll find out where I'm going soon" ""so I can start looking at applying to college."" "What Sara didn't know is the new unit wouldn't even be open for another six months." "NHS England didn't know this either." "No-one made the basic check, a phone call, to find out." "There was no place to go to... so why tell us there was?" "Why build Sara's hopes up?" "Sara's last home visit was in March 2014." "She was depressed at the prospect of returning to the Priory but her mum says they had no option." "She didn't want to go back." "I didn't want her to go back, I didn't..." "I didn't want her to go back, but I knew what would happen if..." " If she didn't." " They would section her." "And they'd made that quite clear over the period of time she was in there." "On March 18th 2014, the day after she went back to the Priory," "Sara Green made a second wire ligature." "This time she wouldn't be saved." "At half past ten she was pronounced dead." "She had used a wire... ..from a spiral book..." "..and taken her own life." "The coroner at Sara's inquest was heavily critical of the Priory." "He concluded she hadn't intended to die, it wasn't suicide, she was self-harming, her anxiety having worsened because of her unacceptably prolonged stay here in the Priory, a hospital 100 miles from her home." "The coroner said the ward manager's evidence that Sara's first wire binding ligature wasn't "a serious incident"" "was a staggering admission." "The Priory's record-keeping was" ""deplorable, so inadequate as to risk future deaths." ""Sara would have been safer at home."" "The Priory told Panorama the safety of patients was its first concern." "Sara Green's death should never have happened." "The fact that it did is absolutely appalling." "For our society, in this day and age, for a young person to be in inpatient care, where she should be getting the best of care, to help her recover, to take her own life is just awful." "And what this indicates is a whole system in collapse." "The verdict at Sara's inquest was that both CAMHS and NHS England had given confusing and contradictory evidence and had no clear plan to get Sara out of the Priory." "The coroner blamed the entire system for Sara's death." "CAMHS in Scunthorpe is run by an NHS Trust." "In Sara's case, she was supposed to be in this hospital for six to eight weeks." "She was there for nine months." "There was no way for her to get out because you had no facilities here." "Absolutely." "And that is absolutely to be regretted." "There was nowhere appropriate for her to go that would have met her needs at the time." "I fully accept that." "Because she couldn't just be transferred to a normal CAMHS service locally - it would require a specialist level of input that was not available locally - hence other units were being sought out." " And none found." " Not at that point." "Since Sara Green's death, a legal campaigning group has been working with her family." "What has been really shocking is how difficult it is to find out the true picture of the number of children who are dying in psychiatric care." "We asked a parliamentary question to the previous Minister, Norman Lamb, who told us that there had been no deaths between 2010 and between 2014." "And yet we knew from our casework that of course there had been deaths." "We then were forced to conduct Freedom of Information requests, which have subsequently found out that there have been nine deaths." "But, of course, Freedom of Information does not apply" " to private providers." " So you think there could be even more deaths?" "My fear is that there could be more deaths." "But what is so shocking is that neither we nor the Department of Health know how many children are dying in psychiatric care." "Do you know how many children have died in mental health units since 2010?" " I'm advised that the number is very small." " Do you know how many?" "I don't know the number accurately beyond..." "Your predecessor said none had died." " Right." " We've been told by the charity Inquest they've established at least nine have died." "Well, my understanding is, actually, it was fewer than that." "Should you not, as the minister responsible, know how many?" "I was advised it was less than that number." "The minister later said they'd records of four deaths since 2010, and now they'd explore Inquest's figure of nine." "He stated..." "Rachel's mum Tara is determined the system must change." "She started an online petition for more localised care and has collected over 100,000 signatures." "It's just amazing, we were overwhelmed by it." "And that means you have the possibility of a parliamentary debate." "Yeah, I think you need over 100,000 to be considered for a debate in Parliament, yeah." "These poor children are being kept so far away from their families, and it doesn't help recovery, it's not helpful at all." "It's not good for them, it's not good for the family." "In February, a long-awaited NHS task force reported that" "England's mental health services have been chronically underfunded." "The minister says he wants that to change." "We're trying to increase the amount both of community provision and specialised care." "We now have 1,400 acute beds available for children and young people, that's the most we've ever had." "We've added 50 since I became the minister." "At the same time, we have an investment of £1.4 billion into children's and young people's services." "Sara Green's death carries many lessons." "I want you to give this person a compliment, OK?" "When I say..." "If we're falling short in caring for the mentally ill, what's to be done?" "Off you go." "Give each other a compliment." "Schools are now on the front line, handling mental health problems." "Three-quarters of mental health trusts in England cut or froze their CAMHS teenage mental health spending last year." "The responsibility's been put onto schools to tackle problems before they take hold." "Teachers are very well placed to actually spot when children are in distress or where there is change which might indicate a mental health problem." "So what we have done is start a new type of programme called" "Academic Resilience." "And this is about helping schools help the mental health of their pupils, and it's a completely brand-new approach." "So when Lara logged on and she saw those comments, how would that have made her feel?" "The school piloting the programme was Hove Park Secondary in Sussex." "She started to regret it, yep, she started to regret it." "And why do you think...?" "They're talking about bullying, a torment for Sara Green, Rachael Palin and millions of others." "Yeah, so it could lead to depression and self-harm." "In what ways do you think it might...?" "Rates of teenage depression have doubled since the 1980s." "On average, three in every classroom will have some kind of mental health problem." "At Hove Park it means around 160 pupils will need help." "Self-harming, have you had any experience of that or do you know any friends who self-harm?" "The school employs three full-time non-teaching staff, the care team, for counselling." "It's really sad to say but I think it's become quite normal now." "The majority of people I know personally self-harm." " Make a wish." " I made a wish." "Sara Green died because she was let down by a broken mental health service." "The family, in their grief, know, like Sara knew, she would have been far safer at home." "Sara was frightened, you could see it in her..." "Because she knew what was going on." "And that's what makes it really, really hard as well." "Because she knew... what was happening and she couldn't do anything about it and... neither could anybody else." ""Fall the floor" ""Close the door" ""I don't want to be me" ""I want to be free" ""I need some relief from all this grief" ""I know I smile" ""But I haven't felt happy for a while.""