Bedlam.

This four part series boldly challenges the myths and taboos about mental illness through unprecedented access to the patients and staff of the South London and Maudsley (SLaM) - the world’s oldest psychiatric institution. The fourth programme visits a psychiatric ward for over-65s. Sylvia became severely depressed following a series of deaths in her family. After being diagnosed with bipolar disorder – in her own words, I’m not sure what it means. I think it means I’m double nutty! – she had a four month stay on the ward. She now returns every Friday as a volunteer, chatting to the patients and generally helping out. 86-year-old Peter has spent his life travelling the world. He comes across as a little eccentric, but actually has a serious mental illness: schizoaffective disorder, characterised by mood swings and delusions. A year ago he was teaching in Istanbul but his mental health began to deteriorate and he took an overdose after returning to England. Peter claims it was a cry for help, but his psychiatrist Dominic ffytche disagrees. Peter refuses to take medication, but has since become more stable and his doctors are satisfied that he is ready to be discharged. 67-year-old Lorraine has been on the ward for five months. She’s forgotten who she is and is unable to recall anything about her past. It happened almost overnight. She was initially admitted with depression, but it now seems she may be suffering from a rare condition called dissociative disorder – formerly known as hysteria. Her psychiatrist, Professor Robert Howard, thinks she may have reached a point in her life where she was no longer able to cope and ‘escaped’ into a different state. Medication is having little effect and the clinical team is unsure how to proceed. Vera, 82, used to be a volunteer helper in the community. She’d never experienced mental illness before but was admitted to hospital with psychotic symptoms six months ago. She’d developed a distorted view of reality and believed the doctors and nurses were imposters. Although those symptoms have been brought under control she now suffers from extreme anxiety and is incredibly nervous about the prospect of returning home. The staff suggest she tries spending a night back her flat on her own but within a couple of hours she phones the hospital, requesting to go back. With no family to support her, she’s unsure whether she’ll ever have the confidence to live on her own. Lorraine’s deterioration happened soon after witnessing an accident which almost killed her husband. She has had a traumatic life, struggling with abandonment at birth and later alcohol addiction. After several months Professor Howard decides on a controversial treatment: ECT, electroconvulsive therapy. Peter was hoping he’d be free to live as he pleased at home, but is still being monitored by a community mental health worker, much to his frustration. After being on his own for a week, he appears increasingly confused. His delusions are also returning, such as talking to his hand and foot. His psychiatrist, Dr Rao, believes that Peter’s drinking may be adding to the problem. After receiving ECT, Lorraine appears to have made a miraculous recovery. She is able to communicate normally and remembers nothing of the preceding months. Professor Howard thinks the intensity of the treatment may have acted like a placebo, enabling Lorraine to believe that it would work. She is discharged from the ward but will return for regular psychotherapy sessions and counselling to tackle the underlying cause of her breakdown. Vera has gradually regained her confidence and is also returning home.