“We’ve got two,” explains Emer Szczygiel, emergency department head of nursing at King George Hospital, as she walks inside a pastel coloured room.
“If I had my time back again, we would probably have four, five, or six because these have helped us so much in the department with the really difficult patients.”
On one wall, there’s floral wallpaper. It is scored through with a graffiti scrawl. The words must have been scratched out with fingernails.
There are no other implements in here.
Patients being held in this secure room would have been searched to make sure they are not carrying anything they can use to harm themselves – or others.
Image: Emer Szczygiel wishes the hospital had more of the ‘ligature light’ mental health rooms
There is a plastic bed secured to the wall. No bedding though, as this room is “ligature light”, meaning nothing in here could be used for self harm.
On the ceiling, there is CCTV that feeds into a control room on another part of the Ilford hospital’s sprawling grounds.
“So this is one of two rooms that when we were undergoing our works, we recognised, about three years ago, mental health was causing us more of an issue, so we’ve had two rooms purpose built,” Emer says.
“They’re as compliant as we can get them with a mental health room – they’re ligature light, as opposed to ligature free. They’re under 24-hour CCTV surveillance.”
Image: The rooms have a CCTV camera in the ceiling that feeds through to the main control room
There are two doors, both heavily reinforced. One can be used by staff to make an emergency escape if they are under any threat.
What is unusual about these rooms is that they are built right inside a busy accident and emergency department.
The doors are just feet away from a nurse’s station, where medical staff are trying to deal with acute ED (emergency department) attendances.
The number of mental health patients in a crisis attending A&E has reached crisis levels.
Some will be experiencing psychotic episodes and are potentially violent, presenting a threat to themselves, other patients, clinical staff and security teams deployed to de-escalate the situation.
Image: The team were already dealing with five mental health cases when Sky News visited
Like physically-ill patients, they require the most urgent care but are now facing some of the longest waits on record.
On a fairly quiet Wednesday morning, the ED team is already managing five mental health patients.
One, a diminutive South Asian woman, is screaming hysterically.
She is clearly very agitated and becoming more distressed by the minute. Despite her size, she is surrounded by at least five security guards.
She has been here for 12 hours and wants to leave, but can’t as she’s being held under the Mental Capacity Act.
Her frustration boils over as she pushes against the chests of the security guards who encircle her.
“We see about 150 to 200 patients a day through this emergency department, but we’re getting on average about 15 to 20 mental health presentations to the department,” Emer explains.
“Some of these patients can be really difficult to manage and really complex.”
Image: Emer Szczygiel says the department gets about 15 to 20 mental health presentations a day
“If a patient’s in crisis and wants to harm themselves, there’s lots of things in this area that you can harm yourself with,” the nurse adds.
“It’s trying to balance that risk and make sure every emergency department in the country is deemed a place of safety. But there is a lot of risk that comes with emergency departments, because they’re not purposeful for mental health patients.”
In a small side room, Ajay Kumar and his wife are waiting patiently by their son’s bedside.
He’s experienced psychotic episodes since starting university in 2018 and his father says he can become unpredictable and violent.
Image: Ajay and his wife were watching over their son, who’s been having psychotic episodes
Ajay says his son “is under a section three order – that means six months in hospital”.
“They sectioned him,” he tells us.
“He should be secure now, he shouldn’t go out in public. Last night he ran away [from hospital] and walked all the way home. It took him four and a half hours to come home.
“I mean, he got three and a half hours away. Even though he’s totally mental, he still finds his way home and he was so tired and the police were looking for him.”
Image: Mr Kumar said his son ran away from hospital and walked for hours to get home
Now they are all back in hospital and could be waiting “for days”, Ajay says.
“I don’t know how many. They’re not telling us anything.”
Matthew Trainer, chief executive of Barking, Havering and Redbridge University Hospitals NHS Trust, is at pains to stress nobody is blaming the patients.
“We’ve seen, particularly over the last few years, a real increase in the number of people in mental health crisis coming into A&E for support,” he says.
“And I don’t know if this is because of the pandemic or wider economic pressures, but what we’re seeing every day is more and more people coming here as their first port of call.”
Image: ‘More and more’ people in mental health crisis are showing up at A&E, says Mr Trainer
The hospital boss adds: “If you get someone who’s really distressed, someone who is perhaps experiencing psychosis etc, I’m seeing increasing numbers of complaints from other patients and their families about the environment they’ve had to wait in.
“And they’re not blaming the mental health patients for being here.
“But what they’re saying is being in a really busy accident & emergency with ambulances, with somebody highly distressed, and you’re sat there with an elderly relative or a sick child or whatever – it’s hard for everyone.
“There’s no blame in this. It’s something we’ve got to work together to try to fix.”
New Freedom of Information data gathered by the Royal College of Nursing shows that over the last five years, more than 1.3 million people in a mental health crisis presented to A&E departments.
That’s expected to be a significant underestimate however, as only around a quarter of English trusts handed over data.
For these patients, waits of 12 hours or more for a mental health bed have increased by more than 380%.
Over the last decade, the number of overnight beds in mental health units declined by almost 3,700. That’s around 17%.
The Department for Health and Social Care told Sky News: “We know people with mental health issues are not always getting the support or care they deserve and incidents like this are unacceptable.
“We are transforming mental health services – including investing £26m to support people in mental health crisis, hiring more staff, delivering more talking therapies, and getting waiting lists down through our Plan for Change.”
Claire Murdoch, NHS England’s national mental health director, also told Sky News: “While we know there is much more to do to deal with record demand including on waits, if a patient is deemed to need support in A&E, almost all emergency departments now have a psychiatric liaison team available 24/7 so people can get specialist mental health support alongside physical treatment.
“The NHS is working with local authorities to ensure that mental health patients are given support to leave hospital as soon as they are ready, so that space can be freed up across hospitals including A&Es.”
Patients in a mental health crisis and attending hospital are stuck between two failing systems.
A shortage of specialist beds means they are left untreated in a hospital not designed to help them.
And they are failed by a social care network overwhelmed by demand and unable to provide the early intervention care needed.
Police have said they are investigating a “racially aggravated” rape in the West Midlands.
Officers were called just before 8.30am on Tuesday after a Sikh woman in her 20s reported being attacked by two white men in the area around Tame Road in Oldbury.
The Sikh Federation (UK) said the perpetrators allegedly told the woman during the attack: “You don’t belong in this country, get out.”
One of the men is described as having a shaved head, of heavy build, and was reported to be wearing a dark coloured sweatshirt and gloves.
The second man was reportedly wearing a grey top with a silver zip.
West Midland Police said it is being treated as a “racially aggravated attack” and has appealed for anyone in the area who may have seen the men to contact the force.
Chief Superintendent Kim Madill said: “We are working really hard to identify those responsible, with CCTV, forensic and other enquiries well under way.
“We fully understand the anger and worry that this has caused, and I am speaking to people in the community today to reassure them that we are doing everything we can to identify and arrest those responsible.
“Incidents like this are incredibly rare, but people can expect to see extra patrols in the area.”
Dabinderjit Singh, the lead executive for political engagement at the Sikh Federation (UK), said: “The current racist political environment is driven by popularism and created by politicians playing the anti-immigration card who are unashamedly exploiting those with right-wing and racist views.
“More than 48 hours later we await the public condemnation by politicians on all sides of this brutal racist and sexual attack where a young Sikh woman has been viciously beaten and raped.”
Gurinder Singh Josan, Labour MP for Smethwick, wrote on X: “This is a truly horrific attack and my thoughts are with the victim.”
He added: “The incidence is being treated as a hate crime.
“The police are working extremely sympathetically with the victim at her pace who has been traumatised by the attack.
“We are grateful for all the CCTV and information that has already been forthcoming from the community.”
“It makes me sad. We left when our country had the troubles so we should have in this world… the humanity”.
We’re sitting in a cafe in Tamworth and Noor, 19, is explaining how it feels to know there are people in the town who don’t want him here.
Noor is from Afghanistan and came to the UK on a small boat.
The cafe is close to the asylum hotel where he’s staying.
Image: The group met in a cafe in Tamworth
He’s agreed to come along with four other men from the hotel to speak to locals about the concern in the town over the Staffordshire hotel being used to house asylum seekers.
There was a peaceful demonstration outside the hotel last month. But last year, a protest here turned ugly. Windows were smashed, petrol bombs thrown, and part of the hotel was set alight.
Among the locals in the cafe is Tom, 25, who reveals he was at both protests.
More on Asylum
Related Topics:
Image: Tom (left) has attended anti-migration protests in Tamworth
He says he was persuaded to go by friends and explains to the group why they decided to go.
“They were annoyed, angry, fuming that the government had let them [asylum seekers] live in a hotel,” he says.
Noor, who speaks the best English of the asylum seekers in the group, replies: “What did we do wrong?”
Image: Noor says he is upset by people who do not want him in the UK
“Your government accepts us as asylum seekers,” he continues.
Tom thinks. “I’m more annoyed with the government than you guys,” he tells them.
‘A place to get the golden ticket’
Noor explains to the group how he ended up in the UK. He left Afghanistan four years ago with his family but they were separated on the journey. He doesn’t know where they are.
Heather, a 29-year-old local accountant, speaks up.
Image: Heather says protests outside hotels makes asylum seekers fearful
“When people protest, I’m like, why don’t you protest near the government?” she asks. “Why don’t you take your issue to them rather than being outside the hotel?”
“Those asylum seekers aren’t going to change the policy at all,” she adds. “It’s just going to make them fearful.”
Each of the locals in the cafe has their own take on why some don’t like the asylum seekers living in their town.
“I think they feel like they’re living better than the British people, some of them, and it’s almost like they feel offended,” says Andrew, 47.
“Some people in the UK see how the asylum seekers are coming over to Britain because they see it as a place to get the golden ticket,” he adds.
Please use Chrome browser for a more accessible video player
10:54
UK’s unprecedented immigration figures
Heather agrees. She says the NHS is a draw and the UK also has “different border control regulations that might be seen as weaker than in some other countries”.
“You get to stay in a hotel,” she tells the asylum seekers. “You get the free health care. And so I think that’s why they’re a little bit annoyed.”
Noor replies: “One thing I should tell you is that when we cross the English Channel, it means we don’t care about our life. It’s very dangerous.”
Image: Noor and four other asylum seekers joined the meeting
Links to the UK
I’m keen to know why they chose to come to Britain. Noor tells the group it’s because he has a relative here and speaks the language.
Azim, 22, who is also from Afghanistan, says he came here because people in the UK “have respect to Islam”.
He also has a family member here.
Image: Azim says people in the UK are respectful of Islam
I ask them if they could have claimed asylum in France, but Noor says his “only hope was England”.
He says it’s “better for education” here. All the men agree it’s seen as the better place to come.
The conversation moves to the protests this summer which began in Epping, Essex, after an asylum seeker there was charged with sexually assaulting a schoolgirl – an offence he has now been convicted of.
Please use Chrome browser for a more accessible video player
56:38
In full: The Immigration Debate
Noor believes British people have a right to be angry about that. He tells the group he believes that asylum seekers who commit crimes “should get back to their country”.
“We also [do] not support them,” he says.
Over the course of the meeting, the mood becomes more relaxed. People with different views find some common ground.
Please use Chrome browser for a more accessible video player
3:30
Immigration Debate audience have their say
Noor tells the group that if things improve in Afghanistan he would like to go back there one day.
If not, he hopes he’ll stay in the UK and earn enough to repay in taxes the bill for the hotel he’s staying in now.
It has been a frank exchange. Some in this town will never want asylum seekers here and people like Noor and Azim know it.
But they were placed here by the Home Office and can only wait until their asylum claims are processed.
“Mum is teaching yoga and English to her cellmates in Iranian prison.”
It’s now over eight months since British couple Lindsay and Craig Foreman were detained in Iran.
Last week, during a long-awaited visit from British ambassador Hugo Shorter, it was confirmed that the pair continue to endure tough conditions with no indication of how – or when – the legal process will proceed.
“They’re both coping, making the best of a bad situation. They’re in conditions you can’t even imagine.”
Image: Lindsay Foreman with son Joe Bennett. Pic: Family handout
Speaking to Sky News, their son Joe Bennett explained how the couple have been crammed into cells with more than 50 other prisoners, while suffering constant back pain caused by metal bunk beds.
“The beds are stacked three high. It’s unsanitary. It’s hot. There are often power outages and they’re in 50-degree heat.”
Image: Craig and Lindsay Foreman. Pic: Family handout
Lindsay and Craig, both 52, were arrested in early January in Iran, as they crossed the country on motorbikes as part of an around-the-world adventure. The couple had left Spain just a few weeks earlier and were aiming to drive all the way to Australia.
They were charged with espionage and have been transferred to various prisons around Iran, with little information provided to British diplomatic staff about their whereabouts.
Joe and the rest of the family have only managed to speak to their parents once on the phone. “In a brief conversation that I had with my mum, we managed to share a laugh and a lot of tears as well. But it’s a test of time, how long they can keep this up for.”
Image: Pic: Family handout
The UK ambassador’s meeting with Craig was the first in over four months, and despite suffering from untreated dental pain, he quipped about becoming a “reluctant Arsenal supporter” while watching football on television with other prisoners.
The couple were previously held together in a facility in the Iranian city of Kerman but have been moved to separate prisons in the capital, Tehran. Family members are calling on the Iranians to move Lindsay into the same facility where Craig is being detained.
Image: Pic: Family handout
Their son acknowledged in his interview with Sky News that he was frustrated with his parents when they were arrested in January. Family members had urged them not to travel through the country.
“I had that natural reaction that some of the public do – why did they go? It’s idiotic, you’re going against the advice, and it serves them right. That’s fair enough when you don’t know them [but] just picture your parents having a bit of a sense of adventure… it’s a different story.”
The Foreign, Commonwealth and Development Office says it is “deeply concerned” about the couple, adding, “we continue to raise this case directly with the Iranian authorities”.
Members of the Foreman family are urging the British government and the new foreign secretary, Yvette Cooper, to take direct action to improve harsh prison conditions and urgently organise for Lindsay and Craig’s release.
“I need them home, you know, and I need them home as soon as possible. We need them, the family miss them dearly – so we’re going to do everything we can to make that possible.”