“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.
Anyone feeling emotionally distressed or suicidal can call Samaritans for help on 116 123 or email jo@samaritans.org in the UK. In the US, call the Samaritans branch in your area or 1 (800) 273-TALK.
Radicalised nine-year-olds, teenagers mixing incel culture with extreme right ideologies and a Muslim who idolises Hitler – this is just some of the casework of those tasked with deradicalising young extremists in the UK.
Monday will mark 20 years since the 7/7 attacks on the London transport network when four suicide bombers killed 52 people and injured 770 others.
A year later the government set up its deradicalisation programme Prevent as part of its counter-terrorism strategy.
Sky News has spoken to two leading intervention providers (IPs) at Prevent who both say their work is getting ever more complex and the referrals younger.
The Metropolitan Police’s Prevent co-ordinator, Detective Superintendent Jane Corrigan, has also told Sky News it is “tragic” that when it comes to terrorism, “one in five of all our arrests is a child under 17”.
She believes parents should talk to their children about what they are reading and seeing online.
“Parents instinctively know when something doesn’t feel right when their child is becoming withdrawn or isolated – not wanting to engage,” she says.
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People worried that someone they know has thoughts that could lead to terrorism can refer them to Prevent.
Image: File pic: iStock
‘A pic-n-mix of ideologies’
Home Office figures show 11-year-olds are the largest age group to get referred.
Concerning cases are passed on to IPs such as Nigel Bromage who told Sky News: “Often there will be a pic-n-mix of ideologies.
“From my own examples and experience, we are aware of people looking at the incel culture and mixing that with some far-right elements.”
Image: Sky’s Jason Farrell with intervention provider Nigel Bromage, who was exposed to extremism when he was a child
Incels, meaning “involuntary celibates” are men who have been unable to have a relationship with women despite wanting one and become misogynistic and hateful as a result.
Like many IPs, Mr Bromage from Birmingham comes from an extremist background himself, having once been a regional organiser for the proscribed Neo-Nazi group Combat 18.
For him too, it began as a child.
“It all started with someone giving me a leaflet outside my school gates,” Mr Bromage says.
“It told me a horrific story about a mum getting killed by an IRA bomb explosion – and at the end of the leaflet there was a call to action which said: ‘If you think it’s wrong then do something about it’.”
He developed a hatred for Irish republican terrorism which morphed into general racism and national socialism.
“At the very end I thought I was going to go to prison, or I would end up being hurt or even killed because of my political beliefs,” he says.
Image: Mr Bromage says his youngest case involved a nine-year-old
Boy, 9, groomed by his brother
Mr Bromage reveals his youngest case was a nine-year-old who had been groomed by his brother.
“He was being shown pro-Nazi video games, and his older brother was saying ‘when I go to prison or I get in trouble – they you’re the next generation – you’re the one who needs to continue the fight’,” he says.
“Really, he had no interest in the racist games – he just wanted to impress his brother and be loved by his brother.”
Every year, nearly 300 children who are 10 or younger are referred to Prevent.
Home Office figures show that over the last six years 50% of referrals were children under the age of 18.
Eleven-year-olds alone make up a third of total referrals, averaging just over 2,000 a year, with the figure rising even higher in the most recent stats.
Another IP, Abdul Ahad, specialises in Islamic extremism.
He says the catalyst for radicalisation often comes from events aboard.
Ten years ago, it was Syria, more recently Gaza.
“It is often a misplaced desire to do something effective – to matter, to make a difference. It gives them purpose, camaraderie and belonging as well – you feel part of something bigger than you,” he says.
Image: Fifty-two people were killed on 7 July 2005 when four suicide bombers blew up three London Underground trains and a bus. Pic: PA
Clients want someone to ‘hear them’
Some of his clients “don’t fit into any particular box”.
“I’m working with a guy at the minute, he’s a young Muslim but he idolises Hitler and he’s written a manifesto,” he says.
“When you break it down, some people don’t know where they fit in, but they want to fit in somewhere.”
Mr Ahad says the young individual mostly admires Hitler’s “strength” rather than his ideologies and that he was drawn to darker characters in history.
Often his clients are very isolated and just want someone to “hear them”, he adds.
Image: Intervention provider Abdul Ahad specialises in Islamic extremism
Mr Ahad is also an imam who preaches at the Al-Azar Mosque in South Shields, a well-regarded centre for community cohesion and outreach.
He uses his understanding of the Islamic faith in his Prevent sessions to help guide his referrals away from extreme interpretations of the Koran by offering “understanding and context”.
He says: “We quote the correct religious texts – we explain their responsibility as a Muslim living in the UK and we re-direct their energies into something more constructive.”
Common theme of mental health issues
Mental health problems are a common theme among those referred to Prevent including depression and autism.
Her mother was critical of Prevent, as well as the police and MI5 after she had referred her daughter to the deradicalisation programme and Rhianan was subsequently charged with terrorism offences.
Last month a coroner found some failings in the processes around protecting Rhianan, but none of them attributable to Rhianan taking her own life.
Det Supt Corrigan says a referral doesn’t mean individuals end up being arrested or on an MI5 watchlist.
She says: “You’re not reporting a crime, but you are seeking support. I would say the earlier you can come in and talk to us about the concerns you have the better. Prevent is just that – it is a pre-criminal space.
“It’s tragic when you see the number of young people being arrested for very serious charges. Just look at terrorism – one in five of all our arrests is a child under the age of 17. We need to think about how we respond to that.”
Prevent has been criticised for failures such as when Southport killer Axel Rudakabana failed to be recognised as needing intervention despite three referrals, or when MP David Amiss’ killer Ali Harbi Ali went through the programme and killed anyway.
Image: Axel Rudakubana failed to be recognised as needing intervention despite three referrals. Pic: Merseyside police
It’s harder to quantify its successes.
Mr Ahad says he understands why the failures hit the headlines, but he believes the programme is saving lives.
He says: “I think the vast majority of people get radicalised online because they are sitting in their room reading all this content without any context or scholarly input. They see one version of events and they get so far down the rabbit hole they can’t pull themselves out.
“I really wish Prevent was around when I was a young, lost 15-year-old because there was nothing around then. It’s about listening to people engaging with them and offering them a way of getting out of that extremism.”
Image: File pic: iStock
‘Radicalisation can happen in days to weeks’
Det Supt Corrigan says: “I’ve sat with parents whose children have gone on to commit the most horrendous crimes and they all spotted something.
“Now, with hindsight, they wished they had done something or acted early. That’s why we created this programme, because radicalisation can happen in days to weeks.”
Twenty years on from 7/7 the shape of the terrorist threat has shifted, the thoughts behind it harder to categorise, but it is no less dangerous.
Image: Liverpool’s captain Virgil van Dijk. Pic: Reuters
Image: Liverpool’s Ryan Gravenberch and Cody Gakpo (right) arrive at the funeral of Diogo Jota and Andre Silva. Pic: PA
Jota, 28, leaves behind his wife of only 11 days, Rute Cardoso, and three young children.
His younger brother, 25, was an attacking midfielder for Penafiel in the second tier of Portuguese football.
Liverpool manager Arne Slot, captain Virgil Van Dijk and teammates including Andy Robertson, Conor Bradley, Ryan Gravenberch, Cody Gakpo, Curtis Jones, Darwin Nunez and Joe Gomez were seen at the service.
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Former teammates Jordan Henderson, James Milner and Fabinho were also there.
Van Dijk carried a red wreath with Jota’s number 20, while Robertson had a wreath featuring number 30, Silva’s number at Penafiel.
Image: Manchester United and Portugal player Bruno Fernandes. Pic: PA
Image: Liverpool’s captain Virgil van Dijk and Liverpool’s player Andrew Robertson. Pic: Reuters
Some of Jota’s teammates in the Portuguese national side also attended, including Bruno Fernandes, of Manchester United, Ruben Dias and Bernardo Silva, of Manchester City, Joao Felix and Renato Veiga, of Chelsea, Nelson Semedo, from Wolves, Joao Moutinho and Rui Patricio.
Ruben Neves was one of the pallbearers after flying in from Florida where he played for Al Hilal in the Club World Cup quarter-final on Friday night.
‘More than a friend’
In a post published on Instagram before the service, he told Jota he had been “more than a friend, we’re family, and we won’t stop being that way just because you’ve decided to sign a contract a little further away from us!”
Jota’s fellow Liverpool midfielder, Alexis Mac Allister, said on Instagram: “I can’t believe it. I’ll always remember your smiles, your anger, your intelligence, your camaraderie, and everything that made you a person. It hurts so much; we’ll miss you. Rest in peace, dear Diogo.”
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Porto FC president Andre Villas-Boas and Portugal national team manager Roberto Martinez were also in attendance.
‘With us forever’
Speaking after the ceremony, Martinez said the period since their deaths had been “really, really sad days, as you can imagine, but today we showed we are a large, close family.
“Their spirit will be with us forever.”
The service was private, but the words spoken by the Bishop of Porto, Manuel Linda, were broadcast to those standing outside the church.
He told Jota’s children, who were not at the service, that he was praying for them specifically, as well as their mother and grandparents.
“There are no words, but there are feelings,” he said, adding: “We also suffer a lot and we are with you emotionally.”
The brothers died after a Lamborghini they were travelling in burst into flames following a suspected tyre blowout in the early hours of Thursday morning.
No other vehicles are said to have been involved in the incident.
Liverpool have delayed the return of their players for pre-season following Jota’s death and players past and present paid tribute to him and his brother on social media.
Rachel Reeves has hinted that taxes are likely to be raised this autumn after a major U-turn on the government’s controversial welfare bill.
Sir Keir Starmer’s Universal Credit and Personal Independent Payment Bill passed through the House of Commons on Tuesday after multiple concessions and threats of a major rebellion.
MPs ended up voting for only one part of the plan: a cut to universal credit (UC) sickness benefits for new claimants from £97 a week to £50 from 2026/7.
Initially aimed at saving £5.5bn, it now leaves the government with an estimated £5.5bn black hole – close to breaching Ms Reeves’s fiscal rules set out last year.
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6:36
Rachel Reeves’s fiscal dilemma
In an interview with The Guardian, the chancellor did not rule out tax rises later in the year, saying there were “costs” to watering down the welfare bill.
“I’m not going to [rule out tax rises], because it would be irresponsible for a chancellor to do that,” Ms Reeves told the outlet.
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“We took the decisions last year to draw a line under unfunded commitments and economic mismanagement.
“So we’ll never have to do something like that again. But there are costs to what happened.”
Meanwhile, The Times reported that, ahead of the Commons vote on the welfare bill, Ms Reeves told cabinet ministers the decision to offer concessions would mean taxes would have to be raised.
The outlet reported that the chancellor said the tax rises would be smaller than those announced in the 2024 budget, but that she is expected to have to raise tens of billions more.
Sir Keir did not explicitly say that she would, and Ms Badenoch interjected to say: “How awful for the chancellor that he couldn’t confirm that she would stay in place.”
In her first comments after the incident, Ms Reeves said she was having a “tough day” before adding: “People saw I was upset, but that was yesterday.
“Today’s a new day and I’m just cracking on with the job.”
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“In PMQs, it is bang, bang, bang,” he said. “That’s what it was yesterday.
“And therefore, I was probably the last to appreciate anything else going on in the chamber, and that’s just a straightforward human explanation, common sense explanation.”