Anxiety has become the mental illness of our time. The NHS issues around seven million tranquiliser prescriptions every year. At the Bethlem Royal Psychiatric Hospital in South London, a specialist anxiety unit treats some of the most extreme cases in Britain: the top one per cent. Most suffer with extreme OCD. James, who's 23, has an unusual anxiety: a profound fear that he'll lose control of his bowel movements in public. Consequently he spends up to seven hours a day in the loo, too scared to leave in case he has an accident. He's been in and out of psychiatric institutions since he was a teenager and had to drop out of university because his OCD got so bad. Helen is a librarian at the British Museum. She has an irrational fear of harming strangers: she believes that somehow she's responsible for killing them in road traffic accidents or putting them in rubbish bins. For two years she's lived the life of a recluse, too worried to leave the house or go to work. Aaron is a middle manager with an oil company who struggles with perfectionism. He can spend hours opening and closing drawers or switching lights off and on, unable to stop until he's carried out the task a certain number of times. He's hidden his OCD from everyone, worried the world will think he's crazy. They're all on an intensive 12-week therapy programme at the Bethlem, which has a three in four success rate. Simon Darnley, the Head of the Anxiety Disorders Residential Unit (ADRU), says some patients can be completely 'cured'.
Lambeth Hospital has pioneered the use of short-stay emergency wards for patients in crisis. It's run like A&E but for people with mental illness. Cameras are granted access for the first time to a world where psychiatrists and nurses take critical decisions about risk every day. Over the course of a few days clinicians assess whether patients are stable enough to return home or if they need to go on to a longer stay psychiatric ward. Most patients are considered a danger to themselves or others. Father-of-four Dominic is a creative director of an IT company. He's been admitted to the ward following a suicide attempt. His psychiatrist must evaluate whether to send him home, or if he might try again to kill himself. Katrina is studying at one of the country's leading drama schools but in her second year at university her life was interrupted by mental illness. She was first diagnosed with schizoaffective disorder at the age of 20 and is now experiencing her third admission to hospital. This time she came on to the ward after threatening her mum following an argument over an iPhone. Rupert, who's 51, has bipolar affective disorder and his behaviour on the ward can be challenging for staff. When he goes missing for eight hours after being given an hour's leave, staff have to weigh up whether or not to send him onto a longer stay ward, but worry how he might react.
Fifty years ago you'd hardly ever see someone with a mental illness out and about; they were locked away in Victorian-style asylums. Today, in South London, almost 10 times more patients are cared for in their homes than in hospital. It's better known as care in the community but our perception of whether it works is often coloured by isolated stories about schizophrenics who have killed. The reality is different. Cameras follow a community mental health team in the Borough of Lewisham. If they can keep their patients well and stable, they will stay out of psychiatric hospital and enjoy their independence. There are more than 1000 patients in the borough living with psychosis. It means they have a distorted view of reality: they hear voices, or experience delusions or hallucinations. Tamara is a mum of two in her thirties who has persistent delusional disorder. Her house contains bed bugs, which the council hasn't been able to remove. But Tamara believes these bugs are multiplying and have got inside her body, behind her eyes and into places it's impossible for them to reach. When she's getting unwell she starts to sleep in the communal corridors outsider her flat. She's determined not to go back to hospital but her mental health fluctuates by the day.
The final episode of the series visits a psychiatric ward for over-65s at the South London and Maudsley. According to psychiatrist Professor Robert Howard, 'In society old people and people with mental health problems come right at the bottom of the heap really. So, if you are old and you have got mental health problems, you have got this sort of dreadful double whammy of disadvantage.' Lorraine, who's 67, has forgotten who she is and can't remember anything about her life. It happened almost overnight. Peter, who's 86, has spent his life travelling the world. A year ago he was teaching in Istanbul but his mental state began to deteriorate and he took an overdose after returning to England. He has schizoaffective disorder, characterised by mood swings and delusional behaviour. He doesn't want to take medication. Vera, who's 82, had never had a mental illness before she was admitted to hospital with psychotic symptoms. She'd developed a distorted view of reality and believed the doctors and nurses were imposters. Although those symptoms have gone, she now suffers from extreme anxiety and, with no family to support her, she's unsure whether she'll ever have the confidence to live on her own. Sylvia was 70 before she first experienced mental illness. She became severely depressed following the deaths of a number people very close to her. After being diagnosed with bipolar disorder, she had electroconvulsive therapy treatment. Two years later, she volunteers every Friday in the ward where she was once treated, chatting to the patients and generally helping out. Friendly, warm and chatty, Sylvia is an example that recovery is possible.