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 third programme explores the work of a community mental health team in the borough of Lewisham. Fifty years ago the mentally ill were locked away in Victorian asylums. Today, in south London, almost 10 times more patients are cared for in their homes than in hospital. Tamara is a mum of two in her thirties who has persistent delusional disorder. Her house is infested with bed bugs which the council hasn’t been able to remove. But Tamara believes they are multiplying behind her eyes and in places it's impossible for them to reach. When she's unwell she sleeps in the communal corridors outsider her flat. Earlier in the year she was sectioned and admitted to SLaM. She's determined not to go back but her mental health fluctuates by the day. In many ways, she’s similar to the 350 patients looked after by social worker Jim Thurkle. If they can be kept well, they stay out of psychiatric hospital and can enjoy their independence. Rosemary lives with paranoid schizophrenia. Thurkle has been trying to make contact with her at home for five weeks but she never answers the door and may be about to relapse. Around a third of Thurkle’s patients regularly refuse to engage with him. Lloyd, 44, started to develop psychotic symptoms six years ago after two stressful life events: the break-up of a relationship and the death of his mother. He has been diagnosed with paranoid schizophrenia and now hears a voice in his head called Martha. He lives with his dad Ray and neither has fully come to terms with the illness or how the outside world will view it. Lloyd seldom leaves the house, afraid of what he might be capable of. We see him spend his first weekend at home alone since leaving psychiatric hospital. Tamara’s mental health is complicated by her long term addiction to speed, which resulted in her children being taken into care and is likely to have been the trigger for her delusions. Thurkle explains that his patients self-medicate because they genuinely believe that non-prescription drugs and alcohol are helping them – the team must work around addiction. Lloyd often turns to alcohol to cope with his anxiety. His psychiatrist Dr Fidel Gallo is worried about the effect it is having on his symptoms. Thurkle visits Rosemary’s home again, accompanied by her psychiatrist, Dr Tom Werner. Her continued refusal to cooperate and signs of mental instability prompt the team to admit her under Section 3 of the Mental Health Act. Once in hospital she will not have the right to refuse medical treatment. Thurkle admits that he is not always comfortable going down this route but there is sometimes no alternative. Following a relationship breakdown, Tamara too has become agitated and disturbed. Thurkle is concerned that she will have to be admitted, but when he visits a few days later with Werner she has calmed down considerably and is able to remain at home. We catch up with Rosemary who is back home after four weeks of treatment in hospital. She is far more relaxed and amenable, and is clearly delighted to be back in her own space. Lloyd is faring less well, having been admitted to intensive care with pancreatitis – a potentially fatal condition caused by excess drinking. For a while it is touch and go, but he is eventually on the road to recovery.