Original subtitles

NARRATOR: Deep in the Berkshire countryside

sits one of Britain's most feared institutions...

My first impression was, "This is a prison."

..Broadmoor Hospital...

It's notorious because of who's there.

..a place where dangerous men are sent...

..when there's nowhere else for them to go.

You are dealing with people

who carry substantial risk of harm to the public.

There's always that risk that violence might erupt.

This is the inside story,

told by those who've worked behind its walls...

One patient suddenly turned on me and said,

"The trouble with you is that you won't let me be mad."

..those once detained here...

..and by the most notorious of all...

He called me Bob, and I called him Peter.

PHONE RINGING

..secretly recorded and speaking from beyond the grave.

This is the story of how to care

for Britain's most dangerously unwell.

It can be sometimes very scary.

There's a risk, there's no two ways about it.

40 miles from London,

perched on a hill above the village of Crowthorne,

sits Broadmoor...

a psychiatric hospital like no other.

You look out and you think, "What a beautiful view."

Countryside, calmness,

seeing the green.

It was stunning, to be honest with you, you know?

Broadmoor's setting, these lovely grounds,

and there's a long drive up to it.

But then when Broadmoor actually appears in front of you,

it's quite an intimidating place.

There's a huge wall that appears like a blanket wrapped round it.

Is it protecting them from us or us from them?

I wasn't ever sure.

These walls hold some of the country's

most dangerously unwell offenders.

Men with mental illness and personality disorders.

Some are dangerous to others, some just a danger to themselves.

There's a very foreboding feeling

that you're going in

and how long this place has been there, who it has housed.

Not only murderers,

but people totally, totally insane.

You have this feeling in Broadmoor, it is fear.

I think my first impression was, "This is a prison, not a hospital."

Today, Broadmoor is home to over 200 men.

And for decades,

it's treated some of Britain's most notorious criminals.

Ronnie Kray, one of the two Kray brothers,

spent a good deal of time at Broadmoor.

Peter Sutcliffe - the Yorkshire Ripper.

Kenneth Erskine - the Stockwell Strangler.

Charles Bronson - real name Michael Peterson -

spent a goodish time at Broadmoor

on the way to being Britain's most famous, or notorious, prisoner.

Michael Adebowale - one of the killers of Lee Rigby,

is in Broadmoor.

This extraordinary collection of high-profile inmates

literally goes on and on.

And that's why it is notorious.

It's notorious because of who's there

and who they're trying to care for.

Broadmoor's patients are detained under the Mental Health Act

and spend their lives living under maximum security...

..something which staff experience on a daily basis.

You go through what we call the airlock,

so we give up our mobile phones and bags are checked

and maybe clothing felt,

and on some occasions, there's even a nice dog at the gate

sniffing for any real contraband.

Right from the moment of going in, you're conscious,

even as a member of staff,

that you're going somewhere slightly different.

I guess, deep down, I always wanted to work at a high-secure.

I knew that these people, patients, um...

..there was nowhere else they could go to be managed,

to be treated.

While staff pass in and out of Broadmoor's doors every day,

patients like Joshua generally only came in once.

Many patients who are sent to Broadmoor are unlike those

on any other psychiatric hospital ward.

The first thing to remember about patients in Broadmoor

is that the vast majority committed a very serious offense.

You are dealing with people who,

certainly in the severe cases,

carry substantial risk of harm to the public.

One such severe case came to public attention in September 2014...

POLICE RADIO: He's got a large knife, sort of machete.

He's trying to get into 3-0-4, 3-0-4.

We do have children in these back gardens.

..when one man's psychotic breakdown

terrorised a street in suburban North London.

There was no doubt that he was intent in killing

anything in his path.

Nicholas Salvador was a 25-year-old

who had come to this country with his parents from Nigeria

in his teens.

On the 4th of September 2014, Salvador had a psychotic break.

That morning, he'd gone into a cafe and left without paying,

and the waiter said later,

"He seemed very depressed and a bit upset."

Well, he certainly was.

He was sharing a house in Edmonton.

He goes back to the house,

takes his shirt off,

picks up a machete and a broom handle,

walks back out into the street and proceeds...

to completely lose it.

He's exploded.

He's like a volcano who's gone off.

He's kicking over garden fences,

he's leaping over walls, he's threatening....

In this rampage, he begins by beheading two cats with his machete.

POLICE RADIO: He's got a large knife, sort of machete.

He's now smashing the fences up.

We're evacuating kids from next door.

What set all this off, we really cannot tell.

But the tragedy, the awful tragedy of this psychotic break,

is the dear lady...

..called Palmira Silva,

who was 82,

and who lived just down the road from where Salvador was staying.

She sees all this happening and comes out.

INDISTINCT RADIO CHATTER

He simply attacks her viciously, suddenly, out of the blue,

stabs her.

And then, for no reason whatever,

beheads this poor 82-year-old woman.

So the police arrive in numbers.

It is not easy to subdue Nicolas Salvador.

POLICE RADIO: He's currently trying to get into 3-0-4, 3-0-4.

We do have children in these back gardens.

REPORTER: The alleged killer was eventually cornered

and tasered in the...

REPORTER 2: He repeated phrases such as,

"Red is the colour," and, "I am king."

One of the psychiatrists who assessed him after the attack

said Salvador thought Mrs Silva was Hitler in a different form.

This was the ultimate psychotic break,

the ultimate explosion of something

which had been building up inside him quietly for some time.

What's unusual about this trial

is that Nicolas Salvador accepts that he killed Mrs Silva,

but he has pleaded not guilty.

He claims he was insane at the time of the killing.

Salvador was actually found not guilty of murder

by reasons of insanity,

and the Recorder of London, Nicholas Hilliard,

actually sent him to Broadmoor.

Most people with mental illness pose no danger to others,

but for individuals like Salvador,

the symptoms can be severe and deadly.

Many of the homicides committed

by someone with mental illness or disorder

were because they were maybe hearing command voices

which are telling them,

"Oh, you're a bastard, you're no good, go out and kill yourself,"

or, occasionally, "Go out and kill somebody else."

Now, they're hearing these voices

very, very much as though they're real voices.

It can take total control of their thoughts, their moods,

their behaviour.

Before he came to Broadmoor,

former patient Joshua's auditory hallucinations

were dangerously out of control.

For Broadmoor, the first challenge is to safely contain new arrivals

who are acutely and dangerously unwell.

This happens in the place where all new patients enter -

the admissions ward, previously known as Luton Ward.

Mental health nurse Paul Deacon worked in admissions.

Admissions wards can be very chaotic.

All these illnesses that people have under one roof,

it's a challenge for them and for the staff, you know?

But you learn quickly, you learn.

They could present quite differently, really.

You could have somebody come in high as a kite.

Swinging, seriously.

You could have somebody who's so depressed

and near enough catatonic.

On the admissions ward,

all patients are under constant observation

because staff need to diagnose their condition, and do so quickly.

The absolutely crucial reason for making a diagnosis

is to know which treatment to give,

especially for somebody who's been very dangerous

because you want to get their symptoms under control

as quickly as possible

to reduce the risk to them and to those around them.

But many of Broadmoor's patients arrive from prison,

and for them, even the turbulent admissions ward

can feel like a sanctuary.

Most patients can move around the hospital,

but new arrivals will stay on the admissions ward

for at least three to nine months

for a period of intense assessment.

We would be encouraged to sit with them

and try and glean as much as you can out of them by conversation.

We were encouraged to interact,

see what they wanted to do - chess or anything silly like that.

Another task for staff on the admissions ward

is flushing out those who might be trying to fake their way in.

Faking mental illness is actually pretty common

amongst people in prison.

But most people who think it through

probably don't want to go to Broadmoor.

I'm well aware of a few exceptions to that.

We had a chap who was in prison,

but he knew that it would be easier and quieter for him

to act, as he put it, "mad",

and get transferred to Broadmoor.

And that's exactly what happened.

And when he walked in and he was on the wards...

..he was mortified, absolutely mortified.

He cried to be sent back to prison.

In 1999, one of Britain's most hated men

was about to put Broadmoor's admissions process to the test.

That April, a wave of vicious bombings rocked the capital.

NEWS REPORT: Emergency services poured onto the streets of Brixton

within minutes of the blast.

Everyone move back for us, please!

Finding those responsible for this bomb attack

is now the number-one priority of the Metropolitan Police.

Over a period of two weeks,

bombs ripped through Brixton, Brick Lane and then Soho.

There had been no warning.

The bomb was clearly designed to bring carnage

to the streets of the capital

on a night when those streets were packed with people

out to enjoy themselves.

Three people died, four had limbs amputated.

I can remember it vividly.

It was utterly shocking.

One of the people who died was a pregnant mother.

London was shocked.

At first it was thought

that this might be some sort of terrorist organisation.

But the police investigation

unearthed some CCTV of the Brixton bombing.

And in particular,

it identified one man as having planted the bomb...

..David James Copeland.

Copeland confessed to his crimes immediately,

but he would soon find an opportunity

to try to get away with murder.

His lawyer put in a plea for diminished responsibility.

So the courts then have to assess

whether he's mad or bad, basically, you know?

If he's mad, he's not responsible. If he's bad, he goes to prison.

So he was sent to Broadmoor to be assessed.

Author Bernard O'Mahoney

wrote letters under various pseudonyms

to men who'd harmed women and children

to ensure they were convicted.

He'd previously gained confessions from others before their trials.

Now he was determined to prove that Copeland

was faking his mental illness.

I invented this name, a name - Patsy.

So I wrote to him, and he wrote back,

and he clearly developed feelings for her.

He was very revealing, really, about himself.

Soon, Copeland was writing regularly

from his room on Broadmoor's Luton Ward.

As I got to know him through these letters,

I could see that he didn't care who he blew up,

he just wanted to blow the world up, do you know what I mean?

At Broadmoor, five psychiatrists diagnosed Copeland

with paranoid schizophrenia,

but his letters to Patsy were revealing another side.

He was a critical of the doctors,

he was saying, "This place is a joke. So are the doctors.

"They think they're clever,

"but they are as stupid as the fools...

"in here."

And then in another letter he's saying,

"Things here are so boring, as usual.

"Someone keeps writing 'kill' on the walls.

"What he writes isn't disturbing,

"but the fact he writes it in his own shit is.

"This is what this place is like."

Copeland's claims had landed him on a ward

with people who really were disturbed.

But he was hopeful that his insanity plea

would get him a fast track to freedom.

He said, "Things are not looking too bad for my trial.

"I could, if I'm lucky, get diminished responsibility,

"and then it will be up to the doctors when I am released."

But Bernard's net was closing in.

He makes the ultimate mistake on 20th December 1999.

"I can't believe that I have fooled all the doctors."

And when he wrote that line, it was just, you know,

I could have wept with joy, to be honest.

Because I knew that was him. He was stuffed.

He'd shot himself in the head, never mind the foot.

At Copeland's trial at the Old Bailey,

Bernard's Patsy letters were used as evidence

to show that he was of sound mind when he planted the bombs.

When the trial happened at the Old Bailey,

the public gallery was full of these misfortunate people

who had lost limbs, had lost friends,

lost, you know, legs, arms, God knows, there was terrible burns.

And he'd sat there with his arms folded,

and he never battled an eyelid. It didn't bother him.

At one point in the trial the prosecution said to Copeland,

"You've been corresponding with somebody called Patsy."

And he went, "Yeah."

And they said, "Are you aware that Patsy doesn't exist?

"It's actually a man called Bernard O'Mahoney from Basildon."

And he had his arms folded, and they said he slumped forward

and just put his head on the desk,

and it killed him, you know what I mean?

He became aware that he'd been exposed.

The jury found Copeland guilty of murder,

and he was given six life sentences.

He was sent to prison,

where he remains to this day.

PHONE RINGS

But another hated figure DID make Broadmoor his home.

In calls secretly recorded by his brother,

Peter Sutcliffe speaks from beyond the grave.

Broadmoor might look like a prison,

but it's a hospital providing treatment for men in secure wards.

All patients start on the admissions ward,

but where they go next

depends on how ill they are and how well they're behaving.

If people are acutely unwell

or a bit disturbed in their behaviour,

then obviously the wards are quite tightly controlled,

there aren't many activities you can have.

Whereas, for a more settled patient,

you want as much activity as possible,

and the atmosphere day to day is a very orderly, peaceful, calm one.

Former patient Joshua was sent to Kent House -

a relatively relaxed ward.

Whichever ward a patient ends up in,

they could be living at close quarters

with some of Britain's most hated men.

CROWD CHANT: Men off the streets! Men off the streets!

For over 30 years,

the hospital was home to serial killer Peter Sutcliffe.

He called me Bob, and I called him Peter.

That's as much as I can say, I think.

We knew what he'd done.

We've seen enough newsreels of it.

He was quite insular. He was never a mixer.

He didn't play pool or card games.

And then gradually, he became accepted

and would, like, just chat,

nothing more.

He frightened me to start with

because his eyes were like looking into a shark.

There was no life there at all.

Like all Broadmoor patients,

Sutcliffe was encouraged to maintain contact with family on the outside.

PHONE RINGS Every week, he would call

his brother Carl...

who was secretly recording their conversations.

We had supervised phone calls.

So he would say,

"Can you put my name down for a seven o'clock phone call?"

And you went into a little booth with the two glass panes

so that people could see you were OK.

And then, latterly, it was headphones,

and I'd monitor it and write down "nothing untoward".

"End your phone call, Pete, we're going."

And he was, "OK. Thank you very much."

With no release date in sight,

Sutcliffe's thoughts turned to life as a pensioner in Broadmoor.

He tried persistently to get his state pension,

telling the world or anybody who cared to listen that,

"I've worked hard all my life, and I've paid my taxes,

"so why can't I have my pension?"

CARL: Bloody hell.

When he asked to get his state pension,

he pointed out specifically,

"This is a hospital, not a prison.

"I'm therefore entitled to my pension."

There would have been the most enormous public outcry.

Because, after all, Sutcliffe was living at the taxpayers' expense.

Three square meals a day, no need to pay board or lodging.

Why on Earth should he be entitled to his state pension?

Sutcliffe didn't get his pension,

but he was trusted enough to be allowed the mundane task

of collecting fellow patients' food orders,

which would then be delivered to former head chef Neil Wheatcroft.

It's a meal order,

a meal order for all the patients on that ward,

compiled by our friendly...

The Ripper Man did that on this ward in 1990.

He would go round in the mornings and ask them what they wanted,

and they told him,

and then he gave it to the nurse to send off to us at the kitchen.

Hospital food is famously bland,

but Broadmoor's menu caters for a wide range of palates.

And with recovery taking years for many patients here,

food takes on a new meaning in their lives.

One of the greatest delights

a patient can experience is the delight of food.

You can never speak to somebody who is on the inside,

so to speak, and talk about food

and come away thinking about food the same way.

You'll appreciate it at a far greater level.

Up to eight choices per meal.

Very big portions, pretty wholesome food.

Fresh meats, fresh fish...

Cheeses, things like that. It was all pretty wholesome.

Like, a chicken in a hospital will do eight people.

This would do four.

So it's... Yeah, difference.

Infamous long-term patient Ronnie Kray

had some specific requests when it came to his diet in Broadmoor.

We asked if we could take him in sausages,

but you couldn't take in the sausages,

he had to have their sausages, which he said was not nice.

So we had a little talk, Charlie Kray, to the chef,

and I said, "He likes Cumberland sausages, good sausages."

He said, "Well, they don't supply us with them."

Charlie Kray said, "He'll pay for them."

From then on, he had Cumberland sausages...

in Broadmoor.

Whatever he wanted.

But in a high-secure environment,

even mundane activities like mealtimes come with risks.

Every single item of cutlery had to be accounted for.

When they finished their meal,

all the cutlery would be collected back up,

washed and put back into the boxes.

It may seem innocuous,

but one of the worst things to be missing was a teaspoon.

Because the handle of the teaspoons

could be made into an impromptu knife.

So it'd have a very sharp point,

but it'd have the base of the teaspoon,

which would be placed under the fingers, inside the hand,

and that could be used to stab.

So when a teaspoon was unaccounted for,

we had to search everybody.

There was a particular patient who used to swallow cutlery

as a regular feature,

more because of his mental health condition,

rather than his desire to pass out a weapon.

And we would take him sometimes to the hospital infirmary,

and they'd show us X-rays of his stomach,

with all these knives and forks and spoons in there.

But it was more the fear during that meal time

that an item would go missing.

And then you would just take as long as you had to take

to find that item of cutlery.

And if you didn't find it,

that was quite a nervous time for us on the ward,

cos you didn't know whether you were going to get,

you know, knifed in the back or whatever.

In between meals, patients attend classes and workshops,

including therapy, art, drama and music.

Everybody had a timetable.

We would aim to keep the timetable reasonably full.

I'm not saying every minute of the day was occupied,

but again, how do you guarantee security on a ward like that?

Part of it is keeping people busy.

But whatever activities patients are doing,

their behaviour is monitored for signs of progress

or anything of concern -

even if this is just watching TV.

They're obviously watching TV with staff,

so you would certainly notice any odd behaviour.

You know, that's why

some people can find the hospital environment oppressive,

because there's never any real free time.

You're watching TV with a nurse.

You'd never be watching TV in a group without a nurse present.

So any behaviour you display is sort of...

it can be put into the mix of how you're getting on.

For one Broadmoor patient,

the journey to recovery would result in a shocking confession -

one that would unmask him as a double killer.

They said, and I quote,

"It's so hard to live with in my head,

"I fear I might do it again."

Hastings, January 1998.

The bodies of two vulnerable women are found in their homes.

They've been strangled and burnt.

It's a horrifying crime.

They lived a matter of yards apart from one another.

For ten years,

the violent murders of Claire Letchford and Beryl O'Connor

went unsolved.

But in 2008, in a therapy room inside Broadmoor Hospital,

a confession would blow the case open.

For patients at Broadmoor Hospital, treatment is everything...

because no-one can leave until they've made progress.

But the therapeutic journey is no walk in the park.

Over the decades, patients have endured all sorts of treatments,

like insulin shock therapy...

..electroconvulsive therapy.

But today, for mental illness,

treatment most often begins with medication.

Medication is incredibly important.

It really is one of the heartening things to see in psychiatry,

the treatment of schizophrenia with anti-psychotics.

These are not just tranquilisers,

they're very specific anti-psychotic,

anti-schizophrenic medications.

And in 90% of cases of schizophrenia,

they're going to produce an improvement,

often a very dramatic improvement.

I mean, it would be quite unlikely that people with a psychosis,

schizophrenia, would be able to manage without any medication.

But while medication can bring relief,

it can also lead to horrific side effects.

Medication is just the starting point of treatment.

Once the symptoms of mental illness are under control,

patients must engage in talking therapies.

When you think about therapy, any therapy, really,

we're talking about the possibilities of change.

My first thought is,

"How did this person come to do this?", really.

"What's happened?"

The recovery journey that Broadmoor patients must go on

is to face up to their crimes and make sure they never happen again.

Usually, those leading the therapy

know patients' index crimes in grim detail.

One of the things that I disciplined myself to do

was to look at the entire story of the crime.

I would see all the police reports,

I would see the photographs of the scene of crime

so that I was under no illusions about what had happened.

But occasionally, a therapy session can unlock dark secrets.

When Graham Fisher arrived in Broadmoor in 2001,

his index crime was the indecent assault

of two students at knife point.

But after seven years in treatment,

he made a shocking confession to his doctor.

Graham Fisher confessed to targeting lonely and vulnerable women.

Graham Fisher had committed two murders

in Hastings in East Sussex in 1998.

Following on from committing the murders,

he set fire to their properties as well.

After ten years of silence,

Fisher revealed he'd killed these two vulnerable women

as part of a wider campaign of terror.

Not only did he kill two women who lived alone,

he then proceeded to attack a woman on a train from Hastings to London.

But his grim revelations didn't end there.

One of the things that Fisher liked to claim

during his confession to the crimes

is that the younger of his victims, a 40-year-old...

..that he'd not only killed her, but he'd eaten part of her arm,

and that the police found other parts of her

in a frying pan on the stove.

Fisher's confession may have been shocking,

but it also marked progress in his rehabilitation.

One of the things that Fisher said to the psychiatrist

during the confession was he said, and I quote,

"It's so hard to live with in my head,"

and that was at the same time he said,

"I think I'm too dangerous to be let out."

When you can start to have a conversation with somebody

where their view of their problems

is closer to the clinician's view,

then you're making progress.

Fisher remains in Broadmoor to this day.

And indeed, that is really the story of Graham Fisher -

that he settled into Broadmoor,

that this was my family, my home.

He ballooned in weight while he was there,

I think ending up at 23 stone - enormous man -

and even had a gastric band operation on the NHS,

which cost the taxpayer £15,000, so that he could lose weight.

And now, by all accounts, he's very happy.

He's become a chef, and he likes cooking all sorts of things,

including chicken curry,

and he's become assimilated into the Broadmoor community.

Some Broadmoor patients will never be well enough

to live back in the community,

but Joshua is living proof

that Broadmoor's treatment programme can work.

Next time - while some patients make progress

and prepare for release,

for Broadmoor's most acutely unwell, it's a distant dream.

They are sent to the intensive care ward.

You'd give warning you were going in,

you'd then go through like an airlock.

The fact is, they are secluded in a locked room

for their own and others' safety.

Broadmoor's most secure ward was formerly known as Norfolk House...

There was no natural light,

there would be a mattress on the floor,

no bedding, chamber pot,

and that would be it.

..and it was the most secret and feared place in Broadmoor.

He said he would never ever, ever want to go there again.

It absolutely terrified him.