11/02/2025
Last night’s BBC Disclosure: Kids on the Psychiatric Ward revealed deeply concerning practices at Skye House, one of Scotland’s few in-patient child and adolescent mental health units. The idea that a place designed to provide care and safety could instead inflict further harm is both distressing and unacceptable. When services fail the very people they exist to support, it represents a profound breach of trust.
But if we want real change, we need to move beyond outrage and ask why these cultures emerge. There is a significant body of research that helps us understand how environments meant to nurture can become places of harm. Staff working in these settings face relentless pressure—managing risk, absorbing distress, and often feeling powerless in the face of suffering. Without proper support, these emotions don’t disappear; they surface in ways that can shape attitudes, interactions, and ultimately, the culture of a service. If staff are unable to process their own frustration, fear, or exhaustion safely, the risk of dehumanisation increases—not because they are inherently uncaring, but because they are struggling in systems that don’t support them.
We have evidence, insights, and approaches that can help prevent these failures, but they need to be applied consistently and shared widely. Exposing poor practice is necessary, but without examining its deeper causes, we risk simplifying a complex issue and missing the opportunity to create lasting change. Holding services accountable must go hand in hand with understanding how to build cultures that truly care—not just in principle, but in practice.
Young women tell their stories from years spent on an adolescent psychiatric ward.
