Nurses have been assaulted and “punched in the face” amid violent behavioural problems at a hospital’s children’s unit, staff have told the BBC.

Since April, nurses at the Great Western Hospital (GWH) in Swindon say a series of troubled teenagers have assaulted nurses, hit another child and verbally abused very young patients and their families.

Other incidents have included a patient who “ripped a TV” from a wall and broke a sink. Numerous staff are now taking sick leave.

A spokesperson for the GWH said: “Our children’s ward is often the only place available locally for vulnerable children and young people up to the age of 18 with complex medical and mental health needs.”

Avon and Wiltshire Mental Health Partnership closed the Riverside adolescent mental health unit as a “temporary measure” in February 2024.

But its continued closure means GWH has to do its best to cope with teenagers suffering form psychiatric conditions.

The unit provides care to children up to the age of 18 and the hospitals does not have an adolescent mental health ward as an alternative.

Statistics obtained by the BBC show that in May there were 13 incidents relating to the behaviour of inpatients that involved harming themselves or others. There were another seven in June.

Five staff or other patients and family members were assaulted in May, and another four in June.

The BBC has spoken to several nurses from the unit who say up to 15 members of staff have been off work because of violence.

They said one nurse who remains off work was left seriously injured after being assaulted two years ago and has suffered ever since with hearing loss and PTSD.

The nurses all want to remain anonymous.

One said: “We kept saying what is it going to take? Still nothing has changed.

“Is it going to take for a child to get hurt. We then had a child hurt on the ward.”

The nurse added that the stats were likely lower than the real number because staff find it difficult to find time to report them.

The nurse described how she felt some incidents were not being dealt with seriously enough.

“It is often put to us these children are unwell so in terms of reporting to the police we are made to feel we are doing wrong against the child.

“We are a secure ward and have to buzz people in and out.

“It’s restrictions like that and some of the mental health patients we have to remove ligatures such as a hoody they then don’t like because we are stopping them from hurting themselves.

“The biggest trouble is we do go up to 18. Most children’s wards go to 16. it almost feels like people run scared because it is children.”

Another nurse said: “A lot of children are medically fit to go home. No one wants to take them because of their escalating behaviour.

“It has caused a lot of holes in walls, damaged pipes and lots of staff being hit with people being punched in face.”

The nurse went on to describe how four registered mental health nurses were unable to restrain one teenage girl who was also verbally abusing staff.

“It is having a massive impact on patients and parents.”

She added: “One of my colleagues went off sick as this girl was smacking her head against the wall. The registered mental health nurses were just watching.

The nurse said they have an “assessment unit for children to be assessed” which was then closed. This has left the hospital unit dealing with these cases.

“One teenager was ripping TVs off the wall, she broke a sink. The whole wall has had to be replaced it has … led to probably at least 15 staff being off sick,” the nurse added.

The nurse said that managers had done very little to address the situation apart from introducing a ‘safe room’ which has not been opened yet.

Another nurse said: “We had a young person who was with us because she had taken an overdose and her behaviour escalated to the point that she was being looked after by three registered mental health agency nurses .

“Her behaviour escalated and she assaulted nurses and security staff. She punched quite a few people.”

An NHS report in 2024 highlighted the difficulties of nursing teenagers on hospital wards alongside younger children.

The South West director of the Royal College of Nursing, Susan Masters, said it is a national problem, adding: “This trust (GWH) is the local provision. There isn’t another provision anywhere else for these young people to go which is why its very difficult here.

“Children with physical health difficulties, young people with illnesses and procedures need a bright, distracting fun environment.

“Children and young people with mental health distress need the opposite-very calming very sombre. The other issue of course is specialist nursing staff.

“So currently these children are being cared for in an acute unit with children’s’ nurses that are not necessarily trained in specialist mental health services.”

A statement from GWH trust said: “We have individual rooms providing privacy and division between age groups, alongside two dedicated rooms for patients experiencing a mental health crisis.

“Many of the children and young people we care for need specialised care and we are planning to recruit specialist mental health nurses so that we have the expertise to better support children and young people with severe mental health needs.

“It’s unacceptable that NHS staff face violence and abuse and we do all we can to keep our staff, patients and visitors safe.

“This is a national issue, however these incidents can be extremely distressing, and we offer a package of mental health support to our staff, which includes de-briefing sessions and counselling services.

“Our Never OK campaign, in partnership with Wiltshire Police, encourages staff to report all incidents and the police regularly visit the hospital and support our own security team.”

A new mother who was detained in a psychiatric hospital for five weeks says she “felt like a prisoner” because she was separated from her baby.

Shelley Browne, who had postpartum psychosis, was admitted under a mental health order after giving birth three years ago.

In Great Britain mothers are cared for in specialist mother and baby units, but women in Northern Ireland are admitted to general psychiatric wards, separated from their babies.

The business case for a mother and baby unit is months overdue, but the Department of Health (DoH) said it was well developed.

However, it has also warned any future unit is dependent on funding being identified.

Shelley told BBC Spotlight she felt “lonely” and “pathetic” after being dropped off at the door of the Ulster Hospital psychiatric ward without her daughter, but said staff tried their best.

“I went in voluntarily and it was just the loneliest feeling in the world getting dropped off at a mental health ward with a bag and no baby,” the 35-year-old said.

Each year, about 100 women in Northern Ireland are admitted to adult psychiatric wards for similar care, without their babies.

• A rare but serious mental health illness that can affect any mother

• Symptoms can include hallucinations, delusions, manic and low moods, loss of inhibitions, restlessness, out-of-character behaviour and confusion

• If left untreated the condition can get rapidly worse and lead to mothers harming the baby, themselves or others

• The most severe symptoms usually last between two and 12 weeks but recovery can take several months

SOURCE: NHS

“I was a mother without her child and I felt like a prisoner,” said Shelley.

“She wasn’t with me, and I was in a mental facility. And it just broke me every morning.”

Seven health ministers have supported the idea of a mother and baby unit in Northern Ireland, but funding has never been found.

Danielle Sands refused hospital treatment to stay with her first son, Joe, in 2022.

Instead she relied on specialist community teams.

“They had made it very clear that when I would go in there, I wouldn’t have my Joe with me.”

“There was voices in my head 24/7, and they were negative,” she said.

“Telling me everything I couldn’t do, I wasn’t good enough.”

Danielle and her partner, Nial, were supported by a community specialist perinatal mental health nurse.

The term perinatal covers the period of time from when a woman becomes pregnant, and up to a year after giving birth.

Each of Northern Ireland’s five health trusts receive more than 250 referrals for the community services each year, but because of staffing pressures they can only accept about 70 patients at a time.

Dr Julie Anderson, chair of the Royal College of Psychiatrists in Northern Ireland, estimates the number of women admitted to hospital could double or triple if a mother and baby unit was established.

“It’s really, really frustrating knowing that there’s much better care that our mums should be getting here in Northern Ireland,” she said.

“And frankly, to be honest, somewhat embarrassing that we’ve been talking about this for almost 20 years and we’re still not there yet.”

In 2018, Orlaith Quinn died at the Royal Jubilee Maternity Hospital in Belfast.

The 33-year-old had given birth to her third child, a daughter, less than 48 hours earlier.

Siobhan Graham said her daughter began showing signs of postpartum psychosis shortly after giving birth.

“To go in and have a baby and come back out in a coffin, and you’ve three children left without their mother, it’s just not a position you think you’ll ever find yourself in a million years,” she said.

Orlaith’s body was found in a part of the hospital that is unused at night. She had taken her own life.

A 2022 inquest concluded Orlaith’s death had been “foreseeable and preventable” and that there were a number of missed opportunities in her care and treatment.

In a statement, the Belfast Health Trust said it would like to extend a sincere and unreserved apology to Orlaith’s family.

It added its maternity team would like the opportunity to meet Orlaith’s family to offer an apology in person.

The trust said it was committed to learning from Orlaith’s death and had put in place a training programme to help staff recognise the wider spectrum of perinatal mental health disorders, and the risk of maternal suicide.

Coroner Maria Dougan tied the death to the absence of a mother and baby unit, finding that one should be established in Northern Ireland.

Consultant perinatal psychiatrist, Dr Jo Black, who is originally from Cookstown, was instrumental in setting up a mother and baby unit in Devon.

An eight-bed unit, the layout and decor of Jasmine Lodge means it does not feel clinical.

It has areas for families to visit, and a team of specialists.

She said it was “extraordinary” there is not a similar unit on the island of Ireland.

“All of our evidence shows us that maternal suicide remains a major killer in the maternity period,” she said.

“We can’t shy away from that, and so these units save lives.”

Between 2021 and 2023, 34% of late maternal deaths have been linked to mental health, according to a report by MBRRACE-UK, which includes Northern Ireland.

A late maternal death is when a woman died between six weeks and one year after pregnancy.

It is currently thought more than 3,500 women develop perinatal mental illness in Northern Ireland each year.

However, poor data collection could mean the need for perinatal mental health services is being underestimated, according to Dr Julie Anderson.

Spotlight has confirmed the Department of Health has yet to implement a 2017 recommendation from the health regulator to improve data collection.

At the time, the Regulation and Quality Improvement Authority (RQIA) said patient coding should be improved.

The Department of Health said a review of coding practices for perinatal mental health conditions, and related hospital admissions, was planned.

If you have been affected by any of the issues in this story you can find information and support on the BBC Actionline website.