Inside Rampton: The Brutal Reality Behind High-Security Hospital Walls

Rampton high-security hospital sits in Nottinghamshire, built in 1912, and Jan Neate describes it with a kind of dread that comes from repetition. She visits her son Jake there, and every time she goes, she must submit to fingerprinting and biometric scanning before being escorted inside. Jake is searched when he enters the visiting room and searched again when he leaves. When they embrace—which they are permitted to do—both usually cry. The hug reminds them both of who they were before, and that memory is its own kind of pain.

Jake is 45 now and has been held at Rampton for eight years. In 2017, after being diagnosed with paranoid schizophrenia years earlier, he killed his partner, Suzanne Brown. He was deemed mentally unfit to stand trial. England maintains three high-security hospitals—Rampton, Ashworth in Merseyside, and Broadmoor in Berkshire—designed for people with severe mental illness who pose grave or immediate danger to themselves or others. They have held some of Britain's most notorious criminals: Peter Sutcliffe, Ronnie Kray, Ian Brady, Ian Huntley, Beverley Allitt. This year, the facilities drew intense scrutiny when Axel Rudakubana, who murdered three young girls at a dance class in Southport in 2024, was transferred from Belmarsh, a category A high-security prison, to Broadmoor, which operates at category B security levels. Officials cited deteriorating mental health and the impossibility of safe prison management. Some observers, including Mark Fairhurst of the Prison Officers' Association, suggested the move represented a softer existence and potential system manipulation. But Neate wants people to understand what life inside these hospitals actually looks like.

Jake experiences seclusion—a form of segregation—and Neate knows of at least two periods so far this year, each lasting several days. She receives almost no information about what happens during these times. When she calls Rampton to ask how he is, staff confirm only that he is eating, drinking, and sleeping. Nothing more. If Jake refuses medication, doctors have permission to inject it against his will. He has been having seizures and injuring himself. Once he fell and hurt his shoulder during a seizure; another time he fell and injured his head. He was taken to an ordinary hospital for these injuries, but Neate was not told where. The uncertainty is its own form of torment. She dreads the day the phone rings with news that something terrible has happened to him.

Care Quality Commission inspections between July 2019 and June 2023 documented serious failings at Rampton: staff shortages so acute that therapy staff were pulled from their roles to cover nursing gaps, which meant patients lost access to therapeutic programs. Overnight lock-ups in rooms were extended due to understaffing. Patients experienced periods of confinement during the day. Medicine management was poor, and safeguarding concerns were repeated. A focused review in March 2024 found that staffing had improved and confinement had decreased, but the hospital still relied on therapy and education staff to cover nursing shortages. Staff did not always follow correct procedures when administering medication, which the report noted could constitute assault and trespass. The review stated plainly: people in long-term segregation were not always treated with dignity, compassion, and respect. By May 2025, Rampton's rating improved from inadequate to requires improvement, though staffing gaps and staff support remained concerns.

Jake's trajectory before Rampton tells a different story. As a boy, he was happy and playful. He and his mother went swimming, to football matches, to museums. At 17, he became paranoid and was admitted to hospital voluntarily for two weeks. Doctors said if he stopped smoking skunk, he would recover. He studied geography at the University of Birmingham, then was headhunted by a bank in Canary Wharf. At 20, he was diagnosed with schizophrenia. He left his job but built a window-cleaning round in Essex where he was popular with customers. Clozapine stabilized him. He gave up recreational drugs and lived successfully in the community. He had an illness, but he also had a life.

In 2007, Jake met Suzanne Brown at a disco in Harlow. She was 23, a nursery nurse with a sweet, kind nature. Whenever she visited Neate's house, she brought a homemade cake. She looked after Jake, ensured he took his medication, attended all his appointments. They bought a flat together in Braintree, had a new kitchen fitted, made plans. Jake's schizophrenia at that time was nothing like it would become. He was never violent. They did not even argue. For ten years, clozapine kept him stable. Then, in 2017, Jake began experiencing severe physical side-effects: constipation, urine retention, inability to eat or sleep. The drug was stopped suddenly. Withdrawal from clozapine is supposed to be closely monitored, but Jake, Sue, and Neate were unaware of this. None of them understood what could happen. Jake began to experience psychosis and repeatedly tried to seek help. He wrote to his doctors listing his symptoms. He did not receive a response. Neate made dozens of phone calls and sent numerous emails. Nothing resulted. Jake texted his mother that he had been researching private hospitals. He wrote: I feel angry that no one told me the implications of this drug. I would like to be an inpatient to deal with all the issues.

On December 15, 2017, a mental health worker visited the couple's flat and said telephone support would be arranged and a home visit scheduled for the following week. That evening, Neate received a call from Sue, screaming and hysterical. Jake was hurting her. Neate told her to leave and called the police. Three hours later, police arrived. By then, Jake had stabbed Suzanne 173 times. Neate learned what had happened when police called and said they had taken the dead woman from the flat. She has spent years asking herself if she could have prevented it had she been closer by. A report on mental health services after Sue's death identified eight failings: no up-to-date risk assessment was carried out after clozapine was stopped; there was no appropriate professional monitoring or guidance for Jake and his family; clinical information was not communicated consistently within and between teams. An investigation by the Independent Office for Police Conduct found the police response was delayed because the call was initially miscategorised. No misconduct was identified, but two control room staff had not met expected standards.

Jake was sent to Rampton on what is called a section 37 order—an indefinite hospital order requiring Home Office permission for release. He was told it would be temporary, that when more stable he could move to a medium-security unit. In a letter dated July 28, 2026, his doctor wrote that in recent years there had been several episodes of decline, but overall he was making progress. The doctor described Jake as having a serious mental health disorder that is very resistant to treatment. Neate believes Jake is deteriorating. He says he is fighting a battle between good and evil and that he has to rescue Sue. He is not the same person he was. She does not think he is always treated as a human being, as a person. Everything is clinical. They talk about his presentation, as if he is a thing rather than a human with a heart. She feels like she is banging her head against a wall. All she wants for Jake is a life that is reasonable, with some hope in it. People who are mentally ill are entitled to care. She does not believe Jake is getting it. It is not cushy or luxurious at Rampton. Very far from it.