A public inquiry has uncovered "systematic abuse" and a "profound catalogue of failures" that left some of Northern Ireland's most vulnerable adults exposed to harm.
A report examining failings at Muckamore Abbey Hospital found that safeguards had effectively collapsed within the Belfast Health and Social Care Trust, while warning signs were repeatedly missed or ignored for years.
It also revealed patients were effectively "zombified" through the overuse of medication as a restraint, while seclusion was misused as a punishment for so-called bad behaviour.
The Muckamore Abbey Hospital Inquiry (MAHI) said some staff inflicted "systematic bullying" on patients.
Delivering the findings in Belfast, inquiry chair Tom Kark KC told relatives that the mistreatment of their loved ones became "normalised".
The hospital has been at the centre of the UK's largest-ever police investigation into the alleged abuse of vulnerable adults, and a number of prosecutions are continuing.
Ultimately, it was CCTV footage, and not oversight, that proved essential to exposing the scale of harm in 2017, and the report found there was a closed staff culture that discouraged whistleblowing.
The inquiry also exposed other failures, including a long-term policy shift to community care that was never properly funded, leaving patients stranded in unsuitable hospitals or readmitted after failed transfers.
The panel issued 106 recommendations, including: ending the misuse of medication to subdue patients; ensuring restraint and seclusion are an exception; improving legal protections and record-keeping; potentially expanding CCTV use; and overhauling inspections and systems for raising concerns.
Inquiry chair Tom Kark KC said the findings must mark a turning point, insisting there should be "no delay, no dilution, and no side-stepping" in implementing reforms.
The Police Service of Northern Ireland (PSNI) told Sky News that of the 124 people reported for potential prosecution, 58 are currently going through the court process, and there have been three convictions and two cautions.
Meanwhile, the Belfast Health and Social Care Trust said 148 people have been under disciplinary processes, and so far 20 people have been dismissed, and 23 have received various warnings.
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