APPENDIX 11
Letter from the Chief Executive, Eating
Disorders Association, to the Clerk of the Committee (MH 33)
I am writing on behalf of Eating Disorders Association
(EDA) to provide evidence and put forward recommendations for
the inquiry into the provision of NHS Mental Heath Services.
ORGANISATION OVERVIEW
EDA is the leading national charity providing
information, help and support for people affected by eating disorders
and in particular, anorexia and bulimia nervosa.
We offer a range of services including:
— Youth helpline and support service
for young people aged 18 years and under.
— Information about eating disorders
and of specialist treatment in the local area.
— Support for research into the causes
and treatment of eating disorders.
— Training for professionals in health,
education and social care.
EDA has an established reputation in the field
of eating disorders and gave evidence to the House of Commons
Select Committee on Health Inquiry into Child and Adolescent Mental
Health Services in October 1996. The recommendations we made were
included in the final report published in March 1997.
EATING DISORDERS
Eating disorders are mental illnesses which
are characterised by control of food and eating. Starvation or
binge eating and purging are symptoms of underlying emotional
or psychological distress. For some people, eating disorders are
a way of coping with life and seemingly, insurmountable problems.
Anorexia and bulimia nervosa are more prevalent
in females than males with the age of peak incidence during the
adolescent years.
We wish to address the following points:
— The ability of care in the community
to cater for people with acute mental illness.
— The transition between adolescent
and adult mental health services.
RECOMMENDATIONS
1. Training on Eating Disorders
There is an urgent need for trained and experienced
health care staff to work with people of all ages, with eating
disorders. A continuing investment in training local mental health
and other professionals about eating disorders is needed.
Evidence
People with eating disorders find that treatment
from staff who do not have knowledge and understanding of the
condition is not only ineffective but can make their problems
worse. We also hear time and time again from people who have visited
their GP, who has not recognised their eating disorder early on
or has not referred a patient for specialist treatment. Early
recognition followed by treatment from trained and experienced
staff offers a much better prognosis for recovery.
2. Continuity of Care
People with eating disorders require a continuity
of treatment and care when moving from one service to another.
Clear and effective communication and sharing of relevant information
between health care professionals and where relevant, social services
staff is vital. Patients need to feel and know that their specific
treatment and care needs will continue to be addressed as part
of a seamless process towards recovery.
Evidence
We have been contacted by many people with eating
disorders and their parents, desperately unhappy and distressed
by the lack of communication between health and social care workers
about their individual case and by the sudden transition from
one service to another. Young people on reaching 17 or 18 years
are being told that they must now be treated in an adult service
and given little, if any help or support with that transition.
People are being cared for in the community, where there has been
little or no communication of their specific health care needs
between health care professionals. We know of more than one case
where after a period of specialist in patient and day patient
treatment, the patient received community care. In one case the
lack of understanding of eating disorders and an inappropriate
care package lead to the death of one sufferer and multiple suicide
attempts by another.
3. Increased and Flexible Funding for the
Treatment of Eating Disorders
Eating disorders often require long periods
of treatment where the quantity and intensity will reduce over
time. Consistent and low levels of treatment are often more effective
than short, inpatient stays with minimal or short term ongoing
support. Funding is needed to provide multifaceted and multidisciplinary
treatment from trained and experienced staff. Funding also needs
to be flexible to allow transition between services, for example,
from child and adolescent services to adult services, at an appropriate
time in the patients treatment and not necessarily at the date
specified by birthday or resource limitations.
Evidence
Members have recounted harrowing stories of
being transferred to other services with no warning, little explanation
and minimal if any, support. Reasons given included lack of funding
for prolonged in, day or out patient care, pressure on resources
available or reaching the designated age to move to adult services.
Being treated in this way only enhances and exacerbates the feelings
of low self esteem and lack of self worth felt by people with
eating disorders. They are left feeling guilty, rejected and hopeless
and often reject any further treatment or help.
We would be happy to provide more in depth information
and more detailed case studies about eating disorders, should
this be required. We look forward to receiving further information
about the findings and recommendations of this inquiry.
28 February 2000
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