Pioneering treatment leading battle to beat eating disorders
Eating disorders are among the most common mental health problems, particularly for adolescent girls and young women.
Yet access to effective treatment is painfully slow – and the consequences of long waiting times can be devastating.
In an exclusive interview for the South London Press and London Weekly News Change Is Possible campaign marking Eating Disorders Awareness Week, reporter Jack Dixon meets the experts trying to reverse the trend.
It is estimated that one in every six or seven young women will be affected by an eating disorder while they are growing up.
Symptoms tend to kick in during the late teens and early 20s – a particularly turbulent time for adolescents as they wrestle with finishing school, leaving home, starting university and developing relationships.
It is the time more than any other in life when they need intimate care and support from those around them.
But for many young women who develop eating disorders, delays in accessing treatment can deepen their health problems.
“We know from research that the longer someone has untreated eating disorder symptoms the more likely it is that the symptoms will become really chronic and that there will be brain adaptations that make it harder to come out of it at the other end,” says Professor Ulrike Schmidt, a consultant psychiatrist at the South London and Maudsley NHS Foundation Trust and expert in eating disorders at King’s College London.
“The burden on families is very high as well. You can imagine the struggle every meal time. It’s horrendous. We all like to relax over a meal but for these poor parents, they have this battle all the time.”
Healthcare professionals are encouraged to keep waiting times for eating disorders down to 18 weeks – from referral to assessment – for those aged 18 and over. But for some it can take up to six months to see a specialist.
Professor Schmidt and her colleagues at SLaM believe this is far too long for vulnerable patients to wait – and it poses a serious risk to their long-term health.
Research suggests that people who are forced to wait are less likely to respond well to treatment. And once they start, further delays can actually lead to a deterioration in their health.
“It’s a really soul-destroying situation all round,” adds Professor Schmidt.
“If you’re 18, in the run-up to your A levels and having to make important decisions about your future, it will seem like an eternity.”
Thankfully, the team at SLaM is stepping in to change the system.
In 2014 the trust secured a one-off grant to pilot a new project focused on delivering treatment much faster.
The FREED programme – which stands for first episode and rapid early intervention for eating disorders – has already achieved stunning results in south London and is now being trialled at two other healthcare trusts in the capital, and a third in Leeds.
Aiming for a quicker response time of just four weeks – from the initial referral to assessment and treatment – the FREED team has significantly improved the take-up of young women accessing services.
Seventy per cent of those who completed the treatment no longer had a clinical eating disorder and 60 per cent of anorexia patients had made a full recovery – in terms of physical weight and psychological wellbeing.
“We decided as soon as we got a referral we would ring people up immediately – within a day or two,” explains project lead Danielle Glennon.
“We would then offer them an appointment within two weeks of that phone call, and further treatment if it was appropriate. We found that drop-out rates were greatly reduced.”
The FREED treatments are sensitively adapted to suit the individual. Certain patients may respond better to one-on-one cognitive behavioural therapy appointments, while others can take part in themed group sessions – thinking about preparations for university life or how to handle the pressures of social media.
Person-centred care, with an emphasis on debunking the myths and stigma associated with eating disorders, is central to the project.
The FREED team believe this rapid response treatment is the best way to tackle the trigger causes of eating disorders such as anorexia and bulimia, which are complex – partly genetic, partly environmental.
“We know that people who have anxious or obsessional traits may be particularly vulnerable to developing anorexia, and with that often goes perfectionism,” explains Professor Schmidt.
“If you have that sort of personality make-up, you may be more sensitive to some of the environmental pressures that are part of growing up. All those quite normal environmental hazards may then affect you more because of other vulnerabilities.”
In order to stem eating disorders before they become hard-wired into the brain, the FREED team believe early intervention is crucial.
And peers in the medical community seem to agree – not only has the project been extended to central, west and north London, it has also been nominated for a top mental health award by the British Medical Journal.
“Traditionally, we are expecting young people to fit in with cumbersome, bureaucratic services – and we thought this was completely bonkers,” Danielle adds.
“We changed our whole approach, encouraging young people into our service to get help. We want them to know this is not a scary place, this is a friendly place to help them get back on the road to their life.”
For more information about the FREED project, visit www.freedfromed.co.uk
Our Change Is Possible campaign aims to promote and protect good mental health for all Londoners, helping to shape a community that makes sure people with experience of mental health problems are treated fairly, positively and with respect.
South London Press, London Weekly News and Lambeth and Southwark Mind are committed to raising awareness about the complex mental health problems that many people in our community face, and working together to expand and improve the range of support available.
We aim to put a stop to the stigma around mental health – at home, at work and at school – and to break down the barriers that prevent people from seeking help.
Future conferences of interest:
Eating Disorders Summit: Implementing the new NICE guidelines
Monday 3 July
De Vere West One Conference Centre