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In Limbo: The Dilemma Affecting People with Eating Disorder

Sam Gordon Webb

Naked Politics Blogger

There is a mental health crisis in the UK. Only a fool would dare deny it. A recent study found that a failure of care by the NHS has lead to lives being destroyed and futures put in jeopardy. Worst of all, nothing is being done about it.

Sir Bernard Jenkin, chairman of the Public Administration and Constitutional Affairs Committee, recently observed that the NHS has “no reliable data” on the number of people suffering from eating disorders and that this ought to be “a bare minimum” requirement.

“How can our health service expect to marshal its care for eating disorder sufferers if it doesn’t even know the scale of the challenge it faces?” he asks.

His point is a valid one. Eating disorders have the highest mortality rate of any mental illness. Sufferers are left “in limbo”; not “thin enough” to be admitted to general hospital but too thin to for the help of a General Practitioner to be sufficient.

This  “limbo” scenario also applies to those young adults who find themselves stuck between child and adult care. Patients are subsequently forced to wait for months before finally receiving adequate treatment. For some, the wait is just too long and the consequences prove to be tragic. Averil Hart, a 19 year old university student who suffered from Anorexia Nervosa died in 2012 having received inadequate treatment by the NHS.

Her death was later described as  “preventable” in the ombudsman’s report.

Patients determined to be in need of care are subject to a “postcode lottery”. A skills gap in the NHS has led to many younger sufferers unable to receive the specialist attention that they require whilst the attention that is provided tends to be marred by a lack of education. This was the case for 21 year old Talia Sinnot, who’s mother was asked by a doctor “why can’t she just eat?”.

Julie Quiery, 54, said that her daughter Naeema, 18 almost died as a result of the lack of specialist support offered by her local eating disorders services. “Nothing is tailored to the needs of the individual,” her mother told the Times recently.

“They used to talk to her about painting her nails, doing her make-up. Anyone who knew her realised that this level of self-care was too much. The team neither knew her nor understood her.”

Sir Bernard Jenkin believes that the answer involves allowing “junior doctors to undertake a four-month psychiatric placement to equip them with the experience they need to identify and treat eating disorders.”

This lack of understanding is far from unusual and coincides with a dramatic surge in hospital admissions for people with eating disorders in the past year. The number of people suffering also seems to be increasing , though the data is patchy; no-one really knows if this is a genuine increase or just the result of greater awareness of the problem.

Whilst there is doubt over the plausibility of the data, there is little doubt over what’s causing it. Sensitive content circulating online promoting anorexia and weight loss has given many social media platforms pause for thought. The director of external affairs for Beat has said that being exposed to content that promotes eating disorders has the effect of allowing it to “perpetuate the illness for people already suffering”.

Instagram has already increased its security measures in an attempt to clamp down on pro-ana content on its platform. Others such as Facebook and Twitter are also beginning to follow suit. But prevention isn’t easy. While Instagram banned high-risk search terms in 2012, users are still able to access images without adequate support or being asked whether or not they want to continue to the content. Research carried out by the Guardian found 3.4 million posts under terms “anorexia” or “thinspiration” over the past year.

Eating disorders are complex and there’s no easy fix. However, there is sufficient evidence to suggest that early intervention gives sufferers the best chance of making a full recovery. As the Royal College of Psychiatrists recently observed, there is greater “recognition”  that “there are different illness stages”  with “brain responses being most malleable in the early stages of illness. As illness duration increases, response to treatment becomes poorer and full recovery becomes rarer.”

If early intervention is linked to greater recovery chances, than surely more ought to be done to give young people the care they need when they need it most.

It’s fair to say that there is reason to feel hopeful. After all, there is a greater level of mental health provisions at schools with more emphasis being given on SRE (Sex and Relationships Education) and PSHE (Personal, Social, Health and Economic Education). There is also less of a stigma surrounding men with eating disorders which often prevent men from ever admitting to having the problem. This can only be a good thing, and ought to be encouraging.  Everyone – male and female –  deserves the same level of support and no one ought to feel left out.

The idea of being stuck between two polar opposites is an uncomfortable proposition. Yet too many young  people  with eating disorders find themselves in exactly this position. They deserve better. They need help. And they need it before it’s too late.

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