Specialised Eating Disorder Services have been rolled out by NHS Greater Glasgow and Clyde (NHSGGC) to help both men and women who have the illness.
The Adult Eating Disorder Service (AEDS) is now operating in the West Dunbartonshire and Paisley areas.
The specialist teams are made up of a multi-disciplinary team of clinical psychologists, psychiatrists, occupational therapists, nurses, and dietitians who all have an expertise of working with individuals with eating disorders.
They work in tandem with other clinicians who have not accumulated the same knowledge of this illness, and treat patients with a body mass index varying from 12 to 25.
Patients are referred to the service through their GP and then via the local Community Mental Health Team (CMHT) who will involve the service if it is believed appropriate, but it is ultimately the patient’s own decision whether to take the next step.
The roll out is an extension of the Glasgow Community Eating Disorder Service which was established in 2008.
Dr Charlotte Nevison, Head of Service/Consultant Clinical Psychologist, NHSGGC’s Adult Eating Disorder Service, explained how patients would enter the service:
“Patients will initially speak to a clinician from their CMHT to discuss the option of a referral to the service.
“This clinician then speaks informally to a member of the eating disorder service to consider the possibility of a formal referral.
“Assessments are ideally carried out jointly with the CMHT because they usually have an established relationship with the patient.
“When a patient decides to go into the service it is regarded as a sign of progress because it indicates some acceptance of an eating disorder illness.
“Gradually they will be encouraged to take more responsibility for managing their care and working towards specific goals.
“One of our main aims is keeping patients out of hospital.
“Each of the treatment programmes is tailor-made for the individual and there is a strong emphasis on family involvement too.”
A “traffic light” system is used by the service to decide the urgency of a referral and the level of intervention and guide the referrer in terms of risk and urgency of cases.
An urgent “Red” includes indicators such as a significant weight loss, a BMI of less than 14, vomiting and purging more than once a day, excessive exercise, and a judgement that the patient is psychologically or physically unsafe.
A routine “Amber” code would follow on from a BMI of under 16 and includes the same symptoms but they are less severe.
A patient with a BMI of more than 16 with milder symptoms of an eating disorder would generally be assessed as a “green”, indicating that their illness should be managed within primary care or the CMHT.
Patients new to the service are offered a month’s trial and are allocated a key worker who monitors their care on a regular basis.
This provides an opportunity to further assess the patient and draw up their treatment package which could include psychological therapies such as motivational enhancement and cognitive behavioural therapy.
These interventions can be carried out on a one-to-one basis or as part of a group.
Patients may be with the service for short-term intervention, up to six months or for a longer term of between 1-2 years.
Hospital admissions are decided by the service jointly with the CMHT. Patients may be admitted to a specialist eating disorder bed at Stobhill Hospital or their local psychiatric hospital.
Dr Nevison went on: “Our service supports the patient and maintains contact with them throughout their hospital stay via weekly appointments and through a member of the team attending ward rounds.
“Treatment can be very intensive, in addition to the individual sessions they are also offered the opportunity of group work on body image, assertiveness and anxiety management.”
Not everyone will be ready to use the service: “For example, someone in their late forties may be more resistant to change because they have been living with an eating disorder for most of their life,” added Dr Nevison.
Currently the service has a caseload of approximately 40 patients, 30 of whom are in treatment (6 inpatient and 24 outpatients) and 10 in assessment.
The service normally works with up to 50 patients and consults to cases as requested.
Notes to Editors:
The body mass index (BMI) is a statistical measure of a persons weight based on their weight and height. It is defined as the individuals body weight (kg) divided by the square of their height (m).
For more information contact either NHS Greater Glasgow and Clyde Communications on 0141 201 4429 or email [email protected]