Eating disorders in Scotland

Comments

1. PJ

   Hi
   Our GP was very good and got us referred to the paediatrician quickly. As we suspected our 11 year old daughter has an eating disorder. The paediatrician talked to our daughter and to us and explained why she needs to eat and that she will get better but it will take time. She also said that we would be referred to CAHMS (we are in Fife) and a dieticcian (but she did not mention FBT fimilar one), but said currently there is at least a twelve week wait. We know having read everything on this site that early intervention is the key and recovery is much quicker with this. We just want to help our daughter get better and we know its due to staffing and demand, but surely they should be given the resources to help.

   Reply
   1. T

      Hi PJ,
      We were in the same situation as you and were frustrated with all the waiting. We saw a dietician and psychiatrist almost straight away as our son ended up at A& E with a low heart rate. We were initially knocked back from FBT as NHS Lanarkshire is over stretched and only seeing the kids who have lost more weight than my son. Very annoying as I was not going to let him get worse!

      We went to our MSP and I kept on at our Psychiatrist about FBT. Our Psychiatrist was very helpful and fought to get us FBT. It started last week.

      Please do not wait for help from NHS. I followed all the amazing advice from Eva's book and watched the videos. I started implementing the FBT approach to re feeding and we have seen some progress. The compassion and separating our son from the eating disorder helped me to understand what he is going through.

      I hope you get the treatment that your daughter deserves soon.
   2. Eva Musby

      T, thank you for sharing with PJ how it's working out for you. I totally agree.
      PJ, you are right, you should get the resources to help your daughter right away.
      In England the standard they're working to is she'd have access to eating disorder treatment (FBT or similar) within one week. You'd also have a direct referral line to the eating disorder service, rather than going through GP-Paediatrician-CAMHS, which may add delays (and a lack of information for you) at every step (it's possible that it's not really "at-least-12-week" wait for eating disorders, 'just' for CAMHS in general). I have written to ministers Maureen Watt and Shona Robison to keep asking for standards for Scotland, and let's hope that the BEAT campaign is taking off well.
   3. Eva Musby

      For those following PJ's distress when told the waiting time for treatment was at least 12 weeks, and anyone wondering about the treatment of eating disorders in Fife:
      CAMHS have informed me that any family referred to the Fife CAMHS with a clear indication of an eating disorder is seen as a priority.
      They confirm that Fife families get FBT as the first line intervention and have multiple staff trained (and certified) in FBT. There is also an "Intensive Home Treatment Team" (ITS) whose remit includes eating disorders.
      So PJ and his family can breathe a sigh of relief that the professional support is there and indeed, a CAMHS appointment is coming up.
      I hope this helps any of you in Fife.

      For the longer term, I would love to see self-referral for eating disorders in Scotland (for young people in England, it's a requirement of the Access and Waiting Time standard). With self-referral, you wouldn't be dependent on every single GP or paediatrician having the most up to date information about referrals to the eating disorder service. And you wouldn't be adding delays with various appointments before you get to the eating disorder service. I have read eating-disorder clinicians in England saying that self-referral works fine, so how about having it in Scotland?

      And in Scotland in general, we just don't know how quickly young people are being seen – we have anecdotes where urgent cases really are seen within 1 week, and others where it's much, much longer. At present our government is only monitoring whether patients are being seen within 18 weeks.
2. T

   Hi Eva,
   I am looking for advice please regarding lack of availability of FBT services for my child due to limitations of the Health Board we come under in Scotland. We come under Lanarkshire. We are attending CAMHs with my 8 year old son who has been diagnosed with a restrictive eating disorder. He has a lot of the behavioural and emotional characteristics of anorexia. He has been referred for FBT but it was refused as the Lanarkshire service is over stretched and only seeing the sickest kids who have lost more weight than my son.
   I am even more frustrated as I live just outside the boundary for Glasgow and I have spoken with their service and they inform me all patients are eligible for FBT.
   I have read a lot in FBT and I have read your book. I am very keen on this approach. I am implementing this myself and I have seen a steady improvement but would really value the support from a trained FBT therapist.

   Any advice appreciated.

   Thanks

   Reply
   1. Eva Musby

      Dear T, this is indeed frustrating and absolutely not right.

      If Lanarkshire is overstretched to the extent they cannot provide FBT then I think that this is a wake-up call for those who think Scotland's adolescent eating disorder services are doing fine.
      Yes, from what I know of Glasgow, your son would indeed be given FBT by now.
      Your priority right now will be to care for your son, day by day, and I know how demanding that is. I am glad my book and all your other reading on FBT is producing improvements.

      If at any stage you find the time and energy in between all your cooking, shopping, calming, and supporting, you would be very justified in complaining to Lanarkshire health board, to your councillor, your MSP and asking for a solution quick.
      If one health board is so overstretched, I wonder if they have any mechanisms for paying Glasgow to pick up the slack? No idea.
      They do have mechanisms for paying for private inpatient units, but that doesn't sound at all appropriate, and it's not FBT either.

      If/when you complain you could refer to the NICE guideline for eating disorders (which I summarise on anorexiafamily.com/nice-guidelines-adolescent-eating-disorder-ng69) and also the fact that in England there are now standards that would make what's happening with your son absolutely not acceptable ( anorexiafamily.com/nhs-england-commissioning-guide-eating-disorders-access-waiting/ ).

      But be aware of the risk that with a few of our Scottish politicians, mentioning England seems to bring a red haze and reduce the chance of rational discussion, so proceed with care. Still, on the whole Scotland wants to comply with NICE.

      May I write on your behalf to the minister for mental health Maureen Watt? She said she wanted to know about what's not working in Scotland. I believe her email is mh@gov.scot
      May I also highlight this to BEAT as they are getting geared up to campaign for prompter treatment in Scotland?

      I understand that you value support from a trained FBT therapist. So one more suggestion I have for you, if you can afford it, is to use one from another part of the world, who is happy to Skype. I list them here: https://anorexiafamily.com/certified-fbt-therapists-family-based-treatment-who-skype/

      Keep in touch! Email me any time.