How schools, parents and clinicians work together to treat pupils with an eating disorder

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How can your school help a pupil who is being treated for an eating disorder?

Your school plays an important role during treatment because it provides positives such as:

• distraction from the misery of the eating disorder and of treatment
• a social life, fun, normality
• academic interests, passions and the building of a future

For the young person to be able to attend school, you need to provide an environment that is compatible with treatment. Get the following right and you will be part of a pupil’s recovery. The converse is that if you don’t attend to these, recovery may be extra difficult or impossible:

• you make it possible for the pupil to eat as required while in school
• you attend to the stress of school work or difficulties with peers
• your school gives helpful messages and avoids harmful ones

Role of a designated staff member

I recommend that your school has one or more designated members of staff who are the go-to people for any issues around eating disorders. It makes sense that they are also in charge of disordered eating, body confidence and obesity.

These designated members of staff can learn the essentials from these web pages. They will also be building their knowledge through interaction with clinicians, parents and pupils. They should:

• shape the school’s policy (I propose a template here) and make other staff members aware of the essentials
• teach other members of staff how to spot signs of an eating disorder
• be a central point of contact for parents, clinicians and other school staff
• coordinate the care of a pupil in collaboration with the pupil, parents and clinicans (setting up meetings, keeping records)
• review what the school is doing in terms of prevention

Does this need to be a counsellor or school nurse?

There is no particular advantage in the designated staff member being a counsellor or nurse. They are unlikely to have the level of specialisation needed to deliver direct care. In fact if they try and get involved in counselling there is a risk of ‘too many cooks‘. The one advantage they have is that they may be well placed to help a pupil access services.

What really matters is that the designated staff member is efficient and that they can communicate non-judgementally with parents and the pupil.

Note that the Head or depute Head often has a useful input even when there is an efficient designated staff member.

Teamwork with parents and clinicians

Treating a young person for an eating disorder requires teamwork. Take your lead from those who have the expertise: the parents and the clinicians. One of the roles of the health service is to liaise with schools to provide general information, as well as to discuss the management of an individual’s care. You can ask them to train staff members.

“At first the primary school seemed very nervous about my daughter, as though she was contagious. After our eating disorder therapist delivered some training, the staff became my daughter’s best cheerleader in her recovery.”

It can also be especially useful for parents to have direct access to catering staff. Schools sometimes wish all communications to go through a designated teacher, but this can create delays. Most often, parents need quick access to somebody who can tell them what’s on the menu, or what their child purchased at lunchtime.

Understand the parents

It’s helpful when parents are comfortable with the main person they are to liaise with. If they are not finding it easy to connect with the usual designated teacher, I suggest you appoint someone they can better relate to. Parents appreciate someone whom they can reach easily at short notice, who is efficient and shows respect and empathy.

Your non-judgemental, supportive stance will be a breath of fresh air for parents. They are going through an intense time. They fear for their child, they may have put work, play and sleep on hold, their life is all about clinical appointments and supporting meals, and the delightful pupil you see in school may be behaving like a possessed alien at home. On top of that, parents will be surrounded by people who don’t understand them.

“The receptionist in Primary School has a special place in my heart. When I handed over my child’s lunchbox in the morning, and she’d offer me hugs, tissues and a cup of tea.”

Confidentiality: who in the school needs to know?

Until people receive up to date information about eating disorders, they can unwittingly add to a pupil’s misery and shame, or they can make unhelpful comments. This could be a reason to limit the number of people in the know.

Quite often, once a pupil is receiving treatment, the agreement is that other members will only be informed of the illness on a need-to-know basis.

The pupil and parents will let you know of their wishes around confidentiality. What is supportive for one pupil may be awful for another.

* Next: Schools, this is how you spot an eating disorder *

* Back to schools portal * : all the resources for schools

* School support: a checklist for parents* : if you’re a parent this will help you discuss with staff your child’s needs and what support is needed.