Contributed by Hannah, Lived Experience Practitioner with the Healthy London Partnership Adult Eating Disorder Programme
Trigger warning: this post contains references to struggling with eating disorder conditions. Please ask for support if you need it from your GP or by visiting Beat’s website for information and resources.
Individuals with eating disorders commonly experience a range of transitions. Whilst it is important to note that eating disorders can affect individuals of any age, this is in part due to the average age of onset (frequently in the mid-late teens) and often lengthy illness duration of an eating disorder – it is not uncommon for eating disorders to begin in childhood and persist into adulthood or to persist for a substantial period of one’s adult life. This means that individuals with eating disorders may transition from child to adult eating disorder services, between services in different localities (e.g., due to moving to university or for work) and within services themselves, transitioning between tiers of eating disorder services (e.g., outpatient, day patient and inpatient services) and between mental and physical health care settings. These transitions occur far more frequently than is perhaps recognised.
It is vital for all those involved in providing eating disorder support to consider the impact of all of these transitions. Situations that involve change and/or uncertainty can be tough for anyone, but particularly for eating disorder sufferers. I have my own experience of these transitions. During a period of intensive treatment my move from child to adult services occurred on my 18th birthday and felt very abrupt. Later, when I moved to university, there was a four month treatment gap. I was left alone with my eating disorder, facing a life-threatening illness on top of all of the normal challenges that come with starting university. What really strikes me is that the impact of so many transitions are often not even discussed. For someone embedded in an illness that thrived on secrecy and denial, these oversights did not help and prolonged my journey to recovery. I can only begin to imagine the impact that these had on my family and others around me.
Fortunately, I am aware that much work is being done to improve transitions within this field. Growing evidence highlights the need for increased coordination, communication and collaboration between service users, carers and health care providers. It is promising to learn that some services are transitioning to models of care that support young people up to age 25, and that transient students should be able to register with two GPs, connecting some of the crucial gaps in our services.
Moreover, it is increasingly being recognised that transitions between tiers of services are a particularly difficult time and that attention must be paid to these periods. Carer support is also now acknowledged as fundamental, regardless of the sufferer’s age. Additionally, services like FREED (an evidence-based early intervention service-model for young adults aged 16-25) must be acknowledged. Their flexible approach, use of technology (even before the pandemic) and attentiveness to various transitions is noteworthy. COVID-19 has shown that remote support is possible – hopefully we can take this forward to reduce gaps in care and ensure continued, compassionate eating disorder support.
We need to ensure that all transitions are planned and phased. When considering moves between localities or services, we need to improve shared access to patient records, and where possible, ensure each service user has a dedicated professional responsible for coordinating their care. Too often, transitions result in gaps in care, feelings of isolation and confusion, and potentially, exacerbation of one’s illness and increased carer anxiety and stress.
If you are struggling with an eating disorder, speak to your GP or visit Beat’s website for further support and resources.
To mark Eating Disorders Awareness Week 2022, HLP’s Mental Health Transformation and Children and Young People’s Mental Health teams have planned a week of activities to raise awareness around the symptoms and conditions of eating disorders. Visit our ED2022 webpage to see the full schedule.