“A BUSY AND clinically demanding year” was reported by the adult eating disorder services of the HSE in 2021.
Figures released from the adult eating disorder team in St Vincent’s University Hospital (SVUH) in Dublin – the location of the only three dedicated inpatient beds for adults in the country – “saw referral numbers to the service surge by over 120% on the previous year”.
A HSE statement said that this was “precipitated by the impact of Covid-19, and reflecting the general increase internationally”.
The total number of referrals received by the SVUH team rose from 65 in 2020 to 144 in 2021, with the number of referrals accepted rising from 39 in 2020 to 105 last year.
“The figures are stark and they show that the pandemic really did have an adverse impact on those with eating disorders,” Fiona Coyle, chief executive of Mental Health Reform told Noteworthy.
In addition to showing the need to invest in promised eating disorder services, Coyle said these new figures alongside other increases reported last year, raise the question whether “we need to set ambitions beyond” those promised in 2018 as part of the national clinical programme for eating disorders.
The implementation of this programme is “not where it should be”, added Coyle. “That needs to be addressed and prioritised.”
A 66% increase in eating disorder hospital admissions was already reported reported last year. Children who required hospitalisation were also reported as being more unwell.
Increase ‘across the board’
“There’s been – across the board – an increase in presentations in primary and secondary care with eating disorders,” according to Dr Aoife O’Sullivan, GP at UCC Student Health and GP clinical lead for the National Clinical Programme on Eating Disorders.
This “makes sense with everything that’s happened with the pandemic, with a loss of structure and increased anxiety”.
Daniella Russell’s eating disorder relapsed during Covid and she told Noteworthy that “not having the distraction” of going to college or seeing friends was very hard. She said the social media trend of “becoming the better you during Covid” also did not help.
With the eating disorder, you have such strong and challenging thoughts. Being in isolation when Covid hit, that was all that was left to focus on. We were isolated with the eating disorder.
Her declining health led to her being hospitalised for a number of months in a general hospital. Russell said she is now “doing well in recovery” and rebuilding her life back in college where she is training to be a nurse.
The services are “trying to catch up”, O’Sullivan added, but they haven’t “caught up quickly enough”. Though more specialist teams and funding was promised, she said that there hasn’t been an improvement on the ground.
“It’s very difficult still to get a good referral pathway. If you feel someone is sick enough to need secondary care, it’s just their local mental health service, depending on where they’re living. And some provide a [eating disorder] service; some don’t.”
Long waiting lists for scarce services means “more and more are relying on private services”, according to O’Sullivan.
Waiting for a bed
Sinéad O’Loughlin is one such young adult who depends on the private services of a therapist “who understands eating disorders” and a specialist dietician, thanks to the financial support of her mother. She is currently waiting for a private inpatient bed in a treatment centre in Dublin.
If she was to rely on the public system, O’Loughlin feels she would end up in the emergency department before having the opportunity to be admitted to a specialist inpatient bed in SVUH due to lack of availability.
Eating disorders don’t just stop and pause and wait until there’s a bed available.
A spokesperson for the HSE told Noteworthy that “most people can and do get better from eating disorders. While a small number of people benefit from more intensive treatment through day programmes or inpatient care, the most effective treatment setting is in the community.”
They added that “adults who have an eating disorder diagnosis and require inpatient care can be referred to any of the HSE’s acute inpatient mental health-approved centres around the country”.
They can “also be treated in an acute hospital if their physical health needs require this”, with three dedicated beds in SVUH “ring-fenced for adults with eating disorders”.
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Daniella Russell and Sinéad O’Loughlin are two of the people that will feature in an upcoming in-depth project by Noteworthy on eating disorder services in Ireland - to be published later this month.
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