The BMJ Awards 2017: Mental HealthBMJ 2017; 357 doi: https://doi.org/10.1136/bmj.j1917 (Published 20 April 2017) Cite this as: BMJ 2017;357:j1917
- Nigel Hawkes, freelance journalist
- London, UK
FREED from eating disorders
The longer it takes a young adult with an eating disorder to get treatment, the harder it is to achieve a full recovery. “The greater the delay, the more entrenched the disorder,” says Ulrike Schmidt, professor of eating disorders at the institute of psychiatry at King’s College, London. The disorder gets worse, patients drop out, and when treatment does begin the outcomes are worse. So in 2014 the institute launched FREED (First episode and Rapid Early intervention for Eating Disorders).
The service is for young adults aged between 18 and 25, the great majority of whom are female. Typically they would have had to wait an average of 19 months between the onset of symptoms and beginning treatment. FREED has reduced that to 13 months while uptake has risen to 100% compared with 73% before. After a year of treatment, 70% of patients are free of symptoms. Importantly, few need admission at a time when hospital beds for patients with eating disorders are in short supply.
Schmidt puts the improvements down to increased staffing and better organisation, in particular by creating a service that is user friendly. “Patients who come to us may be ambivalent. They have at least partially recognised that they are ill, but you still have to find a way of engaging them. Usually if you can bring them onside, they recognise that not all is well and want to get better.”
A pilot was funded by the Health Foundation, which then gave a further grant to scale up. The same model has been taken up in other parts of London and in Yorkshire, where it is going well. “Our ultimate aim …