A 13-year-old girl with severe anorexia, who has been refusing to eat for days at a time since last year, has been in a general hospital for more than nine weeks as there is no specialised eating disorder bed available on the island of Ireland.
Her mother, Elizabeth McCrave who lives in Dundalk, Co Louth, is pleading with the Health Service Executive to fund a bed in a specialised unit in England if necessary. She fears if her daughter Dearbhla returns home she will die: "I am trying my best to save the life of my child . . . do I have to lose her for them to realise?"
The case was raised in the Dáil last week by local Ruairí Ó Murchú (Sinn Féin) with Minister of State for Mental Health Mary Butler. Advocacy groups say it is a "harrowing example of an eating disorder crisis . . . spiralling out of control".
HSE figures show the number of referrals for eating disorders has increased 66 per cent since March 2020.
Ms McCrave brought her then 12-year-old daughter to their GP in July 2020 after four months of continually reduced food intake. He referred her to the local child and adolescent mental health service (CAMHS) with a suspected eating disorder.
“She was going days not letting food pass her mouth,” says Ms McCrave. “She was absolutely shattered, a pain in her head all the time. I couldn’t leave her because I’d never know when she was going to collapse. The only thing I was told was if she did to call an ambulance.”
In July, CAHMS referred her to a specialist eating disorder bed in an adolescent mental health unit, Linn Dara, in Dublin, and she was admitted on January 7th.
“They let her home after two weeks for the weekend to see how she’d get on. Not one bite of food passed her mouth, so they came and took her back on the Monday. She wouldn’t eat and they tube fed her.”
She was discharged on February 15th.
"Four days after that she took an overdose of [over-the-counter tablets]. I rang an ambulance, was wetting facecloths to keep try and keep her awake until they came. The gardaí arrived as she's a child and they took her to the [Our Lady of] Lourdes hospital in Drogheda.
“She was eating a little in there and on March 1st, I took her home. She refused point blank to eat and on March 5th she had a hypoglycemic [dangerously low blood sugar] collapse.”
She has been in a paediatric ward in the hospital since.
“I could not fault the hospital in any way,” says Ms McCrave. “Only for them the last nine weeks my child would probably be dead, but it’s not a mental health hospital, it’s not getting to the bottom of why [Dearbhla] is so unwell.
“Sometimes she tells you she’s struggling and sometimes she says she’s fine. She tells me she feels she has razor-blades in her head, thinking, thinking, thinking, and she wants to go to sleep. I tell her, ‘You have to keep fighting it pet’.”
Ms McCrave said her daughter was eating “a little” in the hospital and had regained strength. “But the minute she gets home the anorexia grabs her by the throat and she will not eat a thing.”
Single mother
CAMHS has sought a specialised eating disorder bed for her in Cork, Galway, Dublin and Belfast without success. "They said last week they could refer her across the water to a clinic outside London. I wouldn't see her for six weeks but at least I'd know she is getting the care she needs."
Ms McCrave, a single mother, has three other children aged seven to 18.
“They are heartbroken over this. They miss her terribly. How extreme does this have to get for her to get the treatment she needs? All them weeks of her lying in a hospital bed she could be in a specialised bed, getting her treatment and the proper care she needs.”
Joyce Russell, founder of Parents Action and Care Group, a support organisation for parents of young people with eating disorders, says: "The eating disorders crisis has been growing for several years and with Covid is spiralling out of control . . . There just are not enough intensive services, understanding or awareness . . . It is a deeply complex mental illness with a high mortality rate."
Mr Ó Murchú says an “audit of the entire eating disorder system is needed” to ensure intensive, early interventions are available throughout the country.
A spokeswoman for the Department of Health said Ms Butler had requested an "urgent report" from the HSE on the case.
“There are no specialist eating disorder beds in the Midlands/Louth/Meath mental health services. A priority for Minister Butler, and the HSE, is to expand the number of specialist eating disorder teams nationally in 2021 and beyond,” she said.