Sir, – It is welcome and timely to see the plight of adults with eating disorders reported on by Shauna Bowers (“Adult hospital admissions for eating disorders at highest level in a decade”, News, October 22nd).
Eating disorders can be extremely complex illnesses that often require assessment and treatment by specialist services. This is particularly the case where the severity is such that inpatient admission is warranted. The headline figure of “210 hospital admissions” almost exclusively refers to admissions to non-specialist medical beds. While these patients undoubtedly receive a high level of care and commitment by the medical team, they are doing so without sufficient resources to address the patient’s needs.
There are just three specialist adult eating disorder inpatient beds in the HSE - compared with 23 envisaged by the 2018 eating disorder model of care. In truth, the growing population and increasing severity of eating disorder presentations mean it is likely that even more treatment beds are necessary than proposed five years ago.
Secondly, it is likely that the lack of specialist inpatient resources has the knock-on effect of artificially reducing inpatient admissions figures, where there is no appropriate treatment available an admission is less likely to be recommended even where it may be necessary. This is further exacerbated by a lack of specialist outpatient services that results in a large uncounted group of people suffering with eating disorders, but unknown to services, who experience high rates of psychological and physical complications without access to appropriate support.
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Finally, the prevalence of specialist teams is far short of what is needed nationally. Of the eight proposed specialist adult eating disorder services, there are five in various stages of development. These teams are highly committed and hardworking but only one has access to specialist inpatient beds, and the other four are in need of significant time and resources to offer the level of services described in the model of care.
In the meantime, in areas with no access to a specialist team, adults with eating disorders rely on support from their GP and community mental health teams, who are stretched and lacking the necessary resources to provide specialist care.
Disappointingly, the National Clinical Programme for Eating Disorders did not receive the anticipated funding in the recent budget to continue the expansion of the service. It is reassuring to see The Irish Times shining a light on this issue - it is in serious need of greater public awareness and political action. - Yours, etc,
Dr ART MALONE,
Consultant psychiatrist,
HSE Adult Eating Disorder Service,
St Vincent’s University Hospital,
Dublin 4.