Young people with eating disorders are coming to harm and ending up in A&E because they are being denied care and forced to endure long waits for treatment, GPs have revealed.
NHS eating disorders services are so overwhelmed by a post-Covid surge in problems such as anorexia that they are telling under-19s to rely on charities, their parents or self-help instead.
They are so threadbare in some places that young people who are struggling to function normally because of their eating disorder have to wait more than a year to start treatment.
The “truly shocking” findings about the help available to young people with often very fragile mental health emerged in a survey of 1,004 family doctors across the UK by the youth mental health charity stem4.
The shortage of beds for children and young people with eating disorders is so serious that some are being sent hundreds of miles from home or ending up on adult psychiatric wards, GPs say.
“The provision is awful and I worry my young patients may die,” one GP in the south-east of England told stem4. Another described the specialist NHS services available in their area as “virtually nonexistent and not fit for purpose”.
Urgent help for eating disorders is so patchy that 60% of the family doctors surveyed fear that sufferers will come to harm before they get it, the charity found. Almost one in three (32%) GPs have seen a young patient’s condition worsen so dramatically that they have had to seek help at A&E.
A pronounced postcode lottery means that many GPs believe that access to treatment has become impossible (23%) or difficult (53%) for under-19s with early, less severe physical symptoms.
Youth mental health experts warned that a young person with an eating disorder who had to wait for help could see their mental and physical health decline and face a heightened risk of suicide. Some who are already dangerously underweight become even more so as they wait.
“This GP survey tells us that young people with eating disorders, who will be most responsive to treatment at the start of their illness, can’t access treatment”, said Dr Nihara Krause, the consultant clinical psychologist and founder of stem4.
“Young people with complex mental illness such as eating disorders will experience deterioration the longer they are made to wait for treatment, and this is why we are seeing record numbers of young people presenting at A&E”, she added.
“People who have eating disorders are at high risk of mortality both due to physical complications and risk of suicide. All young people with poor mental health need treatment early or else their risk increases.” Young people with an eating disorder often have another mental health problem, too.
NHS bosses needed to “accelerate” existing plans to expand the treatment available for sufferers, because patients who went untreated took longer to recover, Krause added.
The GP survey found that the thresholds for under-19s getting help for eating disorders are so high that patients in desperate need are routinely refused NHS care.
Last month the NHS ombudsman for England warned that people with eating disorders were at risk of dying because they were being “repeatedly failed” by a health service that has done too little to tackle the growing problem.
Olly Parker, head of external affairs at the charity YoungMinds, said that young people with eating disorders needed to get medical help quickly, but “the majority face such severe delays that can put them at risk of getting worse and reaching crisis before they get any help”.
He added: “Children and young people simply should not be put in this situation. Often GPs and staff are doing what they can to support young people, but they are working with a broken system that cannot keep up with demand.”
Earlier this month the Royal College of Psychiatrists said that eating disorder services in England had been “flooded” with under-18s being referred by GPs since Covid struck in 2020. The number of such patients was 51% higher then pre-pandemic, it found.
NHS England said the number of young people with eating disorders it was treating was rising.
“While the pandemic has taken a huge toll on many people’s mental health, improving care for people with an eating disorder is vital, with the NHS treating 55% more young people for eating disorders compared to pre-pandemic, as well as rolling out a rapid early intervention eating disorder service for people aged 16-25,” a spokesperson said.
“We acknowledge that more support is still needed, which is why we are also rolling out mental health support teams as fast as we can, ahead of plan, and have doubled the number of children and young people we have seen, as well as establishing 24/7 crisis lines.”
‘Too little and too late’
Quotes from stem4’s survey
Frighteningly short of resources. Exasperating as a clinician trying to keep these patients safe.
Too many referrals are bounced or palmed off to charity and self-help.
Eating disorders [services’ are massively oversubscribed and [there are] huge waits. I don’t doubt the doctors and teams are doing their best but essentially they need huge numbers more.
A local charity is good. But there is no NHS provision. Child and adolescent mental health services (Camhs) reject every referral we do.
The threshold for seeing patients is too high, so illness is entrenched by the time any meaningful support is given. The treatment received is too little and too late/
Camhs is woefully under-resourced to manage eating disorders and cannot cope with the workload.
The services are nonexistent in my area, with patients having to travel hundreds of miles. It is completely unacceptable.
In the UK, Beat can be contacted on 0808-801-0677. In the US, the National Eating Disorders Association is on 800-931-2237. In Australia, the Butterfly Foundation is at 1800 33 4673. Other international helplines can be found at Eating Disorder Hope
