Early intervention and schools work. A talk provided for the Early Intervention in Eating Disorders Conference.

1. 1
Eating Disorders
Early Intervention and
Schools Work
May 2017
Jess Griffiths

2. 2
• Complete assessments of students in local
schools
• Refer young people in to YPEDs
• Deliver training to teachers/support staff
• Teach age appropriate PSHE
• Work as an eating disorders practitioner in one
local school (one morning a week)
• Liaise with families/carers
• Work alongside YPEDs and work with young
people after d/c from NHS service.
What I do….

3. 3
How do schools talk about
food?
Eating Disorders VS Obesity

4. 4
What causes eating
disorders?

5. Key facts and figures
Eating
disorder
Type
% of
cases
Gender age of
onset
Key Symptoms
Anorexia
nervosa
15% 80%
female
12-20 Weight loss, Fear of fatness
Restricted calorie intake
Bulimia
nervosa
45% 60%+
female
18+ Fluctuating weight in normal
range, purging after meals
Binge Eating
disorder
Expected
30%
50/50 30+ Uncontrolled eating of large
amounts, obesity
OSFED Expected
10%?
50/50 From 8+ Mixed symptoms of AN & BN
Just as serious
Slide 11 of 51
*Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) May 2013

6. 6

7. B-eat – the costs of eating disorders
• Electronic survey of 435 sufferers and 82 carers
across the UK.
• Respondents indicated that symptoms of eating
disorders were first recognised under the age of 16
in 62% of cases.
• Almost half of sufferers will wait longer than a year
after recognising symptoms before seeking help.
• Respondents who sought early help have a relapse
rate of only 33% compared to an average level of
63% for all those who sought later help.
7

8. B-eat – the costs of eating disorders
• On average the survey respondents experienced a
lag of 15 months or more between recognising
symptoms and treatment starting with 18% waiting 2
years or more.
• Research involving GP data in the
UK indicates an increase in the age- standardised
annual incidence of all diagnosed eating disorders
(for ages 10-49) from 32.3 to 37.2 per 100,000
between 2000 and 2009.
• This was mainly due to an increase in the
unspecified eating disorder category (OSFED).
8

9. 9

10. 10
B-eat bullying online survey
195 people completed an online survey in 2012
86.4% said bullying contributed to their eating
disorder
50% respondents asked their teacher for help (only
27% reported that teachers helped)
30% asked their parents for help (66% said that
they helped)
“I felt lonely and isolated. I ended up with no self-
esteem or self worth. I thought the only way
somebody would notice how much pain I was in
was if it was visible on the outside.” (P153)

11. 11
Concurrent
Conditions

12. B-eat GP survey 2016
• Of the 1267 people who sought help from a GP
for their own eating disorder, 30% didn’t get a
referral to specialist mental health services from
the first GP they visited, and only 34% felt their
GP knew how to help them.
12

13. 13
‘This responsibility does not rest with the health
service and primary care alone and must involve
parents, schools, colleges, community organisations and
peers to provide a proactive approach that recognises
the symptoms of eating disorders at the right time so
that referrals can be made that have the most positive
impact.’

14. Teacher Training
• Signs and symptoms of eating disorders
• Highlighting children who are vulnerable to
eating disorders
• Discussing safeguarding policies within school
• Creating care pathways
• Highlighting the importance of pastoral staff and
form tutors
• PE Staff, support staff ie library staff

15. 15

16. 16
The SCOFF screening tool can indicate disordered
eating and a need to consult a healthcare
professional. It asks patients if they have
experienced any of the following in the last year:
• Have you made yourself SICK because you feel
uncomfortably full?
• Have you worried that you have lost CONTROL
over how much you eat?
• Have you lost more than ONE stone in a 3 month
period?
• Did you believe yourself to be FAT when others
say you are too thin?
• Would you say that FOOD dominated your life?
For every “yes” that a patient gives, one point is
allocated; if they score 2 or more it is likely that they
are suffering from anorexia nervosa or bulimia
nervosa.

17. NHS Service
• Young Persons Eating Disorders service
01202 492415
• Young people are assessed within three weeks of
referral
• Focus on 8 to 18 but eventually merge with adult
service
• All outpatient treatment for Adolescents
• General hospital if medically unstable
• Inpatient care if ED is too severe to manage in the
community
• Kimmeridge Court ED service 6 Bed inpatient unit, 4
bed day unit (INR), outpatient treatment.
01202 492147

18. • Multi Family Therapy, 4 intensive days, 4 follow
up days.
• Family takes control of food and Adolescent
weight restores
• Family hands control back over to Adolescent
• Establishing healthy Adolescent Identity when
weight is maintained at 95% or over.
The Maudsley Model

19. • Treatment focus starts to shift to the impact AN
has had on the individual establishing a healthy
adolescent identity. This entails a review of
central issues of adolescence and includes
supporting increased personal autonomy for
the adolescent, the development of appropriate
parental boundaries, as well as the need for the
parents to reorganize their life together after
their children’s prospective departure
The Maudsley Model

20. • Studies consistently show that adolescents with
anorexia respond well to family therapy.
• Between 50-75% will be weight restored by the
end of the treatment and at 4-5 year follow up,
60-90% will have fully recovered. (Le Grange &
Eisler 2014)
Outcomes

21. B-eat Contact Details
Helpline: 0345 634 1414
Youthline: 0345 634 7650
Head office: 103 Prince of Wales Road
Norwich
NR1 1DW
Admin: 0870 770 3256
Media: 0870 770 3221
F: 01603 664915
E: info@b-eat.co.uk
W: www.b-eat.co.uk
Slide 51 of 51

22. Useful Resources
• http://www.inourhands.com
Pooky Knightsmith
• Self-Harm and Eating Disorders in Schools: A Guide to
Whole School Support and Practical Strategies
• The Eating Disorders Pocketbook
• Eating difficulties in younger children
http://www.inourhands.com/mental-health/webinar-16/
• https://www.b-eat.co.uk/research/summary-of-
completed-research/913-pwc-2015-the-costs-of-eating-
disorders-report
https://www.b-eat.co.uk/about-eating-disorders/worried-
about-someone/how-to-talk-to-somebody
22

23. • Jess Griffiths
• office@jessgriffiths.co.uk
• www.jessgriffiths.co.uk
• 07791 551990
23