Earlier this month, former ‘Big Brother’ contestant Nikki Grahame died shortly after being discharged from hospital, where she had spent three weeks being treated for anorexia.
Grahame left hospital on a Friday. She was due to enter an outpatient clinic to continue her treatment after the weekend. Within 24 hours, she was dead.
At 38, Grahame had suffered from anorexia for three decades. Given the devastating toll that anorexia can have on the body and mind, it is almost impossible that she could have made much meaningful progress during her brief stay. But as the Labour MP Olivia Blake recently noted in a letter to chancellor Rishi Sunak and health secretary Matt Hancock, demand for beds for eating disorder patients far outstripped capacity even before the pandemic. For adults especially, this has meant that they are often left to fend for themselves.
Eating disorders are among the only illnesses – mental or physical – which can see doctors wait until the last minute to offer treatment. Though they are regarded as conditions under the mental health umbrella when it comes to budgets and resources, eating disorders can manifest deadly physical symptoms. Yet they are often treated inexpertly at home, if at all.
A petition set up in February by Becki Copley, a campaigner who started a support group for eating disorder sufferers, is demanding more funding for care, more inpatient beds, and more training for medical professionals. Since Grahame’s death, signatures have quadrupled. There’s still a long way to go.
Insufficient support
In 2019, 16% of UK adults screened positive for a possible eating disorder. According to the eating disorder charity BEAT, anorexia has the highest mortality rate of any psychiatric illness, yet NHS provision for eating disorders is woeful. While CAMHS, the mental health service for children and young people, requires that 95% of children and young people with eating disorders begin treatment within four weeks, there is no such requirement for adults.
Phrases like “asking for help is the hardest step” are often batted about online. But for eating disorder sufferers, that honesty can precede years of fighting for effective treatment. The likelihood that someone will receive any such treatment depends heavily on factors totally unrelated to the severity of their illness, such as where they live.
Between 2000 and 2018, the number of available beds for psychiatric care in the UK fell from 54,117 to 24,523. At the same time, demand for beds for people who suffer eating disorders has risen sharply, quadrupling between 2007 and 2017.
A 2017 report by BEAT, an eating disorders charity, found that the average gap between someone becoming unwell and receiving treatment was three and a half years, with the delay greatly reducing the likelihood of a positive outcome. Much of that time is due to the fact that it can take a long time for people to even realise they have a problem, and even longer to seek help. But when someone does make it to the doctor, they are still likely to be kept waiting.
Only 14% of people are referred within four weeks of their first GP visit, and 25% are referred to non-specialist services. Better training for GPs and other members of the community, such as school nurses and university support services, to help recognise the signs of a problem could help to cut down that delay in diagnosis. More early interventions, such as evidence-based therapies and outpatient treatment, would relieve the reliance on last-resort services, which often require people to wait to become ‘sick enough’ before admission.
This post was originally published on Radio Free.