Eating disorders: Concern over NI shock treatment

Patients have raised serious concerns about how people with eating disorders are being treated in Northern Ireland.

A 33-year-old woman who spent three months in the Mater Hospital in Belfast over Christmas, said she had been left without any follow-up care.

Amanda Gibson was suffering from bulimia and depression and was given electric shock treatment or ECT.

She said the treatment had left her with memory problems and she could not remember her age or where she lived.

"I was surprised as I didn't think people still got ECT," Ms Gibson said.

"But to be honest, I would have tried anything I was so desperate.

"It's left me with a very bad memory. I can't remember what age I am or where I used to live."

Her twin sister, Claire, is also concerned that, despite such extreme treatment, Amanda had been left "high and dry'".

'Did not happen'

The patient received electric shock treatment at the Mater Hospital in Belfast

"When she was in hospital the nurses were really lovely, but they didn't seem to know anything about eating disorders," she said.

"She spent most of the time just sitting on the bed and walking around. All the activities they had up on the board didn't happen."

In Northern Ireland last year, 307 adults and 109 young people were treated for eating disorders. About 10 were sent to England for specialist treatment.

However, the cost of sending people to England for treatment is high, about £2m a year for fewer than 10 patients.

The total budget for local services to treat 400 patients is also £2m.

The therapy available locally also seems to be in short supply.

Amanda Gibson was told there was nothing more that could be done once she left hospital.

"I was told on the day I was discharged I wouldn't be seeing my therapist anymore," she said.

"I was surprised because if anything, I'm worse since I started seeing the therapist, and now I'm out of hospital I can do what I like.

"I can eat what I like and be sick when I like."

Health Minister Edwin Poots said in a statement: "If a patient requires more intense specialist treatment for an eating disorder, trusts can access beds in England, Scotland and Ireland.

Extremely worried

"Developments in local eating disorder services in recent years have resulted in a significant reduction in the number of patients being referred outside of Northern Ireland for treatment of eating disorders.

"With these local services now firmly established, the HSCB and Public Health Agency, through the Regional Eating Disorders Network Group, are now focussing on the further development of skills in relation to the treatment of eating disorders across trusts.

"A regional care pathway for eating disorders is currently being developed which will span primary to secondary care and improve service quality across the region."

However, those assurances have left both sisters extremely worried.

Claire said: "Since Amanda came out of hospital she needs the help more than ever.

"They're more or less saying that she doesn't want to get better and she's beyond help and she's left to deal with it."

Amanda said nothing could be further from the truth. She said she is desperate to get better and wants more treatment.

She also has a seven-year-old daughter who is currently being looked after by another sister because social workers deemed Amanda too ill to care for her when she came out of hospital.

"I go to see her every day and she's always saying, Mummy, when can I come home with you?" she said.

'Out of date'

The father of a teenage girl, who is currently being treated in hospital in London, also spoke out about the treatment his daughter had received in Northern Ireland.

The man, who wanted to remain anonymous to protect his daughter, described it as "out of date" and said he believed health professionals had waited too long to accept that the treatment she was receiving was not making any difference.

"Obviously we did not want her sent away, we weren't saying, 'please, please, please, send our daughter somewhere else', but looking back on it now having seen her transferred to a proper specialist unit in London, and treated there for six months, if we were going through that again, we would say after two weeks, 'this isn't working, it isn't ever going to work, can she go somewhere where people have the experience and the expertise to cope with such a severe case'," he said.

After being moved out of Beechcroft, a child and adolescent residential unit in Belfast, his daughter had two stays in adult wards before being moved to London.

He said the facility had a very different attitude and a different set of policies.

"She is a million miles away from health and happiness, but she has over there been eating for seven months. She is occasionally refusing food, but essentially she is doing what is asked of her. She is still very, very sick," he added.

Specialist teams

Dr Stephen Bergin, a consultant in public health medicine with the Health and Social Care Board, said he could not discuss individual cases but he defended service provision in Northern Ireland.

He said the service was still in development, but that since 2005, specialist teams have been appointed in all Northern Ireland's health trusts.

"We have a lot of very highly trained specialist practitioners across the five trust areas. They are as trained as any specialist teams you will find, so I would have to defend the teams in terms of the training and competencies in place."

He said the number of specialist eating disorder practitioners had gone "from zero to 40" over the last few years.

"We'd like to do a lot better than that," Dr Bergin added.

"We do need additional staffing, so there is a question of getting additional resources to teams in due course."