Psychiatric Bulletin (2001) 25: 402. doi: 10.1192/pb.25.10.402
© 2001 The Royal College of Psychiatrists
Psychiatric Bulletin (2001) 25: 402
© 2001 The Royal College of Psychiatrists
Eating Disorders in the UK: Policies for Service Development and Training
Council Report CR87 £7.50. 64 pp
Paul Robinson, Chairman
Eating Disorders Special Interest Group
With the collaboration of the Consumers' Association, the Eating Disorders
Special Interest Group surveyed specialist eating disorder services for adults
in the UK, as a follow-up to a previous survey in 1991 - Council Report CR14,
Eating Disorders. We found that specialist services had increased in number
since 1991 but that many areas remain without access to nearby specialist
services. Many patients are sent long distances for specialist care, and
adequate follow-up after such care is frequently impractical. Eating disorders
are of high prevalence, representing a major source of morbidity,
predominantly in young women, and the standardised mortality ratio of eating
disorders is among the highest of all psychiatric disorders. There is a
substantial evidence base for treatment of anorexia nervosa and bulimia
nervosa, although research is urgently required to establish the most
effective treatment for many groups of patients. We recommend the following
action:
- For each area of the country, specialist services should be established,
with one consultant psychiatrist per million population.
- These services should provide a combination of out-patient, in-patient and
day patient services, with an appropriate range of therapeutic
interventions.
- Expenditure on staffing should be approximately £1 per head of
population.
- Steps should be taken to increase the number of consultant psychiatrists
with special expertise in the assessment and treatment of eating
disorders.
- Similar problems apply to the treatment of children and adolescents with
eating disorders. Services for this group should be fully surveyed and
recommendations developed for improving provision.
The Eating Disorders Special Interest Group has undertaken to develop
criteria for specialist training in eating disorders in view of the particular
mix of psychiatric, psychological, medical and nutritional problems faced by
this severely ill group of patients. Our aim is to correct the unacceptable
variation in care between different parts of the UK caused by unequal
distribution of services.