Children with eating disorders hit 'crisis point' in lockdown

The number of children and young people with an eating disorder has soared to “crisis” point during lockdown, a psychiatry body has warned.

The Royal College of Psychiatrists (RCPsych) in Scotland said figures obtained through Freedom of Information show there were 217 referrals for eating disorders in children and young people under the age of 18 in 2018/19.

This increased to 456 in 2019/20 and in 2020/21 almost tripled on the earlier figure to 615 referrals.

RCPsych in Scotland said an emphasis on virtual appointments, loss of support structures, staffing shortages and less access to community services because of Covid-19 has fuelled the crisis.

The College is calling on Scotland’s new minister for mental wellbeing, Kevin Stewart, to ensure new funding for Child and Adolescent Mental Health Services (CAMHS) also covers young people with eating disorders.

Rob Donaldson’s 17-year-old daughter is currently being treated at a young person’s unit after being diagnosed with an eating disorder in 2019.

The anorexia sufferer was first admitted to hospital in April 2020, shortly after lockdown began, having struggled to cope when her weekly face-to-face treatment was moved online due to the pandemic.

Donaldson, from Dundee, said: “It’s worrying to see the statistics for children and young people with eating disorders increase across Scotland. Lockdown has had a huge negative impact on my daughter’s anorexia.

“We were receiving outpatient care at home, and attending weekly family-based therapy sessions, but all of a sudden that stopped. Therapy took place on video calls, and it simply did not work for her.

“There was nothing to motivate her to eat, without school and being isolated at home all day, the illness thrived. Within a few weeks of lockdown, she quickly deteriorated and was admitted to an inpatient unit for young people.

“This was a huge shock for us all and during the early days of the pandemic as we were not allowed to see her for three weeks.”

His daughter was well enough to come home by late summer but by mid-November was very ill again and was admitted to a specialist young person’s unit in Glasgow, more than 100 miles from home as this was the only bed available, which he said was “traumatic” for the family.

He said: “While she remains in hospital battling anorexia on a daily basis, I have some hope, that as we ease out of lockdown, there will be more reasons to fight and make some steps towards recovery, like getting back to school, learning to drive and going out with family and friends.”

RCPsych in Scotland said Grampian saw the most striking increase in referrals, from 28 in 2018/2019 to 70 in 2020/21.

Dumfries and Galloway, Lanarkshire and the Western Isles did not provide figures.

The college said that as coronavirus restrictions ease it wants to wants to see a return to face to face consultations as soon as it is safe to do so, as these types of appointments often work best for patients with eating disorders.

Dr Ereni Skouta, vice-chair of the CAMHS faculty at the Royal College of Psychiatrists in Scotland, said: “While it’s disappointing that not all health boards responded with figures, what is clear from the data is that action is needed now.

“The truth is, CAMHS services were already struggling to cope pre-pandemic but now we’re seeing a worrying trend and a huge increase in the number of children and young people presenting with deadly eating disorders.

“An emphasis on virtual appointments, loss of support structures and staffing shortages as well as less access to community services because of Covid-19, has fuelled this crisis.”

The College is also seeking a firm guarantee that details on the new national transition strategy for all young people with mental illness, is released without delay.

Kevin Stewart, minister for mental wellbeing, said: “We know the pandemic has been an especially challenging time for children and young people and we have prioritised the health and wellbeing of children and young people as we have worked through the restrictions.

“Eating disorders have a devastating impact on individuals and families, making it essential that rapid intervention is available. We will shortly announce the next steps in improving services, having considered the recommendations from the National Review of Eating Disorders Services – which considered the services available, the wider support system and the impact that the pandemic and associated restrictions have had on those with an eating disorder and their families.

“Our Mental Health Transition and Recovery Plan published in October sets out our response to the mental health effects of the Covid-19 pandemic. The plan is supported by a £120 million Recovery and Renewal fund, announced in February, to transform services.

“This year NHS Board allocations of £29.15 million have already been agreed to deliver improved Child and Adolescent Mental Health Services (CAMHS), expansion of community CAMHS from age 18 up to the age of 25 years old for targeted groups and those who wish it, and clearance of any waiting list backlogs for CAMHS.”