All the research evidence to date suggests that in-patient eating disorder units do not lead to better outcomes than community treatment, have high rates of relapse and re-admission, and mean that young people are away from their family, friends and school for a long time. Average admission length, according the government’s most recent report into inpatient care, was 120-130 days*. For those commissioning care, or paying for it privately, eating disorder units are significantly more expensive.
Our service has been designed to prevent admissions into an adolescent eating disorder unit and/or to shorten significantly their duration. We believe it is better for young people and their families if young people can get better whilst remaining at home and in contact with their friends and school for as long as possible.
Eating disorder units do play an important role however. We usually only admit young people to eating disorder units in the very rare situations where they require detention under the Mental Health Act or if there are significant non-eating disorder risks, eg severe suicidality. It would not be safe or appropriate for us to work with these young people on our paediatric ward.
*Child and Adolescent Mental Health Services Tier 4 Report (2014) NHS England
A sabbatical with a difference