Families and carers are being left without enough home support to look after someone with an eating disorder, while delays in getting psychological help are forcing some to go private, according to a report from Scotland’s Mental Welfare Commission.

More people lose their lives from eating disorders than any other psychiatric condition in Scotland.

The findings show ‘significant variation’ in the way services are delivered across the country.

The Commission found that while families and carers reported excellent care – particularly inpatient care – they said there was not enough support for them as they tried to manage the situation at home.

Ten specialist services were visited by the report’s authors, who heard from people with eating disorders, their families and carers, and a wide range of professionals.

Anorexia nervosa has the highest mortality rate of any mental illness and can have a devastating lifelong impact.

Without exception, the families and carers responding to the Mental Welfare Commission’s research said caring for someone with an eating disorder had ‘devastating and long-lasting effects on the whole family’.

The report emphasises service inequalities across the country, including the availability of psychological therapies, with some people accessing support privately.

It states: ‘While early intervention and access to psychological help is critical, there is often a lack of support, and delays in accessing services, particularly in the community.

‘[There is also] confusion and conflict over responsibility for physical health monitoring between GPs and psychiatrists.’

Concerns are raised over the focus on body mass index (BMI) alone as the trigger for referral to more specialist services and as an indicator of recovery, with less attention paid to other mental health conditions the person may also have.

In March the Scottish government announced a national review of eating disorder support would be carried out, with the first report expected in spring 2021.

Interim Executive Director of the Mental Welfare Commission Claire Lamza says today’s report needs to be considered as part of the national review:

“We found some excellent examples of care, but we also found issues that need to be addressed, which include making sure that everyone gets access to the same high-quality level of care and treatment.

“In our recommendations we ask the government to take this detailed report into account as they conduct a national review of eating disorder services across Scotland, which we know they are planning to do. We have also called for a managed network across the country.

“We have made a number of recommendations for the integrated authorities – a health board and/or a health and social care partnership – who are responsible for delivering care and treatment.”

A Scottish government spokesperson said: “We welcome the Mental Welfare Commission’s report and recommendations.

“During Eating Disorder Awareness Week 2020 we announced that we will be taking forward a National Review of Eating Disorder Services.

“This report provides us with the foundation for a full review to ensure that the right package of care, services and support is in place to respond to the needs of those who suffer from an eating disorder, to help them recover and maintain healthy and productive lives.

"We are currently finalising who will lead this review and will announce this in the coming weeks.

“This review is a crucial first step in a phased programme of work to improve outcomes for people living with an eating disorder in Scotland.”

 

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