Eating disorders soared in lockdown, experts warn

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 in Scotland said figures showed referrals had almost tripled in recent years.

There were 217 referrals for eating disorders in under 18s in 2018/19. This increased to 456 in 2019/20 and to 615 in 2020/21.

The Scottish government said it would announce steps to improve services.

The figures were obtained by the Royal College of Psychiatrists in Scotland using Freedom of Information legislation.

The college said virtual appointments, loss of support structures, staff shortages and less access to community services had fuelled the crisis.

As coronavirus restrictions ease it 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.

Rob Donaldson's 17-year-old daughter is currently being treated at a young person's unit after being diagnosed with anorexia in 2019.

She 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.

Mr Donaldson, from Dundee, said: "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 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 she was very ill again and was admitted to a specialist young person's unit.

The facility in Glasgow is more than 100 miles from home as it was the only bed available - something he said was "traumatic" for the family.

"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," he said.

Dr Ereni Skouta, vice-chair of the Child Adult Mental Health Services (Camhs) faculty at the Royal College of Psychiatrists in Scotland, said it was clear that action was needed.

She said: "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 calling on Scotland's new minister for mental wellbeing, Kevin Stewart, to ensure new funding for Camhs also covers young people with eating disorders.

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

Mr Stewart said it was essential that rapid intervention was available.

He continued: "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."

He said the plan was supported by a £120m fund, with £29.15m already allocated to NHS boards to improve Camhs services.

The college said the NHS Grampian area 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.

Erin, 23, spent her teenage years in and out of Camhs after developing bulimia.

She saw the return of her eating disorder over the pandemic, telling BBC Scotland's The Nine that it helped her feel in control when so much else was out of her hands.

"Eating disorders thrive off of loneliness and not feeling in control," she added.

"I think it's appalling that there's that many people that are battling with eating disorders.

"People are coming forward but there's no support for them. My worry for people is that it will spiral or they won't seek support again."