Fiona O'Loughlin (Fianna Fail)
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I appreciate the opportunity to speak about the important issue of eating disorders. I mention that this is international eating disorders awareness week, a week providing information around eating disorders. I refer to the correlation with Covid-19 over the past 12 months. We are aware from a recently published article that sadly there has been a sharp increase in admissions for eating disorders during the Covid-19 pandemic in Ireland. Bodywhys has provided good information over the week and I recommend that anybody impacted by eating disorders, whether it is oneself, a family member or a friend, look at the website and webinars. The telephone number is 01 2107906.

We are talking about eating disorders such as bulimia, anorexia and binge eating. They affect up to 5% of the population at some point in their lives and are not primarily about food but about body image. They are linked with a feeling of loss of control over other aspects of one’s life. They can be seen as a way of coping with a type of emotional stress which is characterised by self-starvation, purging and bingeing. It can be both physically and emotionally destructive and causes huge stress, not just for the individual but for family members and friends. Sometimes it is acknowledged and sometimes it is not.

An article published in January’s edition of the Irish Medical Journalnoted a 66% increase in hospital admissions for eating disorders in 2020 compared to 2019, which is a huge jump. Almost half of the eating disorder referrals seen during the pandemic came in the last three months of 2020 to just one adolescent service.Eating disorders have the highest mortality rate of any psychiatric issue. Therefore, these statistics are very concerning. The authors of this report noted factors such as distress and anxiety related to the pandemic. The interplay of social and economic factors and the impact of restrictions can account for this huge rise.

Since eating disorders span the mental and physical health services, a specialised, integrated approach is vital. There are no emergency services in paediatric psychiatry in Ireland, which needs to change. The HSE has recommended creating 16 specialist hubs around the country as the ideal model of care. We need to see this rolled out in all our hospitals to provide more beds for sufferers of this disease. According to recent media reports, the national eating disorder plan looks set to be delayed by almost four years. That is just not acceptable.

We know and appreciate that resources are stretched to the limit in the health service but eating disorders have the highest morbidity rate of any of the mental health disorders. Reports from professionals working in the area indicate they do not feel well supported in terms of training, resources and supervision. It is also of note that only about 5% to 15% of people with eating disorders seek help. Early intervention and treatment are vital for their recovery.

Ossian Smyth (Dún Laoghaire, Green Party)
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I am here this morning on behalf of the Minister of State at the Department of Health, Deputy Butler, to answer Senator O'Loughlin's questions.

I welcome the opportunity to speak about Ireland's model of care for eating disorders, particularly during eating disorders awareness week. Eating disorders have the highest mortality and morbidity, as the Senator said, of all mental health conditions. An estimated 190,000 Irish people will experience an eating disorder at some point. Sadly, eating disorders often have a very high cost for individuals and their families, as well as for health services and broader society when they are not treated or if they are not treated effectively. Enhancement of specialist services for eating disorders, including improved access and shorter waiting lists, remains a key priority for the Minister of State. She has special responsibility for mental health in government as a whole and in the HSE.

In response to the growth in cases presented to mental health services, €5.7 million has been allocated to the eating disorders national clinical programmes since 2016. The eating disorders programme, launched in 2018, was developed in partnership with the College of Psychiatrists of Ireland and BodyWhys, the national support group for people affected by eating disorders. I commend the work of these organisations in supporting people and families affected by eating disorders. It is imperative that these valuable services, provided through the HSE and our partners, continue to be supported to meet current and growing demand.

Some €1.77 million has been invested to date in eating disorder specialist posts with 21.8 full-time equivalents now in place. In addition, the balance of €3.94 million is fully available to the programme and will enable further investment in specialist posts throughout this year. The Minister of State, Deputy Butler, is keenly aware of previous delays in implementing the programme and she has made it a priority to ensure there are no further delays. She met the programme's clinical lead, along with BodyWhys, this week. They will report to her on a quarterly basis to ensure that real progress is made on the development of eating disorder services this year.

As the Senator is aware, Covid-19 has challenged us all with increased stress, anxiety and fear, not least for those affected by eating disorders and their families. While we do not yet fully understand Covid's impact on mental health, we know that presentations of eating disorders, particularly in young girls and young women, have increased during this time. Funding available to mental health in 2021 will help to tackle increased demand for mental health services due to Covid-19, including the continued development of the eating disorder programme through the establishment of three more specialist eating disorder teams this year.

I understand the Minister of State is fully committed to ensuring that the €3.94 million allocated to the programme is invested this year, in line with clear commitments to improve eating disorder services under Sharing the Vision, our national mental health policy. The funding allocated to date has seen significant growth and improvement in our services.As of last year, there are three specialist eating disorder teams in place. This means that we can treat more 90% of people with eating disorders in the community, avoiding more serious inpatient treatment. Despite the significant increase in referrals in 2020, there was a 43% increase in the number of eating disorder assessments completed compared with 2019, with twice as many people starting treatment. In addition to the three new teams, completion of the three existing specialist eating disorder teams will occur this year.

I commend the work of the programme and the progress made in the past year and I look forward to the full utilisation of the State's investment in this vital service.

Fiona O'Loughlin (Fianna Fail)
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I acknowledge that the Minister of State, Deputy Butler, contacted me to apologise for not attending and to assure me of her commitment to this issue.

I thank the Minister of State, Deputy Ossian Smyth, for his response. It is good to hear that three more teams will be established this year. That is important because the longer a habit is established, the more it takes on a life of its own. Young people are finding their lives being taken over by this difficult disease. As such, early intervention is very important.

I agree with a model that provides care in the community. If we can deal with eating disorders in the community prior to someone needing a hospital bed, it will be important. That there are no emergency services in paediatric psychiatry is wrong, though, and must change.

This is an ongoing issue, but I appreciate the Minister of State's commitment and presence today.

Ossian Smyth (Dún Laoghaire, Green Party)
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I thank the Senator for raising this important issue. Everyone wants the best outcomes for people who are affected by eating disorders. It is clear that progress in establishing the clinical programme has not been as rapid as we wished, but this does not mean that nothing has happened or that there is no work in progress. Considerable work has been undertaken and the programme continues to be developed in line with clinical evidence and international best practice. The Minister of State, Deputy Butler, is committed to ensuring, in collaboration with relevant partners, that significant progress will be made this year and that access to appropriate treatment will continue to increase.

With the right support and interventions, people can and do recover from eating disorders. With the HSE and its partners, the Government is committed to providing and expanding the high-quality treatment and support for all of those affected by eating disorders.