Written answers

Tuesday, 27 July 2021

Photo of Cormac DevlinCormac Devlin (Dún Laoghaire, Fianna Fail)
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2436. To ask the Minister for Health the year-on-year figures for the past four years of those adolescents and adults presenting to the HSE with eating disorders; and the practical measures and supports being put in place to assist those presenting and their families. [28717/21]

Photo of Mary ButlerMary Butler (Waterford, Fianna Fail)
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Enhancement of specialist services for eating disorders, including improved access and shorter waiting lists, remains a key priority for me, Government as a whole and the HSE.

In response to the growth in cases presenting to mental health services, €5.7 million has been allocated for the Eating Disorders National Clinical Programme since 2016. The Eating Disorders Model of Care was launched in 2018 and was developed in partnership with the College of Psychiatrists of Ireland and Bodywhys, the national support group for people with eating disorders.

€1.77 million has been invested to date in eating disorder specialist posts, with 21.8 WTEs now in place. In addition, I secured the balance of €3.94 million for 2021 and this will enable further investment in specialist posts throughout this year. More specifically, it will allow for the establishment of 3 new specialist eating disorder teams and the completion of the 3 existing specialist teams. Premises are already under development for the expansion of the adult community team at the Mount Carmel site, and is expected to be completed by the end 2021. Recruitment is progressing well for all teams.

The funding allocated to date has seen significant growth and improvement in our services. Despite the significant increase in referrals in 2020, there was a 43% increase in the number of eating disorder assessments completed, compared to 2019, with twice as many people starting treatment.

As of last year, there are 3 specialist eating disorder teams in place. This means that we can treat over 90% of people with eating disorders in the community, avoiding more serious inpatient treatment.

Specialist outpatient treatment has been found to be the most effective and fastest way for most people with eating disorders to recover. Although there is good evidence that inpatient psychiatric care is not required for most people with eating disorders, it is recognised that a small number of people, mainly with restrictive eating disorders, require inpatient care for short periods, for structured refeeding and/or stabilisation.

There are currently 2 eating disorder specialist community teams based in CAMHS, one in CHO4 Cork and Kerry Regional Eating Disorder Service CAREDS (operational since May 2019) and the other based in CHO7 Linn Dara Community Eating Disorder Service LDCEDS (operational since April 2018). Funding has been made available in 2021 to progress the recruitment of an additional CAMHS based eating disorder specialist community team in Community Healthcare West (Galway, Mayo and Roscommon, CHO2).

In circumstances where in-patient care is required, child and adolescent care is provided in all of the 4 Regional CAMHS Units across the country. Linn Dara (8 beds) and Merlin Park (6 beds) have dedicated a number of specialist eating disorder beds, while the remaining 2 CAMHS units accept relevant admissions of children with eating disorders. There is national coordination of child and adolescent admissions, with transfer arrangements in place as required by individual clinical need.

There are plans for an Eating Disorder Unit in the new National Children’s Hospital which will provide 8 additional beds. The HSE also funds individuals in private facilities. Decisions are made based on individual clinical need, as assessed by the local mental health team, and the prioritisation of available funding.

For adults, people who require in-patient care are admitted to local general adult approved centres and attend generic inpatient treatment programmes. CHO6 has 3 dedicated beds for eating disorders based in St. Vincent’s University Hospital. The number of adult beds will increase, in line with the National Clinical Programme, including an additional 3 beds in St. Vincent's, 5 beds in North Dublin, 5 beds in Galway and 5 beds in Cork. Timeframes for new beds will have to be established. These beds will be linked to eating disorder hubs. The funding available for 2021 will allow for the creation of 2 new adult eating disorder hubs in CHO4 and CHO9.

Importantly, adults with eating disorders can also access treatment from local community mental health teams. There are currently 112 adult community mental health teams nationwide. Children and adolescents can similarly access treatment through the 72 CAMHS teams units nationwide.

The HSE provides funding annually to Bodywhys to run a helpline which is delivered by a team of trained volunteers. They also provide a range of services (support groups, online groups, email and family programmes) for adults and young people with eating disorders, and their families. The HSE also supports Bodywhys to run the PiLaR (Peer Led Resilience) Programme, a 4-week online modular based programme for parents, friends and carers of a person with an eating disorder to build resilience and gain support in their role as a carer. Additionally, in March 2019 the HSE has launched the first Self Care App which provides valuable information for those with or people caring for someone with an eating disorder.

People with eating disorders can additionally avail of our general mental health supports. The HSE provide a mental health text messaging support service, which is available 24 hours a day, 7 days each week to connect people with trained volunteers. Online counselling and supports are provided by Turn2Me, MyMind and other organisations. There are phone, text and email supports available through existing providers such as the Samaritans, Aware, Pieta and others. Furthermore, Jigsaw provides a variety of online, phone and text supports specifically to young people aged 12 to 25 years old.

If an individual is concerned about themselves or someone known to them, they should be directed to their GP in the first instance for primary care screening assessment and examination. Their GP may then make recommendations which may include, if clinically indicated, referral to the secondary care mental health services for full eating disorder assessment.

With respect to your question regarding the year-on-year figures for the past four years of those adolescents and adults presenting to the HSE with eating disorders, as it relates to an operational issue, it is a matter for the HSE. However, members of the Oireachtas are advised that the HSE is currently unable to access the information to answer Parliamentary Questions due to the recent cyber-attack, which has required a temporary shut-down of HSE IT systems. The disruption to service is on-going, and the HSE is working hard to restore its IT capacity and resume normal services. Members of the Oireachtas will be advised as soon as the HSE is again in a position to provide responses to PQs and are encouraged to resubmit their Parliamentary Questions at that point.

With the right support and intervention, people can and do recover from eating disorders. The Government and the Department, along with the HSE and its partners, are committed to providing and expanding high-quality treatment and support for all those affected by eating disorders.

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