Content note: eating disorders, iatrogenic harm
Four years ago, I was discharged from an inpatient eating disorder ward in London, but I shouldn’t have been. The pandemic had spread a wave of the virus across the hospital, which meant it was deemed safer on the outside. However, even before the pandemic had struck, I would have felt safer outside of the hospital.
Having spent the last ten years in eating disorder treatment, I have witnessed the good and the bad. Sadly, it is the weaknesses that outweigh the good.
Upon my first referral to my local Child and Adolescent Mental Health Service (CAMHS), I was told I was still above the average weight to be seen by the eating disorder team. These words shouldn’t be uttered to someone diagnosed with anorexia. In fact, they shouldn’t be said to anyone. Mental health services should be provided to anyone who needs help or treatment, not just because of a number on a scale.
As my illness deepened, I found my health getting worse, but I still had to beg to be sent to hospital to get noticed at all. Only then did the CAMHS team take me seriously. Shockingly, when I now look back, I should have left them and found help elsewhere earlier, as I can remember witnessing others snapping in the waiting room, having experienced the same absence of support. Placed under a strict regime, I attended therapy and doctors sessions once a week, but neither offered much support. I kept declining right up until they decided that they didn’t want to deal with me anymore. Via a phone call they told me in no uncertain terms that there was nothing else they could do, and that I was going to be put into on an inpatient ward, miles away from my family. If I refused then they would just section me.
Driving away from my family home, I arrived on on a unisex inpatient ward in London in the week of Christmas 2019. Instantly, I was thrown into life on an inpatient ward, with no guidance or introductions. I was shouted at for spilling milk the first morning on the ward. I was woken in the night by flashlights over my eyes and loud banging by staff. My weight determined if I could see my family or not. As someone who suffers from a bad tailbone, causing endless amounts of pain, I was made to sit on it to make my blood pressure rise even though the staff knew that my pressure levels were healthy. I rang my mum to beg her to come and take me home, and as soon as she arrived to help calm me down, she saw how much my mental health had deteriorated and asked to speak to my psychiatrist. Yet, since they only came in once a week, to hold five minute meetings, it was impossible.
Having suffered from starvation and exercise addiction, I didn’t feel like this was the place to help me. The NHS states that on every inpatient ward there should be a dietician. Ours was a good person, who listened to the changes you wanted, yet with funding cuts, there was only a set menu of frozen goods to choose from. This limitation can be particularly difficult for someone with an eating disorder, as your body becomes accustomed to the foods that it knows, and refuses anything else. Being a vegetarian, I had one option a day or a jacket potato. There was literally no way to get over the wall being built to restrict what foods were available to eat, and even if those on the ward felt like they could go over their scaled amount, staff forbid it. Yet, it was fine for staff to eat as much of the patients’ food as possible, with shortages often occurring on the ward.
It wasn’t just the food, however, that showed failures. Within the UK, there are only a limited number of inpatient wards, with many patients not allowed to choose where they go. On the ward I was on, we had patients from Ireland, Scotland and beyond seeking help. The lack of nearby sources meant that comforting family members couldn’t easily visit, the staff becoming the only people you see some days. However, there aren’t enough of them in the system to offer sufficient support either.
Bank members are regularly used across a number of wards to help patrol, sit with or watch each patient. However, due to being used to treat different mental health matters, they often don’t know what they are meant to do for each specific one. I witnessed instances of screaming and threats made by them, with some even falling asleep whilst on site, causing one vulnerable patient to be able to get out of her safe area and harm herself.
This experience has left me with severe PTSD, to the point I find myself shaking even at the thought of seeing a normal GP.
The pandemic has seen a rise in eating disorder cases, yet due to an oversight by the previous government, there has been no commensurate increase in funding. As a new government is brought in, I can only hope that they begin to make changes, and fast, all to break the cycle of patients being mistreated and wards being under-resourced. The Government must take responsibility and act to ensure that no one else has to endure what I, and many others, have had to face. To do this they need to treat patients better, kinder and as human beings. We are those after all. Yet, in a system like this, it’s often forgotten. When I discharged myself, removed the scales and started recovery my way, with my mum, I felt free again. Ready to do it. Yes, I would have liked a good support system, but having seen the way it currently operates and having been left with the scars I have, I am oddly thankful to have been discharged at the start of the pandemic. Those papers provided me with freedom from a failing system that is reeking with the need to be changed. A change that needs to happen now.
Mental Healthcare in a Failing State
This blog is part of our new series, “Mental Healthcare in a Failing State”. All the blogs in the series, when published, will be added here.