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Monday 30 September 2013

Just when I think I've seen it all

I love our NHS.  The treatment *I* have received has been exemplary, kind, compassionate and free.  What more could I ask?  Sometimes I grumble, but hey, nobody's perfect.

But Mental Health - oh dear.

First a quick 101 on Bulimia and Death.  Other medical dangers and complications can be found here:

"Bulimia can be a fatal disease. Mortality rates for eating disorders vary widely between studies, with sources listing anorexia nervosa deaths from .3% to 10%. One fairly new study compared the records of individuals who had been treated at specialized eating disorders clinics with the National Death Index. Their findings for crude mortality rates were: 4% for anorexia, 3.9% for bulimia, and 5.2% for EDNOS (Crow, 2009).

The most common causes of sudden death in bulimia are cardiac or respiratory arrest, the result of electrolyte imbalances from excessive purging. Electrolytes, which are minerals in the blood—like potassium, chloride and sodium—help maintain a regular heart rhythm, as well as the function of the muscles that enable the heart to pump and the lungs to breathe. When these chemicals are depleted due to purging—often made worse by weight loss and excessive water drinking—heart arrhythmia (irregular heartbeat) can occur. Since this can lead to sudden death, it is important to have blood tests to monitor electrolytes, and medical treatment if they are amiss. This danger resolves when proper health and nutrition are restored.

Less common causes of death in bulimia include choking, rupture of the esophagus or stomach, and suicide. Kidney failure is another possible life-threatening side-effect of prolonged low potassium (Mehler, 2010).

It is difficult, if not impossible, to know which bulimics are at greatest risk for developing any of these specific conditions. Certainly, the longer the bulimia continues, the greater the risk of cumulative damage. However, even someone who has only started to purge faces the possibility of serious physical consequences, even death."

You could probably guess by the moniker by Urgent Help Services are the emergency response team that swoop in like the SAS when there is a mental health crisis taking place.  They TAKE CHARGE and help resolve the situation.  How do I know?

It says so here:

So at what point, as a parent, do you lose faith in the system?  Well, that would be about the time, over a year after a diagnosis of bulimia, no treatment except therapy, no guidelines, a lot of blame, a suicide attempt, severe self harm, binge and purge episodes up to 7 times a day, discussions about sectioning, a cocktail of drugs prescribed to a 14 year old and a panicked call to the UHS because the "family are in crisis", that the UHS turn up at your house and write you a care plan.

This care plan is for your 14 year old daughter, who has been bingeing and purging for over a year, has lost weight, is in trouble at school, has been suicidal, has self-harmed, has attacked her parents with a knife, who is SO obviously in serious mental distress and anguish and needs help and is at high risk of death from purgining:

So here it is

Two day menu agreed as N overwhelmed by A demands.
A and N to keep a diary of this.
A can vomit twice a day.
A to consider what else she can binge on to help reduce the overall food bill.
Family unsure if they can do this even for one day.

Dr H to liaise with school re As tiredness and health.
Dr H to contact N in two days time to review meal plan.
UHS to discuss two week admission with Dr G with dietary guidance

Yes. You have read it right.  The Urgent Help Service "prescribed" an underweight bulimic child 2 vomits a day and asked her to consider what food she could binge on to help reduce the overall food bill.

I am sorry if this is putting you off your breakfast but somethings are best out in the open.  If you are in  a mental health crisis, would you want this kind of care?


  1. I've experienced UHS... they completely ignored my ED - even when I was admitted to their unit on the verge of a suicide attempt, I didn't eat for 2 days and they told my parents I was fine! The whole sussex treatment team (for EDs especially), both child and adult need a serious talking to! (Never thought much of Dr Gillett either). It's like SEDCAS telling a not-quite-weight-restored anorexic that they'll help her lose Xkg (back to underweight) and removing near enough everything from her meal plan to do so! Or telling her that binging is ok if it'll get her back to a healthy weight faster.

    I don't think ANYONE wants the sort of care we've experienced - not when lives are at risk.

  2. I am APPALLED and DISGUSTED at this dangerous excuse for a health plan. Once again, Sussex have proved themselves to be woefully ill-informed when it comes to eating disorders. As 'Anonymous' says above, this includes SEDCAS as well as CAMHS.

    OK, so they're probably under resourced and definitely under funded, but so are every other medical and mental health service in the UK. It doesn't excuse giving DANGEROUS advice that puts our children's lives at risk.

    I'm absolutely disgusted with CAMHS over this. Not entirely surprised sadly from our experiences over the years, but definitely disgusted.

  3. (did you intend to include the girl's and Dr's names in the quotation?)

    Totally shocked. But sadly unsurprised.

    1. Missed B's name but easily traceable via forum. Anonymity is not the issue here. Dr G will never have heard of this - never contacted, I don't think.....

    2. OK, no worries :-) Just my inner proofreader coming out and noticing.
      The treatment by CAMHS, etc., in this case is like a textbook example of how *not* to care for someone with this condition. Incredibly sad.

  4. This is reminiscent of the "treatment" I received from my local CAMHS......20 YEARS AGO! Disgraceful and so sad.
    20 years on and I'm stuck deep in the mire of anorexia b/p, having experienced all the consequences you mentioned above, and more besides. Particularly exciting was when my bowels fell out of my arse and had to be pushed back in again by a student doctor in A & E. Lovely. Apologies to the breakfasters.
    Thankyou Charlotte, for highlighting how serious bulimia IS. Despite the crap treatment I had those years ago, I owe my life to numerous medical and psychiatric interventions since. Not all my friends have been so lucky. Bulimia kills.

  5. I too love the NHS, sadly it seems that CAMHS seperate themselves from the principle of care all too often. Be that through lack of education or laziness there is NO EXCUSE.Surely someone who came across this case thought at some point "hang on this needs something different to happen".
    Nothing Urgent or helpful about it.

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  7. Oh, good lord. It's really impossible to believe that we mothers have educated ourselves better than people that are creating treatment plans. Unfreakingbelievable.

    Previous comment deleted due to glaring grammatical error!

  8. CAMHS seems to be the same here in Australia. Melbourne. I fought and fought with them to include me with my daughter's issues. It was always what she wanted said to me. I was fine about the privacy issues she wanted but please include me with knowing how to help her. I did get there finally. Then she turned 18 and now sees the hospital ED psychologist.

  9. That is disgusting, do these people know what mental health is or just know how to fill in blank space on a form.
    There doesn't appear to be anything in the 'plan' that addresses the eating disorder or mental health issues. What actions are they going to review?

    'Family unsure if they can do this even for one day.' - I know it's the written word but did it come across as condescending?