The Eating Disorders Health Integration Team is a team of people with lived experience of eating disorders, psychologists, academics, commissioners, care and support providers and other experts, working together to improve the lives of people with eating disorders in Bristol.
They are focused on improving care and quality of life for people with eating disorders, and is led by Dr Sanni Norweg, Clinical Psychologist Principal Avon and Wiltshire Mental Health Partnership NHS Trust, Consultant Pyschiatrist Dr Hugh Herzig and Helen Malson, Associate Professor of Social Psychology at the University of the West of England’s Centre for Appearance Research. The team is also known as EDHIT.
Eating disorders have some of the highest levels of morbidity and mortality associated with any mental health problem, but they do not attract widespread public attention and tend not to be prioritised by service providers as among the severe and enduring mental illnesses. Eating disorders afflict young and potentially productive members of society and their families, typically endure for years, and the health and social care costs associated are substantial.
The cost of eating disorders in health and social care is estimated to be £5 billion a year. Emergency hospital admissions for eating disorders have increased, and the number of children and young people with being referred for help nationally has risen. In 2013/14, 40 per cent of adult eating disorder referrals in Bristol were for university students, a transient population particularly vulnerable to inconsistent and delayed treatment.
The Beat (Beating Eating Disorders) report The Costs of Eating Disorders identified that the symptoms of eating disorders are recognised under the age of 16 in 62 per cent of cases. It also identified more than half of sufferers will wait longer than a year before seeking help. When help is sought, people experienced a lag of 15 months from presentation to treatment, with 18 per cent waiting two years or more.
This is a particular concern: delays in help seeking, diagnosis and treatment are the most important factor in relapse. The incidence of anorexia peaks in the mid-teens, with bulimia peaking two to three years later, and on average the illness spans six years. So treatment for these disorders will be in both child and adult mental health services. The period of transition is especially risky, and recommendations have been made, for instance at coroners’ inquests, that seamless pathways are established between services.
Anorexia and bulimia can be highly intractable conditions where recovery is often followed by relapse. There is no single therapy which has proven effectiveness for these conditions. Recovery for anorexia following lengthy treatment may be at best only 50 per cent of cases. It is important that treatment pathways are improved to decrease relapse and stabilise recovery.
The most severely affected patients can need treatment in hospital, so the transition between medical wards, home and specialist units can be a problem.
This HIT will look at the full range of treatments, from prevention to intense inpatient care. The HIT model provides the setting for close collaboration between potentially disparate people, organisations and services. The world of eating disorders can be fragmented in so many ways: across ages ranges, across healthcare services, across localities as for the first time young people move away from the family home, and across the potentially conflicting attitudes and motivations of patients, families, health professionals and researchers. At the heart of improving the experience of people with eating disorders lies the need for shared thinking and wide collaboration.
The Eating Disorders HIT aims to improve the support, treatment, services and lives of those with eating disorders in the Bristol area. The team will focus on both prevention and treatment and will work across four themes of:
The leading experts in eating disorders in Bristol are involved in the Eating Disorders Health Integration Team. The HIT is led by Directors Dr Hugh Herzig, Consultant Pyschiatrist, Avon and Wiltshire Mental Health Partnership (AWP) and University of Bristol, Dr Sanni Norweg, Clinical Psychologist Principal Avon and Wiltshire Mental Health Partnership NHS Trust, and Helen Malson, Associate Professor of Social Psychology at the University of the West of England (UWE Bristol) Centre for Appearance Research.
Find out more about who's involved.
EDHIT includes a patient and public involvement contributor, Ellen Devine, who leads this work stream. Ellen has lived experience of eating disorders.
There is a patient and public involvement (PPI) group, made up of service users, carers, members of the eating disorders charity Beat, and professionals. The PPI group was essential to developing the team’s proposal when setting up the HIT. This group offers valuable feedback and actively contributes to the HIT.
Other key patient groups, such as students, young people transitioning from Child and Adolescent Mental Health Services (CAMHS), and patients using the eating disorder support service SEED, will be involved as the HIT develops.
The team focuses on projects that fall into two broad categories of prevention and treatment. They aim to prevent eating disorders through a number of activities, while also improving services and care pathways for people with eating disorders.
To find out more, to subscribe to their newsletter or to get involved, please contact: firstname.lastname@example.org
There is also an instagram account: @helloedhit
Eating Disorders HIT at the HIT conference
The Eating Disorders HIT presented this poster (PDF) at the 2018 Bristol Health Partners Health Integration Team conference.