Thursday 4 November 2021
A local NHS mental health Trust has developed an early intervention pathway tailored to support young people aged 16 – 25 years who are experiencing the early stages of an eating disorder.
Tees, Esk and Wear Valleys NHS Foundation Trust (TEWV) has developed a First Episode Rapid Early Intervention for Eating Disorders (FREED) pathway as part of its existing eating disorders services for adults and children across County Durham, Darlington and Teesside.
FREED is an evidence-based support approach tailored to the needs of young people experiencing an eating disorder for the first time. The approach provides rapid access to high-quality care for people in the early stages of illness when treatment is most likely to be effective.
Under the FREED approach, young people referred to TEWV’s eating disorder services, by their GP or other health professional for example, are contacted by telephone, text or email, rather than traditional letter, by a dedicated eating disorder nurse within 48 hours of referral to talk about their condition and put in place next steps in terms of care and treatment.
David Tate, FREED champion at TEWV, said “Young people face a whole range of challenges in their lives at a very crucial age. This is also however an age when great positive impact can be made by offering early support and help to prevent longer term behaviour patterns.
“Eating disorders often start during adolescence and can go on to take over families’ lives, causing friction and affecting relationships. Key to helping people avoid developing longer term eating disorders is providing the right help at this early stage in a way which works for the young person. We know that people who receive treatment in the first three years of an eating disorder are more likely to work to reverse the changes the illness has on their brain and body.
“The focus of FREED is to provide that early support and intervention and encourage young people to access our existing eating disorders services for support before an eating disorder becomes a long term chronic condition. This starts with supporting GPs and other health professionals to recognise the early stages of an eating disorder and refer people to us for specialist support.
“FREED helps us tailor our approach to the needs of younger people today – a traditional letter through the post is just not the right approach these days for many younger people. We proactively ring, text, message or email young people referred into our services to chat with them in a way they are most comfortable with.
“FREED has been of great benefit to the young people we have contacted. Since April, we have supported 48 young people with this approach. A young person we recently supported with tailored care is now getting ready to head off to college which is great news.
“We can move things along more swiftly –we can contact young people as soon as we receive a referral, find out what support they need and work with them to identify a way forward using treatments and approaches that have proven to be effective such as specialist supportive clinical management (SSCM), cognitive analytic therapy (CAT therapy) MANTRA (the Maudsley Model of Anorexia Nervosa Treatment for Adults) and specialist psychology.”
During the pandemic, TEWV saw an increase in people seeking support for an eating disorder. David added: “We’re seeing lots of people come forward for treatment after suffering for months or years, often because they’ve had time to think about things in lockdown and have decided that they want to make a positive change to their mental health.
“We want to support every individual the very best we can and FREED is helping us do this.”
The FREED approach was initially developed by South London and Maudsley NHS Foundation Trust and King’s College London. TEWV is one of 18 NHS trusts in England to be awarded funding by the NHS to develop and deliver FREED and has been supported by the Academic Health Science Network for the North East and North Cumbria (AHSN NENC).
Paul Johnson, Mental Health Workstream Lead at the AHSN NENC, said: “We are delighted to have supported TEWV to become an early adopter site for the FREED approach across both its children’s and adult services. It is a credit to all involved that this has been implemented during times of extremely high pressure both on services and on the people who use them.
“The progress made to date by David and the team at TEWV to implement FREED has been fantastic, and it’s incredibly encouraging to see the benefits it is already bringing to people accessing the service.
“There is a shared commitment and drive to further embed the FREED approach across the North East and North Cumbria and we look forward to continuing to work closely with TEWV, the Integrated Care System Mental Health Programme, the Eating Disorder Provider Collaborative and Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust on this important work going forward.”
David said: “We chose to develop FREED across both our children’s and adults services which is unique in the pilot phase across the country. This not only helps younger people as they move from children’s to adult services and helps our eating disorder teams, it also helps our other services develop a greater understanding of the impact of this crucial early intervention.
TEWV is working with neighbouring NHS mental health trust Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust (CNTW) to expand the approach across the wider north east and north Cumbria area in the coming months.
Andrew McMinn, associate director for neurological and specialist services at CNTW, said: “We are excited to be working closely with TEWV and our Clinical Commissioning Groups with a view to developing and replicating the FREED model across the Northumberland, Tyne and Wear region. The evidence is clear that the earlier we can provide people with support, the better outcomes they can have.”
Dr Neil Halford, interim medical director for the North East and North Cumbria Integrated Care System said: “Launching this new way of caring for people with eating disorders is testament to the drive and commitment of TEWV and its partners. FREED has been successful in so many parts of the country, transforming the lives of many young people, it’s fantastic it’s now being adopted more locally to give support to those who need it. We hope that the service can be scaled-up even further across all our communities in the North East and North Cumbria.”
If you are worried you may have an eating disorder, or concerned someone you know might have an eating disorder, please speak to your GP or local mental health service.
