Number of children needing eating disorder support ‘through the roof’

The chief executive of the School and Public Health Nurses Association (SAPHNA), Sharon White, has told Nursing Times of her concerns around the rising levels of eating disorders among CYP and of long waiting lists for services which she said meant their conditions were “worsening”.

“School nurses are indeed witnessing an exponential rise in children and young people developing eating disorders”

Sharon White

To help address the situation, the association has recently launched a series of eating disorder training webinars for school nurses.

“School nurses are indeed witnessing an exponential rise in CYP developing eating disorders, as well as a range of mental health problems,” said Ms White.

Referrals from parents or carers, teachers, social care, the public or peers, as well as self-referrals for eating disorder and mental health support were “coming to the attention of school nurses”.

Many CYP were “utilising text services to initially contact, build up trust and then ask for help”, she noted.

However, she warned that children and adolescent mental health services (CAMHS) and eating disorder services had “very long waiting lists”.

Therefore, “although school nurses can offer invaluable support at a universal level, many CYP are worsening as they have lengthy waits for the specialist help they need”.

Separately, the NHS Confederation has also raised concerns about increased demands and growing waiting lists for CYP seeking eating disorder support.

According to the confederation, which represents NHS trust leaders in England, Wales and Northern Ireland, there has been a 72% increase in CYP being referred for urgent support for eating disorders over the last two years since Covid-19.

One mental health trust in London had reported that demand for eating disorder services in its area had increased by 150% from pre-pandemic levels.

Meanwhile, the confederation pointed to latest data from NHS Digital which showed almost 250 CYP in England who urgently need support were on waiting lists, with 94 of those waiting more than 12 weeks.

The number of those on waiting lists with less severe needs was higher at 1,697, including 662 CYP who were waiting more than 12 weeks.

The confederation’s mental health network has this month called for around £12m in government funding over the next two years to ensure that CYP with eating disorders can access the care they need.

Matthew Taylor, chief executive of the NHS Confederation, said: “The explosion in the numbers of children and young people seeking and needing treatment for eating disorders is really concerning and it is very worrying that this could just be the tip of the iceberg as we start to uncover what the pandemic has meant for their mental health over the past two years.”

He said there was an estimated 1.5million children and teenagers who would “need new or additional support for their mental health over the next three to five years”, including seeking treatment for eating disorders.

An “urgent plan” must be developed, alongside investment, to “allow the NHS to get back on track and give these most vulnerable of young people the treatment and care they need as quickly and effectively as possible”, added Mr Taylor.

Ifti Majid, chair of the NHS Confederation’s mental health network and chief executive of Derbyshire Healthcare NHS Foundation Trust, added: “Specialist eating disorder services for children and young people are undoubtedly under strain.

“The numbers seeking treatment have gone through the roof following the intense and often very difficult situations that many of our country’s children and teenagers have experienced over the last two years.”

Responding to concerns about rising demands in eating disorder services, the Royal College of Nursing’s professional lead for CYP, Michelle Eleftheriades, told Nursing Times: “The increase in demand across both community and acute settings must be understood within the wider context of the challenges facing children, young people and their families.”

“The numbers seeking treatment have gone through the roof”

Ifti Majid

She recognised there were several factors impacting the demand for these services, including the pandemic, health inequalities, rising cost of living and increased rates of domestic violence and child abuse.

Ms Eleftheriades agreed that increased funding was needed, but stressed this was “only part of the solution” and that action on workforce shortages was also required.

Separately, the Royal College of Psychiatrists has this month launched new 'medical emergencies in eating disorders’ guidance for health professionals, to help ensure all people with eating disorders needing urgent care, including children, can be identified and treated earlier and appropriately.

The college referenced separate data from NHS Digital which showed hospital admissions for eating disorders of all ages in England have increased by 84% in the last five years.

It added that CYP “are the worst affected”, with a 90% rise in hospital admissions between 2015/16 and 2020/21 – up from 3,541 to 6,713. There had been a 35% increase in admissions among these groups in the last year alone, it added.

The new guidance covers recommendations on carrying out risk assessments, the location of care, safe refeeding of malnourished patients and behavioural manifestations of eating disorders in medical and paediatric wards.

It aims to support health professionals to identify and manage eating disorders when they become life-threatening.

Dr Dasha Nicholls, who chaired the development of the guidance, said it “encourages healthcare professionals to spot when someone is dangerously ill, and dispel the myths surrounding them”.

To “stop the eating disorders epidemic in its tracks”, she said it was “vital” the guidance reached health professionals “urgently” and that it was supported with necessary resources to aid its implementation.

A Department of Health and Social Care spokesperson said: “Eating disorders can be devastating for people living with them, and we are focused on improving services so that everyone has access to the right support.”

They said it was investing “an extra £2.3bn per year by 2023/24 to transform mental health services”, which included £53m for CYP’s eating disorder services.

The spokesperson also pointed towards a recently launched call for evidence to support the development of a new cross-government 10-year mental health plan.