National Review of Eating Disorder Services: report and recommendations

Policy Context

The Scottish Government is committed to delivering high quality eating disorder services. It wants to ensure that people with an eating disorder receive the treatment and support they need, when they need it, regardless of who they are, where they live, or what type of eating disorder they have. Scottish Government is committed to ensuring that people with lived experience of an eating disorder, or of caring for someone with an eating disorder are actively involved in reviewing and developing support and treatment services.

In announcing the review in March 2020, Scottish Government stated that 'it forms part of the programme of work to improve performance in mental health waiting times and support early intervention in community settings and across the third sector, local government and the NHS.'

The Scottish Government Mental Health Strategy 2017-2027 (6) has the ambition to 'prevent and treat mental health problems with the same commitment, passion and drive as we do with physical health problems.' The strategy states that this means working to improve:

• Prevention and early intervention;
• Access to treatment, and joined up accessible services;
• The physical wellbeing of people with mental health problems;
• Rights, information use and planning.

In her introduction to the Strategy, the then Minister for Mental Health stated that "We want to see a nation where mental healthcare is person-centred and recognises the life-changing benefits of fast, effective treatment. We want a Scotland where we act on the knowledge that failing to recognise, prioritise and treat mental health problems costs not only our economy, but harms individuals and communities. In short, we share the ambition that you should only have to ask once to get help fast."

The strategy has a large focus on services for children and young people and the only specific mention of eating disorders is in relation to the development of a digital tool to support young people with eating disorders. Although eating disorders typically emerge in mid to late adolescence (7), we know that half of presentations to services occur in the adult (>18 years) setting and that eating disorders can emerge at any age.

The Strategy emphasises the need to build on lower, less intensive levels of care (Tiers 1 and 2) to prevent people becoming so unwell that they require more highly specialist and intensive treatment. This is highly relevant to eating disorder treatment where we know that early intervention improves outcome and reduces the risk of illnesses becoming more entrenched (8,9).