What health professionals should know about eating disorders

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consequences, contact, counsellors, diagnosis, early intervention, Eating Disorders, family, friends, GPs, health professionals, health service, help, myths, nurses, psychiatrists, psychologists, recovery, sensitivity, social workers, support, symptoms, treatment, weight, young people

What health professionals should know about eating disorders

Over the course of two years, I have met with 40 young women and men who have shared on film honest details about their experiences of eating disorders. Their hope is that sharing their stories will help other people who are similarly affected to feel less alone and encourage them to seek help.

The research shows that common myths about the illness have prevented many young people from getting the treatment and support they needed, from family, friends and even the health service.

During the course of their eating disorder, young people came into contact with many different types of health professionals including GPs, nurses, counsellors, psychologists, psychiatrists, dieticians, social workers and other support workers.

There are some things that health professionals should know when dealing with a young person living with and recovering from an eating disorder.

Anyone can have an eating disorder

Anyone can become ill with an eating disorder. Eating disorders affect people of all ages, backgrounds, sexualities, both men and women. You can’t tell if a person has an eating disorder by just looking at them.

First point of contact is often critical

This first contact with services was often a huge step for a young person. People often found it very difficult to talk about what was going on, trying to hide their problems and it could take months, even years, to seek help. The way they were treated at this point could have a lasting, positive or negative, impact.

Young people hoped that the health professionals would realise just how hard asking for help was and to help nurture and support their confidence to stay in contact with services.

Early intervention is key

Young people often felt that people struggled to recognise the psychological symptoms of eating disorders as well as the range of different eating disorders.

If those who haven’t yet developed a full-blown eating disorder could be recognised, they can also be helped earlier. This is critical, as the longer eating disorders are left undiagnosed and untreated, the more serious and harder to treat they can become.

Effective, early intervention could be achieved when health practitioners were knowledgeable, well trained, sensitive and proactive.

Eating disorders are about emotions and behaviours, not just about weight

A common myth that many of the young people had come across was the thought that people with eating disorders were always very underweight. This idea had made it harder for some to get treatment and support or even to be taken seriously by their doctor.

In some cases, young people felt that the only way for them to be taken seriously and be able to access eating disorder services was to lose more weight. This could have serious consequences; the more weight they lost, the harder it was for them to be able to seek or accept help.

See the whole person, not just the eating disorder

Once in contact with health services, above all else, young people wanted not just to be seen “as an eating disorder” but to be treated as a whole person. It was important that they felt treated as individuals and for health professionals to realise that everyone responded differently.

A good health professional also tried to engage young people on other things than just the eating disorder, hobbies or interests.

Respect the young person

Feeling respected, listened to and being given the space to explain things from their perspective was important for young people during treatment and recovery.

Professionals should take their time and find out what was going on for that particular person, not act on assumptions. Health professionals shouldn’t patronise or dismiss issues that were important to the person in front of them.

This research, funded by Comic Relief, has now been published on online at Youthhealthtalk.org.

Ulla Räisänen is a senior researcher with the health experiences research group at University of Oxford, and was responsible for conducting the study published on Youthhealthtalk.org

Social workers need training to help them better understand self-harm

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autism, awareness, education, family, online support, physical health, self-harm, social workers, support, training, understanding, young people

Social workers need training to help them better understand self-harm

It is estimated that one in 12 young people have self-harmed at some point in their lives, according to charity YouthNet. The charity says 3,000 people aged 16 to 25 visit its digital support service TheSite.org every month after looking up self-harm on a search engine. Yet, despite these statistics, self-harm awareness training for social workers is not always as comprehensive as it could be.

Nushra Mansuri, professional officer (England), at the British Association of Social Workers (BASW), says while some social workers – such as those working in mental health – may be sensitive to the issue of self-harm, there needs to be more awareness of the problem within the profession and that self-harm training is patchy.

“Whatever client group you work with, it will be a feature – it [self-harm training] should be integral because you are working with people whose lives are in crisis – there is a high correlation between the people you work with and people with a propensity to hurt themselves,” she says.

“Social workers need a greater awareness of the issue and need to understand why people self-harm. I wouldn’t lump everyone together, but it can be the impact of trauma, it can be a cry for help, it gives someone, who may have had control taken away from them, a sense of control.”

What mistakes could a social worker who lacks awareness of the issue of self-harm make? “An untrained person may have a tendency to look at the superficial and not go beyond that,” Mansuri says. “A social worker may be out of their comfort zone and not be able to deal with it – dealing with someone’s raw pain is really hard.”

Mansuri adds that social work “doesn’t have all the answers” when it comes to self-harm and that more education is required. “There is an underestimation of the importance of looking at self-harm,” she says.

Jennifer McLeod, managing director of self-harm training provider Step Up! International, says in some regions self-harm training for social workers is inadequate.

“Social workers ought to be trained in spotting the signs; if they aren’t spotted, it could be fatal,” she says. “It’s about listening to what’s not being said, looking for physical signs and emotions – they [people who self harm] are generally hiding something.”

McLeod adds that well-trained social workers will broach the topic with the young people and their families. “There might be denial from parents and social workers will have to find ways of eliciting information from young people.”

McLeod says delegates at Step Up! International training courses are often in a state of panic about the issue as they are uncertain about how to deal with the problem or even broach the subject.

“Some professionals don’t feel confident about bringing up the issue directly, they daren’t ask about it as they think it might make it worse”, she says.

McLeod suspects self-harm is on the increase – and is being talked about more – because of the current economic climate.

“In addition to the emotional and biological changes [young people experience], there is the recession, labour market issues, parents being made redundant – parents may not be managing and may be economically struggling,” she says.

Caroline Hattersley, head of information, advice and advocacy at theNational Autistic Society (NAS), says people with autism face a “raft of challenges” that might make self-harm more likely.

“Autism does bring specific difficulties – we’d like to see more training on understanding autism and its relation to self harm,” she says. “The key is understanding the individual and understanding the underlying causes.” Lacking this understanding could lead to a social worker misinterpreting why someone is self-harming, Hattersley adds.

“The individual might not have done it before, they may be hitting their head because they may have communication difficulties and they’re trying to communicate a physical problem – you might miss an ear infection,” she says.

Hattersley acknowledges that it can be difficult for professionals to admit they are struggling with the issue of self-harm. NAS has set up Network Autism, a forum where professionals can read research, and discuss with each other, the issue of self-harm and how it relates to people with autism.

YouthNet’s chief executive Emma Thomas says all practitioners working with people who self-harm would benefit from a better understanding of the problem. She adds: “If social workers are more aware of services like TheSite.org, many more young people can be directed to safe, anonymous online support to complement the vital offline support they need.”