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TX: 28.01.04 – NEW NATIONAL GUIDELINES FOR TREATING EATING DISORDERS PUBLISHED

PRESENTER: WINIFRED ROBINSON

THE ATTACHED TRANSCRIPT WAS TYPED FROM A RECORDING AND NOT COPIED FROM AN ORIGINAL SCRIPT. BECAUSE OF THE RISK OF MISHEARING AND THE DIFFICULTY IN SOME CASES OF IDENTIFYING INDIVIDUAL SPEAKERS, THE BBC CANNOT VOUCH FOR ITS COMPLETE ACCURACY.

ROBINSON
If you're a regular listener to You and Yours you may remember this:

DUNHAM
Her life became completely chaotic. By chaotic I mean every time I heard the ambulance bell ringing I didn't know whether they were taking Roz to hospital, so many times she was taken into hospital either because she'd broken an arm or because she had just passed out. It was a nightmare, it was a nightmare which strangely enough I would willingly have back again.

ROBINSON
Gitti Dunham, the mother of Roz who struggled with eating disorders for 10 years before she committed suicide at an NHS psychiatric unit two years ago, she was 23. We featured Roz's story last February. It highlighted the fact that reasonably good treatment of children with eating disorders tends to fizzle out when they reach the adult mental health service, there isn't even national agreement about the age at which patients should be switched to the adult service. Today the National Institute for Clinical Excellence has attempted to put right these inconsistencies, it's published the first national guidelines for the treatment of anorexia and bulimia. Professor Simon Gowers chaired the group which drew up the new guidelines.

Professor Gowers this transition between child and adult mental health services comes up again and again, is it something that you've addressed?

GOWERS
Yes, good morning.

ROBINSON
Good morning.

GOWERS
It is a concern at all stages really and in many aspects of the treatment of eating disorders that there's not good communication between agencies and not good advice for the public.

ROBINSON
So what are you suggesting should happen then?

GOWERS
Well the guideline offers advice to clinicians and to the general public about the best evidence for the treatment of the range of eating disorders but particularly highlights the need for communication and liaison between medical and mental health services and between child and adult services.

ROBINSON
Have you settled this business of when does a child become an adult, when is it appropriate to pass a case on?

GOWERS
Well passing on is an over-simplification, I think there needs to be a liaison and overlap and rather than have a rigid age cut off one should take into account the needs of the particular teenager - some are at a different developmental level than others, so depending whether the young person's living at home, still involved in education, or more independent, the rules might need to be varied accordingly. But in general child and adolescent services now will run up till 18 with adult services from 18 and beyond. And the guideline does emphasise the importance of young people being treated in age appropriate services.

ROBINSON
What other problems did you find?

GOWERS
Well we found that services over the country were really quite patchy, there were some parts of the country where services were very well developed and others where there was no local or reasonably accessible specialist eating disorder service. And then the style of treatment that one could expect varied depending more on the local preference of the service rather than the evidence. And so the guideline aims to standardise treatment so that wherever you live in the country you should expect treatment that's based on good evidence rather than just the preference of the local doctor.

ROBINSON
And what do you say to those who say that the fundamental problem here is that eating disorders are a Cinderella disorder in the sense that many people regard them as just an extension of normal teenage anguish and they are within a Cinderella service - mental health - can guidelines, however good they are, compensate for basic lack of funds?

GOWERS
Well I think that that's certainly the hope, the expectation that arises from the publication of this guideline is that it does raise the profile, it draws attention to the severity of these disorders and your opening piece I think highlights the mortality and the severe complications that can arise. And it's not just the lay public who sometimes have a lack of understanding about the needs of these patients, GPs and those in primary care, who aren't specialists, often are short of the information and guidance about how to best manage these disorders. So this is a starting point but I hope that health commissioners will heed the guidance and develop services appropriately.

ROBINSON
Professor Gowers thank you. Well listening to that was Gitti Dunham, the mother of Roz Dunham, are you at all reassured by what you've heard?

DUNHAM
Yes very much. I haven't actually had time to look at the NICE guidelines in depth but they sound as if there's great potential there for improvement.

ROBINSON
I know that you have set up a trust in memory of your daughter, what is that money going to be used for?

DUNHAM
Well we're hoping it'll be used for health professionals who want to have, again, expertise in eating disorders and it will cover the special training that they will need.

ROBINSON
Gitti Dunham many thanks.




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