Approximately 1.25 million people in the UK have an eating disorder. Throughout the week, we shared information and tips to support parents and carers on the many eating disorders affecting children and young people’s mental health.

What is an eating disorder?

Children’s mental health has never been so critical, this week offered a vital opportunity to reflect on how we can support young people.

Last year, NHS Digital found 12.9% of 11 to 16 year olds and 60.3% of 17 to 19 year olds had possible eating problems but what is an eating disorder?

An eating disorder is a mental health condition where you use the control of food to cope with feelings and other situations. Unhealthy eating behaviours may include eating too much or too little or worrying about your weight or body shape.

Anyone can get an eating disorder, but teenagers between 13 and 17 are mostly affected. Are you supporting a child with an eating disorder or need support yourself? Watch the videos below to see four ways you can support a child or young person with an eating disorder.

As part of the Mind of the Matter series, Professor Ulrike Schmidt from King’s College London, discussed how eating disorders have manifested in groups of people over the pandemic, exposed health inequalities and a disparity in access to treatment – you can find the full video below.

With treatment, most people can recover from an eating disorder. Cassius, an ex-service user, shared his story of recovery adding that “Recovery is more than possible. It happened, and it’s made me who I am today.”

What are the different types of eating disorders?

Anorexia Nervosa

Anorexia can cause severe physical problems because of the effects of starvation on the body. If you’re worried about a child or young person’s eating habits, weight or shape – the best way forward is to get help and support early.

Binge Eating Disorder (BED)

There are a number of ways that binge eating disorder can impact a young person’s life. Often (though not always) it can cause weight gain, and in terms of physical health, can be associated with high blood pressure, high cholesterol, type 2 diabetes and heart disease.

Bulimia

There are several reasons that someone might develop bulimia, and many factors that can contribute but know that just being there for them can also play a crucial role in helping them to get better. If you’re worried about someone you know, even if only some of the signs are present, you should still seek help immediately, as this gives the best chance of recovery.

What is EDIFY?

EDIFY (Eating Disorders: Delineating Illness and Recovery Trajectories to Inform Personalised Prevention and Early Intervention in Young People) is a four year project, led by researchers at the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s which aims to revolutionise how eating disorders are perceived, prevented and treated in young people.

By combining the arts and science, researchers will build a detailed picture of why young people develop eating disorders, how they progress over time and what we can do to help.

The EDIFY project, involving over 1000 participants, ensures young people with lived experience of eating disorders are at the heart of the project, serving as advisors and co-producers throughout.

Through this work we will expand professional and public perceptions of eating disorders, share under-represented voices and encourage advances in policy and clinical practice.

In their PaperMate series, the EDIFY team speak to eating disorders researchers about recent projects, such as the experiences of men and the impact of COVID.

What is FREED?

FREED is the First episode Rapid Early intervention for Eating Disorders service for 16 to 25-year-olds who have had an eating disorder for three years or less.

Young people getting help for their eating disorder through FREED are given rapid access to specialised treatment which gives special attention to challenges we know young people face during these years of their life, and in the early stages of an eating disorder.

Originally developed at South London and Maudsley NHS Trust and King’s IoPPN, the Health Innovation Network and Academic Health Science Network have since supported Mental Health Trusts across the country to adopt FREED. More than 2,000 young people nationally have benefitted from the service since 2020, with an initial evaluation suggesting FREED can reduce waiting times by 32% for assessment and 41% for treatment

Most recently, in her BBC documentary Zara McDermott: Disordered Eating, Zara met with our experts and service users at FREED to explore disordered eating. Filming took place at Maudsley Hospital in Summer 2022.

The new FREED-Mobile study, which is now recruiting, is exploring whether online resources could help young people in their decision to seek support for eating difficulties to help facilitate early intervention.

External Support:

Beat – Eating Disorders: https://www.beateatingdisorders.org.uk/

Kooth: https://www.kooth.com/

First Steps: https://firststepsed.co.uk/

Many situations could trigger a mental health crisis in any young person. Around this time of year, it can range from a change in routine, loneliness, overwhelming amounts of pressure, a recent bereavement, and other scenarios.

A mental health crisis means different things to different people. You may feel your child’s mental health has been getting worse over time or that something has happened to make them feel this way. Young people that struggle with their mental health often have more difficulty and react differently to triggering situations.

In these circumstances, there are times when you need urgent suppor1t. It can be overwhelming, and you may feel unable to cope. No matter what your situation is, we are here to help.

How do I know if my child is having a mental health crisis?

There are several signs your child may be experiencing a mental health crisis, these can include:

• They might want to hurt themselves, or someone else
• They might hear voices
• They might see things that are not real
• They might think people are watching them or trying to hurt them
• Making threats to others or themselves
• Feeling low
• Suffering from intrusive thoughts

This list above contains many but not all of the possible signs that your child may be experiencing a crisis. It is best to follow your instincts. If you feel your child is behaving much differently than normal and the situation seems like it is getting out of control, then your child is most likely experiencing a crisis.

What do I do if I suspect my child is having a mental health crisis?

Once you have identified that your child could be having a mental health crisis, you may want to consider the following questions:

1. Do you feel your child is in immediate danger to themselves or others?
2. Can you handle the situation yourself or do you need help?
3. If you need help- what type of help do you need and from who?

If the answer to question one is yes, then please call for help immediately. We can offer telephone advice, support, or crisis counselling for young people concerned about a deterioration in their mental health. We also support parents and carers who are concerned about a young person.

• For South London and Maudsley CAMHS support, out-of-hours call the Crisis line on 020 3228 5980.
• Monday to Friday from 5 pm to 11 pm
• Weekends and Bank Holidays from 9 am to 11 pm

Opening Times over the Christmas holidays are 9 am to 11 pm on the following days:

• 24th December (Christmas Eve)
• 25th December (Christmas Day)
• 26th December (Boxing Day)
• 27th December
• 31st December (New Years’ Eve)
• 1st January (New Years’ Day)

Who do I call when the CAMHS Crisis Line is closed?

The 24hr Mental Health Crisis Line supports children and young people when the CAMHS Crisis Line is closed:

• Lewisham, Lambeth, Croydon, and Southwark call South London and Maudsley services on 0800 731 2864
• Kingston, Merton, Richmond, Sutton, and Wandsworth call South West London and St George’ services on 0800 028 8000
• Greenwich, Bexley, and Bromley call Oxleas services on 0800 330 8590

What do I do if I am unable to keep people safe?

If you are with someone who has attempted suicide, call 999 and stay with them until the ambulance arrives.

What if I’m unsure whether my child needs help?

If you are not sure, it could help to have a conversation with the young person you’re concerned about. We understand that having this conversation with your child is not an easy thing to do. It can be terrifying and overwhelming. Here are some steps and tips below to help you start the conversation.

1. Tell your child what you have observed that is worrying you
2. Let them know you are here for them, and you want to help
3. Ask them as calmly and directly to explain how they’re feeling – just listen
4. If they are not willing to talk, please do not force them
5. Do not leave them alone if you feel they are at immediate risk
6. If your child is not in immediate danger, you should still seek assistance

For the CAMHS crisis line, call 020 3228 5980 during the hours above, or call 111 www.111.nhs.uk

How can I calm the situation down?

If your child has a safety plan, follow any planned strategies you have in place. If you do not yet have a safety plan, try any strategies you feel may be effective in this situation. The intensity of the situation can cause us to project our fears or opinions so do your best to stay calm.

Keep in mind that, your child may be frightened by the feelings they are experiencing. Symptoms such as suspiciousness or distorted thinking can cause your child to be fearful and not trust other people – even you.

You may also want to consider some of the following tips to help de-escalate the situation:

• Try to not raise your voice or talk too fast
• Try not to challenge your child even if what they are saying seems unreasonable to you
• Try to use positive words or phrases
• Stay with your child but try not to restrict their movement
• Listen actively and try to give positive support and reassurance
• Ask simple questions and repeat them if necessary
• Try not to take your child’s actions or comments personally
• Don’t handle the crisis alone if you have people who can support you
• Try to remove all sharp and dangerous objects from your child’s room and the home that might be thrown during a rage or used to harm themselves
• If you care for more than one child, it could be beneficial to have a plan and a safe place for other children to go when a crisis occurs, if available to you

If you’re worried about a young person’s mental health, we can support you in the following ways:

• If you need support call the CAMHS Crisis Line on 020 3228 5980 or South London & Maudsley’s 24hrs Mental Health Crisis Line on 0800 731 2864
• If you are with someone who has attempted suicide, call 999 and stay with them until the ambulance arrives

Extra help

You can also get support from the following places:

Childline

Childline offers a free confidential helpline for children and young people in distress and offers support from counsellors online. Call 0800 1111, or get in touch via www.childline.org.uk

Shout

Shout is a 24-hour text service for anyone in crisis or struggling to cope. Text Shout at 85258, or visit www.giveusashout.org

Samaritans

24-hour confidential emotional support for people experiencing distress, call 116 123.

Kooth online counselling service

A free, safe, and anonymous support online wellbeing community is available at www.kooth.com