"Eating Disorder Service Inadequate"

Dear Susie Porteous

Thank you for your reply. My daughter is currently talking with the psychiatrist at the unit who has recognised the huge decline in her mental health and I believe is surprised to find a cessation in prescribed therapy.

In the 8 yrs since she has been on the radar of NHS Forth Valley, 2024 is the first time she has had a full assessment by a clinical psychologist and then to offer therapy with a qualified clinical psychologist. Her issue was identified, and for the first time, my daughter felt seen and heard and there was hope. The schema prescribed offered hope as it resonated for the first time. The initial part of therapy was started over 3 month and then just scrapped. Abruptly and without notice. What psychological service would do this to an extremely vulnerable patient?

Emails have been exchanged to explore alternative ways to access Schema Therapy, including potential referrals to external providers via a service-level agreement or cross-charging arrangement. My daughter has been told categorically that this is not an option. How can this be acceptable?

I will ask re permission to engage with you but, right now, my daughter is in such a fragile position I actually do not believe she would cope and is terrified of repercussions. Psychologically she actually has lost all hope and her mental health is spiralling downwards thanks to NHS Forth Valley dropping her psychological therapy. So, what do I do, when my daughter is too fragile to pursue this? I want to advocate for her mental health, but am left in an impossible position.

Of note, another ED service she saw very briefly and were appalled that she had never had a full assessment or clinical therapy intervention by a qualified Clinical Psychologist in the 8 years she has been seen by the FV ED unit.

Of note, the only Clinical Psychologist in employment is leaving and NHS Forth Valley are making no provision in their advertising to ensure the next candidate is qualified in the more complex evidence based therapies such as MANTRA recommendations, Schema Therapy etc. What sort of ED service considers this to be the bar in terms of employing a head of psychology within the unit? An ED unit requires a psychologist versed and experienced in the range of (evidence based) therapies often needed for the complex cases that are beyond the scope of CBT.

I have worked within the NHS for many years and am frankly spitting feathers at the way my daughter has been sidelined and failed by the service.

So, my daughter will likely not agree to my making a fuss as she is too fragile to psychologically deal with the fallout. In the meantime, due to being let down by the unit, her weight gain and progress of nearly a year is in reverse and she feels hopeless, unmotivated and less likely to recover.

I am upset. And I am watching my daughter slide. And this could have been avoided if FV agreed to a service level agreement or cross charged. And the department say it’s a hard no. This is entirely unacceptable.

I do not think she will agree to let me discuss with you, for the understandable reasons of fear and overwhelm. That said, I’m sure you will already know of her case. In reality, FV have failed to provide the care necessary for her complex psychological needs, despite identifying exactly what those needs are, Furthermore they are refusing to consider the reasonable request made for service level agreements or cross charging. I have enough on my plate as the mother and carer to someone struggling and not getting the help they need, but I will leverage all ways to fight for the care she deserves and should have access to. If I fractured a hip, and NHS FV did not have a surgeon, I would have to be referred to a place that did have a surgeon and availability - NHS or private hospital - and it should be no different for complex psychological needs.

I hope you can understand my frustration and anger at the situation, and it comes from a healthcare professional AND mother’s perspective. If I get permission, I will be in touch (thank you), but in the meantime please take a close look at how the psychological services within the ED unit at Livilands are failing those patients who are actively and willingly engaging in recovery, in need during the difficult recovery journey and please consider the collateral damage.

As a parent who, 8 years ago, begged Livilands staff for help to guide and advise me in helping my daughter, I was met with indifference, shrugged shoulders and the reply of ‘she just needs to eat more’, there is a long way to go in the provision of a service dedicated to actually helping those under their “care”.

It seems things have not much progressed in the intervening years.

thank you.