What was the impact of a global pandemic (COVID-19) lockdown period on experiences within an eating disorder service? A service evaluation of the views of patients, parents/carers and staff

Abstract

Background The World Health Organization declared the outbreak of COVID-19 as a global pandemic on the 11th March 2020. As a result, the UK Government imposed severe restrictions on working and social contact as part of “lockdown.” Whilst the full extent of the pandemic’s impact on eating disorder patients is unknown, the literature suggests that patients with pre-existing mental illness may be more vulnerable to the mental health impacts. In addition, the restrictions greatly reduced the access to mental health services and presented new challenges to service delivery. A service evaluation was carried out to explore how the COVID-19 global pandemic changed service provision in a young person’s eating disorder service and how this affected patient, family and staff experiences. Methods An audit was carried out to explore how the lockdown period had impacted referrals and service delivery. Quantitative data was collected in an online survey and qualitative data was collected in two formats: open ended answers as part of the online survey and open-ended focus groups, structured using narrative enquiry. The 43 participants consisted of 12 patients, 19 parents/carers, and 12 staff members. Patients were under the age of 18 and had a diagnosis of an eating disorder. Results COVID-19 and lockdown increased the pressure on the service and changed service provision significantly. This has impacted the relational experiences for patients and their carers and staff have been faced with new challenges. Patients, parents/carers and staff all preferred face-to-face appointments over virtual options. There was no difference in service satisfaction before and during COVID-19. Conclusions It is possible to provide an eating disorder service in lockdown restrictions that patients and parents report high satisfaction with. Providing face-to-face appointments at the beginning of treatment and including families in the planning should be prioritised. Staff support is crucial to be able to continue delivering high quality services. The key themes are identified, and clinical recommendations are made to guide service delivery.

Moving online: young people and parents’ experiences of adolescent eating disorder day programme treatment during the COVID-19 pandemic

“…Despite the reported equivalence in alliance ratings between online and face-to-face treatments [ 25 ], this has not been reported in a recent meta-analysis [ 26 ], nor indicated in the current study. The current findings are similar to those of a recent investigation of online treatment experience during the covid-19 pandemic in the outpatient context [ 12 ]. There was a strong preference, particularly by the young people, for a return to face-to-face working.…”

“…Parents generally stated a preference for keeping meetings virtual. This matches the experience of adolescents, carers and clinicians in the outpatient treatment context during the pandemic [ 12 ].…”

“…While several studies have emerged detailing guidelines and the experience of moving outpatient eating disorder treatment online [ 12 , 13 ], no study to date has explored this in an adolescent day programme context. Emerging evidence suggests it has been a promising way of working for adults with eating disorders during the pandemic [ 14 , 15 ].…”

Is this the ‘new normal’? A mixed method investigation of young person, parent and clinician experience of online eating disorder treatment during the COVID-19 pandemic

“…As a result of the COVID-19 pandemic, mental health care, including care for people with eating disorders, has had to rapidly transition to virtual delivery [ 1 – 3 ]. Reports indicate the exacerbation of symptoms for existing patients [ 4 – 6 ], and an increase in referrals to eating disorder services across age groups [ 7 ].…”

Abordaje en Comenzar de Nuevo de los TCA durante la pandemia

“…Contamos con el programa residencial, de atención al paciente en crisis, hospital parcial, intensivo ambulatorio y consulta externa. De acuerdo con el reporte de Shaw et al (2021), tanto familiares como pacientes prefieren la interacción cara a cara que cualquier otra opción virtual. Sin embargo, dadas las circunstancias, tuvimos que migrar la consulta externa e intensivo ambulatorio a teleconsulta.…”