Dáil Éireann Debate, Thursday - 2 May 2024
303. Deputy Catherine Connolly asked the Minister for Health the status of the roll-out of eating disorder outpatient teams across the country; the number of teams established to-date and the locations of same; the funding allocated to eating disorder outpatient teams in 2023 and 2024; his plans to allocate additional funding to eating disorder outpatient teams; and if he will make a statement on the matter. [20092/24]
Amharc ar fhreagraAs the Deputy will appreciate, eating disorders are very complex, very individual and can be one of the most serious mental health illnesses.
Historically, there has been a lack of publicly funded services for people with eating disorders in Ireland. This is now changing, with the Model of Care for the National Clinical Programme for Eating Disorders launched in 2018. Since I have come to Office in July 2020, I have prioritised the roll out of the National Clinical Programme for Eating Disorders.
90% of eating disorder services are now delivered within the community which research shows is the most effective treatment. It is recognised that a small number of people, mainly with restrictive eating disorders such as anorexia, will require inpatient care for short periods for stabilisation and refeeding.
The National Clinical Programme for Eating Disorders is being implemented across the country by multidisciplinary teams on a phased basis. There are now 11 teams in place: 6 Adult and 5 CAMHS teams. It takes 12-18 months to set up a multi-disciplinary team, led by a Consultant Psychiatrist. While funding to roll out teams has been in place for several years, recruitment during the COVID-19 pandemic was very challenging. Six new teams started in 2023. There are now 100 people working across eating disorder teams, including 80 eating disorder Clinicians with 10 Consultant Psychiatrists. It is my stated intention to continue to deliver expanded services for people with eating disorders, through reaching the planned 16 specialist teams. One additional team of specialist eating disorder Clinicians has been funded under Budget 2024.
The location of the 11 eating disorder teams at HSE CHO level is as follows:
• CAMHS ED CH04 (Cork/Kerry)
• CAMHS ED CH07 (Dublin/Kildare/Wicklow)
• Adult ED CH06 (Dublin/Wicklow)
• Adult ED CH09 (Dublin North City & County)
• Adult ED CH04 (Cork/Kerry)
• CAMHS ED CH02 (Galway/Roscommon/Mayo)
• Adult ED CH01 (Sligo/Leitrim and Cavan/Monaghan)
• Adult ED CH05 ( Tipperary/Carlow/Kilkenny/Waterford/Wexford)
• CAMHS ED CH09 (Dublin North City & County)
• CAMHS ED CH06 (Dublin/Wicklow)
In 2023, 385 people had an eating disorder diagnosis. It is important to note that in the same year, 343 people with an eating disorder diagnosis were discharged from specialist services back to their GP.
The HSE works hard to meet the needs of people with eating disorders in the setting most appropriate to their needs, whether that be community eating disorder teams, beds in the public system, specialist beds from private providers (funded by the HSE) or under the Treatment Abroad Scheme. Since 2020, 14 people have availed of the Treatment Abroad Scheme.
Adults who have an eating disorder diagnosis and require inpatient care can be referred to any of the 66 HSE acute in-patient mental health approved centres nationally. I do accept that not all of these approved centres may have the specialist expertise available and in situ as required for all cases. New pathways have been developed between the 6 specialist Adult eating disorder teams and the relevant approved centres in their particular area to provide liaison supports.
Eating disorders affect a relatively young section of the population, with over two-thirds of referrals to the National Clinical Programme last year involving young people under 18. There are 20 dedicated eating disorder beds across the four 4 CAMHS in-patient units. At present, there is no waiting list for young people to access these dedicated eating disorder beds.
Following increased demand for services, and recent preliminary Census 2022 data showing an overall increase in population, a review of the Model of Care for Eating Disorders is planned during 2024. The outcome of this review will inform the eating disorder teams’ staffing requirements from 2025 onwards. In addition, a review of bed capacity across all mental health facilities – including adult eating disorder beds – has taken place and is under consideration by the HSE. I am of the opinion that there has to be a geographical focus on adult eating disorder beds.
A dedicated investment in eating disorders continues, and last year the HSE spent €8.1m on eating disorder services, with a further €4.5m spent on specialist treatment through the Treatment Abroad Scheme. In addition, €750,000 has been allocated since 2021 by the Department of Health Women’s Health Fund to provide for consultant medical/paediatric and hospital dietitian sessions.
As part of my continued drive to improve eating disorder services, I recently announced increased funding for an additional adult eating disorder team. This team will be based in CH07, which will cover the area of Kildare/West Wicklow, Dublin West, Dublin South City, and Dublin South West. This will bring the total number of eating disorder teams nationally to 12.
I want to reassure the Deputy that I remain firmly committed to enhancing specialist services for eating disorders, including improved access and shorter waiting lists.
