National adoption and spread: an update on our national programmes Dr Jaco Serfontein, Consultant Psychiatrist in Eating Disorders at Cambridgeshire and Peterborough NHS Foundation Trust, explains how Eastern AHSN is ensuring young people get the treatment they need within a critical time window E ating disorders are serious mental illnesses that involve extreme concern about eating, weight or shape, plus disordered eating. It is estimated that around 1.25 million people in the UK have an eating disorder1. Most eating disorders develop during over their lifetime and they have the highest mortality rates of any mental health disorder2. Research tells us that we should try and reach someone with an eating behaviour are more easily reversed. After three years, eating disorder symptoms tend to become hard-wired in the brain which means it gets harder to make changes and there may be long-lasting consequences3,4. There are three main reasons for this: 1 2 For anorexia nervosa in particular, illness duration is a key predictor of treatment outcomes. Outcomes are best with duration of illness less than 3 years. Growing evidence suggests that eating disorders functional brain changes. Eating disorder behaviours are initially rewarding, then habitual and FREED Inspiring change through early intervention for eating disorders 3 then neurocognitively engrained. Because eating disorders typically develop in adolescence and young adulthood, when the brain is still developing, these brain changes have potential to disrupt brain maturation. There are two key things that stop early intervention for eating disorders: AHSN Network is working with local NHS systems across the country to First episode Rapid Early intervention for Eating Disorders (FREED) service model and care package. The FREED programme aims for 16 to 25-year-olds with suspected anorexia nervosa, bulimia nervosa or binge eating disorder who have had the condition for less than three years to be triaged within 48 hours of the referral and begin treatment within four weeks. This approach has been found to improve the quality of life and reduce the severity and longer-term impact of eating disorders on patients and families5. Beat Eating Disorders. (2021). How Many People Have an Eating Disorder in the UK?. Available: https://www.beateatingdisorders. org.uk/how-many-people-eating-disorderuk. Last accessed 28/04/21. 1 Priory. (2020). Eating Disorder Statistics. Available: https://www.priorygroup.com/ eating-disorders/eating-disorder-statistics. Last accessed 28/04/21. 2 Brown A, McClelland J, Boysen E, Mountford V, Glennon D, Schmidt U (2016). 3 early intervention in eating disorders): service model, feasibility and acceptability. Early Intervention in Psychiatry, 12, 250-257. McClelland J, Hodsoll J, Brown A, Lang K, Boysen E, Flynn M, Mountford VA, Glennon D, Schmidt U (2018). A pilot evaluation of a novel First Episode and Rapid Early Intervention service for Eating Disorders (FREED). European Eating Disorders Review, 26, 129-140. 4 NHS England (2015). Access and Waiting Time Standard for Children and Young People with an Eating Disorder Commissioning Guide. London: NHS England. 15. Available: https://www. england.nhs.uk/wp-content/ uploads/2015/07/cyp-eating-disordersaccess-waiting-time-standard-comm-guid. pdf Last accessed 28/04/21. FREED The importance of early intervention Simon Brown is the patient and public involvement representative for the FREED programme: Eating disorders are so devastating because as you get deeper into the illness it gets harder and harder to leave it behind and engage in your treatment. Thats why its so important for young people to get tailored treatment as early as possible. The tragedy of this illness is not just the loss of life, but also the loss of potential. My daughter, Emma, was a force of nature; gifted academically and a talented runner being trained to become an Olympic-level athlete. Despite this, right up until she passed away, her life was dominated by an illness she was afraid of recovering from. FREED is the best chance we have of enabling people to recover or manage their condition and live a happy and healthy life. It gives me hope that we can provide young people people in the early stages of an eating disorder and complements rather than replaces existing services and treatments. It emphasises early, proactive engagement with reduce the impact of eating disorders and save lives. both the individual and their families while paying particular impact of social media use, and transitions into adulthood (out of school, to university, into work). Across the East of England, Eastern AHSN has taken a coordinated system-level approach to the adoption and spread of FREED. I am the clinical advisor for the programme, and we began by assembling an implementation group to bring together NHS bodies, commissioners, integrated care system leads, clinicians and patients to shape our strategy. We are ahead of schedule to embed a FREED cover our region throughout summer 2021. We have also established a community of practice to provide peer support and enable collaboration between FREED champions and service managers. The group and materials to support the roll out. 5 References Share this article important and to ensure this, we have completed equality impact assessments for each site. Additionally, the Eastern AHSN team has been working with their neighbouring AHSNs to ensure that FREED services in our region are connected with those in surrounding regions. Over the next year, we will continue to be working to ensure all young people in the region are able to rapidly access support and treatment for eating disorders. Eastern AHSN continues to provide programme support to the FREED programme and we are working with commissioners and NHS England and NHS Improvement to ensure the long-term sustainability of the service. If youd like to know more... Find out more about the FREED programme on our website