Eating disorders in south east Scotland
Forth Valley Fife Lothian Borders

Borders

Education and public awareness (tier 0)

Publicly accessible information

NHS Borders produces a wide range of easily accessible information through our online information portal the Borders Public Information Support Site for You (BISSY). This site includes leaflets on eating disorders and links to other reliable sources of information.

www.bissy.scot.nhs.uk/

Information leaflets about eating disorders have been developed by the Eating Disorders Network South-East Scotland and are available elsewhere on this website.

It is hoped that this SE regional website will also prove a useful tool for raising the level of knowledge of eating disorders in the general public.

Our new information leaflets about eating disorders

Organisations such as b-eat also provide excellent information leaflets and web-based information.

www.b-eat.co.uk/

A self-help manual for Bulimia Nervosa is available for free download from the ‘For the public’ section of this website and from the Moodcafe website.

www.moodcafe.co.uk/

The national “see me” campaign includes information addressing the stigma around eating disorders.

www.seemescotland.org.uk/

Communities and local neighbourhoods (tier 1)

There are currently no Tier 1 eating disorders services in NHS Borders but people with eating disorders can access a number of services for advice and intervention through their GP.

Primary healthcare: primary care mental health (tier 2)

GP

In the first instance, contact would be with the GP. The GP may monitor the patient medically according to NHS QIS guidelines and may refer the patient to one of our 3 community mental health teams (CMHT), our community dietetic service, our Mental Health Dietitian or our Specialist Nurse for Eating disorders via the appropriate CMHT.

NHS QIS guidelines

NHS Borders Mental Health services

www.nhsborders.org.uk/health-services/mental-health

Carer Support

Help, advice and support for carers is available from the Borders Carer Centre based in Galashiels. They are located at:

Brewerybrig, Low Buckholmside, Galashiels TD1 1RT 01896 752431

www.carers.org/local/scotland/galashiels/

Book prescription scheme

This is a scheme providing GPs and other primary care health professionals with information about self help books that can be recommended to help patients with mild to moderate mental health problems. These books can be ‘prescribed’ through a primary care based ‘book prescription’ service. A variety of self-help books are available which address problems such as depression, low self esteem, worry, anxiety and stress, panic and eating disorders.

Mental health services (tier 3)

Community Mental Health Teams

A number of people with eating disorders are supported and treated by staff in our 3 existing CMHTs. These teams are based in Duns, Peebles/Melrose and Hawick, covering the entire region of NHS Borders, and are made up of Psychiatrists, Psychologists, Mental Health Nurses, Occupational Therapists, Social Workers and trained support workers.

Our community mental health teams routinely take referrals for people with eating disorders who are medically stable enough to be managed in the community. When needed they are able to access support from or refer on to the Specialist Nurse for Eating disorders and the Mental Health Dietitian. Referrals can be made by a GP, CMHT, Doctor at the Borders General Hospital or other professional.

Specialist services, outpatient and inpatient (tier 4)

Specialist Eating Disorder Nurse

NHS Borders have a specialist Eating Disorder Nurse who is based in Melrose but provides a Borders wide service for people aged 16+.

Younger patients would be seen by the Child and Adolescent Mental Health Services team based at the Andrew Lang Unit, Selkirk.

Referral is via the appropriate CMHT to ensure that all of the persons needs are properly assessed and that there is appropriate continuity of care.

Problems would be moderate to severe in nature and assessment and treatment are offered mainly on an outpatient basis. Treatment will be individual although in time group interventions may be developed. Care is co-coordinated closely between the nurse, our specialist Mental Health Dietician and medical, psychiatric and psychology colleagues, often developing joint packages of care. The main aim is to treat and support people at home.

People with a less severe Eating Disorder are usually managed within the General Psychiatric services, sometimes with support and supervision from the Specialist Nurse or Mental Health Dietitian.

In Patient Admission

NHS Borders can admit Eating Disorder patients to our Acute General Psychiatric unit, Huntlyburn House which is adjacent to the Borders General Hospital. The specialist nurse and dietitian work closely with the inpatient staff to ensure continuity of care, particularly around diet and eating.

Should referral to a specialist independent sector unit (that is, The Priory Hospital, Glasgow or Huntercombe Hospital Edinburgh) be considered, this would require agreed funding by the Public Health Board of NHS Borders.

There are plans to develop an NHS in- patient unit for the South-East Scotland region and NHS Borders are part of this initiative.

Eating Disorders Network, South East Scotland

This is a multi-professional clinical network set up under the auspices of SEAT (South East and Tayside Regional Planning Group) to provide education, training, clinical and planning advice across the south east region of Scotland (Lothian, Forth Valley, Fife and the Borders NHS health boards).