Inpatient wards are never nice places to be; they can be frightening, frustrating, dictative wards. Anything other than specialist eating disorder units where the service is designed to support and treat the eating disorder service users are suffering with can make acute or other specialised support all the more difficult.
My first inpatient experience was to an eating disorder unit. I remember sitting in costa after being told I was going to have to start inpatient treatment for anorexia nervosa the next day and phoning to mum to break the news and then having to tell my university that I would have to defer absolutely terrifying. I had only been involved with the eating disorder outpatient service 4 weeks and still hadn’t accepted my diagnosis, it all felt rushed and I was resistant to being classed as an anorexia sufferer. I can’t remember my first month or so but slowly came around to being in treatment and it was refreshing to find others like me who had the same thoughts and experiences with anorexia. The groups were all designed directly to focus on anorexia and drive the sufferer forward in their recovery. There was the medical side of it which never stopped being utterly traumatic in my ten months there and I resisted the weight gain side of treatment and at discharge I barely made any head weigh with the weight side of things but I also left with a whole set of skills and a group of friends who truly got it.
Maybe my experience having first been such a safety net and so understanding has made me biased but I’ve never been able to recreate the experience in acute wards. All my admissions since the EDU have been to acute wards and suddenly I was thrown into the world of adult mental health. Each time I have been hospitalised I’ve relapsed to anorexia, maybe not in weight although in some cases lost a significant amount of weight but in behaviours. Every time it’s reached the level where I stop eating and drinking completely. It’s hard on an acute ward to cater to account for all service users difficulties where the funding is low and the supply so demanding. It means though that eating disorder patients can easily slip through the net and only picked up upon when crisis level has been reached. I’ve found that as I’ve moved through services my ability to sustain a low weight and lack of nutrition has deteriorated and in this admission found myself in general hospital for IV fluids. It’s come to the point now that everyone accepts I won’t eat meals and instead have ensure drinks. It can be quite isolating not finding myself able to eat meals in the dining room and I find myself wondering how have I found myself in this position, again.
Acute wards are all about survival and crisis management but this is often to the detriment where specialist services are called in. The level of support and guidance an eating disorder patient is simply not available and in an ideal world that wouldn’t be the case. But for now it’s not and that needs to change.