Eating Disorders Awareness Week

Wera Hobhouse Excerpts

Wednesday 27th February 2019 Westminster Hall

[Wera Hobhouse (Bath) (LD)]

I thank the hon. Member for Angus (Kirstene Hair) for securing this important debate. It has already been said that this debate has cross-party support, and we have come a long way in recognising and understanding eating disorders. I find it depressing that although we have made this progress, increasing numbers of people are suffering from eating disorders. We must get away from just talking and start getting some change. I hope that Eating Disorders Awareness Week will bring about that change, so that we do not stand here next year without having made significant progress.

I will limit my remarks to the research that Beat has done that shows that eating disorders do not discriminate, and the importance of early intervention and prevention. Over the past five months, I have been campaigning to raise awareness. I have spoken before in this place about the need to recognise eating disorders early. Stories such as Hope’s highlight how ludicrous it is for people seeking help to be told that they are not thin enough.

At the heart of any improvement to eating disorders treatment lies education—of our medical staff, of the whole of society, of schools and of families. I have personal experience of a family member with an eating disorder, so I know very much how families and friends suffer around a sufferer. It is not just the sufferer who is affected, but those around them.

Eating disorders are too often trivialised and seen as an illness that exclusively affects one type of person. That is reinforced by research released this week by Beat, which found that discrimination was ingrained in how we view eating disorders. Beat’s research found that four in 10 people believed that eating disorders were more common among white people, and nearly 30% thought that eating disorders were most likely to affect people from higher socioeconomic backgrounds. The reality is that eating disorders do not discriminate.

The tragedy of eating disorders is that they are preventable. By focusing on early intervention, the numbers of those suffering can be greatly reduced, but the stereotypes around eating disorders mean that certain people are far less likely to recognise the condition and seek or be referred to treatment. For example, ethnic minorities are substantially less likely to be referred to eating disorder services than white patients, but once referred, ethnic minorities receive the same treatment as white patients. A central problem is what doctors and the public understand about the population of people who suffer from eating disorders. The network of family and friends who surround those with eating disorders make a great deal of difference to their recognising the condition and receiving the correct help.

Research on specialist out-patient family intervention for children shows that it is highly effective and reduces the need for in-patient care, which eases pressure on the NHS. New ways of looking much more holistically at the treatment of eating disorders are highly effective, and we should look at them. The research identifies the importance of a truly joined-up approach to recovery, ensuring that the community around an individual with an eating disorder is supportive and supported by the medical team. Those types of programmes are being run in select areas across the country, and they must be extended, given their positive outcomes.

Treatment for eating disorders is a postcode lottery. We need to look at that. We must set standards and deliver training that will help doctors and medical staff to identify people who need treatment, regardless of any preconceived stereotypes. Additionally, it is vital that we continue to listen to the stories of real people who have suffered from eating disorders, and hear what they have to say about their experiences of the system.

The last thing I want to mention is the Local Government Association’s “Bright Futures” campaign. It highlights to councils across the country the importance of increasing funding, and ensuring that all the promised £1.7 billion for children’s mental health is spent in children’s mental health, not elsewhere. Prevention and early intervention, as we have heard several times today, are absolutely key to saving many lives from being destroyed, including those of friends and families of sufferers. Together, we can make a real difference, but let us make it happen, rather than just talking about it.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health and Social Care (Jackie Doyle-Price)]

I thank all hon. Members who have contributed to this very constructive debate. They all showed massive care and compassion, with a recognition that we have come a long way but need to go a lot further. I am grateful for their constructive contributions.

I congratulate my hon. Friend the Member for Angus (Kirstene Hair) on securing this debate in Eating Disorders Awareness Week. I thank her for her very frank exposition of eating disorders, and of the helplessness felt not only by those who are suffering, but by those around them. It is essential that we ensure that people have access to the right mental health support in the right place and at the right time, because time is of the essence. Improving those services is a key priority for this Government, as part of our wider agenda to improve mental health services.

As several hon. Members have said, eating disorders are serious: they have some of the highest mortality rates of any mental health disorder. We need to ensure, more than ever, that people get access to support as early as possible, because eating disorders quite often begin when people are young. Representations have been made today about why our targets are for children, rather than adults. Those targets recognise the fact that early intervention is best and that issues often surface when people are younger, but that does not in any way diminish the challenge of ensuring that adults also have access to services.

That brings me to a point that several hon. Members have made: the perception that eating disorders affect only young white women. They do affect adults. I have heard of a case of an elderly lady in a care home being diagnosed with an eating disorder that she had obviously been suffering from for decades. One of the tests that I will set myself is for that never to happen again, because we need to ensure that people get early diagnosis.

As the hon. Member for Islwyn (Chris Evans) very frankly reminded us, eating disorders affect men and boys too. If there is a perception otherwise, it may partly be because men and boys are much less likely to seek help than women and girls. We need to make it clear that the issue can affect absolutely anyone, as the hon. Gentleman showed very courageously by sharing his own experience; I am very grateful for his comments.

It is important to continue to raise awareness. We need to reduce the stigma associated with eating disorders so that people are more likely to talk about them. Like all hon. Members, I pay tribute to the campaigners who do so much to raise awareness, particularly the charity Beat, which does absolutely excellent work. I also pay tribute to Hope Virgo for her campaign and look forward to meeting her very soon.

We cannot emphasise strongly enough that this is not about weight; it is about the mind. Some of the stories that were shared in this debate were quite horrific. If there is such lack of understanding among medical professionals—if the people we trust to look after us end up doing harm because they see eating disorders as a weight issue—we have a serious problem to tackle. Of course training has its part to play, but I should add that we expect a lot of our GPs. One of the real challenges is to continue to roll out multidisciplinary GP service teams to ensure that there is much greater expertise in each medical practice, rather than relying on one individual to be the expert on everything. Frankly, they are only human beings—they are not God.

[Wera Hobhouse]

I thank the Minister for giving way; I know that her time is very limited. When services let people go too early, the danger of relapse is much higher. We could prevent relapses by not letting sufferers go too early, when they are half better but not fully better.

[Jackie Doyle-Price]

The hon. Lady makes a good point that I will address further if I have time. We need to look carefully at the care pathway and at the whole practice of referrals and the journey that people take, so that we can ensure that they are in a position to manage their disorder. The truth is that no one is ever cured of these things; it is a matter of managing their wellbeing to tackle them.

I thank the hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron) for her acknowledgment that we have come a long way. She is right that we need to ensure that we have proper specialist services to do this work, because of the risk of harm. She is also right to mention obesity, which we could do an awful more to address. I watch a lot of rubbish TV—we work long hours here, so that is my relaxation—and I am horrified by some of the channels, which basically run a succession of programmes about weight that are almost freak shows. That is not how we should be talking about the issue if we want to encourage people to access help. We need to tackle the stigma around obesity as much as the stigma around any other disorder.

The hon. Member for Westmorland and Lonsdale (Tim Farron) and I have already discussed his concerns about his area. I know that there are challenges and we need to ensure that provision is sufficient. He spoke very frankly about the guilt and terror that people around those who suffer from eating disorders feel, because they genuinely do not know how to help their friend or loved one. Reducing stigma and raising awareness is partly about helping people to understand what they can do. Everybody wants to help, because nobody wants to see people suffer so much.

Social media has been mentioned a lot. I absolutely recognise that it can be a force as much for good as for bad, but I must say that we are seeing content that encourages harmful behaviour. It is about the whole psychology of people joining communities. When people use social media regularly, they can become isolated from the physical world and join an online world in which everyone is like them. It becomes normalising, and it can worsen their experience.

Equally, social media can be a community of self-help. I agree completely with the hon. Member for Islwyn that we have to be careful: of course we must challenge companies to be responsible, but it is not black and white, and we need to handle the issue sensitively. I am pleased to say that some companies are very responsive, but not all, so we will continue to challenge them. The hon. Gentleman raised an issue that particularly concerns me. It is one thing to regulate public platforms, but encrypted direct contact is having a growing impact. We need to look at Snapchat, WhatsApp and so on, because the fact is the Government are always three steps—probably more—behind technology.

The hon. Member for East Kilbride, Strathaven and Lesmahagow emphasised peer support. I could not agree more: peer support is important for mental health generally. If I could make one challenge to NHS commissioners, it would be to recognise that providing support to people who suffer mental ill health is not just about clinicians; it is about the voluntary sector and peer support workers. If we are to really step up to that challenge, I hope to see much more imagination in how services are commissioned.

I have so much more to say, but I am running out of time. With hon. Members’ indulgence, I will write to them—not least the hon. Member for Newcastle-under-Lyme (Paul Farrelly)—to outline our response to the points that they raised. We have a lot of figures and have shown that we are meeting targets, but I think all hon. Members would be more confident if there were more granularity—not least because of the cases raised today in which people have not received the treatment that they deserve.

Motion lapsed (Standing Order No. 10(6)).