SPRING 2006

Please pass on or forward to all who might be interested!                    ISSUE 2

This Issue includes…
 

1. Letter from Lewis McDonald, Deputy Health Minister
2. Area and other updates
3. Introducing SEDIG committee members
4. Upcoming events
5. New support website

Contact us –

Secretary –

SEDIG,
c/o Binny House
Ecclesmachan Road
Uphall,
West Lothian
EH52 6NL

*Newsletter items to -  smith47@ukonline.co.uk

*www.sedig.members.beeb.net

Editor’s apologies to Maggie Gray for omitting her name from the committee in last SEDIG News, and to Charlotte Procter for mis-spelling her name…sorry!

Programmes for …..
Tuesday 4th April 2006
Speaker – Dr Alex Yellowlees
Topic ‘Eating Disorders and Self Esteem’

Friday 20th October 2006
Speakers – Gráinne Smith and Dr Jane Morris
Topic – Working with Families 

**Dates had to be rearranged as Murray Royal now host tribunal sessions.   Sorry if this caused problems for any members – and thanks to Diane who coped calmly with the flurry of emails and phonecalls involved in the rearrangements.

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“ Lewis McDonald assures SEDIG that he will honour the commitment given to actively monitor progress in implementing Health Committee report and recommendations for treatment of eating disorders.”

“An Integrated Care Pathway to co-ordinate support and care, involving all relevant agencies, has been developed in Lothian.”  -SEAT update.

“The needs of carers and family members will continue to be recognised.” – letter from Lewis McDonald, West of Scotland update.

Scottish Mental Health Nursing Review will be available in 2006

International Academy of Eating Disorders plan a World Summit of Eating Disorders…

Research from all over the world will be the main topic for SEDIG discussions in 2007

"Active commitment to monitor progress in treatment for eating disorders" – Lewis McDonald

In his recent letter, Lewis McDonald quoting evidence in the NICE Guidelines, that family therapy is the treatment of choice for ED in young people under 19 with a less-than-3-year history of an eating disorder, says that HeadsUpScotland has funded family therapy courses across CAMHS in Scotland, and that to date almost 100 training places have been supported under this ongoing initiative.   HeadsupScotland has also funded an analysis of training needs of inpatient nursing staff working in CAMHS.

• Editor’s note – no mention anywhere of training, co-ordination and planning specifically for adult services….crucial for disorders which often begin in adolescence and continue into adulthood…

Regional and other ED updates…

All three regions - North, South and East (SEAT), and West of Scotland - have begun work on identifying what needs to be done and how to develop services for eating disorders.

North is first to appoint a lead clinician to coordinate and progress a managed clinical network… “A Managed Clinical Network gives an excellent opportunity to promote improved services in eating disorders”   Based in Royal Cornhill, Aberdeen, Dr Millar has already started work and will play a key role in developing co-ordinated services in northern Scotland, with an immediate priority reviewing the efficiency and deployment of current resources, preparing plans for improved services both short and long term.  Discussions are in progress about more local inpatients facilities, with major benefits in more easily maintained personal contacts as well as better long term continuity on discharge.  Effective cross boundary and joint agency working will feature in future, with close liaison with QIS (Quality Improvement Scotland), NHS Education Board and academic institutions.

SEAT has set up a regional planning group on ED services with ‘a clear and specific remit to bring about change and improvement in services and offer continuing support for those with eating disorders and their families.’   An Integrated Care Pathway to coordinate support and care, involving all relevant agencies, has been developed in Lothian.

”ANITT (Anorexia Nervosa Intensive Treatment Team) is a small multi-disciplinary team providing intensive treatment to people with low weight AN in Lothian who might otherwise have to be admitted to hospital.”   An NHS service, all referrals are through a GP.

West of Scotland states that ‘attention continues on updated and evolving current provision within a comprehensive Managed Care Network for the whole area, with a regional planning group in place.  Staff skills and training, quality and best practice are seen as key.  Eating disorders are a priority within the organisation of adolescent inpatient psychiatric care in Glasgow with similar priority attaching to community based care for this care group.’

• Editor’s note – again no specific mention of adult services…

NHS Quality Improvement Scotland review of Scottish ED guidelines in line with National Institute of Clinical Excellence guidelines …

Following completion of this review with its tough deadline of end of 2005, QIS will consider how guidelines will apply across Scotland, how implementation will be monitored, and consider the need for further guidance…
Watch This Space!

Scottish Mental Health Nursing Review included - for the first time ever - representatives from the world of eating disorders who stressed how specialist nursing care may make the difference between life and death for people admitted to hospital in a life-threatening condition because of eating disorders.   Their report will be available in 2006.

The international Academy of Eating Disorders has set up working parties to discuss the development of an internationally-recognised Patients’ Charter for patients and their families, and planning for a World Summit Eating Disorders conference.

NEEDS Scotland and SEDIG are represented on the AED Patient/ Carer Task Force by Gráinne Smith, who says ‘Fascinating hearing what’s going on all over the world.  Amazing to talk to folk in so many faraway places, including America, Australia, Japan, Nederlands, even England…and all from a telephone in Aberdeen or Stonehaven!’                                  (*See also page 3)

Research updates have come in from The Priory Hospital Glasgow and from Huntercombe Edinburgh
“The Joint Eating Disorders Research Project with Stirling University is continuing to go well.  The 2 year study is more than half way through and is due for completion in September 2006.” – The Priory Hospital Glasgow.
Huntercombe Edinburgh reports “Current research aims to evaluate the outcome of patients with AN, studying how an individual’s motivation to change, self esteem, tendency for obsessive thoughts, perceptions of their illness and other factors influence recovery.”
With Research as the 2007 SEDIG topic for meetings, further information about these fascinating projects is sure to be reported.

“Committee Members’ profiles help me know who does what in the organisation and who I can approach with ideas and information .”

"Membership of SEDIG is open to anyone with an interest in eating disorders, with an emphasis on a mix of professional and self help participation.  Most areas of Scotland are covered, and we have also welcomed members from Northern Ireland and North of England.  Members include GPs, psychiatrists, psychologists, nurses, dieticians, art therapists, NHS and private therapists, school counsellors, former sufferers, members of support groups, parents and other carers of people with eating disorders, men and women, NHS, private and voluntary sectors…. There are established links with EDA, and through medical members, EDSIG (Eating Disorders Special Interest Group, Royal College of Physicians)" – A Brief History of SEDIG, 2002

Who’s Who in SEDIG committee

Ian McDonald – Chairperson;  ‘I am the father of a young woman who has suffered from anorexia for many years.  I have had experience of both good professional support and the lack of it.  I have found my working experience as an educational psychologist helpful in coping with the situations arising from my daughter’s illness and also in participating comfortably in an organisation like SEDIG.’

Diane Whiteoak  ‘I have worked in healthcare all my working career, the last three posts being in hospital management with Huntercombe, Nuffield and BUPA.  I am as passionate about improving access to healthcare for everyone as I am to devoting time to my family in England, particularly to my beloved grand daughter!  I live in central belt and commute to Edinburgh.’    Diane is Secretary of SEDIG.

Judy Long – A chartered accountant, Judy has been a most efficient treasurer for over two years.  She has had personal family experience of eating disorders through being a carer for her daughter when she was ill.

Gráinne Smith, SEDIG News Editor;  ‘When my daughter aged 23 was diagnosed with AN, I had no information or support.  Since then I have worked to try to ensure that relevant information and support is available for carers to enable them to provide proper support for their loved ones, by working on various working parties and groups, collaborating in writing projects with professionals

Harry Millar is a Consultant Psychiatrist, now leader of the new Managed Clinical Network for northern Scotland, and has led Aberdeen Royal Cornhill eating disorders team for many years.  He has served on many committees and working parties who have worked to improve and develop treatment options across Scotland. 

Maggie Gray is a Nurse Psychotherapist, is interested in and helped develop effective treatments for complex disorders at the Cullen Centre where she has worked for 16 years, also offering training and clinical supervision for these therapies.  One of the founding members of SEDIG, she was chairperson for 3 years.   Maggie says she is also a bit of a ‘Drama Queen’, is involved in local amateur drama where she takes every opportunity to ‘act out’….

Alex Yellowlees,  Medical Director of Glasgow Priory Hospital, is a Consultant Psychiatrist with specialist expertise in treating eating disorders.  Before working in PrioryHealthcare he worked in the NHS, setting up outpatient eating disorders service in Tayside.  

Katy Park is Manager of the ED unit at Glasgow Priory, with a special interest in CBT and research, who helped set up the ED service there when it opened ten years ago. 

Louise Taylor is Clinical Nurse Specialist in ED at Glasgow Priory, has worked in eating disorders for 15 years in London and Glasgow, also helping set up the ED service at the Priory 10 years ago.

Chrissy Munro is a Clinical Psychologist with an interest in eating disorders, who works in a generic child and adolescent service in Inverness.

Jane Morris is a consultant Child and Adolescent Psychiatrist at the Young People’s Unit in Edinburgh, with special professional interests in eating disorders, complex psychosomatic conditions and structured psychotherapies and co-director of South of Scotland CBT Course and is developing a Scottish course teaching CBT for children and adolescents. In 2002 she helped set up the Glasgow Parry-Jones Service.  Within eating disorders she has particular interest in physical and psychological consequences of starvation, and in the needs of families and other carers.   Presently co-editor of the ABC of Eating Disorders for BMJ books, also an investigator in a multi-centre trial of web-based therapy for teenage bulimia.  Many years ago she suffered from an eating disorder and was fortunate enough to have excellent treatment and made a complete recovery.

Worldwide consultation under way – have your say now!
The Academy of Eating Disorders is currently organising a consultation exercise worldwide, as part of the development of a charter for eating disorders to be presented to WHO - in some parts of the world much progress has been made in offering good services, in other countries there are very few services. 

The AED questionnaire on which the charter will be based is now available… short and simple, details of how to take part and have your say are given separately along with SEDIG News.   Please spend a few minutes filling in the brief questions about what your 5 top priorities are for developing an effective service…and forward it to as many others who have an interest in eating disorders for their contribution.  “With a tight deadline to meet to collate the comments and ideas in time for presentation, it is important that everyone fills in and sends back their questionnaires as quickly as possible.”

**Editor’s note – Thanks to Joanna and Sarah for sharing their thoughts on the last SEDIG day.  Two more volunteers will be recruited to write their impressions of the next day, 4th April 2006, when Alex Yellowlees will be speaking on Self Esteem and Eating Disorders.

Co-ordination – lack of….
*Editor – ‘By accident I discovered a new self-help group had started only 30 miles away from NEEDS Scotland Aberdeen – yet neither of us knew until we met at an EDA training day…’

SEDIG recruit?
Lots of interesting and exciting eating disorders projects across Scotland – but no co-ordination at all.  To try to put people in different areas in touch with what may be happening very close to them – but they don’t know about it! - SEDIG are hoping to develop and promote co-ordination of Scottish efforts by recruiting a SEDIG member to build a database of groups/activities/treatments and so on.  SEDIG committee propose this wonderful person will have expenses paid and that the results may be used to promote the idea of a Scottish Eating Disorders Co-ordinator.  Your ideas will be discussed at next SEDIG meeting. 

**Wanted! – Volunteers to forward information to the editor about developments in eating disorders in different areas across Scotland…  Can you help??

 ‘Distress Tolerance and Mindfulness in Eating Disorders’ presented by
Maggie Gray and Charlotte Procter, 6th October 05
Impressions   from Dr Joanna Young (Staff grade, CAMHS Inpatient Unit, YPU, REH)

This was my first SEDIG meeting and I had no idea what to expect, but was keen to learn more about Eating Disorders.  I was pleased to find a welcoming informal atmosphere at Murray Royal where I was put at ease by other members.

As Maggie and Charlotte explained to us, the concepts are taken from Dialectical Behaviour Therapy, introduced by Marsha M. Linehan to help patients with Borderline Personality Disorder stop self-harming. It is postulated that eating disorder behaviours are a form of self harm, with an inability to handle stress and distress at their root. Like self-cutting, the behaviours observed in Eating Disorders may lead to a sense of calm and a feeling of regaining control.

Maggie and Charlotte then took us through “Crisis Survival Strategies,” - skills for tolerating painful events and emotions which are not readily overcome. They described the various strategies: distraction; self-soothing the five senses; improving the moment (by imagery, meaning, prayer etc.), and making lists of pros and cons of tolerating and not tolerating the distress. I found it interesting to think about my own distress tolerance skills, as for the most part I’m sure they’re not being used consciously.

Next on the agenda was ‘mindfulness’ or purposely paying attention to the present moment. We undertook a couple of exercises to help us grasp the concept. The first was a relaxing breathing exercise which focussed on how using the ‘half-smile’ can alter the way we feel. The next exercise involved examining a raisin as though we had never seen one before, using our senses to investigate. This sounds a bit strange, but it was also quite enlightening. I became worried when more than one person claimed they could hear the raisins crackling! It transpired this is the effect achieved by rolling them next to the ear.

1. After lunch we had the business meeting followed by a continuation of the morning session. We were given example cases to think about in groups. It was fascinating to consider how different coping strategies could be utilised in varying scenarios, and how this could be applied to people with eating disorders. The day ended by learning about the basic principles for accepting reality. These include radical acceptance, turning the mind (making a commitment to accept) and replacing wilfulness with willingness.

I really enjoyed my day;  it was an excellent opportunity to meet professionals and carers involved in this field. I was pleased to hear that a ‘Skills Training Group’ is to start soon in my place of work, and will feel more able to support patients for whom these skills could help as a result.

And from Sarah Freeman, Senior Dietician Ailsa Hospital …
“Maggie Gray, nurse therapist, and Charlotte Procter, psychologist, gave excellent presentations in an easy-to-listen-to format.  For people who have difficulty in regulating their emotions, levels of distress can easily escalate out of a manageable range.   This can be caused by such things as getting weighed or even getting dressed, and they may cut to get relief, start to withdraw or to avoid the problem.

Handouts included Crisis Survival Strategies – Distracting with activities which include Contributing, Comparisons, Emotions, Pushing Away, Thoughts, and Sensations.  An easy way to remember these skills is the phrase ‘A Wise Mind ACCEPTS’

Also useful is ‘Soothe the 5 Senses’, and Improve the Moment, which includes prayer, vacation and imagery.   There were two workshops on breathing exercises, awareness and half-smile.  I found the exercise where we concentrated totally on raisins, looking at colour, texture, smell, etc., very interesting!

This was an excellent meeting, full of practical and useful ideas.”

Ideas and stories welcomed for further issues of SEDIG News – please send to
smith47@ukonline.co.uk

Stories or information may be written by members, or an outline of the news item forwarded to the editor to develop.

Check Out New Website

North East Eating Disorders Support (NEEDS) Scotland have recently launched their new website at www.needs-scotland.org  

Group members came up with a new NEEDS Scotland logo, wrote all the pages on the website and worked with a computer expert to develop a clear and straightforward resource which may be used by sufferers and carers, as well as professionals possibly offering the website details as part of an information package to patients and their families. 

Local Aberdeen groups have raised funds to help NEEDS Scotland alsodevelop and print new leaflets and purchase other resources for use by group members in one of the group’s main aims – raising awareness about eating disorders and the need for early recognition, and proper specialist treatment.

Comments on www.needs-scotland.org are welcomed, as well as ideas for further development.

Training News

With training a key Health Committee recommendation to improve treatment in Scotland for eating disorders, there are lots of exciting plans and developments cooking all over Scotland.  These include training offered by The Cullen Centre, Edinburgh, and a two-day November 06 training conference ‘Eating Disorders for Non–Specialists’ in Aberdeen.  Future issues of SEDIG News hopes to keep members posted about what is available and coming up in their own areas.

Please forward info to editor (see address, top left)

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SEDIG……….SEDIG………..SEDIG……….SEDIG……..SEDIG
……..SEDIG…………….SEDIG…….SEDIG…….SEDIG……..
……..Scottish Eating Disorders Interest Group……...
……hope to see you at the next meeting…….