Can i insist GP refer me to eating disorders clinic rather than general CBT?

[TellySavalashairbrush]

I had an eating disorder in my Late teens/early twenties. At the time my older sisters frogmarched me to the GP who didn’t seem very interested but sent me for CBT, it made no difference and I only improved when I amazingly got pregnant a year later.
Fast forward 25 years and a very stressful few years of marital issues , unemployment and caring for an elderly parent . My eating disorder is back with a vengeance and even worse. I look and feel dreadful and have a phobia of gaining weight after losing 3 stone a year ago. I confided in afriend who advised me to see GP. I’m due to go next week. I don’t want CBT again and feel I need to go to a unit which deals with eating Disorders Rather than just general counselling. Can I ask for this?

You can try. My experience is you will get general iapt self referal unless at deaths door. But do ask.

What’s iapt?

IAPT is Improving Access to Psychological Therapies. I've not actually done it - they referred me back to my GP because I had hit the 'anorexia nervosa' criteria, but I believe it's intended to provide quicker access to talking therapies for mild to moderate mental health conditions. sometimes over the phone or sometimes face-to-face.

I suspect that the answer to your first question might vary depending on whereabouts you live, it's somewhat a postcode lottery. Would you be happy saying the county you're in?

Unfortunately there still so often seem to be such strict referral criteria because services are so stretched. The county I have just moved from have a referral criteria for the ED service of a BMI which is dangerously low, and it is so difficult to get anything specific otherwise. But there are counties which seem far better.

Do you have an idea of what you would find helpful? When I came out of inpatient, the ED service did something called Specialist Supportive Clinical Management (SSCM) with me, which was a useful approach. We did a lot of working through CBT stuff as well though.

Many thanks. I live in London . My concern is that I get offered general CBT with the local mental wellbeing service rather than as an outpatient at the eating disorder unit of a local psychiatric hospital. I really think I need to work with professionals who are specialised in ED. My bmi is at the lowest end of normal range, so I’m probably not severe enough that’s my worry. I do feel the worst I have ever felt mentally though as a result of my ED.

ED provision is shocking. Im perusing private counselling with ED practicioner.

I know . It’s taken a lot to admit that I really need help and it looks like I’m going to struggle to get it anyway. Just the thought of being told to keep a food diary by the GP ( what they did last time) as if that’s going to ‘cure me’ is enough to make me weep. I’m hoping that 2 decades on they might be better informed about treating people with ED.

I was referred to the Initial Access and Assessment team within our ED MH team. It has all been community care (though I was offered hosp care as a day patient). I have seen an ED nurse, psychiatrist and later a psychologist.

My care has been very, very good and I hope a similar service is available to you.

I had CBT recently in an inner London Borough. They contacted me very soon after referral for an assessment and were very clear with me that if they thought they couldn’t best help me they would refer me to a more appropriate service. As I’m medical myself they were less discreet than they might be usually and basically said GPs make all sorts of inappropriate referrals to them hence the assessment before offering an appointment!

Thank you all for your replies. They have been very helpful.

@TellySavalashairbrush how did the GP visit go?