Tell me about In-patient Wards

[whethertheweather]

DD18 has today been taken in as an inpatient at an ED clinic in London, where she is based as she is at university there. After much delay, at her insistence they started her off with care in a community setting in March, but her weight has continued to drop with an acceleration over the past couple of weeks so she is now under 6st at 5'6, so they said she should come in today voluntarily (psychiatrist said to me if she refused they would start the sectioning process next week).

She is terrified, doesn't understand why this has to happen, but has still insisted she must deal with this alone and doesn't want me or anyone else from the family there. Can anyone talk me through the environment on an ED ward? Is it as supportive as I am trying to convince myself?

Is it private or nhs?

They are all different. If understandably you don't want to name it I would suggest googling as much as you can about the specific unit she is going to. There really is no general answer on this

My friend was in an ED inpatient unit in London for a good while.

They are intense environments but honestly it was the only way she managed to start regaining enough weight to make her strong enough to continue recovery on the outside, which of course didn't happen immediately either.

She did do outpatient treatment for a long time but she was just counteracting everything there with her actions as soon as she went home, and therefore just continued losing weight just as your DD has done. As much as she hated it, inpatient treatment did help her.

I visited her there and appreciate all are not the same, but it was a fairly nice environment. She had her own room, they had common spaces - like the dining room where they would all have to eat together and stay until they were finished - and facilities to do their own laundry etc. She made some good friends there that helped her through. She also eventually got some home leave each weekend once the doctors were confident she was able to follow a plan without such strict supervision.

However, one thing I just want to pre-warn you of is that 'voluntary' is not really very voluntary in this system (and the wider MH system really), which is a hard lesson I'm sure she will soon learn when she starts demanding to leave and they section her because her weight is so dangerously low. Just prepare yourself that her stay will likely be longer than initially thought as they will not let her out until they believe she is in a safer position, despite her current official status as voluntary. So she will likely accept some visits after a while :)

Yes her weight is very very low ( I worked that out as 13.6).
I'm glad she's gone in voluntarily, but as others have said- if she does change her mind they are likely to look to detain her with her weight as it is.
The in patient wards will follow the Marsipan guidelines and you may want to have a look at these ( although they are guidelines for clinicians rather than patients or family members). BEAT is an excellent resource.

I've worked in an adolescent ED inpatient unit. Typical day involved physical observations taken upon waking. Breakfast/snacks/lunch/dinner supported by staff and then a period of up to an hour sat supervised to prevent purging post meal. There may be groups/individual therapy. Short 20 minute walks twice a day when physical health allows.
Depending on how much she was eating before admitting it is likely she will have daily blood tests to prevent re feeding syndrome and meal plan start small and build up to a weight restoring plan.
Once weight restored will be discharged to community team.

Obviously every place is different but that's usually the general structure.

Thank you all. It’s an NHS clinic in Kensington. The website describes a similar set up to the one you’ve described. The psychiatrist did say they could now take steps to keep her in if she decides to quit.

DD called tonight crying saying it’s not the right place for her and all the other patients are so much more unwell than she is. She is so upset it’s really difficult to hear.

I'm so sorry you and your daughter are experiencing this horrible illness.
From what I know working in ED the illness will tell your daughter that she is not I'll enough because it wants her to keep starving herself. As she is eating so little her body and brain will be experiencing starvation syndrome which has a significant impact on rational thinking. The Psychiatrist wouldn't be considering the mental health act if her weight was not dangerously low.

There is a woman called Eva Musby who has written a book, has a website and a YouTube channel with so many resources for parents of someone with Anorexia. Granted her experience is from supporting her under 18 child but it may give you some ideas for support when you daughter feels more able to accept it.