DD17 recovering well - I have university worries

[LadyCrumb]

Hi there, DD was diagnosed with AN in November and is recovering really well - SLAM getting ready to sign us off.
my real concern is Uni - DD really keen to go and it was the carrot of going to Uni that helped her start to eat and get better. I’m just really worried that the social anxiety of starting uni will cause a relapse, and because she is away, we won’t notice.
has anyone been through this, and if so what did you do? Will unis keep an eye on her if we state she had a ED on her form, or will it rely on her seeking help.
we have another year of school to go, so I may be worrying unduly, but any help/advice would be greatly appreciated.
(excuse typos on phone/train)

How far away is uni?
Im assuming with treatment she understands that it’s lifelong and she could relapse? If so, a chat about keeping her safe isn’t unreasonable

She’s in Y12 currently so hasn’t applied yet, but is hell-bent on getting as far away from us as possible! Her dream is Cambridge, we’re in London so I’m pushing for UCL.

No unis won’t keep an eye on her. Please do not expect or ask this. She may be lucky and have a personal tutor who is caring and attentive and recognises the signs and that she pro-actively sees regularly and that she discloses to. Unless all those stars line up - and you’re asking for a PT to go significantly above and beyond their remit (and student MH advisors are very busy and can only do so much), then no. Unis all have a requirement for their students to be fit for study. If she isn’t, she shouldn’t go.

You’re asking uni to do NHS work. They’re not equipped to.

Unfortunately, it won't be realistic even if the uni knows that there is this in the history. They may be able to support with their student support services, such as counselling, but this could be a short-term measure without much choice in who and how it is done, and engagement is all, as they're so stretched.

The first part of uni can often be anxiety provoking. The last term of the first year will also be something to keep an eye on, as often there are exams that mean you progress to year 2 (which is sometimes a lot less pressured). I had a very close friend who had spent time hospitalised for AN and then had a very sad bereavement not long before going to university. She was not healed and life has continues to be up and down, but was sensible, for a young adult, and compromised, for example by grazing raw food and fruit etc to stay on track if more wasn't a possibility for her. It's not ideal, but better than some coping methods, and I have since spotted this kind of habit formation in other students I don't know so well.

I'm an adult trying to recover from anorexia at the moment, but I also have a lot of experience working with girls of your DD's age.

As people have previously mentioned, uni will not keep an eye on her at all, there is no pastoral care. If I were you, I'd start talking about the transition to uni this summer. I would include in this being more responsible for a few household tasks, washing clothes, cooking a meal or two, personal finances. I would also mention in a drip, drip, drip fashion that this could possibly be difficult with an ED and ways to cope etc. Separately I would ensure you pop over to see her, even for just an afternoon, about 3/4 weeks in to the term and again at 6/7 weeks. Meet her friends, see how she is, just keep an eye on her.

I think the best thing you can do is keep regular visits to a schedule. E.g. you go up 4 weeks in, she comes home for the weekend 6 weeks in, regular contact (day trips) during exam season/high pressure times.

don’t force her to apply to London unis only. She’ll feel like it’s because she’s being punished for her eating disorder

I have a bit of experience of both Cambridge and several London unis (working for academics, mainly). The following may or may not be something worth weighing up with your DD's possible experiences.

Academic pressure: known for being quite intense (in the views of the tutors and employees as well as the student body) for many, at both UCL and Cambridge. However, if she genuinely enjoys working and has good ways of handling the better and the hard times, then this energy can have big positives too.

Cambridge colleges will provide meals in hall, quite or very cheaply. In the majority of cases, this is likely to be a few steps away from the rooms students get in the first year. With some colleges, though, kitchen use to make or store your own food will be very limited - sometimes this is specifically to encourage students to eat in hall regularly for social and rest benefits and it's probable that friends would go all together to eat. Rooms that are owned by the university are good, reliable, and actually can be quite cheap if compared to London and a few other places.
In the London universities I have worked in, meal options are there, and they're good and varied, but they are more expensive than Cambridge. Often via cafes or canteen style outlets open through the day. Reasonable for London, but still not really for 5 or 7 day student budgets - I live outside London and would rarely think the meals at work good value unless I wanted a real main meal for lunch. Even cold sandwiches or salads, for example, are often no different from prices elsewhere. Rooms are hugely variable, a mixture of campus based, or big student landlords such as Scape buildings catering for very large numbers, that can serve all areas based on tube lines to the universities, or find-your-own on a very spread out spectrum of price and quality. So there can be quite a journey time from your sleeping quarters to your learning/eating options.

DS had a good friend in sixth form who had an eating disorder, and they ended up at the same uni. He said that at uni she started rowing (just the novice crew) and it has really helped with her ED. It sounds counter productive but with all the training they are very also very into ‘eating to train’ as it were and encouraging her to get stronger. So I guess she still feels in control (more so than home actually as she’s the one I charge of all her eating) and has real direction and purpose.

As others have said, our young people are essentially on their own at uni which is very daunting, but maybe the fact that she is completely in charge of her food may make her less stressed about it? Obviously everyone is different, but this worked well for someone who in year 12 & 13 had to be picked up from school at lunchtime so her mum could make sure she’d eaten.

Although the unis dont monitor them they may have a wellbeing team who can offer support and if necessary refer on to the local eating disorder service. You can usually speak to the wellbeing team before starting to get some extra support in place for the start of uni. Our experience was that the first term was the hardest but with a combination of professional support, eating in halls (which at times was difficult because of eating in front of other people). 2nd year has been much easier. Lots of mum visits too. We also said we would pay for all food as we didnt want her worrying about the cost aswell.

Instinctively, it doesn’t feel like the right thing to do is encourage her to stay in London when she definitely doesn’t want to. That’s going to come across as a punishment. London and Cambridge are fairly close anyway.

Lots of food for thought here, will read properly and reply later. Thank you 🙏

I'm an academic who has to deal with the most serious student wellbeing issues as part of my role. Please take a realistic view of your DD's ability to live independently and the likely impact of that on her health. Every year I meet students with additional challenges (esp mental health and neurodivergence) who were clearly not well enough/independent enough to live away from home and manage University effectively, and who struggled hugely as a result, with resulting impacts on their mental and physical wellbeing. In my experience parents often hope for the best, sometimes against all evidence to the contrary! It's completely understandable, and I don't blame them at all: they want their child to be able to have the experience everyone else has. But I would urge caution and taking a realistic view.

As a Cambridge graduate, I'd say that the pastoral care can be excellent, but it really is a pressure cooker and I saw a lot of people struggle both with the workload, and the change from being top of the class to average- or struggling to keep up. In your shoes I think I would be worried, in an 'on alert' sense, at least.

Ultimately of course though it's her decision and you can only advise and support, and as a pp says, London is close enough that you could visit frequently/be on hand if needed.

Thanks everyone, such a lot to consider. She seems almost 100 per cent better now, and SLAM are very happy with her, but going to University is hard enough without an ED and I am worried that the social and academic challenges will put her back to square one. She also had a tendency to overthink and be really hard on herself which worries me, but she is having weekly sessions with a Clinical Psychologist who is working with her on that.
I work next to the UCL campus, so could keep an eye on her/ meet her for lunch, and she could come home for dinner a few nights a week if she needed to. Cambridge would be further away but still doable, Leeds and Edinburgh are her other choices, but I have friends living in both who can invite her over from time to time, as well us travelling up there.
I guess that we are all still reeling a bit from this ED which came out of the blue, and am still coming to terms with what life looks like now for her.

I really like your suggestions @CrickityCrickets and will start this weekend. We have over a year before she would actually leave home, so I'm hoping we will have time.

Thank you for that, very helpful. Pleased it's all working out for your DD.

What course is she thinking of at Cambridge. Some have a bigger workload than others. The shorter terms definitely make the workload more intense. There are alot of students all used to being top of their year academically and alot of perfectionists. Definitely not for everyone. I think if mine at 18 she probabky wouldn't have lasted the first year - shes gone as a mature student and although its been really challenging shes now enjoying it and is looking after herself well. So tough isnt it 💐

Hi, my DD has just finished year 1. She was discharged from camhs a month or so before starting uni.

What dd did;
Registered with uni GP, and made arrangements for monthly weights. Having said this it took several months before they started with it (also did a few blood checks ) and only lasted a few months...

Arranged through DSA to have a weekly 1 hour non-medical helper. Just to have a chat, helps with "overthinking" as you mentioned...
Apply for dsa early, even though you may think you don't need help or you are not sure what help you would need later. Whole process took 5 months ( applied June, got helper in November ).

DD uni is 3 hours drive. This was the max she wanted to be away from home.
It made it possible to visit on short notice when she was upset in the middle of the week (happened once). Would visit maybe once a month and she would visit home once a month. Gradually that became less frequent as she didn't feel the need for it.

DD preferred non catered. She contacted residence and by mentioning her eating disorder they made sure to allocate non catered room.

Academics were /are never an issue for her as such. So is not a source of stress. Obviously this may be different for different people.

Be prepared for relapses/slips. DD was however better in managing them compared to earlier years.

There are some resources available about transitioning to uni with ED

Freedfromed.co.uk
Newmaudsley capsule Preparing for College or University – Guide for carers

Thanks so much for this, that’s an amazing resource. I will go through it carefully tomorrow but it looks extremely useful.