Implementing eating disorder prevention policy amidst Covid-19: Challenges and Proposals for the future of Mental Health Support Teams (MHSTs)

In 2017, the Children and Young People’s Mental Health Green Paper proposed the development of Mental Health Support Teams (MHSTs), who would bridge the gap between Child and Adolescent Mental Health Services (CAMHS) and educational settings. One of the roles of the new MHSTs was to deliver “group-based interventions engaging participants in critiquing the ‘thin ideal’, which can be effective in reducing eating disorder symptoms and body image concerns, when targeted toward high-risk adolescent girls.” This proposal is welcomed, particularly in light of the increased rate of admissions to hospital for eating disorder over the Covid-19 pandemic (Beat, 2020).

23 trailblazer sites were contacted directly, and all Wave 2 and Wave 3 sites were contacted through the NHS Futures Platform. A total of 10 responses to the initial questions were received. To further understanding, 9 semi-structured interviews were schedules.

Common themes emerged such as: a) Prioritisation of anxiety disorders and behavioural difficulties throughout the Covid-19 pandemic; b) Omission of training from the MHST curriculum; and c) blurred boundaries and scope between specialist CAMHS eating disorder outreach teams. The study also produced a summary of barriers and facilitators.

Prevention and early intervention of body dissatisfaction and eating disorders are of utmost importance. As the green paper proposals offer an opportunity to embed eating disorder prevention into public mental health policy initiatives, overcoming the potential barriers imposed by the Covid-19 pandemic is critical, and a conscious effort to build capacity within MHSTs to deliver these proposals is paramount.

Hannah Lewis

Hannah Lewis is a London Interdisciplinary Social Science (LISS) funded PhD Student at the Centre for Psychiatry. Hannah had previously studied at the Centre where she completed an MSc in Cultural and Global Perspectives in Mental Health Care, where she undertook a systematic review of school-based body image interventions to assess their cultural inclusivity.

After working in mental health policy for a national charitable organisation, she returned to the Centre in 2019 to study an MRes in Psychological Therapies and conducted a second systematic review which explored the involvement of people with lived experience of eating disorders in prevention and treatment interventions.

For her PhD project, Hannah is building upon her previous research in eating disorder prevention, cultural inclusivity and involvement by co-producing a cultural adaptation of The Body Project – an eating disorder prevention programme based on cognitive dissonance which has the most robust evidence base in the field. By working closely with the diverse community of Tower Hamlets, Hannah intends to co-deliver and co-evaluate the culturally adapted intervention in local schools with educational mental health practitioners and experts-by experience.