This post was contributed anonymously. The writer describes how her GP went beyond the call of duty to support her recovery from an eating disorder during her time at University.

“For weeks, I’d been considering approaching a GP about my ‘eating problems’, but kept delaying it as I didn’t feel ‘sick enough’. I didn’t know any of the GPs at my local practice either. However, I went along one morning and upon enquiring about appointments, was offered a same-day appointment with a GP. I accepted it with mixed feelings. I remember walking into his office later that afternoon and promptly bursting into tears. This GP was very astute and immediately sensed that something wasn’t right. He took me seriously, listened to what I had to say, and was adamant that I was not wasting his time despite my protestations otherwise. He was very ‘switched-on’ to the dangers of anorexia and took great pains to emphasise these. When I came back to see him after two weeks with no improvement, he referred me to secondary services.

Within a week, I had a phone call from a specialist dietitian requesting to see me and by the next appointment, he’d had an influx of emails from secondary services and specialists. I was incredibly lucky to be offered support so quickly. I can’t praise my GP enough for all the support he offered me. He always gave me as much time as I needed, whether that be 15 minutes one week or 45 minutes the next, and always ensured I came back to see him. Admittedly, I was pretty stubborn and difficult at times, probably pushing his patience to its limits, but the fact that he persisted in his efforts to get through to me is a credit to him. He challenged my eating disorder in a way no one else had before and knew how to hit anorexia where it hurt most. He took a calculated approach – painfully honest and blunt at times, but understanding and sensitive to the complexities of what we were dealing with. He certainly didn’t pussyfoot around the issue and that was what I needed – someone to sit me down and tell me the truth.

Whilst he openly admitted that there was a limit to what he could do as a GP, he certainly did everything he could to help me. He even offered to speak to my parents. When I went home for the summer and therefore to a different catchment area, I registered with a new GP, but he still phoned a few times to check up on me and ensure I was okay, small gestures which meant a lot. Even though it’s just his job, I felt that he took a genuine interest in my welfare.

Unfortunately, it is still the case that some GPs lack proper knowledge and understanding of eating disorders, illnesses which can prove fatal and sufferers must be given appropriate care and attention. An eating disorder doesn’t just ‘go away’ on its own and will likely worsen without adequate, timely intervention. It saddens me to hear of people who, upon plucking up the courage to seek help, are turned away by GPs. I realise that eating disorders are not seen every day in general practice, but a little knowledge and compassion goes a long way.

Additionally, it angers me that some services still use BMI so callously, so indiscriminately, as a ‘criteria’ for specialist treatment. I was told I didn’t meet the criteria for a particular specialist team in my area. I’m not going to say what their threshold BMI was, but suffice to say that my GP told me I probably wouldn’t be able to reach it – make of that what you will. I am disgusted and horrified to think that I’d have to risk my life to reach their criteria. Thankfully, my GP reassured me throughout that I have nothing more to prove in terms of how ill I am and I shouldn’t try to push it further.

The importance of GPs and primary care cannot be underestimated. I am absolutely indebted to my GP and his support has played a big part in my coming to terms with the fact that, yes, I do have an eating disorder and I do need and deserve help. It is heartening to know that there’s at least one professional fighting on my side and who genuinely believes I can overcome this.”

This is the latest post in a series looking at the impact mental health services can have when they are working well. If you would like to contribute, please get in touch via Twitter or comment below.

Join the conversation! 4 Comments

  1. I like to look for the positives. I can even find some positives in my own experiences. But this whole issue is problematic. With EDs (the only thing I’m familiar with) there is a massive and real shortage of resources. One person being seen quickly, or at length, means that others are inevitably pushed even further down the waiting list, for longer. Or aren’t seen at all, despite being more health-compromised. (Lab-work is rare.) That’s the reality. I feel it’s in bad taste for people to write in praise of their short waiting times. Most of us waited ages – partly as a consequence of their good fortune. Writing about understanding GPs, therapists etc. is a completely different matter: only good.

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    • I completely understand the frustration of waiting times and the state of ED services and I am really sorry that you have had such a difficult experience yourself. This post is a guest post and I can’t comment for the author, but my own experiences is of being unwell for over ten years, at first in an area with no ED service (ie no adequate support) and later not being referred because my GP didn’t realise I met the criteria. I could have accessed my current local service (which is excellent) years sooner and I didn’t because I couldn’t get past the first hurdle (you need a GP to recognise you need help and agree to refer you). So I do get the frustration. However the fact that some people have to wait isn’t the fault of those who are in treatment. The problem, as you say, lies with resources and funding, not individual clients. People with ED’s generally feel guilty enough for resources being ‘wasted’ on them, so it’s important to recognise where the core of the problem lies. And it generally isn’t with either clients or with individual services themselves.

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      • It’s interesting that your GP assumed you wouldn’t meet the treatment criteria. My GP and I also both assumed that you had to be practically at death’s door to refer to the ED unit, so tried for IAPT, which – as it turned out – “doesn’t do EDs”. When I was eventually assessed by the ED unit it transpired they either don’t have a qualifying BMI, or have one which isn’t inordinately low. (Some units do, some don’t – huge variation). Perhaps media stories around access to treatment have led some GPs to believe that treatment is even more strictly rationed than it actually is? And in that sense highlighting the issue may have been counter-productive, perversely.

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      • Those are really interesting reflections. I started this series to give people the opportunity to share positive experiences of services because in my view the predominant narrative is one which describes the failings of mental health services (including waiting times). I think it is important to recognise when things go well, and that includes people being seen in a timely manner. It can be demoralising when all we hear in the media is the negative, with no reflection of the difference services can and do make.

        I understand what you are saying about referral criteria. However GP’s are (should be) kept informed about referral thresholds for services, especially when these change. It is part of their role to find this out if they are not sure. And actually, good practice would indicate that a referral should be made if they are unsure. It is the service’s job to decide whether someone meets their threshold, not the GP. Had I pushed more, I suspect my GP would have referred me earlier. Thank you for your thoughts.

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About Little_Em

www.progressnotperfection.co.uk

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Mental Health, Positive Experiences of Services

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