The treatment of the most serious cases of childhood and adolescent eating disorder (ED) in Catalonia will include the stay of the patient and family in a supervised apartment after hospital admission and prior to returning home.
This pioneering approach, which has been successfully experimented in Australia and Sweden, is part of the methodology of the new high-complexity TCA therapeutic unit at the Sant Joan de Déu hospital in Barcelona, called the Minerva unit.
This resource, which has been in operation for a few months with good results, aims to provide an intensive and comprehensive response to the most serious and complex cases, cases that have not been able to be stabilized after a year of treatment in total or partial hospitalization.
The idea behind the project is to take into account the participation of the family from the first moment of the treatment of resistant cases and the final objective is to avoid relapses, taking into account that it is estimated that 30% of cases of EDs become chronic.
“By involving the family we have better therapeutic results,” explained Eduard Serrano, head of the ED unit of Sant Joan de Déu. In fact, the involvement of the patients' parents and siblings from the moment they are hospitalized is an essential requirement to be able to carry out the treatment.
The Minerva unit is capable of dealing with 20 cases, a figure that the Health Department considers sufficient to deal with all the serious problems of eating disorders (especially anorexia and bulimia) in minors in Catalonia.
The therapy lasts 4 months, which can provide a response to 60 patients per year, and is developed in three phases. “This phased treatment model is unique in the entire State,” Serrano emphasized.
The first stage consists of total hospitalization of the patient, with an average stay of 30 days and with the family involved so that they obtain tools for the nutritional and behavioral management that EDs imply.
Once discharged from the hospital, the patient (most of those affected are girls) is admitted with the family (parents and siblings) to one of the enabled apartments very close to Sant Joan de Déu, to which the entire group moves. assistance team.
During this phase, which lasts between two and three weeks, family meals are worked on in a non-hospital context and the family becomes part of the therapeutic team. The last phase, already at home, is linked to treatment in the ED reference units. With this model, the intensity of the treatment is gradually reduced in the different phases.
"With this unit we do not solve the issue of eating disorders, but we have a tool to treat the most complex cases, those that remain at the end of an entire process," said the Minister of Health, Manel Balcells, at the event. presentation of Minerva. Balcells has announced the upcoming presentation of a similar therapeutic unit but intended for adults with highly complex eating disorders.
In the case of children and adolescents, this high complexity is determined by the duration of the disease's evolution, by comorbidity (associated psychological problems) and by the factors that maintain the disease: school problems, adolescent relational problems or negative family dynamics after a long time of living with a patient with ED.
