A new partnership between the London Children’s Hospital and Vanier Children’s Mental Wellness will double treatment capacity for kids aged six to 13 in the region who are dealing with eating disorders in the wake of the COVID-19 pandemic.
The program will double the number of inpatient beds for children afflicted with severe disorders from four to eight and will provide a nurse practitioner who will be shared between the two organizations, thanks to a grant of just under $1-million from the provincial government.
The intensive program is called ‘stepped care’ and is the first program of its kind in Canada, where patients are transferred into a community-based setting once they’ve been stabilized in hospital and where they can continue social activities, attend school and be involved in physical activities.
There have been widespread reports of an increase in eating disorders among youth since the pandemic began, with much of the blame for the uptick being placed on lockdowns that upended the normal rhythms of life, including school attendance, socializing and sports.
Long wait list created by pandemic
Since the onset of the pandemic, demand for inpatient care for eating disorders among children and early teens has exploded, according to local healthcare officials, who say the demand outstretches their ability to provide it.
“The hospital can only do so much. We only have so much capacity, so much space,” said Lynanne Mason, the director of pediatric inpatients, outpatients and regional health integration at the Regional Children’s Hospital in London.
It’s our understanding that this is the first community-based step care program in Canada.– Kelly Simpson, Vanier Children’s Services
“It’s the first time in history we actually have a wait list for treatment and we don’t want any child to have to wait.”
Mason said healthcare workers have been able to pare that list down by 100 people in the last few months, but there are still 200 children and teens in the region waiting for eating disorder care.
“It’s distressing,” she said. “The clinicians are struggling with that and are doing what they can to provide care. It’s something we need to fix.”
How stepped care works
In order to cut down on time spent in hospital, the program can now transfer its young patients to a converted cottage at Vanier Children’s Mental Wellness, which provides a community setting.
“It’s like a milieu setting where there’s lots of structure, safety, the kids will be involved in doing their regular activities of daily living, they will be able to attend school, possibly their community school where they came from,” said Kelly Simpson, Vanier’s executive director.
“It’s almost a way to transition them back and set them up for success to go back with their families.”
The community-based program also allows clinicians to work with the entire family, provide group therapies and teach parents and siblings how to best support the child struggling with an eating disorder.
Simpson said working with families is one of the ways stepped care helps children succeed once they return home because it helps provide a structure that every family member can work with once the patient transitions back to home life.
If a patient requires more care, then the child can step down back into hospital care and once they’re doing well again, step back into a community-bases setting before ultimately returning home.
“It’s our understanding that this is the first community-based step care program in Canada,” she said.
Unlike most eating disorders programs that target teens, this one targets kids aged six to 13, with the idea that providing intervention early can help prevent reoccurrence of the eating disorder later in life, Simpson said.
“There’s a lot of evidence that shows if you can provide treatment for eating disorders earlier on, you have better outcomes.”