The treatment of the most serious cases of eating disorders (ED) in children and adolescents in Catalonia will include the stay of the patient and the family in a supervised apartment after hospital admission and prior to returning home.
This pioneering approach, which has been successfully tested in Australia and Sweden, is part of the methodology of the new highly complex TCA therapeutic unit at Sant Joan de Déu hospital, in Esplugues de Llobregat, called the Minerva unit. The resource, which has been operating for a few months, aims to provide an intensive and comprehensive response to the most complex cases, those that have not been able to be stabilized after a year of total or partial hospitalization of the patient.
The idea behind the project is to encourage the family’s participation from the first moment of the treatment and the final objective is to avoid relapses, taking into account that 30% of cases of ACT are chronic. “By involving the family, we have better therapeutic results”, explained Eduard Serrano, head of the TCA unit at Sant Joan de Déu. In fact, the involvement of the patients’ parents and siblings is an essential requirement to be able to access this treatment from the public system.
The Minerva unit is capable of attending to 20 cases simultaneously, a number that the Department of Health considers sufficient to attend to all the serious problems of ED (especially anorexia and bulimia) in minors in Catalonia. The therapy lasts four months (so far these cases were treated for a year), with which 60 patients can be treated a year, and is developed in four phases, a model unprecedented in Spain.
The first stage consists of hospitalization for about 30 days. Once discharged from the hospital, the patient (most of those affected are girls or teenagers) enters with her family (parents and siblings) in one of the apartments provided close to the Sant Joan de Déu hospital, in what is moving all the numerous 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 phases, returning home and linking the treatment to the TCA reference units. With this model, the intensity of the therapy is gradually reduced.
“With this unit we do not solve the eating disorder, but we have a tool to treat the most complex cases, those that remain at the end of a whole process”, said the Minister of Health, Manel Balcells, and announced the next presentation of a similar therapeutic unit, but intended for adults with severe ED.
In the case of children and adolescents, the severity is determined by the duration of the disease, by the comorbidity (associated psychological problems) and by the factors maintaining the disease: school problems, relational problems of adolescence or negative family dynamics after a long time of living with a patient with TCA.