Diagnoses of eating disorders (ED) have increased significantly in recent years, especially during the pandemic and confinements, and essentially affect women aged 12 to 25. In the 2020 Catalonia health survey, 85,397 people declared that they suffered from an ED, mainly anorexia and bulimia. In 2021, the 4,461 cases treated (almost half, new) represent an increase of 61.1% compared to 2018. The 714 hospital admissions of acute cases registered in 2021 are 58.7% more in relation to 2018
The Minister of Health, Manel Balcells, expressed his department’s concern about the situation, which he attributes to “aesthetic pressure, closely linked to social networks”. A situation that has motivated the activation of a two-year shock plan (2023-2024) with the aim of improving the prevention, detection, diagnosis and treatment of ACTs.
Salud will invest 8.4 million euros to change the care model for ACTs. According to Sara Bujalance, director of the Association against Anorexia and Bulimia, so far the model has worked adequately in the last section, in the specialized units to deal with serious cases. “Outside here, attention has been practically non-existent, or very variable, depending on each territory”, he criticized.
This approach will totally change. The Health plan aims to detect and attend to as many cases as possible early. “The more mild cases we detect and treat, the less they will become serious”, summed up Balcells. “This [the early stage] improves the prognosis and the evolutionary course of the disease and makes it possible to address mild cases in primary care and reserve the serious ones for specialized units”, stressed Joan Vegué, head of the mental health master plan and addictions
The improvement of attention to mild cases will be entrusted to a new figure, the TCA clinical reference professional, who will join all (126) public mental health centers (CSM) in Catalonia. These units will include the first preferred visit after 15 days, psychotherapeutic care every 15 days for the first three to four months, nutritional supervision and family care. For this reason, they will incorporate 104 new professionals, half of them optional.
With regard to moderate cases, the plan envisages expanding the number of hospital care places distributed throughout Catalonia from the current 30 to 115 in 2025. In addition, care programs for TCAs will be deployed in all hospitals.
For serious cases, the consolidation and expansion of the professional staff of the expert units (UTCA) is foreseen. The creation of new units in Lleida, Central Catalonia and Alt Pirineu-Aran will be added to the existing eight, so that all health regions will have these facilities. In addition, the plan envisages the creation of two new highly specialized hospitalization units (young people and adults), each of which will have between 15 and 20 beds, which will offer an average stay of around three months.
“The paradigm shift in the approach to TCAs is based on the fact that attention is extended and each specific case can be responded to based on the characteristics and treatment needs,” said Bujalance.
Until now, the shortcomings of the public system have caused a flight of patients to the private sector, so Balcells recognized a “certain failure”, which he intends to rectify through the application of the shock plan.
