There has been a big (and rather heated) debate for quite some time now over the role inpatient units have to play in making people institutionalised. I have spoken to a number of people who absolutely refuse to admit themselves or their children into an inpatient hospital, justifying their decision by explaining how hospitalisation ‘makes the problem worse.’ As someone who spent 7 months in an inpatient unit last year, I can assure you that this is not the case. If I wasn’t hospitalised, I hate to think what would’ve happened to me. It definitely did not ‘make me worse.’ Whilst yes, I did have the odd slip-up during my admission, I left so much better than I went in, and after receiving excellent care that would’ve been impossible to have at home, I am now able to say that I am recovered from Anorexia, and that feels amazing.
To go back to the point I just made about not being able to receive the same excellent care at home, I don’t mean to undermine the support of my parents, but the fact is that there was only so much they could do to help me. They weren’t specialists in eating disorders like the staff are in inpatient units, therefore they were unable to handle the situation in the same way as professionals would. I needed intensive support in order for me to get out of the disordered behaviours and routines I had established. In the beginning of my inpatient treatment, I was on one-to-one support at meal times, as well as 15 minute obs. I was also on supervised bathroom. This meant that I was very rarely left on my own. Although that probably sounds extreme, it was needed for me to get the point I am at now.
It’s important for me to mention that I WASN’T on one-to-one support and 15 minute obs for the duration of my admission. After around 3-4 weeks I was moved onto a ‘self-portioning table.’ For anyone who doesn’t know what this is, it’s where you are sat with the rest of the patients on one big table. There is still a member of staff, often more than one, sat with you on the table, but the support is less intensive. They are there for you if you need them, but they won’t offer you the same level of support as you would get on a one-to-one table (unless you ask for it.) The 15 minute obs also stopped. I went from 15 to 30 to 1 hour, so I gradually got my independence back, which was nice.
As I have highlighted above, it was a very gradual process. Nothing is done too quickly, because you don’t want to be stressed out and feel as though everything is moving too fast. The purpose of the structured treatment is so that you can recover at a steady pace. The end goal is not to simply gain weight, it is to gain YOU back. The pre ED you. So to achieve that goal you have to rediscover yourself, finding what makes you genuinely happy. Often therapy is needed, because when you have been ill, it’s sometimes hard to even remember what you were like before. This is not a quick process, which is why it is taken at a slow pace.
By gradually gaining your independence and freedom back by being given responsibility to take control of your own recovery, inpatient treatment does not make you institutionalised. Whilst of course being in an environment surrounded by people with the same illness as you might ‘normalise’ the eating disorder’ initially, the way the treatment is structured means that you gain your life back- a life that is not centered around food and exercise.
Although it was so incredibly difficult to be admitted to an inpatient hospital last year, I can say, hand on heart, that for me treatment in the community just wouldn’t have been enough. Inpatient treatment was therefore necessary, and it was the best thing that could’ve been done for me. I actually have a life now, and I have the incredible team at Riverdale to thank for that (as well as my family who have stuck by me regardless of all the crap I’ve put them through!!!)
(After reading back through this I realise that I speak as though hospitalisation is the best option. I’m simply writing as though hospitalisation is needed. If you can recover at home, in the community, then of course that is great, but for some people they just need a bit more than that, so that’s what this post is addressing.)