The FREED Project (first episode and rapid early intervention in eating disorders): service model, feasibility and acceptability.
Eating disorders (EDs) are disabling disorders, predominantly affecting adolescents and young adults. Untreated symptoms have lasting effects on brain, body and behaviour. Care pathway-related barriers often prevent early detection and treatment of ED. The aim of this study was to assess the feasibility and acceptability of FREED (First Episode and Rapid Early Intervention for Eating Disorder), a novel service for young people (aged 18-25 years) with recent ED onset (≤3 years), embedded in a specialist adult National Health Service ED service. Specifically, we assessed the impact of FREED on duration of time until specialist service contact (DUSC), duration of untreated ED (DUED) and wait-times for assessment and treatment compared with patients seen earlier in our service. Acceptability of FREED was also assessed.



Sixty individuals were recruited from September 2014 to August 2015. Fifty-one of these were compared with 89 patients seen earlier.



FREED patients, from areas with minimal National Health Service gatekeeping (14/51), had markedly shorter DUSC and DUED than controls (DUSC: 12.4 months vs. 16.2 months; DUED 13.0 months vs. 19.1 months), whereas those with complex gatekeeping (37/51) had shorter DUED (17.7 months), but longer DUSC (16.9 months) than controls. FREED patients waited significantly less time for both assessment and treatment than controls, had significantly better treatment uptake and were highly satisfied with the process of starting treatment.



FREED is a feasible and acceptable service which successfully reduced waiting times. Reductions in DUSC and DUED depend on gatekeeping arrangements. More research is required to establish clinical outcomes of FREED.
Eating Disorders Unit, South London and Maudsley NHS Foundation Trust, London, UK.
Amy
A
Brown
Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Jessica
J
McClelland
Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Elena
E
Boysen
Eating Disorders Unit, South London and Maudsley NHS Foundation Trust, London, UK.|Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Victoria
V
Mountford
Eating Disorders Unit, South London and Maudsley NHS Foundation Trust, London, UK.
Danielle
D
Glennon
Eating Disorders Unit, South London and Maudsley NHS Foundation Trust, London, UK.|Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Ulrike
U
Schmidt
D000293:Adolescent; D000328:Adult; D061345:Early Medical Intervention / Q000458:organization & administration*; D005240:Feasibility Studies; D001068:Feeding and Eating Disorders / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care; D013997:Time Factors; D061665:Time-to-Treatment / Q000706:statistics & numerical data; D055815:Young Adult
anorexia nervosa; bulimia nervosa; early medical intervention; feeding and eating disorders; stage model of illness