"Denbridge House closure"

About: South London And Maudsley NHS Foundation Trust / Eating disorders

(as the patient),

Denbridge House is a residential home that helps people with long standing eating disorders learn how to live again outside of hospital. Most patients there would have already had many in-patient admissions, but were unable to continue with their recovery when sent back home direct from the ward, and so Denbridge helps to break this cycle. I have recently found out that this service is now due to be closed in March 2011, which I feel is completely the wrong decision and may cost lives.

I was a resident at Denbridge House for 3 years, and feel that without this placement, I would not be here today. I had suffered from Anorexia since 9 years old, and had spent many years in hospital, caught in the cycle I explained above, institutionalised and unable to see any way out. Denbridge offered me a chance to actually take some control and responsibility back, in a safe environment, and learn the coping skills to deal with my illness and live back in the 'real' world.

This is not a cure by any means, and many people, myself included, may always have issues with food. Eating disorders are complex issues and do not disappear overnight, but the daily support from staff, the groups, therapy and relationships with other patients, helped to plant the seeds for my recovery, and I still draw on those experiences now when things seem difficult to cope with.

Denbridge is a unique project in that the helps start when you leave hospital, which I believe is the most fragile time for any patient. To go back home to the place where the eating disorder was most prevalent, could have sent me straight back down the road to relapse, it is too familiar, too easy to slip into old routines.

Instead, this place offered me a chance to start again, to learn about myself outside of just being 'Anorexic', to reconnect to things I enjoy doing, to test out new ideas, safe in the knowledge that I would be supported and encouraged. To deal with the emotions that are behind the illness, and separate food from feelings, which takes time, and can not be achieved just by a short hopsital stay.

I feel that to take this away will lead to lives being lost. I don’t feel that the alternative arrangements being set up, which I think consist of day care treatments, and bed and breakfast accomodation, are an equal alternative and I think this needs to clarified. Many patients with eating disorders often have adjoining issues of Obsessive compulsive disorder and depression. Had I been placed in a B&B, my fears over germs and contamination would have thrown me into meltdown almost immediately, and how can you possibly learn to cook, and feed yourself in that environment?

At Denbridge, everyone eats and cooks together, with support from staff, and over time this becomes part of a normal eating pattern and experience. The key here is things changing over time, which is why this follow on after hospital is so important, it gave me time to regain strength, reflect on where I had been and look towards the future.

The staff at Denbridge are all highly trained and do an amazing job, which I think has been evident by the amount of ex-residents getting involved now, to help try and stop the closure of such a highly regarded service.

Money can always be found by trusts if they really want to do something, it is not too late to turn this around and keep this home open.

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Response from Steve Davidson, Service Director, Mood, Anxiety and Personality Clinical Academic Group and Psychological Medicine Clinical Academic Group, South London and Maudsley NHS Foundation Trust We are preparing to make a change

Dear Karen P,

Thank you for your concern about the closure of Denbridge House and for sharing your experiences with us. I am really pleased to hear that you feel Denridge House offered you a chance to start again and that the service allowed you the time to gain strength and look to the future.

I understand your concerns and thought an explanation of our reasons for closing Denbridge House might help to reassure you that we have come to this decision for the best of reasons. I also think it is important that you know about our plans to replace the service with a new rehabilitation treatment service in Beckenham.

As I am sure you know, without effective early treatment for anorexia nervosa, such as the work with families developed at the Maudsley Hospital, a proportion of people go on to develop a severe and enduring illness. This group of people and their families can become isolated and excluded from a productive role in society with a high level of medical disability and use of services.

For this reason we are opening a new service that will see patients and families requiring rehabilitation ‘stepped down’ gradually so they spend fewer days in care and are better able to live independently, build strong relationships and play an active role in society. This approach to the treatment of anorexia nervosa has been shown to be very effective and has been developed using the best available evidence. The service has also been developed by working closely with patients and families with experience of anorexia nervosa and with the charity BEAT.

To fund the new service we have taken the difficult decision to close Denbridge House. Robust alternative arrangements will be in place before the few remaining patients leave Denbridge House and the expertise of the current staff team will be transferred to the new service.

Now more than ever, we have to make the best use of the resources available to us. However, we remain committed to providing treatments that evidence shows work best for our patients.

If you would like to learn more about the treatment model to be used in the new rehabilitation treatment service please please contact Jane Hannon at (jane.hannon@slam.nhs.uk) and Jane will send you more information and you can have further discussion with her if necessary.

Best Wishes

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