Treatment for an eating disorder tends to become increasingly difficult as illness duration lengthens, resulting in the individual spending more time unwell, having a worse prognosis, and increasing distress for both the individual and their loved ones. Multiple barriers to treatment exist and must be addressed in order to ensure people can access the appropriate evidence-based treatment quickly.
Self-referral for specialist assessment removes a significant barrier by allowing individuals to refer themselves or their loved one to the local eating disorder service, so avoiding the need for the individual to seek referral from their general practitioner.
Self-referral for specialist assessment has been recommended for all Welsh eating disorder services, and must be offered by all children’s and young people’s services in England by March 2021. Despite this and in the face of the advantages of self-referral, the proportion of services which accept self-referrals remains low.
A 2017 investigation into self-referral across UK eating disorder services for children and young people found that 50 services (49.0%) stated that they accepted self-referral. A number of these placed restrictions on who could self refer, based on factors such as the individual’s age or diagnosis. A follow-up investigation in January 2020 found that self-referral was accessible in only 33 services (33.7%) for children and young people, and nine services (11.4%) for adults. When compared against proposed best practice standards in the provision, promotion, and accessibility of self-referral, four services (4.1%) for children and young people and 0 services for adults met the proposed standards.
This paper outlines the advantages of self-referral, presents the results from the investigation into availability and access, and recommends best practice standards for services introducing self-referral.