| Morbidity from eating disorders (anorexia
and bulimia) is increasing in recent years, and estimations
are that this trend will continue in the next decade. To date,
in Israel there is only one Eating Disorder (ED) center in Shiba
Hospital in Tel-Aviv. In other areas ED services are part of
the general psychiatry services. Due to increasing demand, two
private centers opened recently. In the Jerusalem area, Hadassah
has been supplying various modes of treatment for ED since the
early 80's as part of the general psychiatric services and internal
medicine eating disorders clinic. The major problems in this
mode of treatment are: there is no professional team totally
dedicated to ED, the treatment is fragmented since the patient
is forced to move from one treatment facility to another and
has to cope with new case managers and different treatment modes.
Moreover, many patients avoid treatment due to the stigma of
psychiatric treatment.
We propose to reorganize our ED services. This will include
organizing all services under one central administrative body,
adding new services that are needed and generating a continuum
that will begin with the detection of cases in the community,
treating them according to their needs, and helping them to
reintegrate themselves back in the community. The unit will
include community preventive and diagnostic services, hospitalization
unit, day care unit, and halfway service and outpatient clinic.
The unit will be run jointly by the division of Psychiatry
and the Nutrition and Eating Disorders Unit in the Department
of Internal Medicine, but will cooperate with specialists
from overlapping fields such as community health, dietetics
department and social work. There will also be outreach programs
to the local schools We believe that this program will enable
us to build a professional team, to improve cooperation between
the different units that are working independently today and
to economize resources.
Organization
The program will actively detect new cases in the community
and will provide treatment according to their needs. Mild
to moderate patients will be treated in the community or will
be referred to the hospital outpatient clinic, while severe
cases will be referred for hospitalization. After the hospitalization
period the patient will move to the day care unit, with the
option of residing in a halfway house and then back to the
community with on going treatment in the outpatient clinic.
While moving among the different service modes, the same treatment
team will continue to treat the patient in order to maximize
the treatment efficacy.
Adult hospitalization unit:
• 10 patients in full hospitalization.
• 10 patients in day care
Halfway house:
6 patients in a apartment in
the hospital neighborhood
Ambulatory unit:
• 50 patients
Community center:
• primary prevention
• secondary prevention
• detection of new cases
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