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.
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.
6 patients in a apartment in the hospital neighborhood
- primary prevention
- secondary prevention
- detection of new cases