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2021 mental health outcome data annual quality report

Key findings from 2021 Patient Reported Outcome Measures (PROMs)

Schoen Clinic Chelsea (PROMs data key findings)

Adult anxiety and mood treatment pathways

The pathway data shows treatment effectiveness in improving mental health, through individual and group outpatient treatments at Schoen Clinic Chelsea

Intensive group treatment programme

  • Depression symptoms improved from admission into the programme to discharge
  • Anxiety symptoms improved from admission into the programme to discharge
  • Functioning improved from admission into the programme to discharge

Outpatient services

  • Depression symptoms improved from beginning of treatment to discharge
  • Anxiety symptoms improved from beginning of treatment to discharge

Eating disorder treatment pathways 

Adults

The pathway data shows the treatment effectiveness in improving eating disorder psychopathology through individual treatment at Schoen Clinic Chelsea

Eating disorder and depressive symptoms improved from the beginning of treatment to midway follow-up during treatment (most outpatients still in treatment and not discharged at the time of reporting)

Children and Young People

The pathway data shows treatment effectiveness in improving eating disorder psychopathology, through individual and group outpatient treatments at Schoen Clinic Chelsea

Intensive group treatment programme:  

  • Eating disorder symptoms improved from admission into the programme to discharge
  • Readiness to change improved from admission into the programme admission to discharge
  • Patients reported they were closer to reaching their goals at discharge, compared to admission

  • Emotion regulation skills improved from admission into the programme to discharge

  • Eating flexibility improved from admission into the programme to discharge

  • Patient anxiety and depression symptoms (as reported by parents) improved from admission into the programme to discharge

  • Parental self-efficacy improved from admission into the programme to discharge

  • However, patient anxiety and depression symptoms worsened from admission to discharge

Possible explanations for this - 

  • Experiencing emotions more intensely, which is a common effect seen with improved nutritional status. We will continue to explore this further
     

  • Anxiety and worries around discharge e.g. having less support

    We recognise this being an issue and as a result have launched a follow-up outpatient programme to continue to offer support but in a controlled and phased reduced way.

    This programme is there if required by the family and we will also evaluate and make a recommendation if we feel it will add benefit to the young person. Mental health comorbidities pre-dating the eating disorder become more apparent.

Schoen Clinic Newbridge (PROMs data key findings)

Inpatient treatment for young people with eating disorders

The Schoen Clinic Newbridge treatment programme continues to ensure patients are increasing weight in hospital, whilst receiving the psychological support they need to return to the community setting and continue their recovery journey

The average length of stay was 151.4 days, 21.6 weeks, 5 months.

Average %mBMI (percentage median BMI) on admission was 73.8% and average discharge %mBMI was 96.8% (meaning on average most young people got to a minimum health weight as part of inpatient treatment).

The 2021 data shows a decrease in all subscales of the *Eating Disorder Examination Questionnaire (EDE-Q) and the global score indicating an improvement in eating disorder symptoms between admission and discharge. The differences in paired scores at admission and discharge for all subscales and global score were statistically significant (<0.05).

Schoen Clinic York (PROMs data key findings)

Inpatient treatment for adults with eating disorders

The 2021 average length of stay was 136 days, 19.42 weeks. In 2020, the length of stay was was 146 days. This demonstrates the service is meeting targets to reduce the average length of stay. 

  • The average BMI at admission for all patients was 14.99 kg/m2 (‘underweight’ range)
  • The mean BMI on discharge was 18.19 kg/m2. Although this is still in this underweight’ range, it is an improvement following admission.

The data shows that adults are more likely to leave inpatient treatment without reaching a minimum healthy weight but having gained weight during their admission.

The data shows that the overall *Eating Disorder Examination Questionnaire (EDE-Q) score reduced from admission to discharge for 17 out of 33 clients (51.51%).

The *EDE-Q scores demonstrate that the clinical team remain focussed on ensuring treatments are tackling eating disorder psychopathy to ensure treatment effectiveness.


*Understanding the EDE-Q
The Eating Disorder Examination Questionnaire (EDE-Q) is a 28-item self-reported questionnaire. It is designed to assess a number of different thoughts, feelings and behaviours that are associated with eating disorders and the severity of these. 

It has 4 subscales (Restraint, Eating Concern, Shape Concern and Weight Concern) as well as a global (total) score.

The Restraint subscale explores the level of food restriction and dietary rules.

The Eating Concern subscale looks at the preoccupation one may have around food/eating and the difficult feelings around this.

The Shape Concern subscale looks at body dissatisfaction and preoccupation with shape and weight.

Finally, the Weight Concern subscale explores difficult thoughts and feelings around one’s weight. Higher scores on the EDE-Q indicate greater difficulties with eating attitudes and behaviours.