NOTE: This article contains content that may be triggering to some people.
A young Cork woman who has been struggling with an eating disorder and obsessive-compulsive disorder (OCD) for a decade says she believes she will die if she cannot access inpatient care, as she does not feel safe in her own home and can no longer cope with supports offered by the HSE.
Emma O’Sullivan, 25, from Ballinlough, was first diagnosed with anorexia when she was 15 and was admitted to Eist Linn Hospital for treatment for six months the following year.
She says her treatment has been “severely mismanaged” since she was a teenager and that the current barriers to her accessing inpatient care through the public health system are putting her “life at risk” as she believes she urgently needs specialised care.
“I’ve decided to go public with my story to raise awareness of how difficult it is to get the right treatment in Ireland, and to start a fundraising campaign so I can access the care I need in St Patrick’s Hospital, which has a specific treatment programme for patients with eating disorders,” said Emma.
“St Patrick’s did accept a referral made by my old GP earlier in the year and I was waiting on a call from their beds manager, but then I found out that my health insurance provider would not cover the cost of care as it was for a 'pre-existing condition'.
Seriously deteriorated
“My health has seriously deteriorated in the last few months and I’ve had to make numerous calls to my GP, visits to SouthDoc, and urgent trips to the CUH mental health emergency department amidst daily breakdowns and a number of near-suicide attempts," she said.
“Despite all this I have been told that the HSE will not give me funding to access specialised care in hospital, as I have been told that the support currently offered to me is adequate, even though I have said that I am not coping repeatedly.
"I don’t know how much worse things would have to get for me before their position changes, or what the threshold is for getting serious help. That’s why I’m asking people to help me get the care I need now," she said.
Emma said that since she left hospital at 16 she has largely depended on her own coping mechanisms to try and get her life “back on track”, but that things have become so unmanageable lately that she has had to give up her job and she struggles to leave the house.
“I started getting support from the HSE’s Child and Adolescent Mental Health services when I was 15," she said.
“Each week they weighed me, and I was often told that I ‘just needed to eat’. It didn’t help.
"As I got worse my mum pushed for me to be admitted. She had to ask local TDs to get involved. When I got to the mental health unit the staff were shocked at my overall condition, and that my spine was bruised.
I had lost so much weight that I couldn’t really walk for three months. I had to get a lift to go up the stairs and I couldn’t sit down in a chair without cushions being placed behind my back.
“The treatment I got there saved my life, but after I left I felt like I was back to coping on my own,” said Emma.
Though Emma went on to finish her Leaving Certificate and attend design college after having to miss out on her Junior Certificate, she continued to struggle with her mental health.
Since the start of the pandemic, both her OCD and her eating disorder have “taken over” her day-to-day life.
“During lockdown I started to have health problems that saw my OCD get worse," she said.
“I experience severe intrusive thoughts that lead to a process of self-checking, and extreme self-cleaning.
“I have told people in the system that this has gotten so bad that I’ve used chemical cleaner on my body as I am so afraid of contamination.
“My OCD and my eating disorder aren’t separate. I can’t prepare food at home because I can’t touch the cooking utensils," she said.
"I’ve been in situations where I am hungry but unable to eat because I am afraid of contamination. I have noticed that I am losing quite a lot of weight again as a result. It is really upsetting to be dealing with all of this at home, and then having to tell a counsellor about it after the fact,” said Emma.
“I have told my GP, my psychiatrist, and my psychologist that I don’t feel safe at home anymore.
“On one occasion I went to the emergency department and was sent home after an hour-long assessment, with a new medication, which my psychiatrist then took me off.
“I’ve gone to the adult mental health crisis team and had a supervisor tell me that I ‘look fine’ because I put on makeup. Our system is really broken, and I don’t think I’m the only person in Cork, let alone the country, in this situation."
The Ballinlough native said that it should not be the case that her health has to deteriorate further before she can access inpatient care.
“I don’t want to die because of this. I want my life back, my ability to work, to maintain relationships, and to have independence.
"I think that I am entitled to treatment. You shouldn’t have to be on the brink of death to get specialised care,” Emma said.
Aside from private facilities, the HSE has three dedicated psychiatric eating disorder beds for adults.
The HSE’s 2018 ‘Models of Care’ report on ED services said that patients are typically referred for inpatient treatment “when more intensive treatment and refeeding is needed".
The same report stated that local Community Health Organisations do “occasionally” provide funding for patients to be admitted to private/independent eating disorder care providers in Ireland.
In March this year Minister of State Mary Butler announced ring-fenced funding for the development of eating-disorder supports.
To donate towards Emma’s GoFundMe campaign for treatment, visit her fundraiser page.
A spokesperson for Cork Kerry Community Healthcare told the Irish Examiner that they cannot comment on individual cases.
"Adults with eating disorders can access treatment from local community mental health teams. There are currently 112 adult community mental health teams nationwide. 90% of new/re-referred adults are offered an appointment within 12 weeks," the spokesperson said.
"Adults who have an eating disorder diagnosis and require inpatient care can be referred to any of the HSE’s acute inpatient mental health approved centres around the country.
"Adults presenting with an eating disorder can also be treated in an acute hospital if their physical health needs require this. In exceptional circumstances on the advice of the treating team, external placements to specialised services have been approved," the spokesperson added.
Cork Kerry Community Healthcare said that in a crisis situation service users should engage with their GP or go to the nearest emergency department.
They also said that service users can make complaints via the HSE website.
If you have been affected by any of these issues, please click here to access a list of available support services: