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Early intervention in eating disorders

FREED (First episode Rapid Early intervention for Eating Disorders) is an innovative, evidence-based, specialist care package for young people aged 16-25 with a first episode eating disorder of less than three years duration. Broadly based on the early intervention model for psychosis, FREED overcomes barriers to early treatment and recovery and provides highly coordinated early care, with a central focus on reducing the duration of an untreated eating disorder.

The FREED approach is important because eating disorders typically develop in adolescence and early adulthood, when the brain is still developing. Eating disorders cause brain changes that negatively affect chances of recovery. The longer someone has an eating disorder the harder it is for them to change. Treatment outcomes are significantly worse after an illness duration of three or more years, compared to earlier intervention.

FREED supports the priority areas outlined in the NHS Five Year Forward View for Mental Health and the recommendations for eating disorder care outlined by the National Institute for Health and Care Excellence (NICE).

FREED has scaled successfully from the eating disorder service at the South London and Maudsley NHS Foundation Trust (SLaM) to three other eating disorder services around England. In April 2020, FREED was selected as one of the Health Innovation Network’s new national programmes for rolling out across England. The Oxford AHSN is now engaging with eating disorders services in the Thames Valley.

Each eating disorders service treating 18-25 year olds will recruit a FREED champion to track all referrals and conduct an ‘engagement call’ within 48 hours of a referral being received if it appears that the young person may have an eating disorder for less than three years.

FREED aims to achieve:

  • earlier intervention and treatment of eating disorders in young people
  • reduction in the length of time young people have untreated eating disorders
  • reduction in waiting times, day/inpatient admissions and bed days
  • cost savings through reduced use of healthcare services, in particular reduced need for day/inpatient admissions.