CW: Eating disorder, mental illness
During my time in treatment for my eating disorder I was kicked out of treatment three times. I wasn’t kicked out for behavior or because I was cured. I was kicked out because I was showing symptoms of an eating disorder.
But wait, aren’t these treatment centers supposed to be HELPING with eating disorders? Isn’t that their whole job? Isn’t their only speciality eating disorders? Yep. And they still can’t handle just that: eating disorders.
A fairly common symptom of eating disorders is not eating. Wether it’s not eating at all or restricting intake, not eating is obviously very harmful to your health. Both physical and mental. So, you would think that a facility completely devoted to treating eating disorders would be able to handle someone restricting. But, no. In most eating disorder treatment centers restricting as actually grounds for kicking you out of the program.
In my case I was kicked out of two programs for restricting, and once I was even kicked out without a plan from the program to seek higher levels of care.
Sidenote: Non-crisis mental health treatment has five levels of care: (in increasing severity) Outpatient, Intensive Outpatient, Partial Hospitalization, Residential, and Inpatient. Programs in trauma, addictions, general mental health and eating disorders all have programs at each of these levels. Eating disorder treatment tends to have a sixth level of care: The ICU, but that’s generally not considered a formal level of care.
Of course, not all levels of care are suitable to all forms of eating disorders. If someone simply won’t eat, they’ll eventually need a higher level of care so that they don’t die. Different levels of care can provide different treatments from bed rest to movement restrictions to feeding tubes. Sometimes people need these things.
Increasing a level of care is a disruptive thing. You have to transfer to a different program (generally), and have a completely different treatment team. It requires research and understanding of the kind of program you’re entering. Not really something you can do when you’re in the middle of battling your eating disorder.
Not only that but some programs have entry tests that challenge you as soon as the program begins. For example, one eating disorder facility requires you to complete 100% of meals selected for you in the first week or you are removed from the program. Since your first week at a program is generally when you’re doing your worst, many people don’t make it past this challenge and thus are kicked out without much of a plan to proceed with their treatment.
Eating disorder programs are few an far between. Here in DC we are lucky to have six eating disorder focused programs at various levels of care (3 IOP, 4 partial, 1 residential, 1 inpatient). But in smaller cities, resources are limited and travel is often required to get into a program that suits your needs. Imagine then getting kicked out and told to go to another program, possibly across the country, just for displaying symptoms of your eating disorder. Most people simply cannot afford treatment because of travel expenses and actual treatment expenses.
Being removed from your program is a constant fear in eating disorder treatment. Either through display symptoms or because of insurance. Insurance is incredibly fickle with eating disorder treatment. Mental health treatment is often considered to be a crisis-only service through insurance. But eating disorders aren’t like that. They require months or years of professional help. Insurance simply doesn’t allow for this most of the time. Seeing someone get kicked out of a program for insurance reasons is incredibly common at eating disorder centers and it’s often the saddest way to see someone leave. Because you know they’ll be back and they’ll be worse.
So yeah, not only is finding treatment for eating disorders incredibly difficult, programs are ready to kick you out simply for having an eating disorder. How is that good treatment? Imagine if you had cancer you it progressed, so you got kicked out of your cancer treatment program. Completely inconceivable. But this happens in mental health treatment all of the time.
If you need assistance seeking treatment for eating disorders feels free to contact me at emma@emma.sh and I will happily assist you. I am not a professional medical negotiator.
None of what is said on this blog should be considered medical advice. I am not a doctor.
If you or anyone you know is considering suicide or self-harm, or is anxious, depressed, upset, or needs to talk, there are people who want to help:
In the US:
Crisis Text Line: Text CRISIS to 741741 for free, confidential crisis counseling
The National Suicide Prevention Lifeline: 1-800-273-8255
The Trevor Project: 1-866-488-7386
Outside the US:
The International Association for Suicide Prevention lists a number of suicide hotlines by country. Click here to find them.