FREED-UP: First episode and rapid early intervention service for young people with eating disorders – upscaled South London and Maudsley NHS Foundation Trust

Eating disorders are severe mental health conditions that usually start in adolescence or early adulthood. The first three years of illness offer a window for early, effective intervention in order to achieve a full recovery. Beyond this, lasting brain changes can lead to much poorer outcomes.

A key barrier to early, effective treatment is poor access to services. The FREED (First episode Rapid Early intervention for Eating Disorders) programme has been shown to reduce waiting times for treatment and the duration of untreated eating disorders in young people (aged 16 to 25) who have had an eating disorder for less than three years.

FREED interventions include a rapid screening and assessment protocol, evidence-based guided self-help interventions and psychological therapies for patients and carers, and an implementation toolkit for staff and services.

This project aimed to demonstrate the scalability of the FREED approach by implementing it across four specialist eating disorder services in Greater London and Yorkshire. 

Each partner organisation had a FREED champion who led implementation locally. Evaluation has included case-control comparisons with patients treated before the introduction of FREED, a one-year outcome evaluation, and qualitative interviews with patients, carers, clinicians and commissioners.

So far, 278 young people have been enrolled in FREED-UP and feedback has been consistently positive. There are now eight services using or preparing to use FREED, and plans are in place to continue to scale up. By 2020, it is hoped that FREED will be available to at least two-thirds of the UK population. 

The evidence is now being used to promote FREED as a national service delivery model that empowers patients and families to engage with treatment, promotes recovery and reduces future service utilisation.