First episode and rapid early intervention for eating disorders (FREED)

South London and Maudsley NHS Foundation Trust

  • ​Led by South London and Maudsley NHS Foundation Trust, in partnership with the Institute of Psychiatry, Psychology and Neuroscience at King’s College London.
  • Intervention for patients aged 18 to 25 with a primary eating disorder diagnosis who are referred to the outpatient service.
  • Developed an innovative early intervention service for young adults with eating disorders
  • Offered a range of proven therapeutic interventions, including online support, group-based therapy, university holiday sessions and evening appointments with clinicians.

The aim of this project from South London and Maudsley NHS Foundation Trust was to create an innovative early intervention service for young people with eating disorders, using the unique window for change within the first few years of onset.

Eating disorders are severe mental disorders with peak onset in adolescence/early adulthood. Early effective intervention within three years of onset is essential for preventing eating disorders becoming chronic and treatment-refractory. However, a key barrier to this early effective treatment is poor knowledge of how and when to access to services.

A team at South London and Maudsley NHS Foundation Trust has investigated whether a novel first episode and rapid early intervention service for young people with an eating disorder (FREED) can shorten the duration of untreated eating disorders and waiting times, and improve outcomes.

The intervention was developed for young people (18–25) who have had an eating disorder for less than three years. The service, which was embedded in a large NHS specialist eating disorder service for adults, involved a rapid screening and assessment protocol, evidence-based guided online and manualised self-help interventions for patients and carers, and an implementation toolkit for staff.

FREED patients waited almost 40% less time for an assessment and waiting times for treatment were almost halved. All of the FREED patients took up treatment, compared to 87% from published data. Overall clinical improvement was rapid, with patients’ average eating disorder symptom at six months being below the cut-off for a clinical eating disorder.

Several local NHS commissioners are now allowing direct referrals of young people from GPs to the eating disorder unit, in response to the project findings.

The most significant challenges encountered during the project were engaging commissioners in the initiative and implementing changes to service administration processes.

Supporting dissemination

This project was given further support through a Spreading Improvement grant to help disseminate learning and maximise the impact of the approach across the health service.

Funding will be used for a variety for activities to help spread key learning from the original project including; a national communications campaign, and the development of a user friendly FREED website for young people that will also function as a resource for health/education professionals, and friends and family.

Contact details

For further information about the project, please email Danielle Glennon at South London and Maudsley NHS Foundation Trust.

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