The Mental Health Act and Anorexia. In the last 14 years, I have been under some form of the Mental Health Act for 13 years and 4 months. Since 2008, I have only had 8 months not under the Mental Health Act. I had 4 months not under the Mental Health when I was discharged from my first eating disorder admission in 2009. Within those 4 months, I rapidly relapsed and had to be readmitted to hospital. I was again placed under Section 3 of the Mental Health Act because of anorexia. I had another 4 months not under the Mental Health Act when I was discharged from this second admission. But again, I rapidly relapsed and ended up back in hospital under section. I was discharged from this third admission on a Community Treatment Order. This was in 2011. I have been under this CTO ever since. Until now.
I have never had much success at being a voluntary patient. As you can see, the 8 months experience I have had as a voluntary patient led to a complete takeover of anorexia. When I had a choice, anorexia always won. I would never have complied with treatment. I couldn’t. The guilt for taking responsibility was so overwhelmingly powerful. I couldn’t cope if I betrayed anorexia. So the Mental Health Act has saved my life on numerous occasions. It forced me to have treatment that I didn’t want. Or, more accurately, that anorexia didn’t want me to have. The Mental Health Act fought anorexia for me when I didn’t have the strength to fight it myself.
The CTO was slightly different. It didn’t “force” me to have treatment. But it threatened me with consequences that I didn’t want if I didn’t follow the rules of the CTO. If I lost weight below a certain number, I would be sent straight back to hospital. I didn’t want that, so following my discharge in 2011, I have continued to maintain my weight above that number to avoid going back into hospital. The CTO was motivating me to not lose weight.
It also continued to take the responsibility away from me. When I was wanting to engage in an eating disorder behaviour, I would tell myself that I couldn’t because of the CTO. Because if I engaged in the ED behaviour and lost weight, the CTO would send me back to hospital. So it wasn’t me choosing to go against anorexia, I had to in order to avoid losing weight below that critical number and ending up back in hospital. You can read more about some of my earlier experiences on the CTO in my old blog Community Treatment Orders
The CTO was really crucial to me to stop me relapsing. Particularly in those first few years following my discharge when I had never had any experience before of not going along with anorexia. Over the years, the more time I had out of hospital, the more I realised that there was more to life than anorexia. And I wanted more from life. But I still couldn’t fight anorexia alone. Anorexia was still so strong and powerful and I knew if I could, I wouldn’t be able to stop myself losing weight. So the CTO continued to stop this. And it continued to help me build a life.
In those first few years, the CTO acted as threat and motivation to maintain my weight. But overtime, I didn’t need it so much for these purposes. I didn’t need to remind myself with every mouthful of food that I had to eat it because otherwise I would lose weight and end up back in hospital. But what the CTO did continue to do in more recent years was continue to take responsibility for fighting anorexia.
Because of the CTO, I knew losing weight was not an option. So rather than spending all of my energy on trying to resist anorexia, I could focus on other things. The CTO was always there in the background preventing me from losing weight. So I concentrated on building my life, whilst the CTO continued to keep anorexia at bay.
Every year the CTO comes up for renewal. It is discussed between myself, my parents and my community team as to whether we feel I still need it. In 2019, we all felt that I could maybe try without the CTO. That maybe I was ready. I thought I was ready, so we agreed that when the renewal was due in a few months, the CTO wouldn’t be renewed. Welcome back anorexia with full force.
As soon as I thought that I would be discharged from the CTO, I started planning my weight loss. I had no idea this was going to happen. I thought that I’d been doing really well and the anorexic temptation wasn’t strong enough to take over my life anymore. Boy was I wrong. Don’t get me wrong, I had been doing well in recovery. But that was with the support of the CTO. That was with the CTO doing the majority of fighting and responsibility taking for me. I hadn’t realised that as soon as I thought I “could,” I wouldn’t be able to resist the urge to lose weight.
I actually felt excited. It felt exciting to plan losing weight and know that after 7 years of maintaining, and gaining, weight, I was finally going to feel weight loss again. And that was going to feel fantastic. But as well as feeling excited, I also felt very scared. I could feel myself free falling back to anorexia. And that felt very scary. I had finally started to build myself a life and now I was going to lose it all again to anorexia. Yes, I wanted to lose weight, but I didn’t want to lose my life along with it.
I told my community team how I had been feeling. They decided to renew the CTO. I actually felt relieved. The CTO could continue to help me fight anorexia and allow me to continue building my life. Because clearly I wasn’t ready to do it alone. The next few years were full of ups and downs. I was doing well in recovery, but anorexia was still strong enough for me to continue to need the CTO. Until now.
As of the start of July 2022, I am no longer on a CTO. I am a voluntary patient. And I am totally ready for it. We discussed the renewal/discharge of the CTO. I didn’t have those same thoughts as I had done back in 2018. I didn’t start planning my weight loss and I didn’t want to start planning my weight loss. Yes, there is more guilt and anxiety now that I am not on the CTO. But the CTO was not really helping me anymore. I didn’t need. I can fight anorexia myself now. Because I want life more than I want anorexia. my life has grown bigger than anorexia. yes, the desire to lose weight will always be there. But I have no intention of acting on it. I know where it ends up and I know the sacrifices that come with that. And I don’t want.
Previously, I couldn’t fight the urges of anorexia, no matter how much I wanted a life as well. But now I can. The urges are still there, albeit not a strong. Anorexia and weight loss was all to powerful if left to my own devices. I needed the Mental Health Act to fight anorexia. But now, the loss of my life is all too powerful. I have things I want to do and achieve. Giving into anorexia and losing weight would not allow those to happen. Being a voluntary patient after all those years is scary. But losing all of my hopes, dreams and life is even scarier.
I have been on the CTO for 11 years. I needed those 11 years to build the strength that I now have. During those 11 years, the CTO was always there in the background helping to keep anorexia at bay. Now, anorexia is in the background and my hopes, dreams and life are keeping it there.
I’d be really interested to hear any of your experiences of The Mental Health Act so please do leave a comment. Also, my memoir is being published on 9th August so if you would like to buy it, you can order it here: https://www.amazon.co.uk/Running-Free-My-Battle-Anorexia-ebook/dp/B09TTB9YTK
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The Mental Health Act & Anorexia – Bex Quinlan
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