Mental health services use and management of eating disorders in an Italian Department of Mental Health

OBJECTIVE: To investigate the clinical characteristics of patients with eating disorders referred to Community Mental Health Centers (CMHCs) in the Department of Mental Health of Bologna, Italy, and to evaluate the number and type of interventions delivered. METHODS: Adult patients with eating disorders who had a first contact with CMHCs between January 1, 2007 and December 31, 2012 were extracted from Bologna Local Health Authority database. Moreover, the hospital discharge records of patients were linked to the mental health information system of Bologna. RESULTS: Among the 276 patients with eating disorders identified, 59 (21.4 %) were diagnosed as anorexia nervosa, 77 (27.9 %) as bulimia nervosa and 140 (50.7 %) as eating disorders not otherwise specified. The mean age of the sample was 37.3 (SD = 13.4), with no significant differences among the three diagnostic groups. The number of CMHCs outpatients increased each year from 2007 to 2011 and decreased in 2012. The proportion of new patients by year comprised about 50 % of the total of patients. Psychotherapy accounted for about 10 % of the interventions. Day-hospital and hospital admissions concerned 6.1 and 11.6 % of the sample. CONCLUSIONS: CMHCs are part of the system of care outlined by the Regional policies for eating disorders and are responsible for providing the first level of outpatient care to adults. To date, there is the need to extend our monitoring across the whole system of care, to assess the implementation of specific and effective strategies to decrease the age of access of patients and to improve the quality of care delivered with the inclusion of evidence-based treatments in the process of care