Bulimia nervosa

I would be interested if anyone has an opinion or can refer to supportive case law in relation to the above condition.

Would the activity of bingeing and purging be considered self neglect?

Would someone who can only eat small restricted items such as chocolate and cereal be incapable of preparing a main meal?

In this case the client’s activities of eating purging varied from 3-30 times per day.

The psychiatrist reports (which variously states bulimia still out of control, extremely bulimic, unstable traits) are largely disregarded by the LQM in the Statement of Reasons as: Psychiatrist unlikely to have spent a lot of time at client’s house and info based on what client told them.

hi

i think you could argue it two ways, either attention or supervision -

on attention side, you could argue that she needs someone to help her not binge/purge so as to enable her to lead a normal life.  would have to come up with examples of sort of things she would do if so helped - see CDLA/618/2006 and commentary on p152 of vol 1 of sweet and maxwell social security legislation (bonner).  if need ‘frequently throughout the day’, for example, could go for middle care comp. 

in relation to cooking test - could argue that needs support and encouragement to prepare a proper main meal because of mental disability - see CSDLA/725/2004. 

also could argue that needs continual supervision - if her health is suffering as a result of her eating disorder, could argue that that represents ‘substantial danger’ and she needs someone to supervise her to stop her from binging/purging.

as regards tribunal’s statement about psychiatrist’s report - could perhaps argue that all psychiatrists make assessments based on seeing the patient outside their home, but that their training and expertise, along with repeated meetings with patient, allow them to make sound judgements about what it true and what isn’t.  if take converse view, means that could never take psychiatrist’s diagnoses into account unless they had arranged to stay with patient for a while - surely a bit unwieldy!

ros