HEALING AUTISM: A Family Constellation Therapy Perpective

Family Constellation Therapy, sometimes known as Systemic Constellations, was created by Bert Hellinger, a German psychotherapist. This amazing method is used to uncover the source of chronic conditions, illnesses and emotional difficulties that may have roots in the inter-generational family systems, rather than the individual, and may be connected to a key stress event. Could resolving past family trauma help unlock the symptoms known as autism. Sadly, some form of autism is now observed in 1 in 55 children and is growing at a rate of more than 1,100 percent. Western medicine focuses on medication to suppress symptoms and alternative approaches focus on treating the underlying biomedical, physical, psychological and environmental causes of autism.

However, illness not only originates in our physical body, but can also originate in our energetic and spiritual body as well. So, it becomes imperative that we treat the entire person for a fuller recovery.

“Autism spectrum disorders can only be fully healed by restoring the self-regulation of the system and making it fully functional.” Klinghardt

This moving and powerful work in the family’s energetic field. This is  also referred to as “the knowing field.” And, is used to examine the emotional factors connected to conditions such as illness, allergies, alcoholism, ADHD and autism. Some parents of children on the autism spectrum have experienced profound transformations as a result of this work for themselves, as well as for their families.

These children are often the recipients of unhealed trans-generational family issues because of their extraordinary energetic sensitivities.  This perpetuates their illness.

Family constellation therapy work, focuses deeper on the ancestral family blueprint – the family soul. Our souls carry information from one lifetime to the next and from one generation to the next.

Children often hold the energetic field of their ancestors. This appears especially true with children with autism, because they are super-sensitive and spiritual souls.  Who, often become unconsciously entangled with others in their family in the name of belonging or wanting to help restore balance in their family system. The purpose of a Family Constellation therapy session is to reveal that hidden dynamic and point the way toward resolution.  And, there are often magical improvements in these children when we resolve issues in the family history.

The Forgotten One

One of the participants in a group “Michelle,” has a brother with severe autism who couldn’t speak and was very self-destructive. She was afraid that he could never live a more “normal” life because he refused all biomedical treatment and other therapies offered to him. In the initial set-up, the facilitator had Michelle, her brother, and both parents of her family represented  in “the field.”

The participant representing her brother was hiding under a nearby chair and was rocking back and forth. Both parents were standing in the field, seemingly disinterested in what was going on. The sister (Michelle) kept looking down at the floor. Later in the set-up, it was revealed that the sister was looking down at a baby—a baby who had died of birth defects three generations ago. This baby hadn’t been properly acknowledged or mourned.

In essence, the brother with autism had taken the place of the “forgotten” baby. Representatives for the great-grandparents (the forgotten baby’s parents) were brought into “the field.” Then, the baby was embraced by the parents and a short dialogue was exchanged. The baby reported that he felt more at ease, relaxed and became more comfortable. A healing took place that was so profound.  A year later, “Michelle” reported that her brother was starting to take a more active role in his recovery and was beginning to accept treatment.

War and Mental Illness

“Andrew,” a man in his twenties who was diagnosed with Asperger’s, participated in my group. He claimed that mental illness and psychosis ran in his family. He cried as he explained that he was taking multiple medications for bi-polar disorder. He claimed it was difficult for him to hold down a job.  He often felt very alone. He stated that he did not have a good relationship with his parents. He said that his mom was “crazy.” The parents divorced when his was very small and he blames himself and his issues for why they split.

In the initial set-up of “his field,” Andrew was represented along with mental illness and his parents.   As it unfolded, it became more obvious that something profound had happened in the past. Mental illness began taking on characteristics of a war and hidden dynamics were revealing themselves.

Later in the set-up, Andrew’s representative started choking, like he was trying to catch his breath. He was mumbling, “I deserve death because I have killed others.”

It was uncovered that his great-great grandfather was in World War I and was killed during a mustard gas attack. Andrew was doing service to the family out of deep love. He took on the feelings of the victim and the perpetrator, which caused him deep inner conflict. Hence, he was carrying the burden of mental illness and autism. In doing this soul work, Andrew was able to find resolution for himself as well as all the members of his family.

In conclusion, trans-generational traumas add to our toxic burden and predispose us to illness. Misfortune or unresolved conflict in our ancestry can create disturbances in the family field, which filter down into the psyche, nervous system and metabolic functioning. Children with health issues are particularly sensitive to such disturbances.

Therapy and biomedical interventions may even succeed better after a healing Family Constellation session with an experienced facilitator. Fortunately, it is never too late to heal wounds from the past. Constellation work is unique in that any living family member can do this intervention for the benefit of all.

 Learn more about her book and her work to spread holistic health awareness at www.healingwithouthurting.com or  Healing Without Hurting: Treating ADHD, Apraxia and Autism Spectrum Disorders Naturally and Effectively without Harmful Medication.

HEALING AUTISM: A Family Constellation Therapy Perpective

Death-trap toilets: the hidden dangers of Mumbai"s poorest slums

On the morning of 4 February, Harish Tikedar, Ganesh Soni, and Mohammed Isafil Ansari waited in a queue to use the community toilet in the Indira Nagar slum in eastern Mumbai. All of a sudden the floor collapsed, plunging Tikedar, Soni and Ansari into the septic tank 15-feet below.

Two others who also fell – Sirajjudin Turat and Ramakant Kanojia – managed to hold on to the sides until they were rescued.

“I was submerged up to my shoulders in the slush,” says Turat. “I could feel it pulling me down but somehow held on to a slab. Then some people pulled me up and I passed out.”

The five men who were pulled out were unrecognisable, covered in faeces. They were all taken to a nearby hospital but Tikedar, Soni and Ansari did not survive.

In Mumbai’s slums, the simple act of relieving oneself is fraught with danger, especially in the slums of M-East ward where population density is high, and the few public amenities are crumbling.

M-East is the poorest and most deficient in civic services of Mumbai’s 24 administrative wards. It has expanded over the last 15 years but has remained on the periphery of the city’s consciousness and governance systems. The differences between the civic amenities available in the smattering of middle-class apartment blocks and the slums, which dominate M-East, are stark.

The majority of slum residents are forced to depend on the thriving informal market for water, operated by a network of local strongmen. Photograph: Rajanish Kakade/AP

Most of the 100 square feet slum houses do not have sanitation and water facilities, either because applications for individual toilets and taps are pending approval or because the slum is on encroached land, which means that the civic body will not provide any services there.

For sanitation, people in Mumbai pay two to three rupees (£0.02-0.04) to use a community toilet, which generate revenues of 3.6bn rupees (£47m) a year, according to a recent report by the Observer Research Foundation. The poorest of the poor pay more than 10m rupees (£120,000) per day for the most basic necessity, yet the facilities are rarely maintained despite complaints.

If it wants, the Brihanmumbai Municipal Corporation can find a way to provide basic rights

Rais Shaikh

Some 78% of community toilets in Mumbai’s slums lack water supply, 58% have no electricity, and many don’t have proper doors or facilities for women to dispose of sanitary napkins. The statistics are worse in M-East.

“The chief minister [of Maharashtra] should order a structural audit of all community and public toilets. All those found deficient must be demolished and reconstructed,” says Dhaval Desai, author of the Observer Research Foundation report. “The long-term solution is to allow slum dwellers to construct individual toilets inside their houses. About 83% of the people we interviewed said they would spend the money, but the BMC [Brihanmumbai Municipal Corporation] denies permission on technical grounds.” Most of the slums appeared after 2005, which makes them illegal.

“That slums post-2005 are not given water is a sham,” says Rais Shaikh an elected representative to the BMC from M-East, and leader of the Samajwadi party. “All of them get water; by what means is an open secret. If it wants, the BMC can find a way to provide basic rights.”

The majority of slum residents are forced to depend on the thriving informal market, operated by a network of local strongmen that supplies water through tankers and via the unfinished pipe system laid by the civic body. The cost depends on demand and supply, from as high as 40 rupees (£0.48) to as low as five rupees (£0.06 ) for a 40-litre can. When the municipal corporation imposes water cuts in the summer, the cost rises considerably.

Where there is a gap in sanitation services, NGOs step in to construct community toilets, or local MLAs (member of legislative assembly) and MPs contribute money from area development funds. A coterie of contractors usually takes up the construction and management of these community toilets. But they have no accountability to either the BMC or residents, and repeated complaints about sinking floors and full septic tanks go unheeded.

After an incident, the MLA or MP comes visiting, often with a cheque. We know life is cheap in Mumbai, but so cheap?

Razzaq Shaikh

The community toilet that collapsed in the Indira Nagar slum was only 10 years old and was built using the local MLA’s area development fund. The contractor was arrested and booked under the Indian Penal Code on charges including culpable homicide not amounting to murder, but he was eventually set free. He was not available for comment.

The accident is not an isolated one. Across Mumbai, seven people have died and one was left disabled in similar incidents in the last three months.

“There must be guidelines that the BMC enforces for construction, otherwise this kind of death will become routine,” says Razzaq Shaikh, who helped rescue the two survivors. “After an incident, the MLA or MP comes visiting, often with a cheque. But what’s the point? We know life is cheap in Mumbai, but so cheap?”

The benchmark for toilets, adopted as part of India’s Swachh Bharat Abhiyaan [Clean India Mission], is one toilet for 25 women or 30 men. In M-East, however, the average is one toilet per 190 people, according to surveys by the Tata Institute of Social Sciences.

“The availability of toilets and tap water is so abysmal that the Swachh Bharat Abhiyaan is laughable,” says Amita Bhide, dean of the institute’s School of Habitat Studies and head of its M-East ward project. “The state and the BMC has to intervene and be innovative, not sit on applications for individual toilets because there aren’t sewer lines to link to.”

Regular water supply is also a perennial election promise, but despite politician’s campaigning, nothing seems to change in Mumbai’s poorest slums.

“All political parties come here using the water issue as their trump card,” says Syed Lateef. “All of them say that when they come to power, water issues will be resolved. Water pipes have been installed and reinstalled, but we don’t get water. We buy it.”

Additional reporting by Suryasarathi Bhattacharya and Jovita Aranha.

A version of this article first appeared on scroll.in and has been republished with permission. Follow the author @urjourno and @scroll_in on Twitter.

Join our community of development professionals and humanitarians. Follow @GuardianGDP on Twitter, and have your say on issues around water in development using #H2Oideas.

Death-trap toilets: the hidden dangers of Mumbai"s poorest slums

‘So, you know I have bipolar?’ – the perils of dating with a mental health problem

Dating is hard. It’s paved with heartache and unrequited crushes and the blurting out of gabbled nonsense in front of the unimpressed person you like. When I finally found myself in a conversation with someone I liked at work, whose head I had resolutely stared at the back of for a full three months, I answered an innocuous, “So, how’s your day going?” with, “I am awash with existential despair.” She stared, confused and unblinking, back into my face. I then followed it up with a tiny, pathetic, “Woo!” She sat down again. I continued to stare at the back of her head from my desk, in the full knowledge that she would never speak to me again. This isn’t just me, right? This is how it is for everyone. This is what it’s like to date. It’s awkward.

But what is it like when, in addition to your inability to say anything remotely funny or interesting to the person you are into, you have a mental health problem as well? How does that affect the way you interact with them? How does it affect a relationship once you are actually in one? And, more pressingly: how do you even tell someone you are, or have been, ill? At what point during the dating process is it appropriate to bring up mental health?

The pressure of not knowing when or how to reveal your mental health status can be an additional and very valid source of anxiety. If you tell them too soon it can feel like you are setting the stakes too high; but if you leave it too long you might find that the person you are dating has offensive views on mental health, doesn’t want to deal with it or just isn’t equipped to handle it at all.

As a serial dater it’s something I’ve contended with a lot. It’s also something I’ve done badly a lot. You would have thought there was a finite number of ways to do this wrong. There is not.

How not to tell someone you are mentally ill

Let’s start with some of the poor ways I’ve handled this so far.

Avoiding telling someone until it was catastrophically too late

Hey! I thought, after a month or two of relative tranquility. I think maybe I don’t have mental health problems any more! I think maybe things are going to be perfect for ever and I’m never going to have to think about this ever again. There’s absolutely no point telling my new boyfriend about it, is there? Nah. It’ll be fine. I’ll be fine. I’m fine.

It was not fine.

At that point I was deeply embarrassed bymy previous psychotic episode, and tried to distance myself from it as much as possible. It was easier for me to avoid the topic and skirt around it awkwardly than to confront it. I chose to blame my breakdown on the stress of starting university, moving away from home, and spending all my time drinking. I didn’t want to think about the possibility that it might continue to affect me for the rest of my life.

But eventually my boyfriend and I did end up talking about self-harm and suicide. It was two years into the relationship and we were in the pub. “It’s all just attention seeking, isn’t it?” he said. “It’s just people who want to feel special: ‘Oooh, look at me, I’m on antidepressants!’ Just get on with it.” He went on to tell me about an ex-girlfriend who had gone on antidepressants after her dad had died unexpectedly; he complained that she lay in bed all day and wouldn’t have sex with him no matter how much he bugged her. It was brutal to hear him write off what was clearly a traumatic experience for his ex as her being “lazy” and trying to “avoid sex” – as if her depression wasn’t about her at all, but was a punishment she had decided to enact upon him. After two dates, this would have been fine – I’d have just dumped him. After two months, even, I could have escaped from the relationship pretty much unscathed. After two years, though, it came as a horrifying blow, one that precipitated the end of the relationship. It forced me to consider how well I really was, and how integral my psychosis, my depression and my mania all were, in their own ways, to my self-image.

We argued about it a lot that day and from then on. He blamed me and said that he wished I would kill myself already and just get it over with if I was so serious about it. There’s no doubt that he was a dickhead about the whole thing, but I can’t help feeling that if I had talked about my experiences earlier in the relationship it might have been avoided.

Rule No 1: it is definitely a good idea to actually, at some point, tell them.

Don’t do it! There is a time and a place for everything. Photograph: Jupiterimages/Getty Images

Blurting it out on a first date

I was on a genuinely brilliant first date. He was tall, good-looking (in a kind of dishevelled professor way) and the first person I had met who had piqued my interest since the breakdown of my previous relationship. I was very invested in not messing it up.

And I was nailing it. There was lots of wine and I was pulling out all of my best anecdotes. Then came this exchange:

Him: “So, you know I have a son?”

Me: “Oh. No. I didn’t, actually.”

Him: “Yeah. He’s 10.”

Me: “Don’t worry about it. I have bipolar.”

Not only had I completely failed to acknowledge anything he had just said, but I had also equated his beloved child with a debilitating and heavily stigmatised mental health problem. I felt like his child and my bipolar were both things that could and would put someone off, and that he had somehow just issued a dealbreaker amnesty by mentioning his son. In fact, he had just wanted to tell me a boring anecdote about a trip to the zoo.

Rule No 2: don’t compare someone’s child to a mental health problem on your first date.

Telling someone during sex

Things you can say during sex: “That feels amazing”, “Keep doing that”, “Could you stop leaning on my hair please?” We’ve all read Fifty Shades of Grey. We know what’s allowed.

But things you should not say during sex? “So, you know I have bipolar?” Don’t ask me why this happened. Don’t ask me about the chain of thought that led me to blurt it out like that.

Just remember rule No 3: never say it when you are literally having sex with someone. Never.

How to tell someone you’re mentally ill in none of the ways outlined above

I would love to be able to say, “Yeah, you should definitely say X after Y number of dates”, but relationships don’t work like a PlayStation cheat code, much as I wish they did. You have to play it by ear, pick up on the person’s vibe and try to work out how best to communicate it to them. I can give you some tips, though.

Actually tell them

Yes, this is obvious, but it’s important. Even if they are the understanding type, it’s best to tell them before you have an episode, because you will need to have a conversation about what you expect from them or what you might need. If they don’t want to date you because they can’t handle it, that’s fine, but it’s unfair on both of you if they are forced to make that decision while you are ill and will cause undue levels of stress when you really don’t need them. It may cheer you to know that a 2013 study undertaken by the charities Mind and Relate found that 77% of people with mental health problems actively told their partners about their mental health problems and just 5% experienced a breakup because of it. A further 74% of partners of someone with a mental health problem said they “weren’t fazed”. So you have almost nothing to worry about.

An honest approach is best Photograph: Hinterhaus Productions/Getty Images

Be honest

You don’t have to tell them all the gross minutiae, but it’s best to be broadly honest. Detail the type and severity of your illness. Tell them how it has affected you in the past and how it is likely to affect your relationship.

Don’t sugarcoat it.

For me, there are two major things that tend to go as soon as I become depressed: being able to leave the house, and being able to take a shower. These are obviously fairly big hurdles in a relationship – having a girlfriend who smells like a bin and who sits in the same spot on the sofa for three weeks may not be the most appealing prospect. But by talking about it – telling someone how best to coax me into leaving the house, how to encourage me to look after myself, how I might respond – I’ve found that these hurdles are far less daunting than they first seemed.

Offer some advice

You’re an expert on your own condition, but your partner might not be: help them out.

Encourage them to research your diagnosis so they know, roughly, what they are dealing with. Tell them what you might need and when, or how they might be able to spot warning signs. As with many people who suffer from mania in some form, the first symptom for me is a complete inability to sleep combined with a desperate compulsion to talk all of the time. Telling someone that those things are meaningful parts of my illness, rather than just random occurrences, means that they’re much better equipped to recognise and deal with them when they occur.

You should also, as a couple, draw up a contingency plan in case of emergency. Which family member or friend should your partner contact in a crisis? What resources do you need? This could be anything from bubble bath, music, books or puzzles to calm you down, to something more serious – do you have spare medication, for example? Make sure you are clear in advance about what actions you are happy to explicitly consent to – it’s important that your partner knows what you are comfortable with. And draw up a list of contacts – local authorities, your psychiatrist or doctor, your support worker, or whoever might be able to help.

Don’t be too hard on yourself

Having someone decide not to date you because they can’t cope with your mental illness sucks. It feels deeply horrible and personal. Talking to a newly single friend recently, she told me that several relationships that seemed to be going well had mysteriously withered away as soon as she mentioned her severe clinical anxiety. Some told her that was the case – that they were unable or unwilling to deal with it – and others mysteriously disappeared as soon as she mentioned it. It, understandably, bummed her out.

There is a silver lining, though: it is far better to be with someone who is willing and able to help you with your illness. Having a mental health problem obviously doesn’t define you, and it’s the same with relationships. But knowing that someone has chosen to stick with you on the bad days as well as the good can significantly reduce anxiety.

• This is an edited extract from Emily Reynolds’s A Beginner’s Guide to Losing Your Mind (Yellow Kite, £14.99). To order a copy for £12.74 go to bookshop.theguardian.com or call 0330 333 6846. Free UK p&p over £10, online orders only. Phone orders min p&p of £1.99

‘So, you know I have bipolar?’ – the perils of dating with a mental health problem

"I loved and hated her in equal measure" – life with an alcoholic mother

It’s two-and-a-half years since I lost my mum to alcohol. At the time I was 21 and she was 49. It was a bitter yet inevitable end to a battle with a drug that had gradually increased its merciless grip on her over many years. Ashamed as I am to admit this, her death brought momentary relief. I had suddenly been liberated from an all-consuming anxiety; I wasn’t waiting to be called with yet more bad news. I wasn’t dreading talking to a mother whom I loved and hated in equal measure, whose wildly erratic state left me unsure of how to address her, what to say. Yet a harrowing period of depression quickly ensued, and I once again found myself doing what life as the child of an alcoholic had made me an expert of: concealing my true feelings and putting on a brave face.

My family had for years grieved for the woman and the life we knew before she became the puppet of a drug. A deafening silence haunted our house when Mum was drunk. Nobody spoke as she staggered around; as she sat at the dinner table barely able to spoon food into her mouth; as she attempted to engage you in fruitless, incomprehensible conversation. Instead we hoped to navigate the fragile situation just long enough for her to fall asleep or for the drunken monster that inhibited her to take its leave.

Chaos frequently reigned. Bitter words were hurled back and forth until both parties were so absorbed by regret and guilt that silence could once again rule, choking us all.

I resolved at the time of my mum’s death to speak openly about her alcoholism because I can’t bear to be complicit in the silence surrounding the issue. Between 2004-14, alcohol-related deaths in England rose by a staggering 13%. My loss is irretrievable, but others can be prevented, and starting a conversation around alcoholism is the first step in changing the national attitude towards this pandemic.

​It is only by reaching out to the children of alcoholics that we can hope to definitively break the cycle of addiction

Though the plight of alcoholics is awful – the demonisation by society (medical professionals included), cuts to mental health services, the ready availability of the drug … the list goes on – often overlooked are the struggles faced by their children. According to a report by the National Association for Children of Alcoholics (Nacoa), children of alcoholics are six times more likely to witness domestic violence, five times more likely to develop an eating disorder, three times more likely to consider suicide, two times more likely to commit criminal offences and two times more likely to have difficulties at school. Perhaps most frightening is the indomitable perpetuity of this ravaging plague; children of alcoholics are three times more likely to develop drug or alcohol problems themselves.

As of December 2016, a review by Public Health England suggests the financial burden could be as much as £52bn per year. This accounts for the cost to the NHS of dealing with alcohol-related illness, alcohol-related crime and the loss of productivity problem drinking engenders. This figure does not, then, account for the money required to combat the multitude of problems that blight the families of alcoholics. No such figure exists because these families remain hidden; the stigma around alcoholism is so great that those affected harbour guilt, embarrassment and shame.

Just as there is no single profile of an alcoholic, there is no single profile of their children. My mother was a successful professional in the NHS, working as an advanced practitioner until four years before her death. She had an infectious character that lit up a room: vivacious, bountiful in love and deeply compassionate. At the time of her death, I was two years into a languages degree. I have since completed this and am now training to become a teacher, largely inspired by the bedrock of stability and normality that school provided me with as a child. I am an “overachiever”.

My record hides a desperate truth, however: the stories of resilience many of us COAs unknowingly share must not be championed as “inspiring”, because then we continue to whitewash a much darker reality and, crucially, fail to get to the crux of the problem.

There is hope for change, however. Following Labour MP Jonathan Ashworth’s frank admission to parliament about his experience as the child of an alcoholic and the urgent need to deal with the wider harm caused by the drug, this month there will be a new strategy to support children of alcoholics (COAs).

Furthermore, the first ever manifesto for children of alcoholics coincided with COA Week and Nacoa’s annual lecture; contains a 10-point plan to help the one in five children affected by alcohol.

Currently, not a single local authority in the UK has a strategy that targets COAs, and neither the social care nor the public health system has developed effective strategies to support them. This manifesto, written by policymakers, medical experts, charities and children of alcoholics, demands that the government appoint a minister responsible for coordinating policy. The third sector must no longer have to take the burden of supporting COAs; as the number of alcohol-related admissions continues to rise, already underfunded drug and alcohol services are seeing further cuts. Local authorities require proper funding to deliver crucial physical and emotional support to children in need.

It is only by reaching out to the children of alcoholics that we can hope to definitively break the cycle of addiction that has a stranglehold upon the nation. By failing to do so – by remaining silent on the matter – we fail them and condemn thousands of children to a miserable fate, while facilitating the very issue we claim as a nation to find so repulsive.

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"I loved and hated her in equal measure" – life with an alcoholic mother

I"m starting a new job, but will need to take time off soon for therapy

Twice a week we publish problems that will feature in a forthcoming Dear Jeremy advice column in the Saturday Guardian so that readers can offer their own advice and suggestions. We then print the best of your comments alongside Jeremy’s own insights.

I’m about to start a new job, my first with any prospect of security after several years of juggling part-time, short-term contracts, and I’m keen to make a good impression.

However, my previous work pattern and some of the stresses involved have taken their toll and I’ve been struggling with depression for a while. I have just been offered a few months of therapy on the NHS, starting in the next couple of weeks.

The catch is, to take this up I would need to take some time out of my working day. As a certain amount of my work is fairly independent of my colleagues’ input, making up the hours won’t be a problem. I’ve already worked out a few strategies to do this, depending on what would best fit with my new employer’s work pattern.

My worry is that I don’t know how to broach the subject – starting a new job by declaring any health issues is difficult enough, but I fear they may see those involving mental health as a stigma and this makes this worse.

How can I best approach this? I don’t feel I can let the opportunity for treatment go. I’ve done the sums and there’s just no way I can afford to get this privately, now or in the foreseeable future, but I also need this job.

Do you need advice on a work issue? For Jeremy’s and readers’ help, send a brief email to dear.jeremy@theguardian.com. Please note that he is unable to answer questions of a legal nature or to reply personally.

I"m starting a new job, but will need to take time off soon for therapy

GPs are failing people with eating disorders, says charity

GPs are routinely failing to provide adequate care to patients with eating disorders, with one in three not referred for specialist assistance, a leading charity has warned.

Beat, the UK’s primary eating disorder charity, found that half of people with some experience of the condition rated GP care as “poor” or “very poor” and 30% were not referred to mental health services after their appointment.

The charity polled 1,700 people, the majority of whom had sought medical help for an eating disorder. Of the 1,267 who had gone to a GP for help, only 34% said they felt their doctor knew how to treat them.

This is despite National Institute for Health and Care Excellence (Nice) guidelines that say patients should “receive treatment at the earliest opportunity”.

It comes amid growing concern about eating disorder services in general and the help available for patients once they are referred. NHS data shows a 36% drop in the number of hospital appointments for eating disorders in England, leaving thousands of children and teenagers forced to wait months for help. Charities warned that some patients were essentially being told they would not get help unless they starved themselves further.

Beat’s warnings will add more pressure on the government to improve care for patients. The charity has called for better training for medical students specialising in general practice, as well as more funding for mental health services once referrals are made.

Andrew Radford, the chief executive of the charity, said: “Unfortunately many of our respondents identified poor care, with many GPs not knowing what the real signs and symptoms are.

“This isn’t about blaming GPs, it’s about enabling the 50% of GPs who didn’t provide good care to be as supportive of eating disorder sufferers as the 50% who did.”

Elizabeth McNaught, 25, a junior doctor who had eating disorders when she was younger, agreed training was not good enough. “Many doctors do not know enough about eating disorders because they don’t feature very highly in medical training. We had just two hours on the subject throughout five years of study.”

Eating disorder numbers among the young have risen over the years. While 658 under-19s in England needed a spell in hospital in 2003-04 to treat an eating disorder, by 2013-14 that number had increased to 1,791, up 172%.

At least 725,000 people in the UK of all ages, genders and backgrounds now have an eating disorder. Research has found 20% of anorexia sufferers will die prematurely from the illness.

Prof Helen Stokes-Lampard, chair of the Royal College of GPs, dismissed claims that family doctors were not trained to identify and treat eating disorders. She added that Nice guidelines did not recommend immediate referral for all patients who might have an eating disorder. “In some cases the condition can be dealt with effectively in primary care,” she said.

Stokes-Lampard said the figures did show the intense pressure GPs were under. She added that it was not always possible to assess the needs of complex patients in a 10-minute appointment, calling for more investment and longer consultations. She also said better mental health services in the community were needed.

The Guardian heard from several people who had trouble with their GP, including Matt Foster, 28. He said: “I had spoken to my GP before about mental health issues and they were unsympathetic.” Another person, who wished to be anonymous, said: “When I first asked my GP for help, he sounded bemused. He said throwing up your food is bad for you and you are hardly fat, so what do you have to worry about?”

Rhiannon Lambert, a nutritionist, said: “Approaching a GP will always be a vital move in treatment and more needs to be done to support patients. Eating disorders need to be taken seriously. While recovery is possible, they often last a lifetime or sadly take a life.”

GPs are failing people with eating disorders, says charity

NHS accused of covering up huge data loss that put thousands at risk

Thousands of patients are feared to have been harmed after the NHS lost more than half a million pieces of confidential medical correspondence, including test results and treatment plans.

In one of the biggest losses of sensitive clinical information in the NHS’s 69-year history, more than 500,000 pieces of patient data sent between GPs and hospitals went undelivered over the five years from 2011 to 2016.

The mislaid documents, which range from screening results to blood tests to diagnoses, failed to reach their intended recipients because the company meant to ensure their delivery mistakenly stored them in a warehouse.

NHS England has quietly launched an inquiry to discover how many patients have been affected. So far 2,500 cases that require further investigation to discover potential for harm have been identified. The NHS is spending millions of pounds paying doctors to assess the scale of the medical impact.

It is also undertaking a clinical review of patients who have died since the loss of documents was discovered in March 2016 to examine whether delays in material reaching GPs played any part in any patient’s death.

The correspondence included the results of blood and urine tests, and of biopsies and screening tests for diseases including cancer. It also included letters containing details of patients’ visits to hospital, including to oncology clinics and information about what they had been diagnosed with after visiting A&E. Other paperwork that went astray included summaries of the care patients had received while in hospital. Some involved material related to cases of child protection.

In total, 708,000 pieces of correspondence were undelivered. However, 200,000 of these were not clinically relevant as they were temporary change of address forms.

NHS England secretly assembled a 50-strong team of administrators, based in Leeds, to clear up the mess created by NHS Shared Business Services (NHS SBS), who mislaid the documents. The private company, co-owned by the Department of Health and the French firm Sopra Steria, was working as a kind of internal postal service within the NHS in England until March last year.

The clear-up team is being led by Jill Matthews, the managing director of the primary-care support services arm of NHS England.

Documents detailing the team’s work, seen by the Guardian, reveal it has finally returned the lost material to 7,700 GP surgeries, and assessed how many potential incidents of harm may have occurred at each practice. They show that GP surgeries up and down England have been affected, with some facing a few dozen cases of potential harm arose from missing correspondence.

GPs have so far been paid £2.2m to examine returned correspondence and cross-check it with other material in patients’ medical records, although the internal documents show that some have said that they are too busy to do so and others have asked surgery administrators to do it.

The British Medical Association warned that some patients might have taken extra drugs unnecessarily or had the diagnosis of their illness delayed because of the blunder.

“This is a very serious incident, it should never have happened and it’s an example of what happens when the NHS tries to cut costs by inviting private companies to do work which they don’t do properly, the private company in this case being NHS Shared Business Services,” said Richard Vautrey, chair of the BMA’s GPs committee and a family doctor in Yorkshire.

He added: “Undoubtedly, there will be cases where patients have been seen by their home GP without [the GP having] the information from previous consultations or tests being their file – so they may not know whether antibiotics have been prescribed to a patient or whether tests and investigations have been done.

Jeremy Hunt, the health secretary, is being pushed to reveal what he knew of the paperwork, including items relating to child safety, that went astray. Photograph: Stefan Rousseau/PA

“That might mean repeat prescriptions, which would be unnecessary, as they have been taken before. And it might mean delay in diagnosis. If that happened it’s at best an inconvenience to the patient, and at worst there’s a risk of patient harm.”

Jonathan Ashworth, the shadow health secretary, said: “This is an absolute scandal. For a company partly owned by the Department of Health and a private company to fail to deliver half a million NHS letters, many of which contain information critical to patient care, is astonishing.

“Patient safety will have been put seriously at risk as a result of this staggering incompetence. The news is heartbreaking for the families involved and it will be scarcely believable for these hospitals and GPs who are doing their best to deliver services despite the neglect of the government.”

He said that Hunt’s statement to MPs last July was “perfunctory, complacent and evasive, failing to reveal any of the catastrophic detail of how 500,000 pieces of correspondence including test and screening results and pathways following hospital treatment, had failed to be delivered and were in fact languishing unopened in a warehouse”.

Ashworth added: “Instead, Mr Hunt gliby told parliament that ‘some correspondence in the mail redirection service has not reached the intended recipients’. For a secretary of state who supposedly has transparency as his watchword this looks like he has tried to hide the scandal from patients and the public. It’s totally unacceptable.”

Tim Farron, the leader of the Liberal Democrats, said: “This looks, to me, like a cover-up. Jeremy Hunt has serious questions to answer, especially his deliberately evasive statement to parliament. Jeremy Hunt often talks about an NHS more open about patient safety failings since the Mid Staffs scandal. His deeds don’t match his words.

“This is a staggering loss of personal and private data, this colossal loss of vital material that may have been absolutely crucial to a patient’s treatment. I worry that while all this correspondence, including test results, has gathered dust, patients had been put at risk. People could have died as a result of this.”

An NHS England spokeswoman said: “Some correspondence forwarded to SBS between 2011-2016 was not redirected or forwarded by them to GP surgeries or linked to the medical record when the sender sent correspondence to the wrong GP or the patient changed practice.

“A team including clinical experts has reviewed that old correspondence and it has now all been delivered wherever possible to the correct practice. SBS have expressed regret for this situation.”

The Department of Health refused to comment.

NHS accused of covering up huge data loss that put thousands at risk