Having any sort of mental health assessment can feel really scary.

However, I’ve always found that the assessments I’ve been to for my eating disorder have felt more anxiety provoking than others. I’m not sure why this is other than that eating disorders often trick you into thinking you aren’t actually that sick, meaning that you feel like a huge imposter when you get there. This, coupled with the fact that sadly to this day so much of your need for treatment is weight dependent, presents a pretty anxiety fueled situation.

I’ve had a few assessments with the eating disorders service up to now, so I’ll talk you through a little bit about what to expect. Although it’s the same team that have assessed me every time I would make an assumption that the process is fairly similar across the board – though please correct me if I’m wrong!

You’ll be given some questionnaires to fill out, usually before your assessment, though if pushed for time these can be completed afterwards. It’s useful to do them before because they can do a really quick scan through before speaking with you. I’ve always been advised to arrive 20 minutes or so before my appointment slot in order to fill these out. They will ask about your behaviours (ie how often are you restricting/binging/purging/exercising etc), your thoughts (how much do you worry about weight/shape/size etc), and your feelings (how distressed are you about eating/weight etc). You might also get given another questionnaire about your mood and about how you view the world in general – I’ve been given this to complete at some but not others.

You are usually welcome to bring somebody to the assessment with you although it is often advised that they do not stay for the entire assessment as it is useful to be seen by the assessor individually. That said, you should never be forced to take part in the assessment alone if you would rather somebody stayed with you throughout. The length of the assessment can be quite variable and to some extent is led by you and how much you have to say. They can take over an hour if you are brand new to the service or have more complex difficulties, however this is not always the case. My most recent assessment was over in about 20 minutes because I’m ‘well known to the service’ so didn’t need to rehash lots of old information about myself. You might be asked to estimate your weight and height but this will also be measured by the service, which for me is the most anxiety provoking part. There will be space at the end to ask any questions you have too. I would suggest writing down any questions you might have as it’s really easy to forget them, especially when in a high stress situation.

Depending on the clarity of your symptoms, you may well receive a diagnosis and proposed treatment pathway on the spot. If things are a little more unclear then the clinician will go away and discuss with the rest of the team to agree the best course of action. It can take a number of weeks to hear back but you should receive a letter or phone call (or hopefully both) with your agreed treatment pathway. Frustratingly it is unusual to be given a time frame of how long assessment to treatment can take as waiting lists for eating disorders services tend to be fluid, in that rather than having a static place on the list they respond to the urgency of each case, which may mean you are overtaken depending on your needs. That’s a pretty horrible thought. I’ve been both the person who is overtaken and the person doing the overtaking, and each of these scenarios feels unpleasant. Being overtaken produces all of those typical ‘I am not sick enough’ thoughts, but jumping ahead brings lots of feelings of guilt.

If you have an assessment coming up at any point I wish you all the luck in the world and hope you get what you need from it! And I hope that this may have helped to relieve some of those anxieties and prepare you for what is to come.

Have you had an eating disorders assessment? Is there anything I’ve missed?