by Mark Austin
So often girls with eating disorders − for it is overwhelmingly, though not exclusively, girls − are forced to wait months, even years, to get real help. And so often, where help can be found it is literally hundreds of miles from home, meaning parents have to make lengthy treks across the country just to see their child. It is expensive, inconvenient and just plain wrong in Britain in the twenty-first century. Affected families have enough stress to deal with without having to travel vast distances just to be with their sick daughter.
In the documentary we also focused on the case of Rachel from Nottingham, whose eighteen-year-old daughter had been allocated an eating disorder unit in Edinburgh, three hundred miles from her home. Rachel told us how the NHS would only pay for two flights a month but she made six trips in eight days, as any mother would want to do. She said the separation and the incessant travelling was ‘inhumane’. This is what she told me: ‘It’s not only the illness that has been so tough, it’s the separation, that’s what’s been traumatic. It’s traumatic each end because I leave my other two daughters here with my husband and quite often they are upset, and then I get there and there’s the feeling of euphoria because we are there together and she’s looking a bit better and we spend the day together and then there’s that separation again.
‘It’s a horrible feeling. I hate leaving her. Quite often I cry all the way to the airport, sometimes all the way through security. You see all the people giving me a wide berth, thinking who is this crazy, unhinged woman.
‘One time, on the way to the airport, I just thought I couldn’t carry on anymore, I just wanted the taxi to crash. But I’ve got to keep going, haven’t I? Because I have two other daughters…’
It was harrowing stuff.
And she’s right. That is exactly what it is… inhumane. And it sums up the way these patients are treated. Rachel has fought for several years to find the right treatment for her daughter. She’s still fighting. She is a brave woman who decided to speak out.
I also met two young women suffering from anorexia, Vicky and Becky from Newcastle. There, the inpatient service had been cut back and there was virtually no outpatient treatment available. Vicky told me she had no support whatsoever. She had often thought about killing herself.
Becky also lacked outpatient support and had been told she wasn’t ill enough to qualify for an inpatient bed in an eating disorder unit. She was in the process of trying to lose more weight so they would have to admit her. She was worried she would take her own life without proper help.
What sort of health service allows that to happen? Someone making themselves more ill to get treatment. It is madness.
And Newcastle is typical of many towns and cities across the UK. Even where help is available, it is often temporary, piecemeal and uncoordinated. Things simply have to change, and change soon. Norman Lamb, the Liberal Democrat MP doing so much to push the whole issue of mental health, says the government must take seriously calls to give mental illness the same level of commitment as physical health. But it is not happening. Get hit by a bus in this country and you will probably receive some of the best emergency treatment available. Get mentally ill, and there is a very grave risk that you will be abandoned.
What are needed are more specialist inpatient centres for sufferers up to the age of twenty-one. Girls with anorexia need immediate urgent inpatient care available to them. And they don’t want to be in adult mental health units.
And in a world where getting an appointment with a psychiatrist or eating disorder specialist can take months, we need walk-in centres on the high street of every town and city in this country, manned by trained counsellors who know about anorexia and mental health. If it works, it would mean, at the very least, that sufferers could be identified earlier, help could come sooner and records kept of the visit. We must not let these girls and boys fall through the net. They will die. They do die. The story is in the statistics. It is reckoned that one in five chronic anorexics die as a result of the condition and malnutrition, or because they will take their own life.
I have asked Maddy several times what it was that triggered her illness, and she has yet to come up with a satisfactory answer. As I said, she was a promising athlete who ran 800 metres to a fairly high standard, winning national school events and taking part in Olympic trials. Was she running because she wanted to control her weight? Or did the pursuit of ever-faster times tip her over the edge? She denies that was the case. And after all, lots of young athletes push themselves to the limit in training without falling prey to anorexia.
I think the truth is there is no one reason. The nearest she has come to a plausible explanation was when she told me she felt her life was out of control and the one thing she could control was the amount of food that entered her body. Why she felt her life was out of control is the interesting issue. And there I think we enter the whole area of the growing pressure on modern teenagers through the ever-increasing use of social media. I am convinced there must be a link between mental wellbeing and an online world where girls are so often presented with supposed ideals when it comes to the way they look and the way they live their lives. It is a daily battering of fragile senses and sensitivities.
Again, Maddy has never identified that as a reason. But my fear is that an entire generation of youngsters are effectively taking part in a vast social experiment, the consequences of which may not be known until it is too late.
I wonder if the day of reckoning will come or whether it is already upon us. I am not arguing that social media is bad; it clearly has enormous benefits. But I am saying that I would not be enormously surprised if one day it was possible to prove a link between its use and teenage mental health issues.
What haunted me, and I imagine haunts most parents of anorexics, is the lurking question that perhaps we were somehow to blame. My daughter and the specialists rushed to tell us we were not, but it doesn’t quell the nagging doubts that something we said or did may have pushed her into this dreadful condition.
I am pleased to say Maddy is much improved. We have our daughter back, where so often other parents do not. I am not sure that eating issues will ever completely leave her, but she is healthy, leading a normal life and is now at university. Others are not so fortunate. For many it is a very long and painful road to recovery, if recovery is possible at all.
About a year after Maddy recovered, she sent me a blog she had written about her illness and specifically about the effect she thought it had on her mum and on me. It was blisteringly honest and painfully observed. She writes about how she had felt, at the depth of her depression, that we, her parents and her siblings, had not wanted her around. Here is a small part of it:
I knew I was tearing my family apart, I’d watched myself shrink and the strongest people in my life began to show their cracks. My mother and father stood there feeling helpless and alone.
In my head, all I wanted was to lie in this grave I was digging for myself, but create a way in which my family could continue their lives without me, I wanted them to forget that I had ever existed so I could continue down my path of self-mutilation and slow suicide.
It was ghastly to read. I had no idea that she had been through such darkness. I wanted to push it out of mind. The illness itself had been hard enough to deal with. Now it seemed it was over, I wanted to brush it aside, even pretend that it hadn’t happened, and get on with our lives. I certainly thought it was not something we should be writing about; that would surely only extend the pain we had felt.
But when Maddy asked what I thought of the blog, I said it was very good but hard for me to read. She told me she had found the process of putting her deepest thoughts onto paper cathartic. She felt better for doing it. And on reflection I had found what she said useful when it came to dealing with what we had been through. She then asked me if I would write something about what I was feeling during the worst of the anorexia.
I thought about it and then put a few thoughts down and kept them on my laptop.
Every so often I would go back to it and rewrite parts or write some more, until I had what I thought was as honest an account as I could manage.
For months I did nothing with it. What I did do was write a piece about mental health and eating disorders for the Huffington Post website. I didn’t mention Maddy at all, but rather just said it had affected my family.
A few days later I took a call from Martha Kearney, then the presenter of the BBC’s World at One on Radio 4. She is a friend and a journalist I hugely respect. She asked if I would go on the programme to talk about the problems we had finding treatment for Maddy. I was torn; I wanted to make a noise about the lack of resources available for sufferers of eating disorders, but I was very reluctant to put her name and story in the public domain. In the end, Maddy and I decided we needed to talk about it, and in a way that would capture the attention of the public. So that is what I did. I spoke as honestly as I could about what she went through, how it affected us and the desperate need for more resources.
Predictably, the newspapers seized on the disclosure that I had at one point said ‘if you want to kill yourself just get on with it’. It was a difficult few days but it certainly had an impact, and Jeremy Hunt faced some pretty tough questions from Martha as a result of it. I was glad I did it.
That led to an article for the Sunday Times magazine and subsequently to the documentary for Channel 4. I had huge reservations about my daughter taking part and being so open about her condition. But she was keen to drive the project forward. She wanted to do it. My concern was that the illness would in some way come to define her. I worried that she would become a poster girl for anorexia. We didn’t want that. We simply wanted to get a message across in the most powerful way we could. I think we did that.
Maddy tells me she found the whole process cathartic and useful, and that it helped her deal with what she’d been through. I certainly hope that is true. I am very proud of what she did.
I just hope other parents and families in a similar situation find some encouragement in knowing people can get better and things can improve. I know we were very fortunate. We have our daughter back.
JOURNALISM
TWO OR THREE years ago, when I was presenting ITV’s News at Ten, I was asked to speak about journalism to some fifth and sixth formers at Lancing College in Sussex. Sad to say that, despite their public school education, they were a bunch of liars.
They lied in a nice way, though. I asked them how many watched News at Ten regularly. Dozens of hands shot up. I said that I didn’t believe them. ‘How many of you really watch News at Ten regularly?’ I asked. There was a lot of looking around and nervous twitches and then just a handful of pupils stuck their arms in the air.
I knew they’d been originally being polite, but the second show of hands was a far more plausible, though still not completely honest representation, I thought. When I asked them how they did actually receive their news, the answer came as no surprise. It was either on mobile news apps, or on Facebook or some other social media platform. And, clearly, this is what’s happening across the country.
Among young people in the UK, social media has overtaken television as their main source of news. In a recent study by the Reuters Institute for the Study of Journalism, around 28 per cent of 18–24 year olds cited social media as their principal news source, compared with 24 per cent for TV. The trend in news consumption is clear, and in a decade or so it will become even more pronounced.
The Reuters study found that Facebook was the most common source – used by 44 per cent of young people to watch, share and comment on the news. Next came YouTube at 19 per cent, and Twitter with 10 per cent.
And it all raises a fundamental question – and one that was put to me after my speech at Lancing College: Has the digital era usurped the traditional “appointment to view” news programme on television? Is new media swallowing up the old?
One thing is certain. Ratings for programmes such as News at Ten on the terrestrial channels are on the slide, and have been for many years now. When I started working as a correspondent for News at Ten in the eighties, when it was presented by the legendary Sir Alastair Burnet and Sandy Gall, it was regularly pulling in 10 million viewers a night. But since the early nineties there has been a pretty steady decline. When I was presenting News at Ten with Julie Etchingham we would get audiences averaging around 3 million, while more recently it had fallen to about 1.9 million. Nothing to do with the presenters (I hope!), but rather the massively changing viewing habits of the nation. In some ways, mainstream journalism and the traditional methods of delivering it are under siege.
The telly is still holding out. Recent figures compiled by Ofcom on which news medium is most regularly used by adults are interesting. Newspapers are the main source of news for 31 per cent of adults, but declining rapidly. Radio is hanging on at around 32 per cent. The Internet, including usage on laptops and mobile devices, is at around 41 per cent and increasing. But TV still wins hands down, with 67 per cent of adults saying they regularly use it as a source of news. It also, by the way, remains the most trusted source.
But this won’t last. The trajectory is pretty clear, and the box in the corner of the living room is on borrowed time. The rising use of other means of delivery, whether news apps or social media, is clearly undermining traditional business models and disrupting news organizations around the world.
Twenty-four-hour TV news channels, including Sky, for whom I now work, are constantly having to evolve to exploit new ways of delivering the news. In 2017, the total global digital audience for Sky News was 153 million unique browsers – up 15 per cent from the previous year. The social media audience for Sky News content topped 27 million.
Interestingly, the television audience remained stable over the year, with weekly total viewers up marginally to 5.2 million. John Ryley, head of Sky News, believes that’s some achievement given ‘the assault on “old” media from the mobile interloper’.
‘Remember Riepl’s Law: innovations in media add to what went before rather than replacing it – they coexist in antagonistic harmony,’ he says. ‘The non-stop television news channel is the production spine of our digital services. If we didn’t have a TV channel, we would have to invent one. Remember, too, we are living in uncertain times – it’s a golden age for journalism.’
But the growing challenge to TV news is clear. I can see that if pictures of a breaking news story or event are up on Facebook or Twitter in an instant, it can make our job seem less valuable. I can also see how if opinion, reaction and comment on a story is running on social media, you might feel it neutralizes what we do on 24-hour news channels or traditional news bulletins. Your mobile phone means you have it all there in the palm of your hand, wherever you are. It satisfies the trend for news on the go, as it happens; information arrives in an instant – quick-fire, bite-sized, fast and dramatic.
And everyone, of course, can now be a journalist. The era of the ‘citizen journalist’ is upon us, and in many ways it is no bad thing. It is, I suppose, the democratization of news. Homemade content is everywhere now, and its growth has hugely influenced the style and direction of journalism. But is it a threat to traditional journalism?
Not necessarily. Citizen journalism is not going to replace or displace the mainstream but will rather be complementary to it; it really is not a case of one or the other. It is a case of the established media welcoming and embracing the new and seeing it as an advantage, a huge boost to the job of gathering news. It’s the ‘antagonistic harmony’ that John Ryley talks about.
I mean, what are the chances of a TV news camera happening to be at the scene of a terrorist attack in London, for instance? Relatively low. But what is the likelihood of someone witnessing an attack having a camera on their smartphone? Extremely high. So, increasingly, the first images we see of any such event are invariably from a member of the public who has been caught up in the incident and who managed to record a few seconds of footage. That footage is often f
irst uploaded to a social media site, but it still only gets real traction when it is picked up by the mainstream media and used as part of news coverage.
The advantages are enormous, and for news organizations it represents a real leap forward, but it also poses a serious challenge. The main news broadcasters like the BBC, Sky News and ITN have reputations built on authority, veracity and reliability. By and large they get things broadly right… and if they don’t, they go to great lengths to put them right. There will be corrections and apologies if they make a mistake. It is all about reputation and credibility. News organizations rely on it.
But it goes without saying that it is much easier to get things right if you are generating the content yourself. You know where the pictures are from, who took them and what they represent. In other words, you can verify whatever it is you are publishing.
It is absolutely not the case with ‘second-hand’ material. So, the footage posted on social media may appear to be genuine, and may seem to be images of the event or incident you are interested in. But how do you know for certain? It is sometimes extremely difficult to tell, and there are many examples of footage posted online purporting to be something that it is not. It is a particular problem when it comes to coverage of wars – for instance in Syria, where it is very difficult for Western news teams to get access. It is quite normal in instances like this for producers in newsrooms to scour the Internet for footage of any particular attack. Finding it can be the easy part. Verifying it beyond all reasonable doubt is often virtually impossible.
Once when I was anchoring News at Ten, we had video footage of children covered in blood in the rubble of a house, which we were told was the aftermath of an air attack by the Syrian government regime. It looked genuine enough. It was heart-wrenching. We were about to include the images in a report on the programme when a producer realized she had seen very similar images a few months earlier. She checked and discovered the similarities were so great that it would be unwise to run them. She pointed out, for example, that one of the children was dressed in exactly the same way. We didn’t include the pictures, and indeed it turned out they were several weeks old and were actually from a previous attack, or alleged attack, in another part of Syria. I noticed other broadcasters did include the images.