Reconnecting Hope: The Treatment of Eating Disorders in Rural America

• Published in: Cognitive and behavioral practice 2023-09
• Main Authors: Copeland, Jenny E., Hefner, Jacob, Estep, Sarah E., Becker, Carolyn Black
• Format: Article
• Language: English
• Subjects: Certified Community Behavioral Health Organizations; eating disorders; Food insecurity; rural mental health; Trauma-informed care
• ISSN: 1077-7229; 1878-187X
• DOI: 10.1016/j.cbpra.2023.08.001

•EDs in rural impoverished communities are often overlooked due to the ED stereotype.•CCBHOs can fill the treatment gap for EDs/other specialized services in rural areas.•Reconnect ED Treatment Program is the first ED program in a rural CCBHO in the US.•EDs must be classified as SMI to reduce treatment barriers in low resource settings. Eating disorders (EDs), a significant public health concern, impact millions of Americans every year. Many people with EDs are often overlooked for multiple reasons, including the stereotype that EDs predominantly affect thin, White, affluent young women and girls. One historically overlooked group is impoverished individuals in rural areas of the United States (U.S.), who may, in fact, be at an increased risk for EDs. The Reconnect Eating Disorders treatment program (REDTP) at Ozark Center is the first comprehensive, evidence-based, multidisciplinary ED treatment program to be developed in a Certified Community Behavioral Health Organization (CCBHO) in the U.S. CCBHOs are a unique model of financially sustainable integrated care well-suited to the treatment of biopsychosocial illnesses such as EDs because CCBHOs offer a full range of services to treat both physical and mental health. This paper details the development of REDTP, including its team, barriers, and successes. The role of Community Support Specialists/Reconnect Coaches and Healthcare Home/Medical Support is reviewed, which includes providing outpatient care and intensifying treatment for the most acute clients. Key domains of growth for REDTP included selecting core evidence-based treatments, building a team and defining team roles, and intensive training to develop evidence-based ED expertise. Persistent barriers included staffing limitations for providing intensive treatment to a small number of clients. Adult case studies of REDTP clients are presented. Recommendations for future ED and other specialized treatment programs in low resource agencies are provided.