In the UK, if treatment is less effective than hoped for in secondary care, then the care of an adult patient in the NHS can be stepped up to a specialist service – for example out-patient treatment at the Centre for Anxiety Disorders and Trauma (CADAT) or the Anxiety Disorders Residential Unit (ADRU) or in-patient care at the Priory Hospital North London.
Children and Adolescents with BDD can be referred to the OCD Young People’s Service for OCD and BDD. After assessment, out-patient treatment maybe provided at the Maudsley or if in-patient care is required at the Priory Hospital North London.
There are two levels of specialist care funding – the local Clinical Care Commissioning group funds the first level and the NHS England funds the second level. (This is called the “Highly Specialised Service for severe treatment refractory OCD and BDD”). It consists of a consortium of hospitals including the Maudsley (for out-patients), the Bethlem (a residential unit) & the Priory North London (for in-patients) (Consultant Dr David Veale), Adolescent at the Maudsley (Consultant Dr Bruce Clark), Adults at the Queen Elizabeth II (out-patients and in-patients under Professor Naomi Fineberg) and Springfield Hospitals (mainly in-patients under Dr Lynne Drummond) who will assess and advise on your particular circumstances.
The type of funding for a client will depend on whether he/she meets certain criteria. For the HSS criteria, sufferers need to be in the severe range on the BDD-YBOCS (36 or above out of 48) and have failed at least two trials of CBT for BDD and 2 trials of SSRI medication at the required dose and duration.
Both levels of funding will require a referral from the local Community Mental Health Team (CMHT) team and a record of treatments that your client has received.