Two months after his summer vacation last year, Matthew Brown began to worry that he had an eating disorder. Brown, who was about to start Merrimack High School as a freshman, wouldn’t talk to his parents about it. But he wanted answers.
After a Google search, Brown found the National Eating Disorders Association hotline. The service offered the option of calling and texting; Brown chose texting. He was soon put in touch with a trained volunteer who helped him better understand his concerns.
“I think getting it off my chest was helpful,” he said. “To have someone to talk to.”
Within a day, Brown had found the support he needed. The next day he called a local legislator, Rep. Rosemarie Rung, with an idea: sponsor legislation to spread it among other students.
House Bill 35 would require all student identification cards for public school students in grades six through twelve to include contact information for the eating disorder hotline. The bill, which passed the Senate earlier this month, is on its way to Governor Chris Sununu’s desk.
If signed by Sununu, the bill would create a new addition to student ID cards a year after the governor signed a bill to require ID cards to include the national Suicide and Crisis Lifeline.
Proponents say it’s essential to pay specific attention to disordered eating. Research from the National Institutes of Health has shown that people with eating disorders are at greater risk of suicide than other populations; giving them resources to deal with their eating disorder can also prevent future mental health problems and suicidal thoughts, supporters say.
And sometimes people are more willing to discuss their eating disorder than their mental health.
Rep. Hope Damon, a Democrat from Croydon, knows the issue personally; she recently retired as a dietician and diabetes educator. In that work, about a third of her patients had eating disorders, Damon testified before a Senate committee earlier this year. Many are difficult to distinguish on the surface.
In addition to correlated psychological problems, eating disorders can also have physical consequences, such as nutrient and electrolyte deficiencies, which can lead to cardiovascular risks, Damon said.
“Eating disorders are treatable, and the most important thing I want to emphasize with that is that early diagnosis greatly increases the chance of a full recovery,” said Damon.
For Brown, it’s a problem other peers face, and one compounded by shame and stigma. Middle and high school students often don’t feel comfortable talking about disordered eating to their friends, let alone their parents, Brown said.
In those situations, it’s essential to have an outside source to provide answers, he said.
The bill comes with one catch: the phone line in question will soon be disconnected. The association is ending the helpline at the end of May after deciding it no longer had the resources to provide adequate services, a spokeswoman said in an interview.
But the association continues to maintain a “chatbot” it launched last year that allows people seeking help to process a series of text-based questions and prompts that help them receive information and resources.
That chatbot will likely be what’s advertised on New Hampshire student cards, rather than on the phone line, said Rung, a Merrimack Democrat.
As passed, HB 35 dictates that the service must be a phone number, but Rung said she believes this could be changed during the administrative regulatory process if the governor signs the bill into law.
“It’s not so much the text of the bill as the legislative intent,” she said in an interview. “So the legislative intent for getting this into law is for school districts to put a contact number on the back of their ID for people who want more information or help with an eating disorder.”
The phase-out of the human-led helpline and the renewed focus on the chatbot came after the helpline became unmanageable to maintain, Lauren Smolar, the vice president of mission at the National Eating Disorders Association, said in an interview.
During COVID-19, interest in the helpline exploded, with calls more than doubling from previous years, Smolar said. Increased demand means that some people who call have to wait weeks for an answer, she said, mainly because the organization doesn’t have the staff to keep the line open 24 hours a day. The organization found that 43 percent of people who called were not getting their calls answered, Smolar said.
“We were really concerned about the people who came to our helpline who were in crisis,” she said. “We really wanted those people to be in direct contact with the right support for the needs they had, especially if active rescues were needed or something like that”
Meanwhile, the chatbot system has advantages, Smolar said. Available at any hour of the day, it allows people using it to navigate their way through a module-based information program that can help pinpoint their problems and better recommend possible paths. The technology enables users to get more lasting information and support — over days or weeks if desired — than during a one-time call with a live volunteer, Smolar said.
And the chatbot, which first launched in January 2022, has already helped a number of people who aren’t ready to talk to a volunteer or clinician about their eating disorder and prefer to talk to a computer.
“There are several reasons why people aren’t in a place where they can ask for help,” Smolar said. That could be personal discomfort or a lack of finances or health insurance.
New Hampshire lawyers say moving to a chatbot-only system will not affect the goals of the bill.
For Brown, the process of talking to a human being and being heard was important. But he said he supports the association’s move to the chatbot and sees it as a way to broaden who can access the information.
“I think it’s important right now to reach as many people as possible, and if this will help create that barrier of privacy then I support that,” he said.
Now completing his freshman year, Brown says his outreach to Rung last summer sparked a new interest: public policy. He worked with Rung in the fall when the bill was first introduced as a “legislative service request,” then took time off to Concord to testify before both House and Senate committees.
Part of that time was spent convincing skeptical lawmakers that the ID cards needed a different number, Brown recalls.
The efforts were personally driven. His mother, Angela, first learned of the bill in October, months after Brown first contacted the hotline. Soon she drove Matthew to Concord for hearings.
Brown, who is now an ambassador for the Eating Disorders Coalition, a national advocacy group, hopes school districts will push to educate teachers to recognize and address eating disorders in students. And he says his days as a lawyer will probably continue.
“I think (I’m) just realizing that the legislative process can look daunting, and I think it certainly is,” he said. “But on the other hand, it’s not that hard. If you find an issue you care about, just get in touch with a representative.”
This story was originally published by New Hampshire Bulletin.
This article originally appeared on Portsmouth Herald: NH Teen’s Text to Eating Disorders Hotline Urges Legislative Action