Severe Cases Only: Apply Within

It’s here that there is a chance to prevent people needing regular GP appointments, costly pathology tests, assessments with acute care mental health teams, Medicare-rebated psychiatric services and PBS medication, let alone lengthy hospitalisations if someone becomes acutely ill. It’s at this stage people don’t need to be ‘re-fed’ before they are able to benefit from working with a psychologist or counsellor on the internal issues which have really caused the illness. After all, an eating disorder isn’t about food at all. It’s about feelings.

Professor Patrick McGorry, Australian of the Year and adolescent mental health specialist, promotes early intervention for mental health conditions (Get Up, 2010). The Brain and Mind Research Institute CEO Ian Hickie take the same stand. It seems ludicrous to refuse to admit someone until they are experiencing a “severe case of anorexia and bulimia” (as quoted by the Centre for Eating and Dieting Disorders of NSW themselves). As favourable as the early intention model is, the reality is the public healthcare system is so underfunded and overstretched that there aren’t enough beds for the acutely ill – let alone those people - deserving as they are - needing early intervention. There is not enough room in eating disorder day-programs; the waiting lists are too long or the criteria too strict to be available to those not critically ill or, in some cases, those who are too ill. The model of early intervention is merely ideological unless something in the health system changes immediately.

An eating disorder is a mental illness. Although it can have severe physical complications, it is actually not a physical disease. There is little research into what types of treatment work most effectively with sufferers and we haven’t got a pill to manage the symptoms of the illness specifically. Sufferers often have a warped perception of themselves and how much space they take up. They engage in disturbing and distressing eating and behavioural patterns which may consist of refusing to eat, eating limited amounts, eating large amounts, frequent vomiting, laxative abuse and more. Recovery from an eating disorder takes, on average, seven years. (Eating Disorders Foundation of Victoria, 2010)

The reality is having an eating disorder is complete psychological torture. It’s endless chattering in one’s head. Negative thoughts. Crazy thoughts. Thoughts you don’t want, but have no power to remove. Eating disorders are extremely uncreative – they say to me what they will say to a 48 year old bulimic in Wales, or a 12 year old anorexic in New York. Books about eating disorders and online forums reveal the same train of thought – when the only common denominator is that the illness is present. What was once merely a chain of thought takes on its own life. It becomes controlling and pervasive. It is walking, talking misery. It’s a disease where a sufferer can rarely ask for help and will do everything to defy what they are asked to do in a desperate attempt to keep control of their illness which is, ironically enough, completely out of control by this time. Yet, for me at least, during the process of recovery, recognising the magnitude of control that my illness had is overwhelming. The respect and thankfulness I feel to the people who helped me when I did everything in my power to prevent them it is immense.

With a model of early intervention, it makes sense for the State Government, the Federal Government and the Health System to wake up and see what’s really in front of them; desperate people, services campaigning for early intervention and nowhere to put people once they’ve been intervened and a system that insists that people get sicker before they are allowed to get better.

There needs to be a complete overhaul of eating disorder services in Australia so that rather than being containment and stabilisation wards, inpatient treatment is a place of true healing, outpatient treatment facilities are able to treat people without them requiring costly hospital admissions and practitioners are trained in early-intervention nationally to detect, treat and intervene in the development of eating disorders.

Recovery, although a journey, is possible for anyone –with the right support and treatment- and just like supporters of sufferers and those of us who have made it through the other side; we aren’t going to give up. The health system shouldn’t either.

If you want help or information on eating disorders, please call The Butterfly Foundation Helpline on: (02) 9412 4499 or The Eating Disorders Foundation of Victoria on: 1300 550 236.