get involved: fed up nsw health
**Trigger warning: Mentions eating disorders, weight & BMI**
Fed Up NSW Health is a new campaign started by Ella that aims to make inpatient and outpatient public eating disorder programs in New South Wales accessible to all of those who need it. Ella has been suffering from her eating disorder for eleven years and has been in and out of hospital numerous times for conditions associated with it. But while she has been admitted on those occasions, she has been unable to access treatment for her underlying problem — the eating disorder itself. “I shouldn’t have to become physically unwell to access care for my mental illness”, she says.
Currently, there are two public state-wide inpatient beds in New South Wales for those with eating disorders. That is right: two. Because of these scarce resources, the waiting list is months long. And not only that but the outpatient services are only open four hours a week. Now this may seem like a decent amount of time per week, for those lucky enough to access it, to pave the path towards recovery. But let me tell you right now that it’s not. Not even close.
This campaign is one that I am very strongly behind due to my own history with anorexia nervosa (AN). When I was diagnosed with AN I was told repeatedly, by doctors and other medical professionals, that I was very lucky to be living in Canberra, as the ACT was one of the only states at the time that offered such extensive free outpatient services. And after attending the Canberra Eating Disorders Program and hearing Ella’s story, I realise just how lucky I was. While it certainly wasn’t perfect, it saved my life. As soon as I was diagnosed I was given a place in the program, which ran from 8:30-4:30 three days a week, and provided nutritionists, social workers, a psychiatrist, and health workers, as well as meals and hours upon hours of cognitive behaviour therapy. I was there for four months during year 12. Most of the girls were attending after being discharged from hospital, while some were hospital inpatients that were released three days a week to attend the program.
But changes have even been made to this program. When I was there it was open to people of all ages. Most of us were under eighteen, as we could be placed there by our parents without our permission. Those over eighteen needed to give consent themselves to be placed in the program. The few adults that joined us never lasted more than a couple of days. As soon as they saw the amount of food that we were required to eat per day, they stopped showing up.
But now the program is only for those with a BMI above 16 (it was 15 when I attended, and the majority of us had to wear four layers of clothing and stuff our pockets with coins just to reach that), and for patients over the age of 18. Hospital is the only option for those under the age of 18, and it is not a good one. Like Sydney, though it as not nearly as bad, there are simply not enough beds. Once someone is admitted, while therapy is provided, force feeding is the focus.
Hospital services at the moment are generally there to stop people dying, but are not there to change the underlying disordered thinking that characterises eating disorders. Two beds designed to actually do so in Sydney are certainly not enough. As I learned during my own experience with eating disorder treatment, it takes many months to begin to even scratch the service and start challenging the disordered thinking patterns that characterise this type of illness.
Currently Medicare offers rebates for 10 sessions with a psychologist per year. And even with the rebate each session will cost the patient approximately $80. This is not good enough. Force feeding those that go into hospital for medical reasons, but not doing any psychological intervention, is not good enough.
As stated on the Fed Up NSW Health campaign website, it takes on average seven years for someone to get over an eating disorder. It took me six. Even four months in an outpatient program and being on meal plans set out by a nutritionist for a year of my life only got me strong enough to start getting better on my own. If we want to see those with eating disorders recover fully, it will take a lot of government support. It will take a clear plan of action, which simply isn’t there now. As it says on Fed Up’s website: There is no policy on how to treat eating disorders patients in the public sector. There is no policy for management in the emergency department or in general wards.
Fed Up NSW Health wants this to change. They want to see the four beds that were originally at the Royal Albert Hospital for those with eating disorders reinstated, with a plan to expand this into a ward solely for those with eating disorders. They want to see a one month maximum waiting time for access to outpatient services. They want to see the outpatient service be opened three days per week, as opposed to the current four hours. And they want an independent review of public eating disorders treatment in NSW, including an inquiry into treatment eating disorder related deaths.
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