It's time to provide adequate care for eating disorders patients in NSW.
For the state of NSW there are currently 2 acute inpatient beds. This has been reduced from the initial & inadequate 4 beds in 2010. With the creation of the National Eating Disorders Coalition in early 2009, the profile of eating disorders was supposed to be raised, yet in this time we have seen a decrease in the number of acute beds available to eating disorders patients in the state of NSW.
Eating disorders have the highest mortality rate of any mental illness; according to The Butterfly Foundation, the mortality rate of anorexia nervosa is 15-20%, with those with anorexia 32 times more likely to suicide than their healthy peers. Statistics for other eating disorders (bulimia nervosa & EDNOS) are poorly researched but outcomes are estimated to be on par with that of anorexia nervosa. The average duration of treatment is 7 years. Eating disorders come in all shapes & sizes. The biomedical approach to care means that patients in the public system are treated when most physically unwell (usually in a state of anorexia nervosa), leaving the illness to most often be treated as a physical illness & not a mental illness. "The health and socio-economic costs are also high with bulimia and anorexia being the 8th and 10th leading causes respectively of burden of disease and injury in young women (18 -24 years) in Australia, measured by disability-adjusted life years (10) and the percentage of disability-adjusted life years associated with eating disorders being comparable to schizophrenia." (The Butterfly Foundation, Eating Disorders Statistics).
The reality is that eating disorders are a mental illness with dire physical consequences. With adequate early intervention, there needn't be a high mortality rate, nor should there be physical complication associated with a mental disorder.
According to the Centre for Eating & Dieting Disorders website (run through the University of Sydney & from Royal Prince Alfred Hospital itself) "2 beds in an acute psychiatric unit for people with severe anorexia nervosa or bulimia nervosa who have already accessed local Area primary, secondary & tertiary services. Available to adults from any AHS [Area Health Service] in NSW." and what conditions are provided care under this particular inpatient service? "AN, BN, EDNOS (although due to service pressure usually reserved for severe cases of AN and BN) " Further information on the RPAH inpatient unit here: http://www.cedd.org.au/?id=272
RPAH also offers a day program & an outpatient program. Both with extensive waiting lists. When people are acutely unwell, there is no time for waiting lists. The Statewide Eating Disorders Outpatient program is open for half a day per week, with the expectation that this will service the entire state of NSW's eating disorder patients.
The Westmead Hospital offers four inpatient beds, but to be accessed the patient must reside in the Westmead Hospital catchment area. Inadequate for the high level of need for the program & of no assistance to anyone living outside of the Westmead Catchment.
The treatment provided for eating disorders is similar to an Oncologist saying “look I know you’ve got breast cancer, but before you can get any treatment for it, we’ll have to wait for it to metastasizes to your spine & if you want any intensive treatment, we’ll have to wait until it’s in your liver & lungs also because we can only offer treatment to the most acutely ill in the state.” That would be considered ludicrous & front page news, yet patients are knocked back for treatment or provided inadequate treatment on an almost daily basis.
We the undersigned request the following:
- A comprehensive and independent review of public eating disorders treatment in NSW be made immediately.
- The original four eating disorders beds at RPAH be reinstated immediately with an agreement to expand the available beds for eating disorders patients in the next two years be reached within the all of the hospital networks in NSW.
- The Statewide Eating Disorders Outpatient services at Royal Prince Alfred be opened a minimum of 3 days per week (instead of the initial 1/2 day per week) to reduce waiting times & provide adequate assessment & follow up for patients.
- A study of relapse & readmission rates to hospital (including follow up & emergency treatment in emergency departments & on medical wards) be undertaken.
- That comprehensive eating disorders services be available in all area health services, not only Royal Prince Alfred Hospital (SSWAHS) & Westmead Hospital (SWAHS).
- Further more, outpatient services have a waiting period of no longer than one month.
- Health practitioners are provided comprehensive training in assessing & identifying eating disorders - particularly geared towards early intervention.
- That patients admitted to medical wards, emergency departments or psychiatric wards who have an eating disorder are identified & documented so accurate statistics on eating disorders patients & hospital presentations are available.
- That the Worldwide Charter for Action on Eating Disorders is stringently adhered to (please see here: http://www.aedweb.org/source/charter/documents/WWCharter4.pdf)
- That the current legalities surrounding involuntary treatment of eating disorders patients be revised to make it easier for health professionals to involuntarily detain or involve patients in treatment services.
- That an inquiry into treatment eating disorder related deaths in the state of NSW be made immediately & any recommended outcomes implemented.
It is time that eating disorders become a state priority & changes be implemented immediately to increase the care available to eating disorders patients, their family, friends & treating health professionals.