EDV responds to Four Corners - Eating Disorders Victoria
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Eating Disorders Victoria (EDV) responds to Four Corners episode 'Fading Away'

28th Feb 2023 

Eating Disorders Victoria (EDV) welcomes the Four Corners investigation into the eating disorder system of care in Australia. As one of the longest running community support organisations in Australia, we know first-hand the debilitating impacts of eating disorders on individuals, families and communities.

We commend those who bravely shared their story in the program, and acknowledge the many others whose experiences weren’t represented. Eating disorder experiences are complex and varied, but the pain, suffering and frustration of all individuals with lived experience remains constant. We also acknowledge the ongoing stigma around eating disorders and associated shame and discrimination that compounds issues of help-seeking, treatment and support. 

The program highlighted a number of key systematic inadequacies and gaps across the various eating disorder systems of care in Australia, including in Victoria. While we cannot comment on individual cases or systems of care outside Victoria, we can address issues raised in the program that reflect the experiences of our Victorian community members.  

Support for people with Severe and Enduring Eating Disorders

People experiencing severe and enduring eating disorders (SE-EDs) are some of the most under-served in the community. People can have SE-EDs across all eating disorder diagnoses and often have limited options for adequate, affordable and coordinated long-term support. For some, this can result in ‘bouncing’ between hospital and the home. The lack of investment in support options for these individuals and their families results in severe loss of quality of life and tragically in some cases, loss of life.

At EDV, we recognise the desperate need for those with SE-EDs to access specialized support and continue to advocate for specialist care for this group.

In 2021, with the support of the Victorian Government, we commenced work on a SE-ED program, a world-first initiative that is co-designed and delivered by those with lived experience of SE-EDs. It also includes specific support for carers and loved ones. Despite having a waitlist in excess of 80 people, this program has no committed state government funding after April this year.

This means that we will have to cease the program while we await news on ongoing funding in the May state budget. The ramifications this has on our SE-ED community and our SE-ED program staff is immense. We implore Minister for Mental Health, Gabrielle Williams MP, to consider further funding so that this program can continue to support those who desperately need it.  

Support for families of young people with eating disorders 

We know that eating disorders have been steadily increasing in young people over the past 10 years, and the COVID-19 pandemic only accelerated cases further. This increase in demand has caused significant pressure on support services for young people. While we have services that provide excellent care in Victoria, we know from our community that this is not universal. The care offered to a young person diagnosed with an eating disorder in Victoria often depends on where they live and what health services they access. Lack of clear information, referral pathways and support for families to be a seen as valued collaborators in treatment are some of the factors that we see that can lead to prolonged illness and family distress. 

Victorian families are crying out for more resources to help their loved ones. We echo this call. However, while inpatient treatment essential for a small number of young people, we believe that more hospital beds are not necessarily the answer to this crisis.

Increased demand on hospital services is a knock-on effect from people not receiving adequate community-based supports.

A key part of the solution must lie in supporting families through wrap around support in the community. This includes skill building, education, peer support, respite, in-home meal support and financial aid. At EDV, we know that supporting families more intensively works. We see the results in the Carer Coaching Program, which we developed in response to extended waitlists for young people in 2020. When carers are given the right information and tools at the right time, they can make significant in-roads in their loved one’s recovery. Again, we are extremely concerned that Carer Coaching Program, like our SE-ED Program, has an uncertain future. As of June, we have no state government funding committed to continue this program.  

Support for those with Binge Eating Disorder

People experiencing Binge Eating Disorder comprise the largest cohort of Australians with eating disorders. 47% of people with eating disorders have BED, yet it continues to be underdiagnosed, undertreated and undervalued by our health system.

In Victoria, there are currently no specific BED treatment programs available in our public health system. EDV has made BED a key part of our advocacy platform and in 2022, we presented this issue to parliamentarians as part of our Feed the Soul event. Key to this advocacy is a vision, devised by Victorians with lived experience of BED, of what a health system response to BED should look like. Read more about this here.  

Role of residential treatment programs

Residential treatment for eating disorders is a model of care that is relatively new in Australia. We hear from our community that the option for residential care is welcome, but that it should be connected to a broader step-up, step-down system of care.

Fragmentation of services is one of the key frustrations that Victorians experience when seeking treatment for eating disorders – we must avoid building new services that don’t ‘fit’ with the rest of the system and are only available to a select few who can afford access.

In Victoria, a new residential eating disorder service for adults was promised by the Federal government in 2019. This service is in the process of being built in collaboration with the State Government. It is located in Melbourne’s south-east and has involved extensive consultation and co-design with the lived experience community. Rising building costs have caused some delays in the process, however the facility is expected to open in 2024 and will co-exist within the Victorian public system of care. We look forward to this facility being available to those in our community who require it.

What’s the solution and where to from here? 

We know that our community just want solutions, and so do we. Victorian lives depend on it.

There are a number of factors that will influence any state and federal government response: The new Victorian Eating Disorder Strategy, due to be released in June 2023, the ongoing roll out of recommendations from the Royal Commission into Victoria’s Mental Health System, and the National Eating Disorder Strategy, due to be released in August 2023.  

We are especially encouraged by the development of the Victorian Eating Disorder Strategy. The Victorian Strategy has enormous potential to amplify and replicate what is working in our Victorian system, and to provide solutions to the key problems that many are experiencing. EDV continues to play an integral role in the development of the strategy, and we thank our community with lived experience for their participation.  

At EDV, we believe there are three core issues that require urgent attention and investment in any reform process: 

1. We need to improve early intervention.

Limited general awareness of eating disorders and lingering stigma prevent effective early intervention in the vast majority of eating disorder cases. Responding early to eating disorders is the single biggest predictor of long-term recovery.

We will not reduce the duration and severity of eating disorders or the impact on our health system without greater investment in awareness, education and early support options. Early intervention is the responsibility of the whole community, and requires a whole community approach. This includes schools, households, community groups and primary health services.

2. We need to fund solutions in the community, not just hospitals.

Evidence suggests that the vast majority of people will respond well to treatment in community-based settings when they have access to a coordinated range of services as needed. This includes clinical, educational, psycho-social, peer and carer services. Access to these services is essential if we want to prevent upward pressure on our health system and reduce the number of people developing severe and enduring eating disorders. Governments must focus their investment on resourcing outpatient or community-based services, including:

  • Sustained and increased funding for EDV’s support services. We currently have no guarantee of funding for 75% of our services post June 30. As the only Victorian eating disorder organisation, this is unfathomable. Lack of continuous funding has enormous impacts on continuity of services and retention of skilled staff. Certainty in funding (minimum 3-year blocks) is essential. 
  • Funding to trial innovative new community-based approaches to eating disorders, such as the SE-ED Program and Carer Coaching Program
  • Funding to diversify and increase the eating disorder workforce, with specific focus on peer workers. 
3. We need our health system to work together to treat eating disorders as core business.

We hear resoundingly from our community that people are confused and frustrated when navigating care. We currently have fragmentation across services and catchments, confusion between public and private options, lack of knowledge or clear information regarding pathways and lack of step up/step down services. GPs, as the entry point to care, often lack up-to-date knowledge on eating disorder assessment, management and referral pathways. Within the mental health system, eating disorders are often treated as ‘too hard’ or ‘too specialised, while the medical health system often lacks the mental health expertise to manage eating disorder patients appropriately. 
 
The reforms through the Royal Commission will go some way in addressing this fragmentation in Victoria. However, the Royal Commission did not specifically mention eating disorders, which remains a concern. We must ensure that eating disorders are not forgotten or ‘othered’ in any system reform process. Eating disorder representatives must be supported to participate in ongoing consultations and reform processes in Victoria to ensure the seamless integration of eating disorder responses in our mental health and medical health systems.  

Use your voice for change

At EDV, we will continue to advocate for the needs of our community. For those who would like to use their voice to help our government respond to eating disorders, we encourage you to contact your key parliamentary representatives: 

Your local state representative Find details here 

Victorian Minister for Mental Health, the Hon Gabrielle Williams
Ministerial Email: minister.williams@health.vic.gov.au
Ministerial Phone: (03) 9096 8587 

Victorian Premier, the Hon Daniel Andrews
Email: daniel.andrews@parliament.vic.gov.au
Phone: 03 9651 5000  

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