Authors: Emma Spiel, Beth Shelton, Louise Dougherty, Kelly Sheard, Alex Cobb, Heidi Lee
Event: 2022 TheMHS Conference
Subject: recovery, lived experience, eating disorders, services
Type of resource: Conference Presentations and Papers
Abstract: LEAD PRESENTATION: Integrating eating disorders care within community-based mental health services: A practical guide for maximising existing resources for service leaders & local champions
Emma Spiel, Beth Shelton, Louise Dougherty
Eating disorders are serious mental health conditions with significant and at times life-threatening physical and mental health consequences. It is recognised that eating disorders sit across a spectrum of experience, behaviours and severity and often co-occur with other mental health conditions, behavioural conditions, and neurological differences such as depression, anxiety, PTSD, longstanding personality-based challenges, psychosis, OCD, substance use, as well as autism, ADHD and other neurodivergent presentations. Eating disorders are common but frequently underdiagnosed or misdiagnosed, and disordered eating and/or body image concerns in people presenting for other mental health concerns, or with neurological differences, may be missed.
Despite many services having a desire to better serve their consumers experiencing eating disorders, many face barriers related to resourcing, insufficiently tailored systems and processes and a workforce who may not feel adequately skilled and confident to work with this group. Nonetheless, resources exist which support practical and manageable changes that can be made promptly to create meaningful and sustainable change that improves outcomes for people experiencing eating disorders.
The National Eating Disorders Collaboration along with our state-based partners and service leaders are developing a national strategy to support the development of a person-centred, stepped care system within Australia that involves people experiencing eating disorders, their families, carers, and communities as partners in the treatment, care, and recovery process. Within this system, care is delivered at the right time, and is flexible to changes in the person’s needs - regardless of their geographic location, age, economic circumstances, identity, co-occurring mental health conditions and/or cultural group.
This presentation aims to provide service leaders and local champions with an interest in service improvement for people experiencing eating disorders with access to tools and frameworks that NEDC is developing for the National Eating Disorders Strategy 2023-2033 (National Strategy). Attendees will learn about existing frameworks for articulating the system of care for eating disorders and tools for developing and implementing a sustainable service response. Attendees will also be given access to resources supporting the embedding of a skilled and confident workforce, including access to eating disorder training resources with support for effecting a sustainable workforce response using implementation science frameworks.
LEAD PRESENTATION: Taking STRIDEs to Improve Access to Eating Disorders Treatment
Kelly Sheard, Alex Cobb
ACT lacks adequate clinicians trained to treat people with eating disorders, resulting in long wait times. In August 2021, adults waited on average 318 days to start treatment with the Eating Disorders Program (EDP). Delayed access to treatment is associated with lower remission rates, higher levels of dropout and increased burden on the health system. The newly established Eating Disorders Clinical Hub aims to improve treatment access by implementing programs like a student-led clinic.
Our QI project evaluated the impact of the Short-Term Recovery Intervention for Disordered Eating (STRIDE) Program, a student-led clinic, on wait times and its acceptability for students and clients.
STRIDE offers a ten-session cognitive behavioural therapy treatment (CBT-T) for milder eating disorder presentations. CBT-T has an evidence-base supporting its delivery by supervised provisional psychologists with multi-disciplinary input from dietitian interns. We collected data on wait times and feedback from students and clients to determine program efficacy.
Outcomes and implications
EDP’s waitlist reduced by 54% down to 146 days with EDP clinicians’ capacity to see the more severe presentations increasing. Student and client feedback was positive, finding STRIDE valuable. STRIDE has contributed to ACT’s workforce expansion for eating disorders which subsequently improves client access.
PANEL PRESENTATION: Unravelling My Eating Disorder
On paper I had an Eating Disorder, however for me I had a lot more than the diagnosis and these two words. Having my Eating Disorder and living with it moved beyond what I ever imagined it to be, or initially thought it was. Connecting to the realm of my Eating Disorder was enlightening, complex and recovery aiding. A journey of discovery, sustained wellbeing and mutuality within that would benefit my Mental illness. I want to tell my story that it’s not just about the mechanics and perception of food it is so much more than that.
A morning wake up and routine of complex chaos with a hint of hope that today may be different and my eating disorder might leave me. Pack it’s bags and go, she would stop talking to me, controlling me and leave. However, for 7 years my Eating Disorder stayed active with strict eating habits, denying my body of food and a conversation within my head that never stopped controlling.
There is a web of many parts to my eating disorder. This is where I would like to shed some light, for there to be a conscious gain of perspective for how the mind of what seems a food fight is so much more than that. Anxiety, hearing voices, control, psychosis, soul searching, disconnect, determination, visual perception, lies, self-loathing. These are just to name a few of what went on in my body, mind and what my Mental Illness along with state of mind were. The Eating Disorder side to me had to grow to a point our relationship no longer served us both and it was over, recovery and a breakup of a part of me that would never leave but no longer be me, I would be it!
Growth, connection and understanding aided my recovery and sustaining my mindful wellbeing. Incorporating distinguishable moments, paths, epiphanies, and lessons to walk a way where I am able to be me. Unpacking and re mapping my mind, process by process, thought by thought until I was able to recognize and appreciate my mind and embrace it for all the colours it was. A new relationship with oneself would enable this mutuality to connect all while establishing a place with food and my bodies acceptance of it.
The focus of my abstract and the workshop I would like to do is more focused on recovery and the changes I feel need to be looked at in helping someone with an Eating Disorder.