‘ED’ of Eating Disorder notoriety, has no ‘Use By’ date. Without evidence-based treatment intervention, ‘ED’ doesn’t just ‘go away’. It thrives on torturing innocent minds and sending families into a spin. Band-aid treatment – a few weeks of therapy here and there – simply won’t work. It is like taking a cake out of the oven half way through the baking time – the cake flops, and so do the patients when they receive only a portion of the care they need. Full care is required until they, like the cake, are strong enough to stand alone in the world outside the oven of their illness.
Miss the small window available for ‘early’ intervention, within the first 18 months that the illness develops, and recovery treatment is likely to take 12 months, or much much longer. Sadly, our politicians and health policy makers don’t seem to understand this. In Australia, services that were already insufficient, are being cut back further. Only a public outcry will cause a re-think. I have signed the two petitions listed at the end of this article and I hope you do, too. We need to speak up (loudly) on behalf of those who are too sick to speak for themselves. Anthea Fursland, President of the Australia & New Zealand Academy for Eating Disorders (ANZAED) explains:
I … again raise concerns regarding federal funding of mental health services, both the 2011 changes to Medicare rebates for mental health practitioners under the Better Access Scheme and the federal government’s funding freeze to the Mental Health Nurse Incentive Program. As you know, ANZAED, represented by Past President Chris Thornton, together with the Butterfly Foundation, successfully lobbied against the November 2011 Better Access Scheme cuts. In February, Minister Butler announced that individuals will be eligible for an additional 6 allied mental health services, under ‘exceptional circumstances’ – but only temporarily, from 1 March 2012 until 31 December 2012.
Last week, former Australian of the Year, Professor Patrick McGorry, made a statement that the November 2011 cuts to psychological treatment were ill-advised and the plan to scale back the program by the end of this year “should be permanently taken off the table”. Professor McGorry has stated that our mental health system should be strengthened and expanded rather than eroded. ANZAED is pleased that Professor McGorry has spoken out against the cuts to Better Access. We feel that the provision of 10 sessions through of the Better Access Scheme is inadequate. We were pleased that Minister Butler reinstated a further 6 sessions for ‘exceptional circumstances”, however, concerned that this is a temporary reinstatement.
In addition, the federal government announced a funding freeze to the Mental Health Nurse Incentive Program in the recent budget. This innovative primary mental health program provided unlimited mental health nursing support to over 40,000 Australians with complex mental health problems such as eating disorders. The funding freeze may result in reducing or freezing intakes and limiting services available. This will be a particular problem in rural and regional areas where specialist services are limited.
Eating disorders are amongst the most serious psychiatric disorders and affect up to 15% of Australian women. Anorexia nervosa, the third most common chronic illness effecting adolescent females, has the highest mortality rate of ANY psychiatric illness, with 10-20% of patients dying from the illness after a prolonged history. Death from suicide is relatively common, being 32 times higher than expected than in the general population (for comparison, patients diagnosed with major depression are 20 times more likely to die from suicide). Eating Disorders are often chronic and debilitating illnesses, with one of the highest impacts on health related quality of life of all psychiatric disorders. On average, patients with anorexia nervosa have a similar level of disability to those suffering from schizophrenia. Patients with eating disorders are the most expensive patients to treat in a hospital setting. This is due to the complex psychiatric and physical comorbidity, the protracted length of treatment, and the requirement of specialist care.
ANZAED is concerned about the consequences of the recent changes to the Better Access funding arrangements on access to effective treatment for patients suffering from eating disorders. We know that patients who have access to the empirically supported evidence based approaches have a significantly improved outcome. This is particularly so for those who are able to access these treatments early in the course of their illness. ANZAED recommends that access to the 18 sessions (available under the exceptional circumstances provision) be permanently reinstated as a minimum for patients meeting diagnosis of an eating disorder as this is more in line with the length of treatment required under empirically validated treatment protocols.
If you are interested in registering your opinions about the cuts to Medicare rebates for mental health practitioners under the Better Access Scheme, you can sign a petition at Change.org.
To support a petition by The Australian College of Mental Health Nurses to the Minister for Mental Health Mark Butler, to reverse the funding freeze, click here.