AWH's Haylee Adamson explains rise in number of severe cases for eating disorders

From patients and their carers to public and private practitioners and politicians, comes a resounding cry for better access to dedicated treatment and recovery services in local communities.

Albury Wodonga Health (AWH) psychiatric nurse consultant Haylee Adamson says the organisation has seen an increase in eating disorder presentations across all age ranges.

"And in some cases the presentations are more complex and severe," she says.

"Locally we do not have a specialist funded service specifically for eating disorder treatment, care and support.

"We have a core group of passionate and knowledgeable clinicians .... however this is no substitute for a clear system of care and pathway to treatment."

Eating disorders "thrive in isolation", Ms Adamson explains.

That's why the COVID-19 proved challenging for people with, or at risk of developing, an eating disorder.

It produced a sharp rise in the number of presentations and admissions to Albury and Wodonga's emergency departments as well as the number of referrals to public mental health services, according to AWH figures supplied to The Border Mail.

For instance, the total number of admissions for people with either a primary or secondary diagnosis of an eating disorder tripled from 21 in 2020 to 60 in 2021.

The number of referrals (coded as an eating disorder) to public mental health services at both campuses doubled between 2020 and 2022 (from 84 to 162).

The fact eating disorders are not always easily identifiable and that they are, in fact, complex mental illnesses with physical complications make treatment pathways more complicated, according to Ms Adamson.

"It can be a hidden experience," she says.

"The environment of a busy and often under-staffed emergency department is not always the best place to receive specialist mental health treatment.

"ED is typically a place to treat or stabilise physical symptoms."

AWH's executive director of mental health Lucie Shanahan concedes part of the complexity for individuals and families trying to navigate the system of support services is "there are lots of doorways in front of them".

"The challenge is how do we get them through the right doorway quickly," she says.

AWH plays a major role in supporting a stepped system of care for eating disorders - from early intervention and education to early identification, community-based and more intensive treatment options.

Gateway Health, for example, offers supports including the Food in Mind program for people aged 12 to 25 with mild to moderate symptoms of an eating disorder, while headspace can provide access to dietitians, doctors and psychologists.

Ideally it's about being able to access the right level of care when it's needed in a co-ordinated, community led approach.

Unfortunately that's not always the reality of what Ms Adamson describes as a "fractured system", compounded by the vagaries of cross-border health jurisdictions.

She says the lack of access to specialist services in regional and rural areas impedes the recovery process.

Having to travel to Melbourne, Sydney or even the hinterlands of Queensland for treatment "is a barrier".

"When a person returns from that intensive care experience, there is a lack of awareness or connection to the services that sit in our region," Ms Adamson says.

"It's dislocating and disconnecting for the person and their family members, who are left to hold that burden. Treatment close to home, where a person is not isolated from their social supports, is also more conducive to long-term change and meaningful recovery."

That's why AWH supports advocacy around a specialist eating disorder service on the border, Dr Shanahan says.

"Ideally (it would be) a comprehensive service that provides co-ordinated community, outpatient and bed-based care that would provide gold standard care to families across southern NSW and north-east Victoria.

"We are exceptionally thankful for the advocacy of local state and federal politicians and community agencies around the need for specialist services in the region."

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