Page 4225 - Week 11 - Thursday, 25 October 2018

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I think it would be fair to say that eating disorders are poorly understood. I also think it would be fair to say that, partly due to them being misunderstood, they have not always been given enough consideration by health systems. They are not a phase. They are not a “diet gone wrong”. And they are not some sort of growing pain of adolescence. Eating disorders are serious illnesses that cause high levels of psychological distress for people who experience them. A person with an eating disorder has increased risks of developing long-term mental and physical illnesses, an increased risk of premature death due to medical complications, and an increased risk of suicide. And although the incidence peaks nationally between the ages of 12 and 25, eating disorders can occur at any stage of life.

Eating disorders carry extensive costs to individuals, to the community and to the economy. A report by the Butterfly Foundation estimated that in Australia in 2012 eating disorders had impacts on productivity roughly equivalent to $15.1 billion. These costs are largely borne by individuals, including financial impacts from lower employment participation and greater absenteeism as a result of illness or caring for someone with eating disorders.

A few months ago, I asked ACT Health to carry out some work to consider the current need for eating disorder services in the ACT, the range of services available, and where we need to develop or expand services. ACT Health established an eating disorders working group to review the current eating disorder services in the ACT and provide recommendations for improvement. This working group included key stakeholders from the Capital Health Network, the Australian National University, the Butterfly Foundation, ACT Health clinical and policy staff, and the principal petitioner, Molly, as a consumer representative.

Based on the discussions of the working group and wider consultation and feedback from the community, ACT Health has developed an eating disorders position statement, which I have presented today in response to this petition. This position statement has been developed to communicate the guiding principles that outline the government’s approach to the development of eating disorder services in the territory. The position statement establishes a clear ACT government commitment to develop services for the treatment and management of eating disorders. It describes a number of short-term initiatives that are underway, as well as longer term projects that could be pursued, depending on more detailed work and future budget bids.

The position statement is grounded in the premise that the most effective eating disorder service system enables seamless treatment and transitions across the continuum of health services. This is supported by evidence from eating disorder literature and clinical guidelines. This approach is presented in the position statement as a stepped care model, which emphasises four key pillars that should work together to allow for patients to flexibly step up and step down into appropriate services according to their needs. These are: first, generalist mental health services, including primary care and community programs; second, specialist eating disorder interventions, including day programs and outpatient clinics; third, local hospital interventions, including the management of cases in general medicine and paediatric wards; and, finally, intensive tertiary supports, including multidisciplinary teams and


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