Barriers to Care
Vital access to treatment and recovery can be hampered by a limited availability of care or lack of care in remote areas, by stigma, poor professional skills and poor understanding of the pathways to care.
Inaccessible care in remote areas – Specialist services for eating disorders are mainly concentrated in large metropolitan centres and access to care in rural and remote areas can be inadequate and in many cases, non-existent.
Unacceptable care – The availability of care for varying age groups, types of eating disorders and specific treatment interventions can often reflect clinician interest and expertise, rather than coordinated planning, individual treatment needs and holistic care as required by each illness.
One principal barrier has been identified as the stigma that exists around eating disorders.
To reduce the stigma associated with eating disorders, there needs to be a shift in the attitudes and knowledge of the general community. This can be achieved through the development of a ‘no-blame’ model, aimed at minimising the shame or humiliation experienced by people with eating disorders.
Standards and regulations also need to be applied in the media, with a particular focus on counteracting negative or inaccurate views of eating disorders.
For instance, negative body image issues and unhealthy eating practices are commonly represented in the media. Steps are required to ensure that the media communicates appropriate messages regarding eating disorders, healthy eating and body image.
Skills and knowledge
When people do seek help, it is often for a separate problem and practitioners may fail to look beyond the presenting issue to recognise symptoms of an eating disorder. This may be due to lack of knowledge or inaccurate beliefs about eating disorders. This can be corrected through targeted health literacy programs and specific training in eating disorder awareness and recognition.
People who work in primary care, fitness and weight loss industries need to be aware of the importance of early intervention in eating disorders.
It is a known fact that prolonged duration of an eating disorder is likely to have harmful physical and psychological effects and can make recovery less likely. Despite this, the eating disorder field has been slow to implement the concept of early intervention.
Improving eating disorder health literacy of those in the medical, educational and health sectors is vital to increasing early identification of people in the formative stages of an eating disorder or who are at risk of developing an eating disorder.
Of particular importance is the training and supervision of generalist inpatient/outpatient mental health services in assessing and treating people with eating disorders.
Mental Health Literacy
For early intervention to occur, young people and those in their circle of support need to be able to recognise and respond to various signs and indicators that present early in the development of an eating disorder.
This can include evidence of distress, reduced functioning and changed behaviours or eating patterns.
In Australia, growth in mental health awareness has also promoted growth in active efforts by government, media and the wider community to reduce stigma and improve mental health literacy.
The mental health literacy of young people and their wider support network is an important area for continued research and intervention.
Future intervention research must focus on:
Uncovering the most efficient ways to improve and impart knowledge
Promoting recovery-oriented behaviour, such as seeking professional help
Prioritising cost-effectiveness, sustainability of resources and time available to implement interventions
Drawing on lessons learnt from past interventions to develop more effective approaches
Pathways to care
Unclear pathways to care – Unfortunately people with eating disorders and those caring for them do not have a clear understanding of how and when to access help. Clear indicators of referral and care pathways are needed to promote available resources and services.
The Care Team
Eating disorders are complex and multifaceted. While the minimum treatment team is a medical practitioner and a mental health professional, input from practitioners from a range of disciplines is often necessary for comprehensive care. Family and supports are integral to the care team.
Stages of Change
The stages of change model can be helpful in understanding how a person living with an eating disorder may be thinking and feeling at different stages of illness and recovery. There are six stages of change that a person experiencing an eating disorder may go through.
It's different for everyone, but recovery from an eating disorder involves overcoming physical, mental and emotional barriers in order to restore normal eating habits, thoughts and behaviours.
Relapse & Recurrence
Relapse can be a common part of the recovery process; many people with eating disorders experience a relapse or recurrence as they recover from their disorder and learn to manage their eating habits.