This page includes questions that have been received by stakeholders regarding the implementation of the National Strategy. NEDC will continue to update this page as further questions are received. Questions have been deidentified and may have been edited/abridged for clarity.
If you have a question for our team, please email us at nationalstrategy@nedc.com.au. If you have a question for any of our presenters, you can also reach out via this email and we can connect you.
The National Strategy can be a really helpful tool for understanding what should be available to you in the system of care, and to understand what you should be able to expect in terms of standards when interacting with the different components of the system of care. So in that sense, it is an information piece and a guide; it could be used as a navigation tool to help understand what the system looks like and what you should be able to expect.
If you're in a good place in your own journey, you might also want to use the Strategy to have conversations in your region about what's needed - and get involved in local initiatives. Having lived experience representation and advice embedded within project or service design, delivery and evaluation is essential for getting the best outcomes for people with lived experience, and lived experience leadership and guidance is the first principle of the National Strategy. You could connect up with your local Primary Health Network and other local services, or state-based and national eating disorder organisations to find out about opportunities.
The role and varied contributions of the Lived Experience workforce to the system of care is also extremely important. This includes people in designated Lived Experience roles, including consultancy, leadership, policy, peer support, training and advocacy, to name a few roles, and there are actions in the Strategy related to the Lived Experience workforce (see the Workforce section). There are also many people working in the system of care in non-designated roles who have their own lived experience, who can bring a valuable lived experience-informed lens to their work, while being guided by the standards and actions within the Strategy relevant to their role's context or setting.
There are multiple aspects to consider for the evaluation of the National Strategy. Firstly, there is evaluating the implementation and impact of the National Strategy itself, and then there is also services evaluating their own initiatives. NEDC is currently developing a detailed evaluation plan to support evaluation of the implementation and impact of the Strategy, which will build on the key progress indicators identified on p.74 of the Strategy. This evaluation plan will be available in the new year.
We have already developed an evaluation tool that clinicians and services can use to evaluate their own initiatives.
While access to affordable eating disorder care has improved in recent years (through a range of initiatives including the introduction of the MBS Eating Disorder items, and service development activities to increase eating disorder service provision within public mental health services), there is still much more work to be done to ensure that eating disorder treatment and support is available to all. A key aim of the National Strategy is to ensure equitable access to services. Achieving this will predominately require top-down initiatives and change. Treatment Standard 8 (see page 55 of the National Strategy) states "Treatment if affordable". The actions that sit under this involve government and health services ensuring that public mental health services provide eating disorder services consistent with the needs of their region, that regional planners ensure that there are low-cost treatment options in their region for those who require them, and that training providers and relevant professional organisations ensure that GPs, mental health professionals, dietitians, psychiatrists and paediatricians are equipped to utilise the Medicare Eating Disorder Treatment and Management Plan items. There are also a range of workforce development actions in the Strategy to support the workforce in these settings to be able to deliver these services. NEDC, in our coordinative function, will be working with these stakeholders to implement these actions across jurisdictions.
NEDC will be forming a range of implementation groups to support Strategy implementation by particular stakeholder groups. If you would be interesting in participating in an implementation group, please email nationalstrategy@nedc.com.au and include a description of your service setting. Stakeholders are also welcome to contact NEDC to seek specific guidance and consultation support.
In addition, NEDC has a workstream dedicated to supporting Primary Health Networks to build on their eating disorders response - please contact nationalstrategy@nedc.com.au for more information.
Navigating the system of care is one of the biggest challenges identified by people with lived experience and their families/supports and communities, with many people experiencing a fragmented system with a lack of connection and coordination across services. These challenges can be even greater in regional, rural and remote areas, where there may be a lack of services and providers with eating disorder-specific knowledge and skills.
The Stategy's vision is for eating disorder care to be embedded in the health systems of all states/territories and regions, and for people all across Australia experiencing or at risk of eating disorders and their families/supports and communities to be able to access an effective, equitable and coordinated system of care. To achieve this, services need to be available to people when and where they need them, they need to be staffed by people with appropriate skills and knowledge, and operate in a way which helps people understand their options and navigate/connect to other services as needed.
There are a range of Standards and Actions within the Strategy to help achieve this, including a mix of 'top-down' and 'bottom-up' actions. 'Top-down' approaches include actions by national, state/territory, and regional planners to identify and address system gaps, and ensure adequate access to treatment services in every region, as well as a range of workforce development actions. 'Bottom-up' approaches within the Strategy include standards and actions related to transitions between services, tailored care navigation, and the provision of information about the system of care at every service entry point. There are a range of stakeholders with a role in these 'top-down' and 'bottom-up' actions, including but not limited to government, service planners, treatment services and clinicians, initial responders, and psychosocial and recovery support providers. NEDC will be supporting these stakeholders to implement the actions outlined in the National Strategy.
NEDC recognises the challenges faced by services in responding to and meeting the needs of people within their local region, often with limited resources. However, it is highly likely that mental health and drug and alcohol services are already seeing clients experiencing or at risk of eating disorders, due to the high rates of co-occurence of eating disorders and other mental health conditions.
There are a range of initiatives that mental health and drug and alcohol services can undertake to build capacity within their service to better meet the needs of people experiencing or at risk of eating disorders, which have only a small cost (time or direct cost). These include encouraging staff to complete free online training to develop skills in identification and initial response, such as NEDC's free Eating Disorder Core Skills: eLearning for Mental Health Professionals, designed to equip mental health professionals with the knowledge and skills needed to identify when a person is experiencing an eating disorder, complete a comprehensive eating disorder assessment, refer to appropriate services in the stepped system of care, and understand the components of eating disorder treatment and recovery.
Other strategies may include providing training to staff on brief treatment interventions, such as CBT-Guided Self Help, as a first step, with a view to staff completing additional training in other treatment modalities over the longer term. These actions will assist services to work towards Workforce Action 2.2 (Health and mental health services to routinly include consideration of eating disorder-specific skills in workforce planning to match the scope of the service) and 2.3 (Health and mental health servcies to ensure sufficient eating disorder expertise for their team to meet the needs of people presenting with eating disorders).
The National Strategy is a 10-year strategy. Sustainable change will take time, and the process of National Strategy implementation will occur across three main phases - activation (years 1-4), integration (years 5-7), and sustainability (years 8-10). NEDC has developed an implementation timeline which identifies key priority targets within the activation phase of National Strategy implementation. Taking action towards these key priority targets will help to achieve early change towards the Strategy’s desired outcomes for people with lived experience and their families/supports and communities, and will lay the foundation for effective action across the subsequent phases of National Strategy implementation. Some actions have already commenced. NEDC has discussed the implementation timeline with key stakeholders, and will make this timeline publicly available in the new year.
Within the stepped system of care, there are three levels of treatment: community-based, community-based intensive, and hospital and residential. The National Strategy includes five Standards related to hospital and residential care (see pages 62-64).
Funding for the state and territory residential care facilities sits separately to the National Strategy and each state and territory is at different stages of development of their facilities. For more information on progress within your state/territory, we suggest contacting your state/territory government.
The concurrent development of the National Eating Disorders Strategy 2023-2033 and the Victorian Eating Disorders Strategy presented a valuable opportunity for national and state collaboration. NEDC has been involved in the development of the Victorian Eating Disorder Strategy and both strategies are underpinned by the NEDC stepped system of care for eating disorders. The National Eating Disorders Strategy provides national standards and priority actions which are to be met with local knowledge in the creation of context-sensitive, practical solutions. In this way, the Victorian Strategy provides an example of how national standards and actions may be applied to a state/territory context. NEDC will continue to support alignment and implementation of the two Strategies.
NEDC was also asked:
How are you ensuring the strategy is neurodiversity-affirming and considers the access needs of neurodivergent people with eating disorders? Additionally, is NEDC working with the National Autism Strategy working group that is developing the National Roadmap for Autistic health and wellbeing? If not, will they?
NEDC has ensured representation of neurodivergent people, including neurodivergent people with lived and living experience of eating disorders, as well as neurodivergent clinicians and researchers, throughout the development of the National Eating Disorders Strategy. We particularly acknowledge the expertise of Eating Disorders Neurodiversity Australia (EDNA), who provided extensive and valuable input throughout the development of the National Strategy. The key principles underpinning the National Strategy are informed by these and further intersectional perspectives. These principles should underpin all actions undertaken to implement the Strategy. In addition, several standards and actions aim specifically to address the needs of neurodivergent people as well as other underserved and higher risk populations (see for example Identification Standard 3 Action 3.3, and Treatment Standard 5 and associated actions). The Strategy emphasises the need to better understand and meet the needs of underserved and higher risk population groups, as a key enabler to drive needed change across the system of care.
To date, we have not been involved in the development of the National Autism Strategy, but would welcome the opportunity to provide input as appropriate to support alignment with the National Eating Disorders Strategy and related initiatives. Our current work to develop 'eating disorder-safe' principles (relevant to 14 actions across the National Strategy) will result in practical guidance on eating disorder prevention and harm minimisation across a range of settings, including within public policy. We have neurodivergent perspectives represented (lived experience, clinical and academic) on the Eating Disorder Safe Principles Expert Advisory Group as well as on the project team. Due to be published in June 2024, these principles could usefully inform key policy developments and strategies across a range of areas, such as health, education and social and community services. This could include the National Roadmap for Autistic Health and Wellbeing.
We are committed as a team to continuing to learn and develop in this space and welcome ongoing feedback.
NEDC recognises the challenges associated with accessing care in regional areas, and calls for people to be able to access timely, affordable care, as close to home as possible. The National Strategy contains standards and actions to address a range of these challenges, including ensuring that community-based public mental health services (including child and adolescent/youth mental health services) provide evidence-based eating disorder treatment, and that regional planners address service gaps.
To ensure these actions can be met, NEDC will be supporting stakeholders with activation, planning, and implementation. In the interim, while these shifts are occuring, resource gaps may be able to be addressed through access to digital resources, telehealth options, case consultation, and supervision.
The National Strategy is a system-building strategy. The focus is on defining what is needed in an effective, equitable and coordinated system of care for eating disorders, and on feasible, grounded steps for building it. It is not a clinical guideline and does not provide recommendations or information about specific models of clinical care. Links to clinical guidelines for eating disorders can be found here.
From a system-building perspective, the National Strategy identifies the settings where treatment should be delivered, as well as the competencies required for the workforce to be able to deliver this treatment. Regional planners and individual services should ensure that workforce planning considers a range of treatment modalities to meet local needs across eating disorder presentations and population groups, and that workforce development activities support the workforce to be able to deliver these treatment modalities.
The National Strategy also emphasises the need for new models of care to be developed to better meet the needs of people across the full range of eating disorder presentations and population groups, and for emerging and new models of care to be evaluated.
There are many stakeholders who have a role in implementation of the National Strategy. Some of these stakeholders are actively involved in eating disorder system-building activities and implementation of the National Strategy, and others are at different stages of recognising and understanding their role. NEDC are utilising a range of Implementation Science-informed mechanisms to enhance engagement and uptake, such as working with stakeholders to identify barriers and enablers, developing targeted stakeholder implementation resources, identifying champions to help drive regional implementation, and providing targeted consultation.
You can find your local Primary Health Network via the following link: https://www.health.gov.au/our-work/phn/your-local-PHN/find-your-local-PHN
for example, telling a client with ED to go on a more restrictive diet without consulting with GPs or dietitians.
Supervision (individual and group), mentoring, and communities of practice can be helpful tools here, and ensuring that people are seeking support from an eating disorders-informed clinician. Some people may not know about the National Strategy and evidence-based guidelines. We highly encourage you to help others to engage in best practice, and access resources to support them to do so where you feel you can. You might also support your colleagues to upskill in this area by promoting key resources and training, or bringing this topic to any group/peer supervision or team meetings that are held. If you feel that there is potential harm to the client, we recommend following your professional guidelines.
The Federal Government Department of Health and Aged care has extended NEDC's funding for 2024/25 to continue to support the implementation of the National Strategy. NEDC will work closely with all states and territories to implement the National Strategy and ensure its Standards and Actions are embedded across existing health and mental health services. We can't say at this time whether further funding will be committed to the implementation.
The National Strategy helps to articulate the specific roles that clinicians can hold across the Stepped System of Care, and what needs to happen in those roles. For example, within Initial Response, clinicians should be able to complete a comprehensive assessment, provide psychoeducation, ensure the person is safe (physically and psychologically), engage families and supports, and make a referral to or support a person to access treatment appropriate to their needs.
We recommend reading the Identification (pages 41-44) and Initial Response (pages 45-48) which articulates these specific roles and actions.
There are some great resources to help clinicians upskill to be an 'Identifier' and Initial Responder' - see NEDC's Eating Disorder Core Skills: eLearning for Mental Health Professionals for free introductory training and supporting resources.
Over the 24/25 year, NEDC will be developing a suite of resources to continue to help with workforce planning, development and implementing change.
NEDC will also be working closely with all states and territories to support them with implementation of the National Strategy. This will include exploring workforce and service development for public funded mental health services.
Your local statewide services (for example, CEED, InsideOut, QuEDS) can provide support with this work. Similarly, connecting with your Primary Health Network can be a good place to start. Please reach out to our team if we can provide more specific guidance on your specific target.
If you are ready to start exploring and planning for workforce development, you can check out NEDC's new national Training & Workforce Development database. This will help you to identify professional development opportunities available for your target workforce.
NEDC will be launching Eating Disorder Safe principles on 24 July 2024. The Eating Disorder Safe principles will underpin ongoing work to drive positive culture change in the ways that people talk about and respond to health, food, minds and bodies across a wide range of settings. The development of these principles arose from National Eating Disorders Strategy: there are 14 Standards and Actions spanning prevention, identification, treatment, psychosocial and recovery support and workforce which all call for the establishment of eating disorder safe principles so that social and environmental risks and harms can be eliminated as far as possible.
NEDC will be developing and launching a Workforce Development Hub, an online suite of evidence-based tailorable workforce development resources to help organisations and individuals to plan and implement workforce initiatives in line with the National Strategy standards and actions.
We will continue to be responsive to the sector and develop resources and eLearning programs that we know clinicians and services need, including implementation resources. Let us know if there is something that you need to support your National Strategy Action Plan.
The National Strategy Action Hub serves a few different functions:
NEDC offers flexible support based on your needs and available resources. We can collaborate with you to brainstorm implementation ideas and identify practical next steps within your specific context. For example, in a clinical setting, this might involve introducing ED Safe practices through an information session, making adjustments to intake forms, or identifying further avenues for integration.
Recently, within an early psychosis service, NEDC introduced the concepts of ED Safe and explored ways to incorporate the guidelines into existing practices. In another example, at a dance school, we provided education to both teachers and leadership to implement ED Safe principles from both a bottom-up and top-down approach.
Additionally, the NEDC website offers several "how-to" guides to help you and your service integrate ED Safe principles effectively.
Consultation typically begins when a service reaches out to NEDC with a request. A team member specialising in the relevant portfolio area is then allocated to support the consultation.
NEDC consultations vary based on the needs of the organization and may include:
Reviewing documentation such as models of care and intake forms
Providing in-service training sessions
Supporting the development of a workforce strategy
For example, NEDC has worked with NEAMI to strengthen workforce confidence in identifying and responding to disordered eating and eating disorders.
While NEDC is unable to provide funding for initiatives, we can support services, workplaces, and community to better prevent and respond to eating disorders.
The Tertiary Project has been underway for some time, starting with a mapping of current eating disorder curricula across specific discipline groups (medicine, psychology, nursing, psychiatry, occupational therapy, dietetics, social work) at both undergraduate and postgraduate levels. Following this, we surveyed professional groups to determine the most appropriate stage to include eating disorder education. You can find the results of the scoping review on the NEDC website.
Currently, in collaboration with academics from various professional groups, we are developing a range of resources to support the teaching of eating disorder identification and ED Safe care within the tertiary system. These resources are designed to assist and enhance the work of educators already teaching eating disorder content.
This initiative is part of a broader strategy to map a competency development and implementation plan that supports academics and universities in integrating eating disorder education. For psychology, the primary focus will be on undergraduate studies, with postgraduate studies addressed further down the track. If you are working within a university and would like to speak with NEDC about levers for increasing eating disorder content and learning activities within the postgraduate program, please reach out to us.
EDC has a strong and longstanding relationship with the Australian Institute of Sport (AIS). This collaboration has included AIS representation in the development of the National Eating Disorder Strategy and the creation of a position statement on disordered eating and high-performance sport (2020). AIS continues to focus on rolling out this work across the national high-performance sport system.
In addition, NEDC, in collaboration with The Australian Ballet, has published guidelines for responding to body image concerns, disordered eating, and prevention of eating disorders in dance.
We also acknowledge the valuable work done by the Butterfly Foundation and Embrace Collective and other independent health professionals in this space.
We recognise the flow-on effect from elite-level sport to club-level settings and the emerging opportunities to enhance positive messaging and eating disorder prevention at all levels.
NEDC is focusing on different phases of workforce development which is set out in a longer term workforce development strategy. Currently, we are working to develop tools and resources to support the implementation of the Eating Disorder Safe principles in healthcare settings, and supporting broad workforces to identify and respond to eating disorders early via various professional development activities. While the eating disorder sector has a highly skilled treatment workforce, a key gap lies in identifying and supporting people to access an initial response and prevent harm in everyday interactions.
Via the tertiary project, we are helping to ensure that clinicians and practitioners across health professions access the foundational information and learning activities that support them to prevent, identify and respond, and for those interested in becoming treatment providers understand the pathways available to do so.
This year, NEDC is developing a Workforce and Professional Development Hub to help individuals across relevant discipline groups access training at any level of the stepped system of care. The Hub will be targeted towards GPs, mental health professionals, and dietitians, with plans to expand into other health and community professions over time.
The Eating Disorders in Tertiary Education project recognises the importance of ongoing professional development to complement formal education. This aligns with ANZAED credentialing pathways and professional development standards, ensuring that learning continues beyond tertiary studies.
By integrating professional development opportunities, we support graduates and professionals in building their skills and confidence in eating disorder identification, early intervention, and treatment throughout their careers.
Suggested articles include:
Ivancic, L., Maguire, S., Miskovic-Wheatley, J., Harrison, C., & Nassar, N. (2021). Prevalence and management of people with eating disorders presenting to primary care: a national study. Australian & New Zealand Journal of Psychiatry, 55(11), 1089-1100. Available here: https://journals.sagepub.com/doi/abs/10.1177/0004867421998752
Rowe, E. (2017). Early detection of eating disorders in general practice. Australian Family Physician, 46(11), 833–838. Available here: https://www.racgp.org.au/afp/2017/november/early-detection-of-eating-disorders
You can also refer to NEDCs professional resources for GPs.
The National Eating Disorder Clinical Guidelines are being developed in alignment with the NHMRC Guideline Standards. This means that they will be informed by a breadth of expertise, including regional and rural considerations.
Through its dedicated PHN work stream, NEDC engages with all 31 PHNs across Australia. NEDC also works in partnership with four geographically diverse PHN regions as part of the Right Care Right Place project. Insights from Right Care Right Place and NEDC's broader PHN engagement will inform the development of the Clinical Guidelines, alongside additional consultation processes.
Yes, the National Strategy identifies Psychosocial and Recovery Support as a key component of the stepped system of care, which includes peer support services. The National Strategy calls for greater access to Psychosocial and Recovery Support services, and outlines a number of actions required to achieve this. For more information, refer to https://nedc.com.au/national-strategy/psychosocialrecovery.
An evaluation of the Eating Disorders Medicare Benefit Schedule Items commissioned by the Australian Government was released in 2024.The Australian Government is considering the findings from this evaluation. While the MBS items are an important mechanism for improving access to care, another important mechanism for ensuring affordable access to treatment is the strengthening of the public mental health system to respond to eating disorders. NEDC and other eating disorder organisations are working to ensure that eating disorders are core business among state and federally-funded mental health services, such as Child and Adolescent Mental Health Services, Adult Mental Health Services, headspace, and Medicare Mental Health Centres.
The InsideOut Institute have developed a Practice Management Toolkit which includes care plan templates, quality improvement projects, screeners to import into practice software and links to InsideOut resources.
