Eating disorder treatment options in Dubbo

When she was 13 and - together with her parents - first sought help for her eating disorder, she hit roadblock after roadblock in her hometown of Young, in the South West Slopes, and her GP had to fight to find the specialised treatment she needed.

Ellie, now 20 and still living in Young, says her story isn't limited to the area she lives in, but likely exists in various regional towns in the state as the health system struggles to offer sufficient treatment pathways for people living with eating disorders outside our major cities.

READ ALSO: I felt like a freak: Teen's struggle to find anorexia treatment

Ellie's partner grew up in Dubbo and Ellie visited the central west town a lot as a teenager, but she didn't find help there, either - she had to travel to Orange and Sydney.

"We had to fight a lot with overheads to get me into a psychologist, and get me into proper help because we're from a small town and there's only so much that a small town doctor can say and do in a sense," Ellie told the Daily Liberal.

"My sister also struggled with other mental health issues and getting into psychologists and psychiatrists was an absolute nightmare."

Ellie began her treatment as an outpatient with Westmead Children's Hospital, working with a child psychologist. Her condition worsened and she was admitted to Westmead through the emergency department while she was on a family holiday.

She worked as an inpatient and then was discharged and worked with the Butterfly Foundation and a dietician in Orange.

During this time, she came across some "not very good" psychologists in Young who she doesn't believe had sufficient training or experience in treating eating disorders.

READ ALSO: Pandemic 'perfect storm' for eating disorders to thrive: expert

She found a local dietician she liked but after the specialist left to go on maternity leave, Ellie was teamed-up with "some not so great psychologists and dieticians" instead.

Ellie's story is a familiar one of inconsistency of specialised care for people living with an eating disorder in the regions, and comes only days after Liam Manning shared his story about feeling "like a freak" when he sought help for an eating disorder as a teenager growing up in Dubbo.

Liam finally accessed the help he needed in Sydney, after Dubbo clinicians failed to diagnose his anorexia nervosa for seven years.

Ellie is calling for "a whole reform within the medical side of things" - an overhaul of the health system so people with eating disorders in the regions have better access to care that's local to them, and at an affordable price.

"There needs to be ... some form of subsidies in place for everyone," she told the Daily Liberal.

"My parents had to fight for a while to get me under the eating disorder plan with Medicare and spent a lot of money to get me well."

NSW Health told the Daily Liberal treatment for eating disorders is a joint responsibility between healthcare providers, however they did not acknowledge there was a problem with the amount of eating disorder treatment available for individuals in Dubbo.

The health district works under the NSW Service Plan for People with Eating Disorders 2021-2025, which is a relatively new framework for providing care along with support to navigate pathways for patients, their families, and carers.

InsideOut Institute for Eating Disorders, on its website, describes the NSW Service Plan as requring "a whole of health reform, driven centrally and implemented locally, to prepare and equip the NSW Health system to identify, provide access to, and treat people with eating disorders".

The plan is focused on strengthening inpatient and community pathways, building workforce capacity and working with public and private health partners to better identify and treat eating disorders.

READ ALSO: Dietitian sees rise in eating disorders since COVID, and why she's not surprised

"Eating disorders are complex, serious mental illnesses that can cost lives. Western NSW Local Health District (WNSWLHD) is fully committed to ensuring people living with or at risk of developing eating disorders can access high-quality, safe care as close to home as possible," a WNSWLHD spokesperson said.

They said treatment for eating disorders is a whole-of-healthcare responsibility and the district's teams work with public and private partners, including GPs, "to ensure no matter where a person enters the health system they are identified and provided the best care possible."

The WNSWLHD spokesperson said: "Across the District, including at Dubbo, people living with or at risk of developing eating disorders can access comprehensive assessment and evidence-based medical, psychological, and nutritional treatment in both hospital and community settings."

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The District's has a dedicated Eating Disorder Coordinator who provides guidance and support for local treating teams and carers to help navigate care pathways, assisting them to access assessment and treatment locally.

In 2021, an Eating Disorder Clinician was employed in the District to provide psychoeducation to carers, meal support to people in the community and in hospital and co-therapy with LHD clinicians, reducing the need for people to travel for vital assessment and care.

"There are also a range of private services for both assessment and treatment available, including psychologists, dieticians and psychiatrists. The InsideOut Institute and National Eating Disorders Collaboration have resources available to identify clinicians who are trained in these processes on their websites," the spokesperson said.

"Western NSW Local Health District has been actively engaged in a range of research projects including the Family Based Therapy Telehealth Project and the Binge Eating eTherapy online research program. The District will maintain involvement in all relevant research to continue improving services and access to care."

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