Eating disorders – service providers

Victorian health services, including public and private primary and community-based services as well as specialist public mental health services, provide services to people with eating disorders.

All mental health services have policies, procedures and clinical practice to support the needs of people with eating disorders.

Different services play a role in the assessment and treatment of eating disorders at different stages of illness.

Who provides services for preventing and treating eating disorders

A large number of services, both public and private, promote healthy nutrition and body image. These include early-years services, schools and community organisations.

General practitioners and community health counselling services, school counsellors, private paediatricians, psychologists and psychiatrists provide early identification and intervention.

Specialist mental health services provide treatment for people with severe eating disorders, with input from area mental health services and child and adolescent mental health services.

Service responses for different stages of illness

People at different stages of illness require different responses.

Initial early intervention in eating disorders

This group includes people who experience significant disruption and functional impairment due to disordered eating, where primary services are unable to address their needs.

Examples

People with:

• partial syndromes causing major impairment – they may not meet full diagnostic criteria for an eating disorder, but they have a high risk of experiencing deterioration without intervention
• early onset (within three years) anorexia or bulimia nervosa.

Service response required

Child and adolescent mental health services and adult area mental health services undertake:

• assessments, treatment planning and referral
• shared care
• family-based interventions
• work with general practitioners and others to raise awareness of the assessment, treatment and support needs of people with eating disorders.

Individuals with moderate to severe eating disorders

This group includes people with a diagnosed eating disorder who have a complex combination of factors that increases their vulnerability.

They need support for their physical and psychological health as well as their psychosocial adjustment.

Examples of people with moderate eating disorders

People with:

• history of abuse, trauma, family instability or domestic violence
• comorbid mental health issues and disorders
• physical decline with compromised general health
• isolation from regular supports
• inabilty to participate in, or relinquishing of, regular activities
• risk of self-harm
• chronic and unremitting condition (over five years duration).

Examples of people with severe eating disorders

People with:

• comorbid alcohol and drug abuse or dependency
• comorbid acute mental health disorder, including personality disorder and high-prevalence mood disorders
• comorbid pre-existing physical health condition.

Service response required

Child and adolescent area mental health services deliver outpatient and inpatient treatment for children and young people under 18. This includes evidence-based family-focused interventions.

Adult area mental health services work with adults who are moderately or severely affected by eating disorders.

Critically affected people with eating disorders

This group includes people who are at grave risk to both their physical and mental health.

Examples

People with:

• severe emaciation
• rapid or life-threatening deterioration from a previous state of already compromised health
• grave risk of self-harm or suicide.

Service response required

Child and adolescent mental health services share responsibility with acute hospitals that provide paediatric medical treatment.

For adults at grave risk, tertiary specialist eating disorder services in designated hospitals deliver inpatient, day-program and outpatient services.