Eating disorders are serious psychological conditions, which frequently have severe medical consequences. People experiencing eating disorders will need to access both mental health care and physical (acute) health care services for assessment and treatment.
ALERT:
Patients at high physical risk should be directed to a local emergency department for assessment for medical admission for urgent medical stabilisation and nutritional rehabilitation.
Within the four tiers of the system of care (see HERE) there are a range of service types that people with eating disorders and their families generally access, influenced by the person’s age, severity of illness, location and financial situation/preferences. Services across Victoria vary, however people with a suspected eating disorder should be referred / arrange to see to their General Practitioner for an initial assessment of their physical and mental health risk and planning the required treatment and support plan. This could include mental and physical health services from the public, community and/or private sectors. Access to other public services including specialist eating disorder treatment services, acute and outpatient medical and mental health care are through local intake processes.
Public Sector Services
Funded by Government, there are a range of public sector services that people with eating disorders and their families may have contact with (see Victorian Government)
These services can include:
Mental health services:
Public specialist mental health services assess and treat people with severe and complex mental health problems and disorders, including eating disorders.
Victoria’s state-funded general health and specialist mental health services are integral to meeting the range of medical and mental health needs of people with eating disorders.
- Child and Adolescent Mental Health Services (CAMHS) and Child and Youth Mental Health Services (CYMHS)
For people up to the age of 18 years (up to 18 in CAMHS, 25 in CYMHS), these services:
- receive enquiries and referrals from general practitioners, paediatricians, teachers and sometimes parents and young people themselves
- undertake assessment, treatment, management and referral
- provide individual, group and family-based interventions via community-based programs and inpatient services
- deliver consultation and liaison services to some acute hospital paediatric/medical units
- support promotion and early intervention activities.
Children and adolescents who need medical stabilisation should be admitted to an acute hospital paediatric/medical facility.
If all avenues to deliver community-based treatment and paediatric medical inpatient treatment are exhausted, the young person may be admitted to an inpatient mental health service.
- Adult Mental Health Services
Adults with moderate to severe eating disorders receive crisis intervention as well as continuing care from area mental health providers through their triage and referral systems.
Adult mental health services deliver responses including:
- community and inpatient treatment
- crisis assessment and treatment
- consultation and liaison
- continuing care
- mobile support and treatment
- inpatient services.
All avenues for community-based treatment, tertiary eating disorder services and medical inpatient treatment should be explored before a person is admitted to an adult acute inpatient service.
Adult acute mental health inpatient units do not necessarily provide medical stabilisation. This requires close collaboration with acute medical units.
People who need medical stabilisation should be admitted to acute hospital medical inpatient treatment.
The health.vic.gov.au website provides a guide to Area Mental Health Services (AMHS) and contact / triage service details. Contact local mental health triage to discuss mental health crisis referral and support and community mental health treatment services.
Area Mental Health Services are regionalised in Victoria. Consult the Area Mental Health Service maps to determine your public mental health catchment area.
Medical services:
General practitioners and paediatricians provide local medical monitoring and support. People may present to general health services with a range of physical health complications as well as depression and anxiety. Primary care and local health services (general health and specialist mental health) respond to health and mental health concerns that commonly co-occur with eating disorders. For example, general practitioners are often an easily accessible, pivotal point of continuous contact for someone with an eating disorder. People may return to their general practitioner for reviews, mental health plans and referral to specialists.
Further, local responses to people’s acute, subacute and continuing care needs can also be addressed through emergency and crisis responses and case management services provided by local general health and mental health services. Mental health community support services are part of Victoria’s state-funded specialist mental health service system.
Eating disorders specialist services:
Specialist child and adolescent eating disorders services are provided for young people aged up to 18 years by Royal Children’s Hospital, Austin Health and Monash Health.
Each service is staffed by experienced and trained clinicians and co-located paediatricians and is committed to providing evidence-based treatment for eating disorders, including family-based treatment.
There are three acute hospitals in Victoria who provide specialist adult eating disorder services for people 16 years and over who cannot be managed by area mental health services.
- The Royal Melbourne Hospital accepts people from central, north-west and western metropolitan Melbourne and the western regions of the state.
- Monash Medical Centre accepts people from southern metropolitan Melbourne and south-east regional Victoria.
- The Austin Hospital accepts people from the eastern and north-eastern suburbs of metropolitan Melbourne and the north-east regions of the state.
These services include onsite medical expertise and offer inpatient, day-program and outpatient services to people critically affected by eating disorders.
Community Health Services
Primary care is often the first point of contact people have with the health system. Many also provide services funded by the Commonwealth and other sources. Victoria’s network of community health services deliver a range of primary health, human services and community-based support to meet local community needs. Community health services provide universal access to services as well as targeted services for vulnerable population groups. They sit alongside general practice and privately funded services to make up the primary health sector in Victoria. Some are also major providers of a range of health and human services including drug and alcohol, disability, dental, post-acute care, home and community care, mental health services and community rehabilitation.
Consult the Victorian Government’s Community Health Service Directory for more information.
Private Sector Services
There is a wide range of inpatient and community services available to people with eating disorders and their families that will result in financial costs to them. Rebates from private health insurance or Medicare schemes can assist to cover costs but may incur an excess payment and tend to be capped by cost or number of sessions. Alternatively people and their families can fund these services privately.
Further information on the mental and physical health, and eating disorders specialist services in the public, community and private sectors available to people with eating disorders is provided on pages dedicated to the following age ranges:
- Children and Adolescents under 18 years
- Young adults between 18 – 25 years
- Adults over 25 years