Letter to Health Canada on Advisory Panel on Healthcare Innovations

We still have 24 hours to add Canadian signers to this letter; please leave a comment here or on our Facebook page if you would like us to add your name (deadline noon EST 12/5/14).

Stakeholder Input on Eating Disorders

Submitted: Eating Disorders are deadly, brain-based illnesses with an unacceptably high mortality rate directly related to the lack of services.  For further insight into this, please read Eating Disorders Among Girls and Women in Canada: Report of the Standing Committee on the Status of Women which was just released.

As parents of someone with an eating disorder, the deficiencies in the Canadian health care system in this arena are painfully apparent. Of great interest it is that because the current system is run so inefficiently, more money is being spent to help people only at a late stage of the disease than would be spent if the system were run in a medically and fiscally responsible manner.

The current system, vis a vis eating disorders diagnosis and treatment is analogous to this scenario: A patient presents to a physician with a mole of irregular color and shape. The physician either doesn’t recognize that this type of mole can be dangerous or does recognize it and recommends the patient see a specialist. If the patient sees a specialist, the specialist says, “We don’t intervene this early—we will put you on a list and call you when there is a spot.” Provided the patient lives until the spot is available, the patient presents again and is told the disease is far too entrenched to treat effectively, and in any event, treatment at this stage is so costly there are very few options.

Suggested Innovation #1

·       Provide for adequate training, and continuing education of, physicians, nurses and other healthcare professionals, in the recognition and medical management of eating disorders. (This need not be a costly endeavor. The international group Academy of Eating Disorders has excellent resources on which to base a curriculum and continuing education program.) Note that the current curriculums, which provide only a few hours of training on the deadliest of all mental illnesses, are clearly insufficient.  All training and materials must reflect that eating disorders can strike any gender or age and occur across cultural, ethnic and socioeconomic lines.

Suggested Innovation #2

·       Increased access to Community-Based Partial Hospitalization Programs (PHP) and Intensive Outpatient Programs (IOP).  It is indisputable that early detection and intervention are key factors in the ability for someone to make a full recovery from eating disorders. Beginning treatment immediately upon early diagnosis also increases the likelihood that expensive inpatient and residential programs will be avoided.

Suggested Innovation #3

·       Pursue evidence-based treatments for PHP, IOP and Residential Options. This will acknowledge that in most situations inclusion of families is a key factor for recovery. Family Based Treatment (FBT) is the top choice for adolescents with anorexia nervosa and Cognitive Behavioral Therapies (CBT) are indicated for bulimia nervosa and adults with anorexia nervosa. Given the persistence of, and resistance to treatment in, eating disorders, all programs should provide education for Carers on how to support recovery outside the medical environment; again this is important both from a medical and cost perspective. The Families Empowered and Supporting Eating Disorder treatment (F.E.A.S.T.)  site contains the latest research and citations on treatment protocols.

Suggest Innovation #4

·       Pursue the use of technology in providing services to those in remote locations and for follow up after more intensive treatment—including platforms similar to Skype and phone applications like Recovery Record.

Suggested Innovation #5

·       As the above innovations will take time to develop, increase funding and streamline processes for sending patients to the United States for treatment if a residential option is the only suitable one (as is the case for many at this point as the system has never properly functioned). While this may seem like a high initial cost, it must be noted that the very expensive physical complications of an untreated eating disorder are costing, and will continue to cost exorbitant amounts of money that far exceed that spent on treatment for an eating disorder.