As anorexia nervosa rates continue to climb, eating disorder experts are examining the efficiency and availability of treatment options in Australia's health system.
Increased demand for more services creates the need for smarter tailored service provision, says Flinders University Distinguished Professor of Psychology Tracey Wade, and this highlights the value of a South Australian 'Day Program' format which gives intensive daily treatment but no overnight admission treatments.
Accessible and targeted professional mental health and welfare services for eating disorders are vital as community prevalence of anorexia nervosa has been steadily rising over the past two decades.
Australian Institute of Health and Welfare data shows a significant increase in overnight hospital admissions for anorexia nervosa in young Australian females (aged 15-29) over the past two decades, but a separate study in Australasian Psychiatry indicates this is not reflected in mortality rates and community incidence.
"The good news is that mortality rates and average hospital inpatient length of stay for anorexia nervosa declined during the study period," says Flinders University psychiatry researcher Dr Stephen Allison, a co-author in the study and affiliated with the Consortium of Australian-Academic Psychiatrists for Independent Policy Research and Analysis (CAPIPRA).
Professor Wade, co-author of another study in Nutrients, says improving the quality of targeted services is more important than providing more general services for these conditions and other eating disorders.
A new study of 56 patients using the Statewide Eating Disorder Service in Adelaide, SA assessed whether meal options for a streamlined day program provide adequate support and incentives for young women (average age 25) to self-manage disordered eating conditions including anorexia nervosa and bulimia nervosa.
The study tentatively concludes that a moderate decrease in costs but increasing opportunities for patient autonomy did not negatively impact outcomes.
"Both for hospital, partial hospital day programs and other treatments, we must continue to monitor clinical outcomes, as well as any additional disadvantage to patients including food for meals, staffing levels and patient care," says Professor Wade, director of the Órama Institute for Mental Health and Well-Being and the Blackbird Initiative at Flinders University.
The Matthew Flinders Distinguished Professor of Psychology has been instrumental in setting up the SA Day Program and is a credentialed eating disorder clinician.
The researchers recommended further research on a larger cohort of patients to identify the best formats for specific groups of eating disorders.
In South Australia, a purpose-built $7.1 facility is being built for the Statewide Eating Disorder Services to provide expanded non-residential and residential day support for people living with anorexia nervosa, bulimia nervosa and other specific eating disorders.
Located at The Repat Health Precinct, the new centre will provide evidence-based treatment for eating disorders and support Flinders University research in a community-based setting, rather than a medical or hospital setting.
The article, 'Eating Disorder Day Programs: Is There a Best Format?' (2022) by Ertimiss Eshkevari, Isabella Ferraro, Andrew McGregor and Tracey Wade has been published in Nutrients DOI: 10.3390/nu14040879.
Also, 'Increasing hospital admission rates for anorexia nervosa amongst young women in Australia from 1998 to 2018' (February 2022) by Martin Nguyen, Stephen Allison, Jeffrey CL Looi and Tarun Bastiampillai published in Australasian Psychiatry (RANZCP) DOI: 10.1177/10398562221077890
