People with eating disorders and medical experts are speaking out about a “horrific” lack of public hospital beds and other support services available in Australia.
There are only 25 public hospital beds for eating disorders across the country: five in New South Wales, six in South Australia, nine in Queensland, 14 in Victoria and none at all in Tasmania, the Northern Territory or Western Australia.
It estimated more than 1,800 people died from complications associated with eating disorders in 2012.
Tara Powell has anorexia nervosa and is fed via a nasal gastric tube.
“We need programs and hospitals and more training as soon as possible. Because people do die and are dying from an illness that’s really treatable,” she said.
Ms Powell was diagnosed at 13 after her school realised she just had not been eating for some time and she was rushed to hospital.
Since then the 24-year-old from the New South Wales Illawarra region has been admitted to hospital about 30 times.
But things became particularly bad three years ago.
“I was just on this downward spiral of not eating and exercising and I ended up in my local hospital emergency department,” Ms Powell said.
“I was so terribly unwell that they didn’t know what to do with me. And so they called every hospital in the state and spent hours trying to find a bed.”
Ms Powell did not have top-level private health cover, so her parents had to pay up front – $3,500 per week.
Her father, Ken Powell, has terminal cancer and could not afford his daughter’s hospital bills.
Patients put in locked psychiatric wards
There are only five public hospital beds for eating disorders in New South Wales but after desperate lobbying, Mr Powell managed to secure one at Sydney’s RPA Public Hospital.
It was a decision he bitterly regrets. RPA’s eating disorder beds are in the hospital’s locked, unisex, psychiatric ward.
“I took Tara there on the first day. And I was a little bit shocked. And I’m thinking ‘Hmm, I’m not so sure about this place’,” Mr Powell said.
“And each visit thereafter we saw that Tara wasn’t getting better, there was no program… and it was quite apparent that there was nobody there who knew how to treat a patient with an eating disorder.”
Ms Powell says she lost weight while in the ward.
“I thought that living with anorexia was a nightmare. But living with anorexia while living in RPA was just unbelievable,” she said.
She says no-one supervised her eating and she stayed in her room, terrified of the male psychiatric patients who roamed the ward.
“A lot of the time I just did what the anorexia told me to do,” she said.
“I’d spend hours exercising, to the point where I had sores all down my spine on my bottom from just hours and hours of exercising.”
Mr Powell says he found her lying on her bed at RPA in a semi-conscious state.
He felt he had to get her into a private hospital. By now he had got top level health cover, but it would take six months to come into effect.
A friend offered him a no-interest personal loan, but to pay back that personal loan Mr Powell had to take a second mortgage on his house.
One of the private hospitals Ms Powell attended has closed its eating disorder program. This week Ms Powell’s healthcare provider sent a letter announcing it had ended its arrangement with a second.
Hospital says eating disorders ‘tough’ to treat
The New South Wales Government has announced it will increase its beds from five to nine. The four new beds are at RPA Hospital.
Susan Hart from RPA Hospital says eating disorders are tough to treat.
“I think there’s a lot of challenges in terms of how things are managed in terms of the re-nutrition. It is really difficult,” Dr Hart said.
“We have got specialist services here at RPA and we’ve got a range of them – from the inpatient beds, we have a comprehensive day patient program and we’ve got outpatient services.
“So we do aim to, you know, provide specialist services and meet people as per their clinical need here at RPA.”
Cassie, who doesn’t want to use her surname, lives in Perth and has just come out of a second stay at Fremantle Hospital after her weight plummeted to under 35 kilograms.
There are no public eating-disorder beds in WA, so she was admitted to the locked psychiatric ward.
“I think it’s just appalling that the only option in the public health system is a general psychiatric ward, where they don’t address the psychological issues related to an eating disorder and they don’t have specific programs,” she said.
Cassie says she sustained injuries after she was restrained by hospital staff.
“I asked them ‘What if I agree to eat?’, and they said that it’s not negotiable. And because having a nasogastric tubing is very painful, and I didn’t want to lose that control and didn’t want to have it in, I tried to run out of the hospital ward,” she said.
Psychologist shocked by lack of patient support
Psychologist Sarah McMahon specialises in eating disorders and says she is “constantly shocked” by lack of services available.
“The reality is that we live in a country like Australia which leads the world when it comes to public health and medical interventions,” she said.
“So for a problem like anorexia, which is very common, and bulimia, which is even more common – to not have access to treatment is phenomenal.”
Ms McMahon is based in Sydney, but sees interstate clients via Skype because of the dearth of services. She has often tried to help them get into hospital beds.
“We have a horrific situation in Australia with a whole cluster of people who can’t access treatment,” she said.
“On one hand, private hospitals are limited in what they can offer and that means that people who have a very low body weight or if they have more problems than just an eating disorder, they won’t be admitted to a private hospital.
“On the other hand, the public system will only accept the very, very sickest simply because they’re so poorly resourced.”
This article first appeared on ‘ABC‘ on 6 February 2014.