The complexity of eating disordersBefore continuing, please be aware that the thoughts below may be difficult for some to read. If you need support or are impacted by this content, please connect with Butterfly’s National Helpline on 1800 ED HOPE (1800 33 4673), chat online or email support@butterfly.org.au. For =
urgent/crisis support, contact Lifeline on 13 11 14 or 000 in an emergency. I accepted the invitation from Mental Health Australia to write this week’s Blog after watching the ABC Four Corners documentary on eating disorders ‘Fading Away’. I was mindful that the focus of the program would include people with anorexia nervosa and possibly invalidate the experience of the broader community living with other pernicious eating disorders such as bulimia and binge eating disorder. I was also conscious of some of the dedicated health professionals burning the candle at both ends either desperately trying to meet the increasing demand for access to treatment or holding people safely in the community until they can receive appropriate care. I recognise the purpose of the program was to highlight the critical increase of eating disorder diagnoses, which are still significantly misunderstood and stigmatised. A 45-minute program is a big ask to fully capture the complexity and underlying causes of eating disorders which are often deeply entrenched, causing significant harm to the individual, physically and mentally. As someone embracing a full life in recovery after three decades with a severe and enduring eating disorder, the program hit close to home. It is fundamental that people with complex mental health challenges such as eating disorders receive quality evidence- and experienced-based care. I strongly feel that to meet a contemporary understanding of person-centred and multi-disciplinary care, we need to make a commitment to understand and consider the diverse and unique needs of people and their circumstances. Many in our community experience co-occurring needs, be it an eating disorder, mental illness/distress, disability, suicidality, psychosocial needs - or all the above. The system is still significantly fragmented yet what we need are multi-disciplinary teams that include a diverse range of skilled professionals working together to meet the demand, rather than working in silos. The key to effectively practice person-centred care is to consider ALL of the person; their supports, environment, and the impact of distress in their lives. We know early intervention will profoundly change the trajectory for many at onset of a diagnosis, but care can’t be dissuaded for those with chronic and enduring issues. People deserve continuity of care, with a clearly defined and transparent care plan with support to the community. I cringe when I still hear people defined as ‘challenging’, ‘complex’ or ‘treatment resistant’ due to lack of progress. These ignominious terms are unwarranted when we know all too well that people aren’t ‘complicated’, or ‘treatment-resistant’, it’s their circumstances that influence their outcomes in treatment, which are often related to a lack of early interventions or receiving inappropriate care. Should this not give us more reason to hold hope for people, rather than turning them and their families away. With all we’ve learned, I believe we can collectively determine better ways to capacity-build a broad, diverse, and skilled multi-disciplinary workforce. After all, if done well, we can ultimately give people a chance to stay out of hospital. It’s devastating to know people are losing hope when we know that people can and do heal and live a quality of life beyond their diagnosis. I would never have fought to be where I am now, if I didn’t firmly believe we can provide better care for people in our community. Shannon E. Calvert
Lived Experience Educator & Advisor
Consumer Co-chair of the National Mental Health Consumer Carer Forum (NMHCCF) | 
