Recently, the Andrews government announced a much-needed additional $2 million in funding to support Victorians with eating disorders.
Eating disorders, such as anorexia nervosa, are not only distressing and sometimes disabling, but have the highest mortality rate of any mental illness. The risk of death due to physical causes of anorexia nervosa is about five times higher than the general population, while the risk of suicide is 32 times higher.
The risk of death due to physical causes of anorexia nervosa is about five times higher than the general population.Credit:Sylvia Liber
Eating disorders can arise in children as young as 10, with a spike occurring in adolescence, impacting on the psychological, social, educational and vocational development and attainment during the formative years in a young person’s life. The impact on the young person, their family, friends and community can be immense and lifelong.
Unfortunately, estimates suggest that eating disorder presentations have increased by as much as 25-50 per cent since the beginning of the COVID-19 pandemic, with calls to the Butterfly Foundation’s national eating disorder helpline increasing by 43 per cent when compared with the same timeframe in 2019.
This new funding is therefore welcome and includes $500,000 to support the work of Eating Disorders Victoria and a further $1.5 million to be invested across six metropolitan health services.
What has been overlooked is the tyranny of distance for young people living in rural and regional areas.Credit:Louie Douvis
While this funding is necessary to support mental health services for many patients and their families, what has been overlooked is the tyranny of distance for young people living in rural and regional areas. The availability of child and adolescent inpatient services and specialist eating disorder services outside metropolitan Melbourne is scarce – and in many regions in Victoria it is non-existent.
To access sometimes life-saving mental health care, young rural and regional people are frequently expected to travel long distances from their homes and support networks.
When this is not an option, all too often our young rural and regional kids simply don’t get the help that they need. This experience is outlined by the findings of the recent Victorian Student Health and Wellbeing Survey, in which 63 per cent of students from rural and regional areas reported being unable to access mental health services when they needed them.
As a result, rural and regional young people rely heavily on access to general practitioners for mental health support – a workforce that faces similar challenges with underfunding and under-resourcing across the state. The Royal Commission into Victoria’s Mental Health System noted that the decreasing numbers of rural and regional GPs in Victoria was concerning, given the central role that GPs currently play in supporting patients with complex mental illness in lieu of access to specialist mental health services.
Sixty-three per cent of students from rural and regional areas reported being unable to access mental health services when they needed them.Credit:iStock
In Victoria, out of sight is seemingly out of mind when it comes to investing in the mental health of rural communities.
As such, it is critical that we improve access to mental health services for young people in rural and regional Victoria. The 1 in 4 Victorians who live outside Melbourne deserve equity of access to mental health care – and equity in health economic investment.
Prioritising funding, decentralising access to specialist mental health services, and enhancing innovative models of mental health care in the regions is a health system imperative.
Importantly, mental health care is not technology dependent. It is not chained to the infrastructure of large tertiary centres. The COVID-19 pandemic has demonstrated the vulnerabilities of centralised systems of healthcare, and mental health by nature requires the inclusion of a person’s support networks, families, friends and community in the recovery journey.
Local access to services should be the norm, not the exception.
And while it might be costly to establish, we don’t really have any choice. Young rural and regional Victorians are currently being asked to pay the price.
Butterfly Foundation 1800 33 4673; Lifeline 131 114.
Dr Skye Kinder is a psychiatry registrar and Vice President of the Rural Doctors Association of Victoria. She was the VIC Young Australian of the Year in 2019. Twitter: @skyekinder
Associate Professor Mathew Coleman is a consultant child and adolescent psychiatrist and clinical academic in rural and remote mental health practice for the University of Western Australia. The views represented in this article are his own.
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