The Chronicle Herald (Provincial)
Dying for help with eating disorders
Atlantic Canada’s bottleneck for in-patient treatment intolerable
It was hard to recognize my behaviour as an illness at first — our society applauds restrictive eating under the disguise of “health,” but condemns anorexia as vanity. And it was anorexia that I was experiencing.
Seven months. I survived seven months with Canada’s most deadly mental illness before receiving treatment in Nova Scotia. My story is not unique.
It was my second year of university and classes had just begun. I was quickly overwhelmed by the transition and was desperate to regain some control. That translated to controlling my body — how many calories I consumed, how much weight I could lose, and how far I could physically push myself. The illness crept into my life so stealthily that within mere weeks, my disordered thoughts and actions had become routine.
It was hard to recognize my behaviour as an illness at first — our society applauds restrictive eating under the disguise of “health,” but condemns anorexia as vanity. And it was anorexia that I was experiencing.
Unfortunately, mental health continues to take a backseat to physical health; and societal, as well as institutional, stigma encourage this disconnect.
Eating disorders (EDS), classified by a consistent pattern of unhealthy attitudes and behaviour towards food, are more fatal than any other psychiatric disorder, killing more than 10 per cent of individuals who struggle long-term. Disordered eating behaviours can quickly compromise one’s health, regardless of body mass index (BMI) or weight, through comorbidities including dehydration, low bone density, and heart complications. With early intervention, EDS are treatable and recovery is possible. Unfortunately, said treatment is hard to come by across the country, even more so in the Atlantic provinces.
Upwards of three per cent of Canadians meet the diagnostic criteria for an ED at any given time, according to Statistics Canada’s latest data from over a decade ago. Experts suggest these numbers have increased dramatically since then; patients are now younger, conditions are more critical, and treatment resources are being stretched thin, particularly since the beginning of the pandemic. Eating Disorders Nova Scotia (EDNS), a non-profit organization dedicated to offering accessible ED support, recently reported a 400 per cent increase in demand for their services over the past year.
Through dietitian services, peer support, and online chats, EDNS has continued to make incredible strides in access to ED support. However, this type of organization is not equipped to treat clients requiring medical care at no fault of their own. In fact, the Nova Scotia Health Authority (NSHA) Eating Disorder Clinic suggests that patients with a BMI under 18 be admitted to in-patient treatment, due to cognitive dysfunction and ineffectiveness of outpatient/community care below that range.
From my own experience, I know this to be true. At my worst, no amount of group discussion, meal planning, or journaling would have stopped starvation from taking my life. But when I turned to in-patient treatment, it was not available to me either. Upon referral to in-patient treatment, I was given an estimated wait time of at least two months. When I finally did receive treatment, it saved my life. Sadly, many Nova Scotians with EDS will never get so lucky.
In all of Atlantic Canada, there is one adult inpatient treatment program — the NSHA ED Clinic located at the QE II Abbie J. Lane Memorial Building in Halifax. Within the clinic, there is capacity for three patients at a time; never more and certainly never less.
Wait times for clinical ED treatment in Canada range anywhere from four weeks to 24 months. With referrals from each respective Atlantic province nearly doubling every decade, the NSHA ED Clinic is likely receiving four times the number of referrals than it was over 30 years ago at its establishment. Meanwhile, the number of in-patient beds remains stagnant at three. This not only increases the risk of death in patients awaiting treatment, it also supports a stigma-laden belief that only those in the most critical physical condition are worthy of treatment for their ED.
Nova Scotians deserve better than to die waiting for publicly funded treatment — treatment that they were referred to, that is their only option, that will legitimately save their life.
As a provincial election approaches, I am calling upon our electoral candidates to act in support of Nova Scotians with EDS in three ways.
First, more provincial research must be completed on EDS and their outcomes. The Status of Women Committee (2014) found that nationally, in a five-year time frame, just $7.5 million had been allocated in operations grants for ED research, while $86 million had been allocated to schizophrenia research. Meanwhile, EDS are estimated to cause up to 1,500 deaths annually across Canada, compared to about 100 due to schizophrenia.
Second, more health-care professionals must receive training relevant to the treatment of EDS. With only 70 per cent of medical doctors receiving five hours or less of training specific to ED treatment, there are simply not enough health professionals qualified to treat this mental illness.
Last, more than anything, I am begging for more in-patient spaces in the NSHA ED Clinic. Three beds were not enough 30 years ago, and they are far past insufficient today.
Until appropriate ED treatment is equitably accessible in Nova Scotia, the consequences of stigma will prevail.