Eating disorders – clinical services

Public specialist mental health services assess and treat people with severe and complex mental health problems and disorders, including eating disorders.

Victoria’s state-funded general health and specialist mental health services are integral to meeting the range of medical and mental health needs of people with eating disorders.

General health services

General practitioners and paediatricians provide local medical monitoring and support. People may present to general health services with a range of physical health complications as well as depression and anxiety.

Primary care and local health services (general health and specialist mental health) respond to health and mental health concerns that commonly co-occur with eating disorders.

For example, general practitioners are often an easily accessible, pivotal point of continuous contact for someone with an eating disorder.

People may return to their general practitioner for reviews, mental health plans and referral to specialists.

Further, local responses to people’s acute, subacute and continuing care needs can also be addressed through emergency and crisis responses and case management services provided by local general health and mental health services.

Mental health community support services are part of Victoria’s state-funded specialist mental health service system.

Key features of the newly commissioned mental health community support services in Victoria include reorganised intake processes, individualised packages of support and developmentally informed models of care in youth residential rehabilitation services.

A new planning function for mental health community support services will support responses to locally identified needs in each region.

There is an opportunity over time to assist these services to identify and respond to complex mental health conditions with co-occurring physical health issues like those that are present in people with eating disorders.

Child and adolescent mental health services

For people up to the age of 18 years, these services:

• receive enquiries and referrals from general practitioners, paediatricians, teachers and sometimes parents and young people themselves
• undertake assessment, treatment, management and referral
• provide individual, group and family-based interventions via community-based programs and inpatient services
• deliver consultation and liaison services to some acute hospital paediatric/medical units
• support promotion and early intervention activities.

Children and adolescents who need medical stabilisation should be admitted to an acute hospital paediatric/medical facility.

If all avenues to deliver community-based treatment and paediatric medical inpatient treatment are exhausted, the young person may be admitted to an inpatient mental health service.

Adult mental health services

Adults with moderate to severe eating disorders receive crisis intervention as well as continuing care from area mental health providers through their triage and referral systems.

Adult mental health services deliver responses including:

• community and inpatient treatment
• crisis assessment and treatment
• consultation and liaison
• continuing care
• mobile support and treatment
• inpatient services.

All avenues for community-based treatment, tertiary eating disorder services and medical inpatient treatment should be explored before a person is admitted to an adult acute inpatient service.

Adult acute mental health inpatient units do not necessarily provide medical stabilisation. This requires close collaboration with acute medical units.

People who need medical stabilisation should be admitted to acute hospital medical inpatient treatment.

Tertiary specialist eating disorder services

Three acute hospitals in Victoria provide specialist adult eating disorder services for people 16 years and over who cannot be managed by area mental health services.

Specialist child and adolescent eating disorders services are provided for young people aged up to 18 years by Royal Children’s Hospital, Austin Health and Monash Health.

Each service is staffed by experienced and trained clinicians and co-located paediatricians and is committed to providing evidence-based treatment for eating disorders, including family-based treatment.

These services include onsite medical expertise and offer inpatient, day-program and outpatient services to people critically affected by eating disorders.

The Royal Melbourne Hospital accepts people from central, north-west and western metropolitan Melbourne and the western regions of the state.

Monash Medical Centre accepts people from southern metropolitan Melbourne and south-east regional Victoria.

The Austin Hospital accepts people from the eastern and north-eastern suburbs of metropolitan Melbourne and the north-east regions of the state.

Other services

Southern Health Butterfly Day Program

This is a specialised eating disorders day program for young people aged 12–24 years.

It provides psychiatric, paediatric and dietary expertise in a three-month group program for 10 to 12 young people at a time.

Young people who are within the target group and live in the southern metropolitan region of Melbourne can access the program.

Centre of Excellence in Eating Disorders

The Victorian Centre of Excellence in Eating Disorders (CEED) is a statewide service that provides leadership and support to public mental health services and their programs.

It develops strategies to build quality, sustainable eating disorder treatment delivered by public specialist mental health services.

CEED also:

• assists mental health services in assessment, treatment planning and management of people with eating disorders
• conducts training programs for mental health service staff
• engages with services to determine the types of resources and training to best meet AMHS requirements.

Eating Disorders Victoria

Eating Disorders Victoria (EDV) is a non-clinical statewide non-profit organisation funded by the Victorian Government.

It supports people whose lives are affected by anorexia and bulimia nervosa and other eating disorders and seeks to better inform the community about these disorders. The EDV helpline team provides phone and email-based helplines and drop-in support during the week.

It provides support and information services including a referral list of eating disorder treatment options and other relevant services available in Victoria.