Monique Ryan (Kooyong, Independent) Share this | Hansard source

While the COVID-19 pandemic has affected the population's mental health globally, it has had a particularly severe affect on people—especially children—who are at risk of eating disorders. All available studies in Australia, Europe and North America have identified a marked increase in the incidence and severity of disordered eating conditions since the start of the COVID-19 pandemic. Although data is limited, health professionals in Victoria, as my colleague from Goldstein has mentioned, have estimated that as many as one in nine adolescents have disordered eating or a diagnosable eating disorder. Unfortunately, because of the limited funding for research within this area of mental health, we can't be entirely sure how pervasive this problem really is.

The elements contributing to the development of an eating disorder are complex. Exposure to social media from a young age, with peer pressure to conform to unrealistic ideals of thinness and appearance, have increased the prevalence of disordered eating and the resulting eating disorders. While these were on the rise before COVID, the pandemic has made these things much, much worse. Why? It's a combination of things: social isolation, disrupted routines, family stress, interruption of sport and recreational activities, food insecurity, fear of contagion, and increased use of screens for school and for social interactions. Those most at risk are children and adolescents who are entering social and biological transition periods—typically, those aged 12 to 17. Females are more commonly affected than males, but boys are also at risk—in fact, increasingly so.

Our children are victims of unrealistic images to which they're exposed on social and mainstream media, and sometimes in vicious peer comparisons. This risk is exacerbated in those with perfectionism or compulsive personality traits and in kids with a history of family or social trauma, low self-worth and forms of weight shaming. Other mental health issues or medical problems make it worse. These conditions can cluster in school groups, often in schools from higher socioeconomic environments. The significance of these conditions is clear, but their treatment is problematic. Most GPs are unfamiliar with best-practice management of eating disorders, and the funding models and schedules are ill-suited to the management of complex psychosocial conditions.

Our public hospital system is poorly equipped for dealing with those with mild or moderate eating disorders. Its paradigms are based mainly on the treatment of the acutely medically unwell. Specialist beds can stabilise and renourish eating disorder patients as quickly as possible, but they are very limited. It's a shocking fact that there are only 35 designated public hospital beds for eating disorders in this country, and they do not equip patients or families with ongoing support for discharge. Outpatient programs can facilitate access to group support, but their waiting lists are long and their programs are often short and relatively inflexible. Most patients need three years or more of intensive, expensive treatment. The few private clinics which are now starting to offer a multidisciplinary approach have long waitlists, and access to them is limited to those who are wealthy enough to afford them.

We need more treatment centres. We need better and more effective evidence based management of eating disorders in Australia. We need a more comprehensive understanding of what's needed for prevention, treatment and relapse prevention. We need more support for families and carers who are bearing so much of the strain and receiving so little support. We need metropolitan and regional multidisciplinary eating disorder specific clinics and programs, which would be able to provide appropriate family based therapy and individualised prescriptions. We need a commitment from all state, territory and federal governments to fund these centres, and we need more dedicated hospital beds for those at immediate medical risk. We need enhanced nutritional and psychology resources in schools, and we need our GPs to be better equipped and supported to provide best-quality primary medical care. We owe it to our children, and to all of those who are suffering right now, to do better.

See this speech in context