I thank the Ceann Comhairle for allowing me to raise the issue of eating disorders. With so much attention on food, Christmas is a difficult time for people with eating disorders. Last year, Bodywhys dealt with over 2,000 helpline contacts, sent out over 3,000 information packs and facilitated 40 on-line support meetings. Calls to its helpline increase dramatically over Christmas.
There is a need for recognition that eating disorders are a serious psychiatric illness from which up to 20% of sufferers die. Eating disorders have the highest mortality rate of any psychiatric illness. The expert group on mental health report, Speaking Your Mind, says: "Eating disorders such as anorexia and bulimia have the highest rates of mortality for any psychiatric condition."
Eating disorders are not self-inflicted. They affect all classes, urban and rural, male and female, albeit the majority of sufferers are young and female. They are complex disorders that have no one cause or cure. Addressing the problem involves co-ordinated efforts from school education programmes, public awareness and health promotion activities, professional training for health professionals and access to service provision at community, primary and inpatient level.
Some 1% to 2% of young females are affected by anorexia while 3% to 5% are affected by bulimia. It is estimated that 10% of new eating disorder cases are male. A recent community survey indicated an increase in the number of people engaging in inappropriate weight management behaviours such as laxative abuse and forced vomiting. These dangerous behaviours can lead to an eating disorder. People with eating disorders can and do recover — 60% make a full recovery. Early intervention is the key to recovery.
The report on service provision by Bodywhys pointed out that the majority of health care professionals, including general practitioners nutritionists, psychiatrists, counsellors and psychotherapists, had treated one to two eating disorder patients in the previous 12 months. Over 20% of respondents had between three and four patients. It also pointed out that there are no specialised services for patients at a local level. The three public beds in St. Vincent's Hospital have long waiting lists with an average of four new clients being diagnosed via the outpatients' department each week. The average stay for an eating disorder patient is eight weeks while the longest length of stay at St. Vincent's in 2003 was 217 days. The report indicated that a multidisciplinary approach is currently not available within the public health care system despite recommendations from health care professionals, and from Fine Gael. Both the public and private inpatient programmes do not provide aftercare community based services. Aftercare therefore falls back to the primary health care team who often feel ill-equipped without specialist understanding. Some 75% of general practitioners surveyed stated that they had no training in eating disorders. Of the 25% who had, the majority felt it was inadequate. The report also found that general practitioners were the first point of contact with a health care professional for a person with an eating disorder.
We eagerly await the report from the expert group on mental health policy in 2005. While Bodywhys can provide a listening ear and play a vital support role for people facing their disorder and seeking treatment, it cannot signpost people to professional health care services which are not available. The majority of sufferers will require professional intervention to overcome their eating disorder.
Some of the key recommendations of the report are the need for research into eating disorder incidence, that is, the number of new cases, and prevalence, the number of people living with an eating disorder; the need to include professional training for all health care professionals on eating disorders; the need for specialised services, including access to a multidisciplinary team for mental health and social services, at a local community level; and the need for greater self-esteem building work and development of coping skills within the education system. Other key recommendations are that messages of positive body image and healthy eating need to be addressed and not allowed to get lost in the midst of more recent discussions on obesity; and the need to implement and resource the recommendations of the expert group on mental health policy which is consulting with an eating disorders sub-group.
There should be specific arrangements for a clinic in each health board area to deal exclusively with eating disorders. I welcome the Minister of State at the Department of Health and Children, Deputy O'Malley, and look forward to his comments.