Thank you.
I'm just going to back up here for a minute.
Across the country, senior top psychiatry experts are falling away, leaving tertiary care programs with vacancies that are filled by new graduates with little training and less experience, filled by pediatricians, or left vacant. This has occurred in some fashion in all but one of the seven provinces that currently have tertiary or specialized intensive programs to treat adolescents with eating disorders.
Would we accept this situation for any other life-threatening illness? What if all the senior pediatric cardiologists left? Would this not be a crisis? Would it be okay if the cardiology programs were just hiring new graduates to run their programs even if they had little or no training? Would it be okay if they just hired an adult cardiologist who had no training in working with children? Maybe they could hire a pediatric thoracic surgeon to run the cardiology units. After all, the heart is in the chest cavity, right? Close enough; it should be okay, right?
When families seek help in a specialized program, they assume they are being treated by experts with both training and experience. Why are children and adolescents with eating disorders not equally entitled?
I have only one answer for you: discrimination. It's discrimination that we find within the health care and mental health care system, rather than in the community. It's my colleagues in research, in academia, and in clinical care who simply do not like patients with eating disorders and who dismiss people like me as just bothersome.
Raise the issue of lack of training and get ready to be told that we should be glad eating disorders are even mentioned in training. Express the need for more services and get told there are enough already in place and that, after all, it's a rare disorder. Submit for research funding and, even if it's a study that's the first of its kind in looking at the long-term medical consequences of eating disorders, get pigeonholed off into a nutrition category, and then get rejected because there's no dietician as a co-investigator on the study.
Like many of my colleagues, I have just given up, not on eating disorder patients, but rather on the medical institutions that care little for our patients. We do what we can with what little we have. We advocate whenever we get the chance. Our institutions become interested only if and when we get some funding, but no matter the need or the funding, eating disorders rarely become identified in an institution as a priority program.
I'm here because I'm seeing patients become chronically ill because they have no access to respectful and appropriate services in a timely fashion. I'm tired of watching parents tolerate humiliation and discrimination in the hopes that their child might receive adequate care. Nobody should have to take their child home and watch her slowly starve to death because she's too sick for outpatient or residential care but is refused admission to hospital because they just simply don't like dealing with eating disorder patients and don't feel like admitting her.
This is the standard here in Canada, and it's not good enough.
What can the federal government do?
First, we need a national eating disorder registry so that we can track what happens to patients with eating disorders. At this point, there is no database that consistently tells us enough about what's happening, and if we don't measure the problem, it's as if the problem does not exist.
We need a nationally funded research strategy. The current funding strategies ensure that our colleagues will not share...[Technical Difficulty—Editor]...the pie with us. Crumbs are simply no longer enough. We need infrastructure funding to ensure that training and knowledge translation occur across the country and at all levels of training.
Evidence-based interventions exist that result in recovery rates of 60% to 70% in adolescents with severe eating disorders, yet there is nowhere in this country where families can consistently find these services in a timely fashion. In fact, in most of the country, these services are unavailable, meaning that these unlucky adolescents are sentenced to chronic illness and a shortened lifespan.
We need to act now as a nation.
Don't let this cycle of neglect repeat itself another time. Let this time be the last.
Thank you.