Status of Women committee  Just one, really...? I was trying to interrupt before to say that I think people are really being clear that, optimally, care is offered by a multidisciplinary team to treat the complex medical, mental health, psychological, and emotional needs, and also the family and partner support needs that are part of an entire system.

Status of Women committee  I'd be happy to. I don't think anyone at the table is leaving it up to family physicians to complete the diagnosis. What would be really effective is to have a very consistent method and approach across the country for screening and identifying individuals who are at risk. In mental health, we diagnose by listening to people's thoughts and feelings and how much that's impairing their day-to-day life when it comes to occupation, schooling, family relationships, and responsibilities.

Status of Women committee  Our program is a newly funded program in London. We are seeing cultural diversity within our program and also very statistically matched male presentation as well within our program. Can I answer that accurately—is it a function of being in western society that we're seeing these folks present with eating disorders at this present time?

Status of Women committee  I will. My final comment was about a recommendation for a research chair for eating disorders and a centre of excellence for eating disorders for Canada. I think that would be a great first step to facilitate a tracking system and a national registry, and oversee a lot of the gaps and the components that all of the speakers have talked about today.

Status of Women committee  You're talking about registered nurses, first of all.

Status of Women committee  In undergraduate programs in Ontario there is a mental health component that is part of the curriculum. Eating disorders might get one or two lectures out of that mental health curriculum. It's very minimal.

Status of Women committee  You're talking about screening? Yes. That would be part of those lectures, but again, it's very brief, and how that gets picked up into clinical practice is really tough to evaluate. I mentioned best practice guidelines used by the RNAO, which in particular in Ontario have been a really efficacious way to disseminate screening and early identification practices in the treatment of other chronic illnesses like asthma and diabetes.

Status of Women committee  Do you mean specific to eating disorders? Because there have been many best practice guidelines launched and disseminated across Ontario. I think probably the big red-letter one at the moment is the smoking cessation program, which has been a really great program. The model and framework have been well formatted and developed over the last 15 years through RNAO, so it's a proven model that works.

Status of Women committee  I haven't been part of that program myself; it's just been implemented in the last decade in Ontario. I think what I'm highlighting is that best practice guidelines through the nursing organization have been effective. For primary care physicians, practice guidelines have been another very effective strategy for screening and early identification, which are essential.

Status of Women committee  Sure. I'm just mindful of the time.

Status of Women committee  Okay. Clinically I have seen this time and again with our patients who are normal weight and have normal blood values. An 18-year-old I co-treated with an in-patient medical team last year met this description. However, she had been extremely symptomatic two months prior to hospitalization with bingeing and purging up to eight times per day.

Status of Women committee  Thank you. As a tertiary care nurse practitioner, I bring 22 years of mental health experience to this consultation session. During my career I have been a part of system and program development in geriatric mental health, adult mood and anxiety. I spent nine years as a pediatric mental health nurse practitioner, and two years as an adult eating disorders nurse practitioner.