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Preference: Government and politics

Increasing funding to improve outcomes for eating disorders

The Federal Budget allocated $80 million for Australians with a mental illness such as severe depression, eating disorders, schizophrenia and post-natal depression resulting in a psychosocial disability, including those who had been at risk of losing their services during the transition to the NDIS.

The Government also announced it will provide $9.1 million over four years to improve access to psychological services through telehealth in regional, rural and remote Australia.

Health Minister Greg Hunt has also freshly announced that eating disorders will be included in the 5th Mental Health Plan and that the current Medicare Benefits Schedule Review Taskforce investigate Medicare coverage for the treatment of those with an eating disorder.

The National Mental Health Commission described the funding announcement as timely.

“Timely that eating disorders will be recognised officially as serious and complex mental illnesses with serious physical consequences,” said the Commission’s chief executive Peggy Brown.

The Butterfly Foundation, which is the country’s peak support organisation for people with conditions such as anorexia and bulimia, says that the current health system is failing people with an eating disorder.

Its chief executive, David Murray, said: “Too many times in the past 12 months Butterfly staff have sat vigil with families as the health system has failed.”

“When suicide is up to 31 times more likely to occur for someone with an eating disorder, clearly the Government should address this problem with a dedicated focus.”

According to the National Eating Disorders Collaboration (NEDC), an initiative of the Australian Government Department of Health, more than 1 million Australians suffer from eating disorders and represent the third most common chronic illness for young females.

The NEDC also cites research that shows anorexia has the highest death rate of any mental illness and carry a very high rates of mortality with one in 10 people who suffer from an eating disorder dead within 10 years.

Deaths associated with eating disorders are typically caused by medical complications (such as cardiovascular issues and multiple organ failure), suicide or complications relating to substance use.

A 2012 Deloitte Access Economics report examined the economic and social impact of eating disorders in Australia and found the total socio economic cost of eating disorders to be $69.7 billion per year.  These costs can be reduced with early detection.

The Australian Medical Association believes that a greater focus is needed on ensuring appropriate access to early intervention and treatment services for young people especially in rural and remote locations.  The AMA also believes that a nationally coordinated approach is necessary in order to develop effective and consistent practices in preventing and addressing the incidence of unhealthy body image and eating disorders. 

If this article has raised concerns about eating disorders, please contact the Butterfly Foundation national hotline on 1800 33 4673; or visit www.thebutterflyfoundation.org.au for support and resources for eating disorder sufferers and their families and carers.

Meredith Horne

[Correspondence] Ahmadreza Djalali: questions everyone must ask

Dr Ahmadreza Djalali is hovering near death in an Iranian jail.1 The efforts of the international community in securing his release, as extensive as we can muster, seem increasingly ineffective, in great part due to the fact that all international petitions appear to have been ignored by the Iranian Government. Strong positions from the international community—ranging from Physicians for Human Rights,2 Amnesty International,3 the Swedish,1 Belgian,4 and Italian5 Governments, and multiple academic institutions worldwide—have fallen on deaf ears.

Aboriginal and Torres Strait Islander health organisations: Online Services Report—key results 2015–16

This is the eighth national report on organisations funded by the Australian Government to provide health services to Aboriginal and Torres Strait Islander people. In 2015–16: 204 organisations provided primary health-care services to around 461,500 clients through 5.4 million client contacts and 3.9 million episodes of care; 216 counsellors from 93 organisations provided social and emotional wellbeing services to around 18,900 clients through 88,900 client contacts; 80 organisations provided substance-use services to around 32,700 clients through 170,400 episodes of care.

National Key Performance Indicators for Aboriginal and Torres Strait Islander primary health care: results from June 2016

This fourth national report on the national Key Performance Indicators (nKPIs) data collection is based on data from more than 240 primary health care organisations that received funding from the Australian Government Department of Health to provide services primarily to Aboriginal and Torres Strait Islander people. Information is presented for 22 ‘process-of-care’ and ‘health outcome’ indicators for June 2016, which focus on maternal and child health, preventative health, and chronic disease management. The report shows continuous improvements for the majority of indicators.

[Comment] Realisation of human rights to health and through health

The powerful interplay between health and the human rights of women, children, and adolescents forms the cornerstone of the global development agenda. When their right to health is upheld, their access to all other human rights is enhanced.1 The corollary holds true. When their right to health is denied, the impacts inhibit their exercise of other human rights, undermining their potential and undoing realisation of the promise of the Sustainable Development Goals and Agenda 2030. That is why whole-of-government leadership is needed to fulfil the potential of the powerful nexus of intersecting, interdependent rights.

[Department of Error] Department of Error

Global Burden of Disease Health Financing Collaborator Network. Future and potential spending on health 2015–40: development assistance for health, and government, prepaid private, and out-of-pocket health spending in 184 countries. Lancet 2017; 389: 2005–30 —The collaborators for this Article also include Lalit Dandona (Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA and Public Health Foundation of India, New Delhi, India), Rakhi Dandona (Public Health Foundation of India, New Delhi, India and Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA), and G Anil Kumar (Public Health Foundation of India, New Delhi, India).

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Global Burden of Disease Health Financing Collaborator Network. Evolution and patterns of global health financing 1995–2014: development assistance for health, and government, prepaid private, and out-of-pocket health spending in 184 countries. Lancet 2017; 389: 1981–2004—The collaborators for this Article also include Lalit Dandona (Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA and Public Health Foundation of India, New Delhi, India), Rakhi Dandona (Public Health Foundation of India, New Delhi, India and Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA), and G Anil Kumar (Public Health Foundation of India, New Delhi, India).

[Correspondence] Addressing underlying causes of violence against doctors in India

The Lancet has helped bring global attention to the problem of violence against doctors in China through its Editorials in 2012 (May 12, p 1764)1 and 2014 (March 22, p 1013),2 and has stimulated local discussion on potential solutions. India’s health system faces a similar crisis and the magnitude of the Indian problem is, perhaps, greater. More than 2000 junior doctors from 17 government-run hospitals in India’s largest city, Mumbai, went on strike for 4 days in March, 2017, to protest a recent spate of violence against doctors.

Caring for the carers partnership to be developed

Health Minister Greg Hunt will work directly with doctors to develop a mental health care package for the medical profession.

Addressing the AMA National Conference on May 26, Mr Hunt said a recent spate of young doctor suicides – including that of Deputy Chair of the AMA Doctors-in-Training Council Dr Chloe Abbott – has been a cause for great concern.

The Minister said that after speaking with AMA President Dr Michael Gannon and former President Dr Mukesh Haikerwal, he was determined to develop a mental health package targeting doctors.

“One of the main things we introduced in the Budget was prioritising mental health. For the first time, this has been raised to the top level as one of the four pillars of the long-term national health Plan,” Mr Hunt said.

“And we were able to invest significantly in mental health, both in the election, but in particular, in the Budget as well. There’s a very strong focus on suicide prevention with support for suicide prevention hotspots and an $11 million initiative, but also complementing that with the rural telehealth initiative for psychological services.

“Much of this is deeply important preventive health work on the mental health side and it goes with what has to happen in, I think, the medical work force. The case of Chloe Abbott was outlined and I’m aware that many people have been affected by Chloe’s loss, as well as others.

“And Michael and I have been speaking this week, and also been speaking in recent weeks with Mukesh Haikerwal, and I am determined to offer a partnership with the Government and the AMA for us to provide new investment directly into caring for carers.

“And so I want to announce that we will offer a partnership going forward and we will develop the suicide prevention, mental health programs with the AMA and the broader medical work force for suicide prevention and mental health support, specifically for doctors and other medical work force professionals.

“One of the critical roles that you have is psycho-social services. There’s the clinical work with those with mental health issues, but then there is the support services.”

The Minister offered few details of the partnership, stressing that it was still in its conception stage.

But he was determined to take action.

Following his address to the conference, he spoke more to the media about the plan.

“There have been some terrible tragedies in the sector. Michael Gannon and other doctors, Mukesh Haikerwal, have talked to me about that,” he said.

“What we’ll be doing is developing a caring for carers package which will be assisting with specialist channels, because sometimes, and this is what’s been explained to me, those who are doctors or nurses (a) will feel that they shouldn’t be seeking help even though they’re just the same as everybody, and (b) they might feel professionally uncomfortable. Even though they might be in the depths of despair they’ll still feel that professional discomfort at reaching out.

“And so if they have some specialised services for them then they will feel more comfortable, we hope, and that’s what’s been proposed by the profession.”

He did not know if the plan would address the mandatory reporting lines, where doctors might fear they would be reported to the Medical Board when they seek help.

He also promised funds to the partnership, but could not say how much at this stage.

“There’s been no proposal put to me yet, but as I’ve said, in designing of this, what I really want to do is work with the AMA and the GPs,” he said.

“What we’re doing is we’re designing together, and from that we’ll have the outcome.”

Chris Johnson