Access to evidence-based treatments for eating disorders outside of specialist providers is rare in Australia, leading to difficulties accessing care, long waitlists and durations of illness, poor outcomes and high mortality. By upskilling frontline mainstream mental health workers to identify and support treatment of eating disorders and by giving them access to standardised, freely available, evidence-based digital therapies, we can rapidly and significantly transform access to care for large numbers of Australians with eating disorders.
To meet this need, a pilot has been conducted in collaboration with headspace National to facilitate access to InsideOut’s Brief BEeT support eTherapy for bulimia nervosa (or compensatory behaviours, i.e. sub-threshold binge eating disorder or bulimia nervosa) [1] or binge eating [2]. Brief BEeT comprises of four online (one-hour) sessions, and four supporting sessions with a clinician via telehealth, of a low-intensity, cognitive behavioural therapy-based intervention which has demonstrated strong program feasibility via relatively high adherence and low dropout rates, and promising significant reductions in overall eating disorder psychopathology and general psychological distress. headspace is the National Youth Mental Health Foundation, founded in 2006, and now across 154 community centres nationally, providing early intervention mental health services to 12-25-year-olds. With a focus on early intervention, headspace works with young people to provide support at a crucial time in their lives – to help get them back on track and strengthen their ability to manage their mental health in the future.
This program has the potential to radically transform the provision of care for people with eating disorders in Australia, by embedding early access to proven interventions for the first time into mainstream mental health pathways. This initiative will increase the confidence and capacity of frontline health workers to treat eating disorders, and see digital therapies become part of routine care in mainstream settings. This should lead to increased access to care, shorter timeframes between identification and treatment, reduced symptom burden, reduced waitlists and assist in meeting unmet demand for eating disorder care nationally.
mainstream provided initial seed funding (Phase 1 from December 2021 to June 2022) and research support to facilitate access to Brief BEeT prior to the commencement of the Upskilling project (Phase 2). As part of the mainstream NSW research translation hub, InsideOut Institute (IOI) partnered with headspace National to collaboratively establish a fit-for-purpose eating disorder early identification and supported digital intervention pathway, with a staged training program for centre staff embedded in it. Nearly 50 headspace centres nationally signed up during that period to implement the pathway, and training and treatment provision commenced resulting in 41 client referrals, with data collection complete and analysis pending. To note, eating disorder referrals are rarely accommodated at headspace centres, mainly due to need for staff specialist training and extended treatment needs, so this pilot program was a welcome first step to addressing some of these barriers to care for young people, our most at risk population, within primary health care settings.
The Upskilling project (Phase 2, June 2022 – June 2025) managed by InsideOut Institute in partnership with headspace National and Head to Health, funded by the Australian Federal Government is in process and received 112 referrals by June 2023.
References
Barakat, S., Maguire, S., Surgenor, L., Donnelly, B., Miceska, B., Fromholtz, K., Russell, J., Hay, P. and Touyz, S., 2017. The role of regular eating and self-monitoring in the treatment of bulimia nervosa: a pilot study of an online guided self-help CBT program. Behavioral Sciences, 7(3), p.39, https://doi.org/10.3390/bs7030039.
Rom, S., Miskovic‐Wheatley, J., Barakat, S., Aouad, P., Fuller‐Tyszkiewicz, M. and Maguire, S., 2022. Evaluating the feasibility and potential efficacy of a brief eTherapy for binge‐eating disorder: A pilot study. International Journal of Eating Disorders, 55(11):1614-1620. https://doi.org/10.1002/eat.23803.
Presentations:
Barakat S, Rom S, Touyz S, Lymer S, Kim M, Hazelton J, Sidari M, Fuller-Tyszkiewicz M, Aouad P, Corry S, Miskovic-Wheatley J, Maguire S. From evaluation to real-world implementation: Translating findings from an online self-help program for binge-eating disorder and bulimia nervosa. 2023 Australian and New Zealand Academy of Eating Disorders Annual Conference, Gold Coast.
Barakat S, Rom S, Touyz S, Lymer S, Kim M, Hazelton J, Sidari M, Fuller-Tyszkiewicz M, Aouad P, Corry S, Miskovic-Wheatley J, Maguire S. Moving from evaluation of an online self-help program to real-world implementation in an Australian youth mental health service. 2023 International Conference on Eating Disorders, Academy of Eating Disorders, Washington, DC.