Eating disorders first mental illness to be assigned a MBS diagnostic category

Healthcare professionals urged to upskill on ED evidence-based care

In an Australian first, eating disorders (ED) represent the first mental health disorder to be assigned specific item numbers under the revised Medicare Benefits Schedule (MBS) scheme, commencing November 1, 2019. This development has sparked an urgent call by ED experts to the Australian health workforce to upskill in the management of these complex illnesses.

Announcement of the pending MBS revisions, coinciding with World Mental Health Day today (Thursday, October 10, 2019) and an article just published in MJA Insight, marks an important milestone for the million Australians living with an ED who will gain access to 40 rebated psychological therapy sessions and 20 dietetic sessions (an increase of 30 and 15 sessions, respectively).

According to MJA Insight article author and Director of InsideOut Institute for Eating Disorders (IOI), Dr Sarah Maguire, Sydney, EDs are curable for many if a person receives the correct treatment, at the right time, with access to an appropriately trained multidisciplinary team, including, at minimum, a medical practitioner, a psychologist, and in most cases, a dietitian.

“Both national and international guidelines recommend a skilled multidisciplinary treatment approach for EDs, and access to between 40 – 50 sessions, in order to achieve satisfactory remission.

“Prior to the upcoming revision of the MBS, patients living with EDs, and all other mental health disorders, have had access to just 10 rebated psychological sessions through Medicare,” said Dr Maguire.

“While EDs have one of the highest mortality rates of any mental illness, concerningly, more than 70 per cent of people living with EDs do not receive treatment, and of those who do, only 20 per cent receive evidence-based treatment.”

Dr Sarah Maguire

Under the new scheme, diagnosis by a general practitioner and mental health practitioner will be required, in recognition of the significant physical burden imposed by these psychiatric illnesses, which necessitates integrated treatment.

The Eating Disorder Working Group Report, which underpins the updated MBS, outlines the minimum training standards required by providers to achieve timely diagnosis and treatment. Under the new scheme, treatment options available will be limited to the defined list of evidence-based eating disorder specific treatments,” Dr Maguire said.

Research suggests most health practitioners feel ill-equipped to treat EDs and targeted healthcare professional training is required to address the needs of this patient group.

“As a major eating disorder workforce development provider, IOI delivers a range of online, evidence-based eLearning training packages.

“I therefore urge any healthcare professional working with people living with EDs, to consider upskilling, in order to best support their patients,” said IOI Senior Clinical Dietitian, Gabriella Barclay.

The efficacy of IOI’s Eating Disorder Treatment Essentials training program has been examined in two peer-reviewed studies, most recently in the Journal of Eating Disorders in May, 2019. The study found there were significant improvements in confidence, knowledge and skills to treat eating disorders, and a reduction in stigmatised beliefs among the 480 participants who completed both pre- and post- assessments.

“Under the new scheme, there will be 64 specific MBS item numbers for the treatment of anorexia nervosa, bulimia nervosa, binge eating disorder and atypical presentations, creating an opportunity to analyse treatment uptake or response.

“The MBS will allow Australians living with severe EDs, and their carers’, to access comprehensive treatment plans, saving around patients and their families thousands of dollars each year,” Ms Barclay said.  

“These changes are all the more significant when you consider research shows one in three patients experiencing an ED goes into debt to fund their treatment, 55 per cent stop working or studying due to their illness, while a quarter go without basic and essential healthcare or living necessities.”

Three-time Olympic hurdler, IOI ambassador and recently qualified medical doctor, Jana Pittman, Sydney, has similarly welcomed the MBS news, but warned Australians need support to find suitable trained healthcare providers in their local area.

“As someone who has lived with an eating disorder, and is now trained as a healthcare professional, I am familiar with the various barriers faced by those who require professional help, but are unsure where to turn.

“A major barrier is finding someone who is skilled, who you can trust, who will empathise with you, and understand your situation. Importantly, IOI’s online Treatment Services Database allows Australians living with an ED to identify a local healthcare professional simply, at the touch of a button on their website,” said Ms Pittman.

Jana Pittman, IOI ambassador

About InsideOut Institute

InsideOut Institute (IOI) is Australia’s national institute for research and clinical excellence in EDs. IOI is housed in the Charles Perkins Centre at the University of Sydney, in a partnership with Sydney Local Health District. With resources, rigour and perseverance, IOI aims to transform the treatment landscape for EDs in Australia, and to ultimately, find a cure.

The Institute comprises a team of expert researchers, clinicians and public policy makers dedicated to solving the tyranny of EDs.

About IOI’s eLearning Suite

IOI is a leader in developing and disseminating innovative training for health professionals in the identification, assessment and treatment of people with ED.

As a major ED workforce development provider, IOI delivers a suite of online, evidence-based eLearning training packages which, to date, have trained thousands of clinicians nationwide.

IOI’s eSuite currently has seven evidence-based programs available, with another three programs set to launch later this year.

To register for an IOI ED training module, join IOI’s Treatment Services Database or to learn more about EDs, head to: www.insideoutinstitute.org.au  

To find out more about the MBS changes, visit: www.mbsonline.gov.au/internet/mbsonline/publishing.nsf/Content/Factsheet-EatingDisorders

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