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7. HEALTH IMPLICATIONS
Eating Disorders Queensland (EDQ) recognises the impact that eating disorders can have on the physical, emotional, cognitive and spiritual health of an individual.
We are aware of the serious consequences of a range of eating behaviours. It is therefore a requirement that all clients who access EDQ be involved with a medical practitioner of their choice.
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Medical stability is important for a range of reasons including:
• To sustain life. • To increase an individual’s capacity to be present and engage in treatment. • To engage cognitively and therefore reduce rigid and obsession thinking. • To regulate mood and emotion.
48. Undertake regular and ongoing assessments for client risks and respond according to organisational policies and the guidelines and ethics of the relevant professional bodies.
All eating disorders have the potential for serious health and nutritional complications 86 . Of all the mental health issues, eating disorders have the highest incidence of physical health related issues 87 .
Assessment and risk management occurs throughout the entire journey of recovery and includes attention to medical safety planning to reduce physical health risks and increase medical stability 88 . Safety plans may include verbal or written agreements and, at times, the involvement of third parties such as other health providers or family and carers.
Where significant risk of harm is identified these concerns should be discussed with the client’s GP and treating team.
49. All client presentations must be responded to in a non-judgemental way.
All eating disorder presentations, including a range of eating behaviours such as restriction, purging, bingeing, excessive exercise, laxative use, as well as alcohol and other drugs (AOD) use, violence, and physical and emotional health issues, must be discussed in a nonjudgemental way. The ongoing importance of the therapeutic relationship is particularly important in this regard 89 . The therapeutic relationship should encourage the client to be open about changes in their eating behaviours and medical stability. These relationships must be based on trust and respect to ensure clear communication when risks are identified.
50. Clients are encouraged to engage in a multidisciplinary team approach including support from carers and key support people where possible.
It is important to take a holistic view of recovery that actively seeks to provide linkages with other health professionals and carers / key supports as well as other related organisations and community services. This is particularly relevant given that therapeutic workers are not medically trained.
This may include appropriate referrals for a range of practitioners including GPs, psychiatrists, dieticians, exercise physiologists in both outpatient and inpatient settings where appropriate.
An integrative approach is required to ensure that medical stability and nutritional and psychological treatments progress together in order to reduce the risks of recurrence, premature mortality, chronicity and physical morbidity 90 .
51. Duty of care responsibilities should be balanced with transparency and open communication.
Issues such as duty of care responsibilities and confidentiality must be explained to the client at initial intake, at which time a consent form should be signed by the client. It is important to provide education about the health implications of eating disorders and indicators of concern. Similarly, proactive communication with the client’s treatment team regarding the best ways of responding to and managing identified risks should occur early in the client’s involvement with the service.
Clients should be supported to make informed decisions regarding their health where possible. However, there may be times when this is not possible. At these times it is important to maximise client agency while balancing the need for medical intervention.
