Eating Disorders Service
Who we are
The Eating Disorders Service at Perth Children’s Hospital offers a range of supportive treatment options for children and young people who are experiencing difficulties in managing their health, in relation to eating and exercise.
It is a multi-disciplinary team who provide outpatient care, day treatment, inpatient care and support groups. The program supports children and young people and their families through assessment, recovery and discharge from the service.
Conditions we manage
Eating disorders are serious and potentially life-threatening mental illnesses that result in physical health consequences and requires treatment.
We manage all types of eating disorders, up to the age of 18 years (as long as the patient has been referred at 16 years old), although they are most common during teen and young adult age groups.
There are several types of eating disorders, including:
- anorexia nervosa: where someone is trying to lose more weight than what is healthy, or more rapidly than is safe, by placing severe restrictions on the amount and type of food and drinks they consume. There is an intense fear of gaining weight, accompanied by a belief they are overweight, and often behaviour to avoid weight gain such as excessive exercise.
- bulimia nervosa: where someone feels a sense of loss of control over the volume of food eaten and then tries to get rid of the food (for example, by vomiting, excessive exercise or taking laxatives).
- binge eating disorder: where someone feels a sense of loss of control over the volume of food eaten, followed by feelings of guilt and shame.
- avoidant restrictive food intake disorder (ARFID): when someone only eats a small range or amount of food and doesn’t get the nutrients they need. Generally, people with ARFID are not scared of weight gain, but often resist the need to eat because of the issues they have with eating. Treatment is offered to young people of high school age up until 17 years and 11 months, if referred prior to being 16 years old.
Services we provide
Young people are referred to the Eating Disorder Service by a medical practitioner including general practitioner, psychiatrist or paediatrician.
Assessment
If deemed appropriate for the service, the young person will be added to the wait list for an assessment from our multidisciplinary team, made up of:
- Family Based Treatment Therapist / Care Coordinator
- Psychiatrist
- Paediatric medical team
- Dietitian
- Physiotherapist
The assessment will discuss the specific strengths and difficulties that the child or young person and their family are experiencing and will involve several members of the Eating Disorders team.
The assessment will help our team understand if your child has an eating disorder that meets the criteria for treatment with our program and what support your child or young person and your family will need moving forward.
Currently the waitlist for an outpatient assessment is extensive and we are unable to provide a time frame regarding when a young person will be assessed. Families should stay engaged with their GP and where appropriate, we ask referring doctors to explore other options of support for the family.
Outpatient care
The most likely treatment recommended for you and your young person during outpatient care is Family Based Treatment (FBT). This is the leading evidence-based treatment. It places parents or carers at the centre of a child or young person’s recovery and charges them with the task of ‘renourishing their starving child’. This is with the goals of restoring a child or young person’s physical health and helping them return to their age-appropriate activities that their eating disorder is preventing them engaging in. Some families need additional therapies or another form of treatment towards the end of FBT.
For more details, please see the CCI FBT information sheet via the link below:
Eating Disorders Information Sheet - Family Based Therapy for consumers carers and professionals (health.wa.gov.au)
Day Program
The Day Program is a group-based treatment program for young people and their families who need intensive therapy and support to overcome barriers to recovery in the outpatient setting. The program operates on weekdays during the school term in Clinic K at PCH. The program offers young people individual and group therapy, meal support, peer support and school. Parents/carers play a key role to support the young person’s recovery. The parent/carer program involves family meetings, psychoeducation, skills groups and peer support groups. Currently the day program is offered to young people active in the Eating Disorder Service.
Inpatient care
Most children and young people with eating disorders will be managed through outpatient care, but sometimes they need to be admitted to hospital to be assessed if they are medically unstable, at high risk of refeeding syndrome or experience ongoing weight loss despite outpatient support.
At PCH, Ward 4A provides care to children and young people up to the age of 16 years.
For young people who are 16 years old and over that need mental health care in hospital, an Eating Disorders care coordinator can help finding the best inpatient setting to meet mental health care needs.
Transition to youth and adult services
Treatment under PCH Eating Disorder Service is time limited, dependant on age (up to 17 years and 11 months), and completion of treatment goals. Case coordinators work with young people and families to explore if there are any ongoing care needs prior to treatment ending or when transitioning from the service. This may involve referrals to local community mental health, youth services or private practitioners. This is done collaboratively so that transition is seamless for young people and their families.
Support and education groups
There are several support groups run by the Eating Disorders Service:
- Parents and Carers Support Group
- Mothers Support Group
- Fathers Group
There is also a two-day education workshop:
Eating Disorders Essentials
These are open to the parents, carers and families of the children and young people in the Eating Disorders Program, and to those who are on the waitlist. This psychoeducation workshop for carers is open to anyone to refer to, however priority is given to those on the waitlist or active with the service.
Parents/carers of children and young people on the outpatient waitlist who have completed Eating Disorder Essentials will be invited to opt in to Eating Disorder Essentials Plus, giving them access to a further workshop and 4 parent/carer sessions with one of our specialised dietitians.
Getting help
The Eating Disorder Service does not have capacity to respond to urgent referrals. If you have concerns regarding a young person, you are seeing please follow the below advice and review our pre-referral guidelines.
For Families:
If your child or young person is aged 15 years or under and they are experiencing severe dizziness or fainting, it may be a sign that they need urgent medical attention. Please bring them to the PCH Emergency Department or any other emergency department. For young people 16 years and older, please bring them to their local hospital emergency department.
If you have non-urgent concerns about your child’s eating or weight, please book an appointment to discuss this with your GP.
For urgent mental health help or advice for children and young people, call CAMHS Crisis Connect on 1800 048 636, 24 hours a day, 7 days a week.
If you are concerned and need advice about your child or young person, you can contact:
For GPs:
GPs assessing patients aged 15 years and under: if you have concerns regarding a young person’s medical stability, we recommend you promptly consult our escalation criteria and if appropriate contact the Adolescent Medicine (AMed) Consultant on call via PCH switch board on 6456 2222 to formulate a plan regarding the need for a further assessment and/or admission.
GPs assessing patients 16 years and over: if you are concerned or require advice on management promptly contact WA Eating Disorder Outreach and Consultation Service (WAEDOCS) for advice and recommendation 9am to 4pm Monday to Friday on 1300 620 208. Outside of hours call the local emergency department.
Referrals
We accept referrals for young people up to 16 years of age. Provision of care is up to 18 years of age, but the young person must have been referred by 16 years.
A written referral from a general practitioner, psychiatrist or paediatrician is required in order for any young person to be waitlisted for a full assessment and to access treatment through the Eating Disorders Service. Referrals with insufficient information will be returned.
Please review our pre-referral guidelines before sending a referral to ensure you have all the required information.
All Specialist Rooms, GPs and WACHS referrers are advised to direct all non-urgent referrals for PCH outpatient services to the Central Referral Service.
When a referral has been received and accepted on to the waitlist, the triage officer will contact you/the family to discuss the waitlist and assessment process, ask some preliminary assessment questions and discuss options for support in the meantime.
We can organise consultations via videoconference for families from rural or remote areas. Visit the WA Country Health Service website to find out if you are eligible for travel support via the Patient Accommodation and Transport Scheme (PATS).