Victoria White: Change law to recognise eating disorders as mental illnesses

We need to prioritise the understanding of healthy food shared in joyful communion with family and friends, writes Victoria White.

Victoria White: Change law to recognise eating disorders as mental illnesses

THE outgoing government can boast that they stopped the export of a young women’s health problem to the UK by getting the abortion referendum past the people.

But they have continued the export of extremely ill anorexics, most of whom are young women, to the UK.

I didn’t know this until I heard on the radio about the Child Care Law Reporting Project, which published some of its reports this week.

I was shocked to hear that our beautiful young people, some of whom are unwittingly starving themselves to death, can’t be detained for treatment in Ireland because our laws don’t recognise eating disorders as mental illnesses.

When I dug further, I found out that even when cases could be treated in Ireland under the law, the services are often not there for them.

The five year Clinical Programme for Eating Disorders, which was launched exactly two years ago, was meant to deliver specialist treatment “hubs” in Dublin, Cork and Galway with “mini-hubs” in Cavan, Kilkenny, Sligo, Limerick and Waterford.

Late last year it was reported that of the €3.1m allocated to resource the brave new strategy, just shy of €140,000 had been spent, virtually none of it last year.

This is an absolute disgrace.

These are serious mental illnesses, reckoned to affect or have affected nearly 200,000 in Ireland including 4,000 children and adolescents.

Though most cases are curable, anorexia has the highest mortality rate of any mental illness.

I said mental illnesses; eating disorders are about what happens in peoples’ brains, not their bodies.

The Mental Health Act 2001 doesn’t recognise them as such; the Child Care (Amendment) Act 2011 doesn’t catch them.

Victoria White: Change law to recognise eating disorders as mental illnesses

It’s as if our legislators believed they could make a division between a person’s body and mind and could not attribute to the mind an illness represented in the body.

More often than not, that body is female because women outnumber men three to one when it comes to eating disorders. I can’t get over the suspicion that eating disorders have suffered from relative neglect from legislators in Ireland because they are regarded as illnesses of the female body.

I was trying to process all of this when I had a visit from a friend I hadn’t seen in ages. I knew her daughter had been anorexic but I thought she’d got over it.

Sadly, I learned she’s had a relapse and will be admitted to hospital if her weight goes down far enough. I was shocked all over again.

“Are you telling me,” I shrieked, “that they actually wait for her to get down to a certain weight before they admit her?”

That seems to be the case, although her anorexia is in her head, not her body, and she would still be anorexic if she were chubby. She needs treatment before her weight goes down, not after.

Is anyone listening out there in the political stratosphere?

The good men and women who administer laws which fail to protect some of our most vulnerable young people have a tough job and that task falls heavily on the president of the High Court, Judge Peter Kelly.

It is Peter Kelly’s unenviable job to make children and young people, who can’t be detained even for their own good under our legislation, “wards of court”.

Two consultant psychiatrists must independently concur that the individuals lack the capacity to act in their own best interests before they can be made a ward. The judge can then make an application for the ward to be transferred to a secure unit abroad.

It defies belief that our State would suggest to anxious parents that they abjure their right to protect their child in order to protect their child.

It doesn’t always go smoothly, either. Young people may feel stigmatised by their wardship. In 2017, the case was heard of a man with severe anorexia who was objecting to being made a ward of court though the judge warned that time lost in bringing the man into care could seriously threaten his life.

Victoria White: Change law to recognise eating disorders as mental illnesses

Unbelievably, the High Court is routinely involved in cases of eating disorders which are being treated in this country and sadly, require “coercive” tube feeding.

Commenting on a case last year, Judge Peter Kelly said one eating disorder specialist he had consulted perceived it as a defect in the Mental Health Act that orders to tube feed patients had to be sought from the court.

This court process is often traumatic for patients and must be horrendous for their loved ones.

The feeling that she was being stigmatised was reported in the case last year of a woman who had not eaten for a week at the time the High Court ordered tube-feeding to commence. She believed she was seriously obese, was hearing voices telling her she did not deserve to live, and had made two serious suicide attempts.

If it’s clear we can’t let lovely young people starve themselves to death under hospital supervision, why do we have to go to the High Court to administer tube feeding?

It’s so stupid and it’s so wrong. The Mental Health Act 2001 needs to be amended urgently so that eating disorders fall within its ambit and tube-feeding is specifically allowed when a person’s mental illness means they will not eat.

Of course, anorexia and bulimia are coping mechanisms used by people who are overwhelmed by life. However, it is clear they are inappropriate coping mechanisms which can have devastating implications for a sufferer’s health and can even be fatal.

Victoria White: Change law to recognise eating disorders as mental illnesses

WE have to get in there and fight that mental illness long before tube feeding comes into the frame. We need a whole of society approach to reducing presentations.

We need to prioritise the understanding of healthy food shared in joyful communion with family and friends from the first day of preschool. That means making space in our competitive culture for families to cook together.

It means a cross-departmental approach to lessening stress in the lives of our school kids, including tackling the destructive points race. It means strengthening education to combat the pressure felt by young people when they see perfection presented to them as the norm by the media — research shows even three minutes spent looking at model figures can make 70% of young girls feel depressed, guilty and shamed.

It also means having effective services around the country to tackle eating disorders in people in the context of their community and family, starting by talking, not by weighing.

For advice on eating disorders contact Bodywhys on 01-2107906 or info@bodywhys.ie or the Eating Disorder Centre Cork on 021-4539900 or info@edcc.ie

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