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‘A system of failures:’ Adult eating disorder services quietly dropped on south Island

Non-emergency resources have been a lifeline for Greater Victoria residents
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Sara Maksymowicz worries about the effect of cuts to non-emergency care on the South Island for adults facing eating disorders. (Courtesy Sara Maksymowicz)

Sara Maksymowicz knew finding help for her eating disorder would be an uphill battle, but she didn’t think she would lose that help over time.

The 48-year-old has been using services administered by the South Vancouver Island Region Eating Disorders Program since 2018. The program is part of a provincial care framework for eating disorders, but local advocates say the framework is failing adults.

READ MORE: How a year of COVID-19 has impacted our mental health

Eating disorders are a range of conditions characterized by mental illness and abnormal eating habits.

Types of eating disorders include anorexia nervosa, bulimia nervosa and binge eating disorder, among other manifestations.

In B.C., eating disorder services are funded provincially and administered by regional health authorities in partnership with the Ministry of Children and Family Services (MCFS).

For clients in the South Vancouver Island Region, the ministry oversees all non-emergency adult eating disorder service options. In the past, those services included one-on-one and group counselling as well as workshops to promote healthy skills.

However, in 2019, South Island clients were no longer given the option of one-on-one counselling.

Documents obtained through a Freedom of Information request and provided to Black Press Media confirmed the region transitioned to a “group service delivery model” for treatment that year.

Later, those group services were also quietly removed.

In the fall of 2021, clients of non-emergency adult eating disorder services on the South Island started to hear rumours of care being cut. Some heard it from their case manager or general practitioner, while others found out through friends or even online.

Without concrete information about the fate of South Island services for adults, local advocates stepped in.

Vancouver Island Voices for Eating Disorders, a citizen advocacy group, launched an online petition demanding the B.C. government “take urgent action to support adults struggling with eating disorders in our community.” As of Dec. 14, the petition had garnered 596 signatures.

Client says cuts worsen symptoms

Greater Victoria resident and group co-founder Sally Chaster has been living with anorexia nervosa for over 50 years. While she’s needed emergency care before, she told Black Press Media, her upcoming admission to a Vancouver inpatient program feels like it could have been easily prevented.

Feelings of isolation and anxiety spurred by the COVID-19 pandemic worsened her eating disorder and drove her to seek support in the South Island, Chaster said. But when she found resources, they were either full or cancelled.

Without any preventative services open to her, Chaster’s condition worsened. Because her needs are now beyond what local services offer, she’s been referred to Providence Health Care’s provincial adult tertiary eating disorders program.

This inpatient treatment program will last five to seven weeks, and will require Chaster to travel to Vancouver.

“I really just needed that structured and supportive environment to re-establish better eating habits,” she emphasized, adding her admission to St. Paul’s Hospital is “necessitated by a system of failures.”

“Because of the absence of any knowledge about eating disorders, I’m heading to St. Paul’s,” she said. “I won’t have Christmas with my family. I won’t have New Year’s with my family.”

READ MORE: Victoria businesses doing their part for harm reduction

Changes only temporary, ministry says

An increase in reported eating disorders during the pandemic and a lack of trained staff forced authorities to cut less essential services, the ministry said in a statement.

“To ensure the most vulnerable populations are receiving services, clinical priorities have been reviewed,” the statement read. “The priority populations that will be seen are adults with acute and emergency needs, youth 19 and under and their families.”

The ministry told Black Press Media it expects the removal of non-emergency adult eating disorder services in the South Island region to be temporary, but declined to provide a timeline for restarting programs.

In the meantime, it recommends South Island adults seek other options.

“Those adults in Victoria requiring less acute services will be asked to connect with a general practitioner or nurse practitioner and online resources.” Those resources include provincial programs, a local peer support group and private clinicians and dietitians. But at least one expert believes those substitutes won’t suffice.

Cole Little is a registered clinical counselor who worked part-time administering services with the South Island eating disorder clinic for over a decade until May 2021.

Now working exclusively as a private counselor, Little said the program changes came as a surprise.

“I actually first heard of the program changes through my own clients,” she told Black Press Media. “It left a lot of (them) in a state of panic.”

Little said multidisciplinary, comprehensive programming for adults with eating disorders is irreplaceable, especially considering Greater Victoria’s ongoing shortage of primary care professionals.

With many of her questions left unanswered, Little said she isn’t sure how to help clients get the care they need from community resources.

Makysmowicz confessed she’s worried about loved ones who relied heavily on the programming.

“I don’t want to hear about my friends dying,” she said. “Not having this service means a lot of us are going to quietly die.”

READ MORE: B.C.’s mental health crisis is bad and getting worse


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