I Didn’t Think It Could Get Worse

Here we are over 1.5 years into a pandemic that has completely shifted all of our lives. Many of us have still not completely processed this year  Many of us are still getting up every day and living with this background noise that they cannot quite hear or identify. The weight of the world, the weight of the pandemic, the weight of the unknown trajectory of moving forward.

Many people who have followed my work know that a driving force behind what I do and why I started in this field is the desire to bridge the gap in services for people who are touched by Eating Disorders and other related Mental Health concerns. There was a brief sweet spot in my career where I felt empowered, felt hopeful and felt we could do this. Hopeful we could meet the needs and give people the care they needed and deserved.  We were advocating like crazy (my time with NIED) we had resource centres seeing people in person and we were working together with hospital-based programs. It felt good. This unfortunately didn’t last too long as the demand for services kept usurping our ability to make change and keep up to the demand so here we are.

I didn’t think it could get worse.

Anyone who follows NIED’s work will know the devastating state of available care for Eating Disorders. Anyone can read this and think, wow that must be difficult. Similarly, to hearing the headlines in the news saying “this is not just about COVID patients, if we don’t take care of this virus ALL healthcare services will suffer” unless you have been diagnosed with an illness that has had to have treatments postponed during this year – it’s ALL JUST WORDS.

When I get a call from a family who has just faced a diagnosis of an Eating Disorder my stomach drops as I know that that person has likely been suffering for years by the time they are reaching out to me. The pain that person is feeling is so deep. The next step for me is to ask for permission to be honest. This is where the painful part comes in. This is the part where the hopeful tone in their voice shifts as I start to explain a tenth of what they are up against. This is the part where I have to prepare the person with a script of what to say when they are looking for help, how to approach a family doctor and how to advocate for themselves when they are already struggling to stay above water, and lastly to let them know that there is very little help out there (especially accessible help).

I didn’t think it could get worse.

There is nowhere to refer right now. I am a Hamilton based practitioner and myself and everyone at Carly Crawford Psychotherapy (CCP) work hard to provide the care that is needed but we have little to no help. The level of care needed to properly treat an Eating Disorder is just not available – it doesn’t exist right now.  It requires a multidisciplinary team and constant monitoring. Eating Disorder programs that are funded by OHIP are all online (please tell me how this works?) I appreciate that it is better than nothing, but we are talking about a mental illness that has the highest mortality rate! Can you please tell me why there’s not funding to make this a priority? Right, we cannot do that.

I didn’t think it could get worse.

So here we are, and it’s worse. We are without care. We are tired and we are dealing with higher (soaring rates) of Eating Disorders. We are here fighting and screaming and no one is listening. I agreed to write this blog post and I said to myself – Carly you have to be positive. Talk about your recovery, how you saw death and are living a full life but no one needs to hear that right now. We need to make the reality known and although I burnt out from fighting for change in ways I used to. I have now devoted my career to working right directly with patients and it still brings me to tears as I type this.

I didn’t think it could get worse.

If you’re a therapist or therapist in training, this message is for you.

I started out working for not for profit and tried to provide barrier free services at Danielle’s Place, then moved to working at making changes on the policy level. I then moved to (and continue to) provide care for those walking into our doors at CCP and I have realized I need to shift to focus on helping other clinicians feel less afraid and more confident working in this field.

We need more clinicians who are ready and willing to treat Eating Disorders. Just like in our society at large, in the private therapy world there are a lot of misconceptions and misunderstandings when it comes to treating this population. With very few therapists to refer to and a high level of burn out in this line of work, we are left with very few of us who are able to provide care to this population. In the past several years, what I have come to realize is that Eating Disorders and related illness are so prevalent that if you are treating mental illness; just like you should be trauma informed, you really and truly need to be Eating Disorder Informed. If, as a society, we could realize that Eating Disorders are primarily diagnosed in people who are not emaciated. That you CANNOT TELL SOMEONE HAS AN EATING DISORDER BY JUST LOOKING AT THEM. That Binge eating and Bulimia are Eating Disorders that require equal attention and treatment as Anorexia (seems ridiculous to even have to type that). Then we may start to see progress we may start to see people getting help at the first signs of struggle, we may start to see less resistance to talk therapy and more resilience in the face of relapse.

I know it’s scary. I know that the pain that we see in people impacted by this illness can sometimes seem overwhelming. But let me tell you, when you sit across from someone in a therapy session and you help them to see that they are not their symptoms, that they are more than this illness and help them to strip away the shield they have created – it may just feel a bit easier to help them.

I didn’t think it could get worse AND we are still here doing what matters.

This pandemic has highlighted the divide that comes when a public health issue comes to the forefront. You have people on either side, people who are very scared and people who are completely avoidant. You have advice and guidance that doesn’t fully make sense and moments of riding the waves blindly.

When it comes to mental health care, much like the pandemic. You may not realize how broken our health care system is unless you have to access it. Until you are in desperate need of support, until you have been made to feel you have to be sicker to warrant more help, until you have been made to feel that there is no reason to be concerned you may be stuck.

The hopeful part is that Body Brave and I launched an Eating Disorder training for professionals and the first workshop sold out in one day. We have another one launching in January that is already half sold out. So, it means that on the ground we have therapists, nutritionists and social workers who want to learn…who want to help you and will look at making things BETTER instead of worse. Eating Disorders cannot afford to wait and we are doing our best to ensure we have better supports available.

I refuse to sit at this desk in another ten years to write another blog post for my friends at NIED starting with “I didn’t think it could get worse”!