Off the Board, Opinion

Reinstituting systems of care: Treating eating disorders at McGill

I was lucky. I was able to sit down with my mum and tell her how scared I was. The people I love supported and watched out for me. When I woke up in the middle of the night and I couldn’t see, my dad was there to drive me to the hospital. Not everyone is that lucky. Support systems are crucial to those struggling with an eating disorder (ED), especially when alone at university for the first time. When McGill cancelled its ED program in 2017, it eliminated a key resource for struggling students, and it needs to find a way to replace that resource.

Students struggling with an ED need multifaceted and comprehensive care. EDs are all too common among people our age: According to a 2017 NEDIC report, 1.5 per cent of women aged 15–24  had an eating disorder. The most alarming statistic is the mortality rate of those with EDs. Anorexia nervosa (AN) has the highest mortality rate of any psychiatric illness: Researchers have estimated that 10 per cent of those with AN will die within 10 years. The discussion around EDs often fails to consider the imminent danger that many face. For this reason, medical and psychiatric health care systems are imperative.

The need for comprehensive care systems has been on the minds of administrators for a long time. In 1996, McGill launched its Eating Disorder unit, a “multi-disciplinary team, comprised of staff from Mental Health, Counselling, and Health Services.” According to documents sent to the The McGill Tribune by a former administrator, the program had been successful in treating multiple life-threatening cases within its first two years. Having a program accessible to students is of paramount importance when it has the capacity to do  such profound good.

No matter how many students it helps, systems of care have a profound impact on each student who engages with them. When McGill cancelled its program, it eliminated an opportunity to seek care. According to Executive Director of Student Services Martine Gauthier, the ED program served 70 students annually by 2017. It provided students with access to a nurse, dietician, and a number of psychiatrists and psychologists. It was a multifaceted system of care that allowed McGill to offer support at any given stage, as necessary. Accessing care at McGill is daunting, and the obstacles are countless, including a lack of information, a daunting bureaucratic process, and disheartening wait times. These obstacles are infinitely more difficult to overcome when already struggling with an ED. It is McGill’s job to remove these roadblocks, and for the administration to work in tandem with the student body  to change the status quo.

But institutions move at a slow pace, and every decision comes in the form of a trade-off. In an 2018 email to The McGill Tribune, Martine Gauthier wrote that, at its most expensive, the ED program cost $711,000, in the 2014–2015 academic year, with an average annual cost of around $400,000–$500,000, representing 4.5 per cent of the Student Services budget that year. Supporting the program is expensive, so McGill should look into alternatives for providing multi-faceted care. It needs to make sure that there is easy access to the separate parts of the now defunct ED program, including discussion groups and nutritionists. Moreover, McGill should work to make in-patient care more accessible by establishing or strengthening memoranda of agreement with treatment centres around Montreal, like Douglas Hospital, that streamline and subsidize access to care. Lastly, McGill needs to accomplish the all-too-elusive goal of effective communication. What comes to mind for students when they think about EDs at McGill is the treatment program’s cancellation in 2017. The school needs to replace that narrative with a new one, and centralize and clarify information about accessing care

Not everyone is as lucky as me. It is important that institutions like McGill provide systems of cares so that luck doesn’t have to be a factor. But that might take some time, and some convincing. In the meantime, students need to open a dialogue. McGill has barriers it needs to break down, but so do we.  We need to seek love from ourselves and others, and lead with honesty.

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