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Speaker 1: My name is Lily Madden and I'm a proud Arunda

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Speaker 1: Bungelung Calcottin woman from Gadighl Country. The Daily oz acknowledges

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Speaker 1: that this podcast is recorded on the lands of the

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Speaker 1: Gadighl people and pays respect to all Aboriginal and Torres

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Speaker 1: Strait Island and nations. We pay our respects to the

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Speaker 1: first peoples of these countries, both past and present.

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Speaker 2: Just a warning before we start this episode, we'll be

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Speaker 2: discussing mental health and eating disorders. If you need to

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Speaker 2: talk to someone, you can call the Butterfly Foundation helpline

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Speaker 2: on one eight hundred three three four six seven three.

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Speaker 3: Good morning and welcome to the Daily os. It's Tuesday,

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Speaker 3: the thirtieth of May.

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Speaker 2: I'm Zara and I'm Nina. The federal government has announced

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Speaker 2: they'll be spending seventy million dollars on research and treatment

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Speaker 2: for eating disorders and childhood mental health. But with eating

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Speaker 2: disorders on the rise with young people, is that funding enough.

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Speaker 4: Does it meet the need? Well, of course, not nowhere

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Speaker 4: near it. It's going to take time and consistent investment

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Speaker 4: to bring equity to the situation.

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Speaker 2: In today's deep dive, we'll talk to Director of the

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Speaker 2: Inside Out Institute doctor Sarah Maguire about how we're dealing

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Speaker 2: with eating disorders at the moment and what needs to change.

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Speaker 3: But first the headlines, there were some big news from

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Speaker 3: our Western Australia friends. Mark McGowan has announced he'll be

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Speaker 3: stepping down as Premier of WA. McGowan has been Premier

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Speaker 3: since twenty seventeen and has led the WA Labor Party

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Speaker 3: to two successful elections. He provided the reason of just

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Speaker 3: being totally exhausted when he announced his resignation. The role

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Speaker 3: of political leadership doesn't stop.

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Speaker 2: It's relentless.

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Speaker 3: It comes with huge responsibility that is all consuming each

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Speaker 3: and every day. Now is the right time to step

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Speaker 3: away from the job that.

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Speaker 2: I have loved. Nine partners from PwC have been asked

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Speaker 2: to take immediate leave in the wake of the firm's

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Speaker 2: alleged improper use of confidential government information. The Australian Federal

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Speaker 2: Police launched a criminal investigation into this alleged sharing of

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Speaker 2: information last week, with PwC directing some of its senior

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Speaker 2: leadership to go and leave while an independent investigation gets underway.

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Speaker 2: And if you want more on that story, you can

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Speaker 2: listen to the Deep dive we put out yesterday.

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Speaker 3: President Erdowan in Turkey has won the country's runoff election,

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Speaker 3: so that was a second election that followed an inconclusive

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Speaker 3: result earlier this month. The victory will extend Erdwe's two

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Speaker 3: decades span in power.

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Speaker 2: And the good news investment into solar energy is expected

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Speaker 2: to outpeace the funds directed to oil production for the

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Speaker 2: first time in twenty twenty three. The International Energy Agency

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Speaker 2: has forecast about one point seven trillion US dollars will

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Speaker 2: be invested into clean energy this year. Eating disorders are

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Speaker 2: among the most deadly of mental health conditions, with teams

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Speaker 2: at particularly high risk. They're also among the most expensive

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Speaker 2: to treat in the public health system, and yet research

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Speaker 2: shows that eating disorders receive the least amount of mental

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Speaker 2: health funding in Australia.

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Speaker 3: Eating disorders might receive the least amount of funding. Like

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Speaker 3: you said, but that area of mental health did receive

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Speaker 3: funding yesterday. Can you talk me through that a bit.

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Speaker 2: Yeah, The federal government made a seventy million dollar announcement

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Speaker 2: yesterday and that's to fund research and treatment for both

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Speaker 2: mental health in children and eating disorders. One of the

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Speaker 2: organizations that will be benefiting from that funding is called

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Speaker 2: inside Out. There are national Institute researching treatments for eating

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Speaker 2: disorders in Australia. So in this new funding they've been

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Speaker 2: allocated eight million dollars towards two of their pre existing initiatives,

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Speaker 2: which we'll get into in the interview, but they'll also

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Speaker 2: have the opportunity to receive a portion of fifty million

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Speaker 2: dollars set aside for research into children's mental health on

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Speaker 2: top of that eight million dollar already be getting. So

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Speaker 2: I spoke with the director of the Institute, doctor Sarah

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Speaker 2: Maguire about this funding and whether or not it actually

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Speaker 2: goes far enough. Sarah, thanks so much for joining us

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Speaker 2: on the pod this morning.

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Speaker 4: Nina, thanks for having me.

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Speaker 2: You've been working in the realm of eating disorders for

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Speaker 2: a long time. What is it about this space that

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Speaker 2: you find an important place for you to be working in.

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Speaker 4: Yeah, I've been working in the space for twenty years,

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Speaker 4: just over It was my first job. Really. I was

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Speaker 4: really very, very very struck by the lack of services.

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Speaker 4: You know, when I was growing up and when I

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Speaker 4: was at school, eating disorders were a thing that we

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Speaker 4: all knew about. We all knew friends that had them.

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Speaker 4: They were everywhere you know, they were on every second magazine,

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Speaker 4: And so when I transitioned into the health system, I

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Speaker 4: was really shocked at the disparity there that something that

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Speaker 4: I felt was so talked about at a public level

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Speaker 4: had not translated at all to assistant.

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Speaker 2: Wonts and something that touches so many people personally.

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Speaker 4: Yeah, and it is better now, but at the point

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Speaker 4: that I entered, I mean people were completely desperate. Families

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Speaker 4: were totally devastated and lost and had no options. And

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Speaker 4: you know, in the case of anorexinovosa, you were looking

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Speaker 4: at the mental illness that was most likely to kill

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Speaker 4: their kid, you know, and they knew that by then,

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Speaker 4: And yeah, I just felt it was unjust. I think

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Speaker 4: that's why I stayed.

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Speaker 2: When you're talking about eating disorders, now, what kind of

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Speaker 2: treatments exist and how easy is it for people to

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Speaker 2: access the care that they need.

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Speaker 4: So we've actually got some strong evidence space that if

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Speaker 4: a person has biliminovosa or bing gating disorder or a

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Speaker 4: subclinical version of those, and we get them a reasonably

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Speaker 4: short treatment like ten to twenty.

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Speaker 2: Sessions psychology sessions.

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Speaker 4: Yeah, yes, most of the therapies that have been demonstrated

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Speaker 4: in the evidence for eating disorders are psychological interventions. So

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Speaker 4: for those two illness groups, for biliminovosa and bing gating disorder,

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Speaker 4: if you get ten to twenty sessions fairly early, you know,

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Speaker 4: as early as possible, in that you will have like

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Speaker 4: almost an eighty percent chance of recovery. But at the moment,

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Speaker 4: less than twenty percent of people get those treatments, I

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Speaker 4: would say quite a bit less actually.

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Speaker 2: So inside Out has done research and found that despite

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Speaker 2: the prevalence of these disorders and how expensive they can

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Speaker 2: be to treat, they also receive the lowest amount of

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Speaker 2: mental health spending. Why is that the case.

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Speaker 4: The research that we've done is on the mental health

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Speaker 4: research spend of the major mental health categories that were analyzed,

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Speaker 4: and trauma isn't in there. Other things like borderline personality

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Speaker 4: disorder and the other personality disorders aren't in there. We're

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Speaker 4: not the only stigmatized underfunded group, but we've made it

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Speaker 4: onto that list of analysis at least, and on that

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Speaker 4: list we are by far the lowest and perhaps even

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Speaker 4: more concerning consistently the lowest. It doesn't change at all.

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Speaker 4: So we did a statistical analysis on that which which

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Speaker 4: detects statistically significant change, and all the other illness groups

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Speaker 4: had had changed over the thirteen years. Ours just flat lines.

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Speaker 4: And I think that's what we've known in our field

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Speaker 4: for a long time, that that research dollar spend is

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Speaker 4: just really hard to budge.

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Speaker 2: And so inside Out is now going to get some

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Speaker 2: extra funding that was announced yesterday. What will that money

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Speaker 2: go towards?

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Speaker 4: Inside Out is one of the recipients of the competitive

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Speaker 4: round that was announced yesterday. There was fifty million dollars

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Speaker 4: for a research agenda I suppose you would say, focusing

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Speaker 4: on children and mental health. I'm glad to hear that

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Speaker 4: eating disorders is part of that conversation, because one of

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Speaker 4: the problems in our field has been that we've been

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Speaker 4: off the list of the major mental health funding initiatives,

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Speaker 4: often that we're an exclusion criteria or we just weren't included,

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Speaker 4: even though we have the mental illness with the highest

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Speaker 4: mortality rates. So we're very glad to be able to

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Speaker 4: compete along with everybody else and all the other pressing

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Speaker 4: needs for that fifty million dollars.

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Speaker 2: Step that out a little bit for people, so that

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Speaker 2: fifty million dollars is allocated to do research into children's

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Speaker 2: mental health, and so inside Out has the opportunity to

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Speaker 2: get some of that funding to say, well, what are

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Speaker 2: the areas in eating disorders that we can gain more understanding?

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Speaker 4: That's right, Yeah, that fifty million is for competitively funded research.

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Speaker 4: Everyone competes and people who are researchers who specialize in

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Speaker 4: eating disorders will be able to compete too.

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Speaker 2: And so before we talk about the funding that is

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Speaker 2: guaranteed for inside Out, what are the questions about young

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Speaker 2: people and children with eating disorders that you would hope

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Speaker 2: to be able to explore with that type of funding.

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Speaker 4: That's a really good question. That's a question for a

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Speaker 4: nation of researchers to answer. But I will say that

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Speaker 4: last year Australia voted on the top ten research priorities

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Speaker 4: for eating disorders and a bunch of those in there

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Speaker 4: relate to young people. One of the things that Families

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Speaker 4: and Carries put on that top ten list was about

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Speaker 4: GPS and how can we improve and change that interaction

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Speaker 4: at the GP call face. Some of the funding they

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Speaker 4: received yesterday speaks to that. I can talk about that

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Speaker 4: in a minute. We know a fair bit about risk factors,

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Speaker 4: but we don't really understand the full picture of what

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Speaker 4: causes eating disorders. We had some very promising genetic findings

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Speaker 4: come out a few years ago, but the way science

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Speaker 4: funding works is that they don't ever really like to

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Speaker 4: fund the same thing twice. So when it's a really

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Speaker 4: big thing like genetic samples where you need hundreds of

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Speaker 4: thousands of samples, those sorts of questions need to be asked.

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Speaker 4: We understand how to prevent body image, we're less sure

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Speaker 4: about preventing actual eating disorders, particularly in young people. A

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Speaker 4: lot of the prevention work has been done at university,

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Speaker 4: which I think, well, is that where we're trying to

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Speaker 4: prevent or could we get down a lot earlier. So

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Speaker 4: there's a lot of really important prevention work to be done.

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Speaker 4: We've got one treatment for our kids with anorexianovosa. A

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Speaker 4: lot of families find that brutal. There are people for

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Speaker 4: whom it isn't suitable. We don't have another alternative. We

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Speaker 4: really need to be researching treatments as well.

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Speaker 2: Okay, so we've talked about potential for more research. Let's

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Speaker 2: talk about the money that is guaranteed for inside out.

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Speaker 2: There's eight million dollars. What will that money do?

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Speaker 4: So we had two things that were funded. One is

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Speaker 4: our GP tool, So it's basically a tool that tries

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Speaker 4: to work with GPS in the way that they practice

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Speaker 4: in their practices. People talk a lot about GPS needing training.

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Speaker 4: That's probably true, I mean, but gps are actually really

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Speaker 4: well trained, and I think we don't talk enough about

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Speaker 4: how do we support them to be able to do

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Speaker 4: the things that the health system sort of requires of them,

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Speaker 4: if you like. In this particular situation and for eating disorders,

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Speaker 4: what we really need to try to impact is how

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Speaker 4: many people get that diagnosis early. So we've tried to

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Speaker 4: design a tool that gives the GP the right information

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Speaker 4: at the right time, in the ways they're used to practicing,

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Speaker 4: so they don't have to go out looking for you,

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Speaker 4: reams of information across reams of websites.

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Speaker 2: So they know who to refer on to as well.

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Speaker 4: That's right, so that they can diagnose and then create

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Speaker 4: a sort of care team around that person. That's right.

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Speaker 4: And the other really important thing about this tool and

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Speaker 4: the other one that we're funded is that they are

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Speaker 4: to be implemented in rural and regional areas and metropolitan areas,

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Speaker 4: and they should have the same impact or the same

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Speaker 4: capacity for impact for people in rural and regional settings

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Speaker 4: as they should in metro settings. We've got to stop

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Speaker 4: designing models of care that only work in one very

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Speaker 4: well funded, highly populated area, you know. And then the

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Speaker 4: other thing that we got funding for is our e clinic.

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Speaker 4: So we've been developing an e clinic for a very

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Speaker 4: long time now, about seven years. It's been a long road,

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Speaker 4: and we've been trying to think about how busy all

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Speaker 4: of the clinicians in the health system are, how hard

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Speaker 4: it is for them to get the training that they

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Speaker 4: need to feel confident in delivering that training, how hard

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Speaker 4: it is for people with a needing disorder to receive

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Speaker 4: the evidence base. So we tried to staydize and put

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Speaker 4: on a digital platform all the parts of therapy that

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Speaker 4: we think can be delivered well over a digital platform.

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Speaker 4: That is not all of therapy. You still need clinicians,

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Speaker 4: you still need community teams, you still need a multidisciplinary team.

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Speaker 4: But after four trials, what we've been able to demonstrate

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Speaker 4: with these four and ten session e therapy programs is

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Speaker 4: that you can create really significant clinical change, in fact,

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Speaker 4: for quite a few people total emission using these digital therapies,

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Speaker 4: either supported by a clinician or as a pure self

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Speaker 4: help and we're able to do a limited national role

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Speaker 4: out of that, which will be fantastic.

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Speaker 2: So today I think we've briefly touched on some very

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Speaker 2: complex issues that we could discuss for years and not

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Speaker 2: capture all of the nuance and complexity. We've also spoken

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Speaker 2: about that challenge historically in getting adequate funding. So I

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Speaker 2: guess to end this conversation, I wanted to put to

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Speaker 2: you this seventy million dollars that we had pledged this

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Speaker 2: week from government. Does it come close to filling the

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Speaker 2: gap that eating disorders have historically faced in terms of

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Speaker 2: getting that funding.

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Speaker 4: Yeah. Well, the seventy million dollars is twenty for eating

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Speaker 4: disorders and fifty for mental health. It's wonderful in a

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Speaker 4: really tight fiscal environment with a really tight budget to

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Speaker 4: see any money towards high priority areas you know, and

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Speaker 4: certainly clinical groups that have been overlooked. Does it meet

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Speaker 4: the need? Well, of course, not nowhere near it. It's

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Speaker 4: going to take time and consistent investment to start to

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Speaker 4: bring equity to the situation.

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Speaker 2: Sarah, thank you so much for your time on a

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Speaker 2: really busy morning. I really appreciate it.

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Speaker 4: Thank you Nina for having us. We really appreciate you

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Speaker 4: covering it.

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Speaker 3: If today's episode raised anything for you and you need

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Speaker 3: to talk to someone, you can call the Butterfly Foundation

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Speaker 3: helpline on one eight hundred three three four six seven three.

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Speaker 3: Thank you for joining us today on the Daily OZ.

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Speaker 3: If you learned something from today's episode, don't forget to

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Speaker 3: leave a review and we'll be back again tomorrow. Of

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Speaker 3: have a great day, h