An eating disorder is a complex mental illness which can be severe and enduring. Approximately 1 million Australians are currently experiencing an eating disorder, 2/3 being female.
In Australia, hospital care is the standard approach when an eating disorder is at its most acute and its physical effects severe. The focus of this kind of care is on medical stabilisation and weight gain with a view to improving vital bodily functions. However, often this care does not address the underlying psychological dimensions. Admissions to hospital are often repeated with traumatic effects for the individuals receiving treatment, often unwillingly.
To solve this problem, Butterfly has opened Wandi Nerida – Australia’s first residential care facility which opened in July 2021. Using a new Clinical Model of Care, the facility provides holistic, individualised treatment drawing on a range of evidence-based therapies with a high staff-to-client ratio.
As this treatment is intensive and provided 24/7, the cost per participant is very high – based on an expected average stay off 60 days, the cost per participant is $75,000. To ensure this treatment is accessible to all Australians, we offer bursaries to individuals based on eligibility and means. These bursaries are funded by private philanthropy – the greater our pool of bursary funds, the more we can provide equitable treatment for all Australians who need it the most and ensure no one misses out due to lack of financial means.
Expected outcomes include reduced financial burden of eating disorder care on the hospital system (and other systems), increased access to care for those without means to travel overseas for treatment, and improved recovery rates (less recovery time, less relapse, sustained long-term recovery).
A range of clinical and economic outcomes will be measured through independent evaluations to be conducted by the Western Sydney University (clinical evaluation) and Deakin University (health economics evaluation).
Together these evaluations will establish the evidence base to inform similar residential care facilities being developed around Australia, thereby transforming the current system of care for people with eating disorders and their families and carers.
Clinical data will be collected according to the indicators in Butterfly’s Framework for Clinical Assessment.
Qualitative elements of the evaluation will include conversations about identity, purpose and values strengthening participants’ ‘healthy self’ (contrasted to the ‘eating disorder self’); acceptance, understanding, and positive change among participants (making room for difficulties and difficult emotions as part of life); stress relief and immunity; and self-esteem.
The economic evaluation will include a cost effectiveness analysis of the facility versus treatment as usual, including all relevant financial, health system, other social costs and burden of disease costs.
Findings will be shared with other facilities to directly influence practice, and translated into sector knowledge through journal articles, conference presentations, and online content. Knowledge translation indicators will include: number of state- based facilities adopting program elements and their number of participants; number and type of publications, events and digital reach measures; and discourse analysis of sector influence over future years.
Butterﬂy Foundation (Butterﬂy) is the national charity supporting Australians experiencing eating disorders and body dissatisfaction. Butterﬂy exists so that every person experiencing an eating disorder or body image concern can access affordable, evidence-based care, irrespective of their postcode or economic status. Butterﬂy’s services include Butterﬂy National Helpline, Prevention Services offered in schools and communities, Treatment and Recovery support services, advocacy work and awareness programs and campaigns. Butterﬂy’s support and services provide a touch point for all individuals and their families, no matter where they are on their journey.