Tommy Broughan (Dublin North East, Labour)

I thank my Fingal colleague, the Minister for Health, for coming to the House to discuss this matter.

First, there are only three public beds, instead of the recommended 24, for eating disorders nationwide. Second, we do not have standards or regulations for physiotherapists and counsellors who work in this field.

In 2006, the Vision for Change report on mental health policy estimated that up to 200,000 people in Ireland may be affected by an eating disorder, whether anorexia nervosa, bulimia, binge eating disorder or otherwise. It also reported that approximately 400 new cases of eating disorder are diagnosed each year in Ireland which, shockingly, represents approximately 80 deaths per year.

A Government study of children and adolescents carried out in 2006 indicated that 1.2% of Irish girls are at risk of developing anorexia nervosa and 2% are at risk of developing bulimia. Figures from the Health Research Board report on the activities of Irish psychiatric units in hospitals indicate that eating disorders represented the second highest level of diagnosis, at 18%, of child and adolescent psychiatric admissions in 2008. There are also worrying trends internationally. A study of Scottish secondary school students reported that approximately a quarter of boys and girls had engaged in bulimic or anorexic behaviour.

Eating disorders, as a psychiatric condition, have a significant mortality rate. A 1995 study in the American Journal of Psychiatry, shockingly, found that "aggregate annual mortality rates associated with anorexia are more than 12 times higher than the annual death rate due to all causes for females aged between 15 and 24 and more than 200 times higher than the suicide rate of females in the general population".

This issue that does not predominantly affect girls and women, as the incidence of men who are affected by eating disorders is significantly on the rise. International studies estimate that as many as 25% of patients being treated for anorexia and bulimia are male and perhaps 50% of binge eating disorder cases are men.

All of these astonishing statistics have been compiled and highlighted by the outstanding campaigning organisation for victims of eating disorders, BodyWhys, led by Ms Jacinta Hastings. Many colleagues in the House, attended the excellent briefings provided by Ms Hastings during Eating Disorders Awareness Week in February and her follow-up briefings.

One of the most incredible facts surrounding eating disorders services is that there are only three beds in the public health system specifically designated for citizens with an eating disorder. Many patients approach their GP, and the Minister has emphasised that the treatment of eating disorders by community mental health teams is the best way forward. Bodywhys and other health professionals, however, believe there is an urgent need for at least 24 beds in the public health system to adequately treat the needs of the growing number of citizens with an eating disorder.

Recommendation 15.4.7 of A Vision for Change proposes an eating disorder sub-unit in a regional general hospital mental health unit with six beds each, which would contribute 24 public eating disorder beds. What can the Minister promise or what can he indicate will happen in this area? There is also a clear issue of equality at stake. With just three public beds, is it the case that only citizens who can afford private treatment will be able to access treatment for an eating disorder? There are many outstanding eating disorder counsellors and psychotherapists working in this country but it is an unregulated sector. As Bodywhys emphasises, citizens seeking treatment for an eating disorder are in an exceptionally vulnerable position. It is therefore essential that the areas of counselling and psychotherapy are strictly regulated to the highest standards. There is an opportunity for regulation, either by statutory instrument or by the introduction of legislation to the House. I urge the Minister to introduce regulations urgently in this regard and to ensure standards for counsellors and psychotherapists are provided either through legislation or by a statutory instrument. I seek a commitment from the Minister that eating disorder services will be introduced as a matter of urgency, as outlined in A Vision for Change, given the dramatic effect of eating disorders on young people.

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