Advocacy & Awareness Projects

2024 BC General provincial Election

VIVED is currently working on our report card for the 2024 BC general provincial election campaign. With the recent announcement by David Eby regarding involuntary “care” and the treatment of “severe addiction” (this is not a medical term, hence the quotation marks), we want to highlight the ways in which some political platforms and their harmful policies dehumanize vulnerable people.

The same stigma that is perpetuated against people who use substances or experience the “scary symptoms” of mental illness are very similar to the way that people with eating disorders are also treated. Blaming us for “choosing to be sick” when our government has failed to provide access to safe housing, cultural care, social supports, harm reduction support, and dignified treatment options is absurd.

Our BC Mental Health Act currently involuntarily commits 20,000 people a year, yet there is little evidence to support improved recovery outcomes or reduced re-hospitalization. So why are we forcing people into treatment they don’t want when the people who want treatment can’t get it?

If political leaders cannot recognize the humanity of our most marginalized community members and continue to use the suffering of human beings as scapegoats for political points, we will continue to stand up and advocate for those who can’t.

The following PDF document is for the Greater Victoria area and is comprised of three parts: (A) summary of each party platform, (B) candidate details, and (C) calendar of events. We will update information as it becomes available.

Service Pathway Mapping Project

*Please note, this project is still in progress and we continue to update information

Vancouver Island Voices for Eating Disorders (VIVED) has been working on a project to map referral pathways from regional adult eating disorder services to tertiary programming across the province of British Columbia.

Our goals for this project include:

• Public data collection via our team and community members across the province

• Identification of barriers, bottlenecks, and unnecessary delays between individuals reaching out for support and accessing various levels of support

• Outlining areas for improvement and streamlining of services

• Reducing the fragmentation of services around the province; developing clear communication and understanding of referral pathways as well as how they differ for those seeking services, their families, and clinicians

• Creating a resource for advocacy by individuals, their families, clinicians, and other VIVED projects

Overview of Project Findings (in progress)

*We will update this section with more accessible summaries of our findings as we continue to finish this project.

World Eating Disorder Action Day (WEDAD) 2024

Reclamation Art Project

Summary

World Eating Disorder Action Day (WEDAD) is June 2nd; this year Vancouver Island Voices for Eating Disorders (VIVED) wanted to honour the power of peer spaces by creating a process group specifically designed to explore the theme of reclaiming our voices and stories through creative means. 

This creative space was inspired by a personal art project one of co-founders had been exploring in their own healing journey: reclaiming their health records through collage.

“I may not be able to change my experiences and the things that have been said about who I am as a person and what I am capable (or incapable) of, but I can reclaim my story in my own way - taking these incredibly damaging words, terms, and descriptions of my character back through creative means.”

Over the past several months we have come together with a small group of interested community members to process some of the challenging experiences people have had with formal publicly-funded eating disorder treatment in the province of British Columbia. Early in the process we collectively identified our intentions for the space and the things each of us as individuals were hoping to get out of the project. 

The main intentions and hopes that participants identified were connecting with community, validation of challenging experiences, honouring and reclaiming a personal voice, and participating in a collective creative project that prioritized the process over the product.

During initial brainstorming sessions, the group identified many potential themes to explore, all of which encapsulate a fundamental critique of standardized eating disorder treatment as it currently exists in Western colonial healthcare.

Ultimately, the group decided on creating a zine out of the individual art pieces. “Historically, zines have provided community for socially isolated individuals or groups through the ability to express and pursue common ideas and subjects. For this reason, zines have cultural and academic value as tangible traces of marginal communities, many of which are otherwise little-documented. Zines present groups that have been dismissed with an opportunity to voice their opinion, both with other members of their own communities or with a larger audience.”

We hope that you enjoy the work we have created together: that it encourages conversation, reflection, and contributes to change in the ways we talk about and treat eating disorders.

(Our zine is still in the making, we will upload it here when finished and handing it out at local events in future.)

Ready Or Not by G.G.

Artist statement to come

Is It The ED Talking? by Anonymous

“I find the common phrase "it's your ED talking" to be super reductive and dismissive. As if the "ED voice" is some foreign being who came from the sky to inhabit your brain and sabotage you, rather than the best your system could do to protect you from overwhelming and unsafe feeling circumstances. The "ED" voice is likely an amalgamation of many different phenomena and experiences unique to every person, worth curiousity and understanding rather than banishment and dismissal. My "ED voice" may not see reality clearly or have a logical world view, but insisting that it disappears has never worked. Rather, any progress I have made has happened through meeting the parts of me that are emotional, afraid, and self protective where they're at.”

You Don’t Seek to Understand by Anonymous

“This is about the impact on self esteem and identity that eating disorder treatment spaces can have on an individual. The power and emotional dynamics in these spaces have very much impacted my sense of self and sense of self worth in the past. A person is supposed to surrender to treatment, but the treatment team does not have to earn or be worthy of the trust expected.

Treatment experiences have flattened me into the single dimension of my ED behaviours, my receptivity or "resistance" to treatment, and the ways I have been received by staff, a process that ignores my full personhood. In treatment, I am a success or a failure at the one size fits all structure of eating disorder treatment instead of a person who, by definition, struggles with emotional regulation, communication and self care and is deserving of compassionate understanding.”

Tell Me About Yourself & Where Have All the Good Patients Gone? by S. Ritchey

CONTENT WARNING - descriptions of forced psychiatric treatment (CW will be placed around the paragraph so read with caution, I share because it is an essential part of my story.)

”I first started making reclamation art with my medical records a number of years ago after an incredibly traumatic admission to a general psychiatric ward for my eating disorder and concurrent depression. I wanted the records because of what had happened to me and my lack of clear memory, but reading those documents at the time felt nearly as damaging - my experience was captured in cold and clinical language, told from one perspective that offered no context. 

From that experience I was labelled with what is known as a “purple dot.” This “dot” indicates a history of violence and is a way of communicating a potential safety risk to healthcare providers which I understand as a registered nurse myself. (CW) However, what was essentially a trauma response and reaction to the very real threat of being forcibly detained by four large men, having my clothes removed, forced invasive care, being placed in 5 point restraints, and injected with sedative medications that my body reacted poorly to (resulting in a “code blue” event) and significant extrapyramidal symptoms that took days to recover from (CW). I was not violent towards others (though I was desperate to escape and resisted forced care), I was reacting to a very real threat, but I am the one who will forever be marked by this label and scarred by this experience.

I came back to creating art out of my medical records over this past year as I have come to fully separate from eating disorder services and the idea that I could ever fit within those narrowly defined conceptions of illness and healing. It is a grieving process that ebbs and flows; there is anger, there is pain, there is understanding, there is acceptance, there is hopelessness, and there is freedom. There is everything all at once. I occupy many privileged identities, I will never fit within standardized eating disorder treatment models, and I am not remotely the exception. The difference now is that I am no longer willing to break myself to fit into spaces that cause me more harm than healing. This is not to say that those spaces must be perfect; it is simply the recognition that there are many complicated cost-to-benefit considerations when it comes to pursuing a higher level of care within the very limited options that are available through publicly-funded treatment in British Columbia.

Over the course of my experiences in treatment settings, both through voluntarily sought outpatient, residential, and inpatient eating disorder treatment options, as well as involuntary inpatient experiences on general psychiatric wards - primarily for suicidality related to my eating disorder, depression, and experiences of trauma (though these are rarely understood or treated in relation to one another) - I have come to collect a fair amount of clinical diagnoses, commentary, and associated labels from the healthcare system. Reading over my medical records and the various descriptions of who I am as a person has been brutal; however, it has felt healing to take that narrative and quite literally reclaim it. The visceral act of cutting these formal pages into pieces, taking each harmful phrase out of context (as I so often have been) has been empowering.

These words, phrases, and labels will forever remain on my medical records and continue to influence how I am perceived and treated whenever I am forced to interact with the healthcare system, but these are things I cannot change. While I may not be able to change my experiences and the things that have been said about who I am as a person and what I am capable (or incapable) of, I can reclaim my story in my own way - taking these incredibly damaging words, terms, and descriptions of my character back through creative means. I think this is worth pursuing although I also recommend people do so with caution because even as a healthcare worker who is familiar with using clinical terms in my own charting, the way it reads (particularly when it comes to psychiatric care) can be incredibly hurtful, but that is not who you are and the people who truly see you and you love in every state of being, know this.

The pieces I have created for this project contain charting from my experiences of inpatient eating disorder treatment through provincial adult tertiary eating disorder services in British Columbia. These are largely the words of psychiatrists, though there are also descriptions from dietitians, allied healthcare staff, and nurses - even those I thought I had good rapport with. While I felt devastated reading these records and spent time processing them with my psychiatrist (a clinician that has no background in eating disorders), I can look at them now and also understand how difficult I can be as a patient. This is not to agree with how I am described as a whole and complex human being in these records, but it is how I can present when I am entirely outside my window of tolerance, feeling highly unsafe, and reacting from a trauma response. That isn’t me as a person, but that is how I can react in highly abnormal and harmful settings when basic autonomy, respect, collaboration, and safety is lacking.

What is important is not locating the issue in myself as an inherently flawed person nor blaming individual clinicians - I was non-functional and completely dependent on my parents to look after me by the time I actually got the help I “reached out for.” Rather it is the important act of paying close attention to the way language can seriously harm people, affect every single care encounter they have in the future, and critique systems of “care” that replicate a lack of safety, paternalism, Western colonial values, and extreme black and white rigidity (which is rather ironic when that is what these models of care are supposed to be treating.)

While I can understand why I am described in these ways, the result is that I cannot picture ever pursuing eating disorder treatment through formal services (as they currently exist) ever again. While I believe and do see change occurring, I cannot imagine ever feeling safe enough to set foot in an environment where the people providing care for me see (or have seen) me as a toxic, selfish, manipulative person who chooses to be difficult. These pieces are not made to further an “us” versus “them” dynamic, they are meant to be a reply and hopefully, a conversation that follows.

The first image is direct wording taken as it is used. The final image (“Where Have All the Good Patients Gone?”) includes some direct phrases alongside phrases that have been taken out of context. These latter words and phrases were fears that I expressed about the way I felt I was being perceived by this program and included things that were not said to me by clinical staff; however, alongside the words and phrases that were documented, it all blends together which is the point of this piece.”

IG @tatlioca (main), @shay.dood.les (art account)

Right Practitioner, Right Treatment, Right Time by L. Clarke

“It’s hard to capture the damage of the statement ‘right patient, right treatment, right time.’ It puts all the pressure and blame on the patient to fit neatly into this little box, telling us eating disorder treatment is a one size fits all solution. Reframing the statement to ‘Right practitioner, right treatment, right time’ has become a joke with my friends to reclaim our power and understand we’re not bad or broken for not succeeding in westernized eating disorder treatment.”

Growing In by L. Clarke

Distance Between Us by Sara Maximus

A representation of feeling misunderstood.

Biography

Sara Maximus - She/her/hers. Born in Penticton, BC, Sara grew up in Manitoba and currently resides in Saanichton on traditional W̱SÁNEĆ territory. Although she studied and worked as a digital illustrator, graphic designer, web/media developer, and photographer, she stepped away from her career ten years ago to focus on her mental health journey. 

Most of Sara’s work now is primarily art therapy in traditional mediums. She loves to learn and experiment with new techniques, mediums, and subject matter and is constantly evolving as an artist. “The learning part is just as fascinating to me and I love to incorporate my research and symbology into the art-making process.” Currently in her “nature era,” she is most inspired by the living things growing around her on Vancouver Island. 

Sara is a lover of all animals, tree hugger, and mental health advocate. 

IG @redsaidfred

Make A Choice & Complacency Kills by K.H.

Artist statement to come.

Rally at the Legislature 2024

Rise with us as we honour the resilience of our community, remember those we have lost, and demand better lives for adults with eating disorders. Press conference to follow.

Celebrating our community

On the final day of Eating Disorders Awareness Week, rise with us to honour those who are living with, recovering from, or lost their lives to eating disorders. We will hold space for our collective anger, love, grief, hope, and determination.

Rally details

Meet up at noon on the front steps of the BC Legislature, 501 Beleville Street, Victoria, BC. 

VIVED is calling a press conference with media at 1:00 PM immediately following our rally to voice our concerns with the delivery of a new Telus Health virtual eating disorder service.

VIVED speakers & guests:

• Shaely Ritchey (VIVED co-founder)

• Chelsea Kelly (VIVED media spokesperson)

• Graham Hughes (VIVED member)

• Sara Maximus (VIVED member)

• Adam Olsen (MLA for Saanich North & the Islands)

• Jonathon Morris (CEO of CMHA BC)

VIVED Virtual Town Hall EDAW 2024

*Update - VIVED Virtual Town Hall 2024 Summary and Next Steps.

Vancouver Island Voices for Eating Disorders (VIVED) invites you to join us for our second Virtual Town Hall this Thursday, February 1st from 6:30 to 8:00 PM PST to acknowledge national Eating Disorder Awareness Week (EDAW) - February 1st to 7th, 2024. 

Our panel discussion provides an opportunity to honour the voices of lived & living experience in our community and share alternative ways of meaningful healing outside of standard models of care.

This event is facilitated by VIVED members, including our Moderator Chelsea Kelly. We want to honour the inherent capacity of each one of us to navigate challenging feelings and difficult conversations. Volunteers will be available to provide peer support.

Our panel of speakers includes persons with lived & living experience of an eating disorder, their loved ones, clinicians, mental health advocates, and government change-makers. 

This event is closed to the media and there will be no recording of the session for confidentiality of all in attendance. We look forward to an evening of sharing and learning.

Our Featured Panelists:

Dr Anita Federici, PhD, CPsych, FAED
Clinical Psychologist & Owner of the Centre for Psychology + Emotion Regulation
https://www.psychology-emotionregulation.ca/

Adam Olsen, MLA for Saanich North & the Islands
Member of the BC Green Caucus
https://adamolsen.ca/ 

J Nicole Little, PhD, RCC-ACS
Mental Health Therapist, Owner of RO DBT Canada
https://radicallyopencanada.ca/ 

Jonathan Morris, CEO of CMHA BC
Canadian Mental Health Association BC Division
https://bc.cmha.ca/ 

Local Advocacy Group Recommends Caution

Accessing New Island Health - Telus Eating Disorder Service on Vancouver Island

VICTORIA, BC - Vancouver Island Voices for Eating Disorders (VIVED) is concerned that the new Telus Health virtual eating disorder service will not deliver what is most needed for adults with eating disorders on Vancouver Island. While we support individuals in accessing whatever services they can, we urge those considering this option to ask questions and be fully informed about the service.

Our question and concern is whether Telus Health can deliver the following critical aspects of care as listed in the Request For Proposals (RFP) set forth by Island Health:

• Virtual or in-person services with flexible hours, available Island-wide, and with self-referral options;

• Meaningfully trauma-informed care;

• Support services for adults who have have a persistent and enduring struggle with an eating disorder and/or have repeatedly not benefited from traditional recovery-focused treatment (in particular, those with comorbidities that exclude them from treatment);

• A focus on reducing harms associated with the condition as opposed to full recovery, and increasing meaningful activity;

• Counselling and wrap-around care including therapists, psychiatrist, physician and dietitian. Trauma therapist, outreach counsellor, occupational therapist, and substance use therapist would also be preferred components to proposed models;

• Liaising with existing Island Health community-based services (which don’t exist in the South Island or other Island regions) when readiness and engagement to work towards recovery and pursue tertiary care occurs;

• A shared care framework with primary care, general mental health and psychiatry, supported housing providers, Island Health community based eating disorder services, and local hospitals (it is unclear if a shared care framework exists, or how Telus is developing it);

• Access to supervision from clinicians experienced with eating disorders.

We are also deeply concerned with: 

• The neglect of informed consent related to private health data shared between organizations involved in this service and referral to it - MCFD, Island Health, and Telus;

• Unclear communication between service providers on what the service provides and the target population;

• Unclear determination of which clients/patients may be directed towards the service, the criteria such determinations are made on, and who makes such determinations;

• Uncertain how the shared care framework will work when clinicians in VIHA’s Adult Mental Health services currently have no knowledge of the Telus program;

• The complete absence of people with lived and living experience involvement in development of this service. VIVED’s request to participate in the evaluation process was denied;

• Not providing adequate opportunity for competent nonprofit organizations to apply. The RFP for this service was announced before the winter holidays on Dec 20th, 2022 and closed only a few weeks later, leaving too narrow a window for proposals; 

• Potential treatment costs being offloaded onto patients. In 2022, the BC Medical Services Commission petitioned the BC Supreme Court for an injunction against Telus Health for violating the Medicare Protection Act by offloading costs for MSP-covered services. While the parties have since reached a settlement, few of the services offered by Telus are MSP-covered. It is unclear whether clients will be charged for extra services or if they need to continue care after their one year of service is over.

Over the course of 2023, VIVED held numerous meetings with the multiple government ministries (including the MMHA, MoH, MCFD) and our regional health authority (Island Health) presenting our policy brief and bringing forward ideas for change and alternatives to the severely under-resourced and under-funded public healthcare system. Unfortunately, Island Health and MCFD walked away from the table in the fall of 2023. 

VIVED envisions a future where eating disorder services on Vancouver Island are safe, effective, and accessible to all. While our vision will take time and funding to achieve, we believe that Island Health can be offering a wider range of outpatient and inpatient services than currently available and we have made this feedback available to the government and the health authority on countless occasions.

To achieve this vision, VIVED has recommended a fulsome review of existing eating disorder services, followed by a broad redevelopment of services—both informed by PWLLE. This would align with A Pathway to Hope’s aim of improved access and better care, as well as the roadmap’s commitment that “people with lived experience inform and are leaders in mental health and addictions policy, planning and delivery of services and supports.”

What VIVED envisions for eating disorder care on Vancouver Island and across BC:

• Timely access to primary, secondary, and tertiary care services on Vancouver Island;

• Increased availability and diversity of local adult outpatient services, including day programs (also called “partial hospitalization”);

• Multifaceted care which involves general practitioners, occupational therapy, dietetic support, family therapy, spiritual care, trauma therapy, individual counselling, meal support, traditional and alternative therapies, and community outreach;

• Services which integrate harm reduction, palliative, and quality-of-life focuses as a viable and meaningful pathway to healing, persistent and enduring struggle with an eating disorder and/or have repeatedly not benefited from traditional recovery-focused treatment (in particular, those with comorbidities that exclude them from treatment);

• Community-based, upstream, stepped levels of care which reduce disruptions to work, school, and family obligations and prevent cycling through existing treatment models;

• Care that is comprehensive, holistic, patient-led, longer-term, part of a continuum of services, culturally-relevant and sensitive, as well as meaningfully trauma-informed, gender-affirming, weight-inclusive, and intersectional;

• Increased support for loved ones of people living with eating disorders.

Specific suggestions to the health authority have included:

• Improvement to psychiatric services through accredited continuing education on eating disorders for all Island Health psychiatrists working in outpatient and inpatient environments; 

• Adapting of existing outpatient mental health services to include adults whose primary diagnosis or concurrent diagnosis is an eating disorder;

• Expanding publicly available dietetic services through Island Health. Presently, Island Health Community Health and Nutrition Services are not qualified to provide dietitian support for eating disorders; 

• Expanded eating disorder education and speciality for case management services through outpatient mental health programs; 

• Expansion and improvement of education regarding eating disorders in emergency and psychiatric emergency settings, with a specific focus on dismantling stereotypes and the medical risks associated with all eating disorders;

• An Eating Disorder Advocacy Nurse (EDAN) program, modelled on the Sexual Assault Nurse Examiner (SANE) program. 

References

• Island Health RFP https://www.bcbid.gov.bc.ca/page.aspx/en/bpm/process_manage_extranet/11409

• The Tyee: Exclusive: Telus Handed BC Contract to Provide Eating Disorders Care https://thetyee.ca/News/2023/12/13/Telus-BC-Contract-Provide-Eating-Disorders-Care/

• The Tyee: Lobbyists, Telus and BC Health Care https://thetyee.ca/News/2023/12/22/Lobbyists-Telus-BC-Health-Care/

• The Tyee: Telus and the Politics of Privatized Health Care https://thetyee.ca/News/2024/01/02/Telus-Politics-Privatized-Health-Care/

• The Tyee: Telus Health Clinics Are Breaking BC Law, Alleges Medicare Watchdog https://thetyee.ca/News/2022/12/02/Telus-Health-Clinics-Breaking-BC-Law-Alleges-Medicare-Watchdog/

• The Tyee: Medical Services Commission, Telus Health reach agreement on LifePlus program https://news.gov.bc.ca/releases/2023HLTH0050-000595

Eating Disorders Awareness Week (EDAW) - our 2024 Statement

Better Lives for Adults with Eating Disorders

VICTORIA, BC - From February 1st to 7th every year, Eating Disorder groups across Canada unite to light notable landmarks in purple and commemorate Eating Disorder Awareness Week (EDAW) with a national week focused on raising awareness and creating change to improve the lives of people experiencing eating disorders and their loved ones.

Eating Disorders affect people of all genders, sexual orientations, ages, socioeconomic class, abilities, races, and ethnic backgrounds. Adults with eating disorders are whole and complex peoples who cannot be separated from their rich and varied spiritual, artistic, intellectual, and social lives, all of which collectively complement their own resilience.

Seeking these alternative internal resources is often exhausting and alienating. Adults with eating disorders have inherent capacity and can identify what support they need and when they need it. Rather than offering restrictive and highly rigid treatment options, services need to be creative and individual in focus; this requires collaborating with clients and remaining flexible to their unique needs.

When treatment doesn’t seem to be working, it’s important to ask questions, while remembering that it’s not a failure of the individual person; often it is a black-and-white treatment model that just doesn’t accommodate the individual person in the unique intersections of their lives. People do not fail treatment, but all too often treatment fails them; particularly if they exist with multiple intersecting, marginalized identities.

Treatment providers must recognise and mitigate the intersecting layers of oppression and the compounding rigidity of treatment structures provided through Western healthcare approaches, which frequently cannot meaningfully address the complex needs of diverse client groups, including 2SLGBTQIA+ folks, BIPOC & Indigenous peoples, older adults, neurodiverse individuals, gender non-conforming folks, concurrent physical and mental health diagnoses, trauma, substance use, as well as socioeconomic status, and food insecurity.

Services that neglect to accommodate treatment options that are supportive and holistic are alienating and unsafe for individuals who already face multiple barriers and a lack of safety in Western colonial society.

The inclusion of diverse people with lived and living experience of eating disorders is critical at every stage of designing, planning, implementing, and evaluating existing approaches to treatment within Western healthcare models and are key to building outside of it.

VIVED urges the government to take immediate action and commit to collaborating with people with lived and living experience to improve the lives and outcomes of adults struggling with eating disorders on Vancouver Island.

Eating Disorders Awareness Week (EDAW) 2024

Join Vancouver Island Voices for Eating Disorders (VIVED) from Feb 1st to 7th for national Eating Disorder Awareness Week (EDAW).

You are invited. We are hosting a series of events to raise awareness, advocate for meaningful change, and to envision better lives for adults with eating disorders.

It is estimated that upwards of *16,000 people on Vancouver Island are struggling with an eating disorder and yet there is an alarmingly critical shortage of accessible, timely, and adequate services available - especially for adults and marginalized populations.

VIVED has been calling for desperately needed change in our community for years! Every year, we get louder! Every year, we urge decision-makers to take action! Every year, very little changes for those who cannot afford to wait. It comes at the cost of people’s lives and quality of life.

This year, we are honouring our community first and foremost by celebrating our resilience and supporting each other as best as we can. We don’t have the energy to make our pleas for help more palatable and we are done asking politely. Please rise with us and amplify our voices!

We want access to healthcare that meets our diverse and unique needs. We want resources in our own community that allow us to participate meaningfully in our lives. And we want the voices of lived and living experience to be respected as experts of our own lives and how we define healing for ourselves.

* 1.5% of population based on 2006 statistic

Eating Disorders Awareness Week (EDAW) - our 2023 Statement

Vancouver Island Voices for Eating Disorders (VIVED) is calling on individuals, businesses, organizations, health authorities, and the government to take action on eating disorders.

Eating disorders are complex, serious illnesses

• Multiple types of eating disorders exist.

• Binge Eating Disorder is the most common kind of eating disorder, yet it is severely underserved.

• As we understand it, eating disorders often occur when those who have multiple interacting vulnerabilities experience a period of malnutrition or stress. This stress triggers physiological and psychological changes that together culminate as an eating disorder.

• Vulnerabilities can include biological, psychological, cultural, and structural factors. 

• Eating disorders affect people of all genders, sexual orientations, skin colours, sizes, (dis)abilities, ages, cultures, and socioeconomic classes. Those who face higher levels of marginalization and oppression are at disproportionate risk. 

Not enough is being done to address eating disorders and support those struggling

• There is a lack of accessible, timely, safe, effective services on Vancouver Island.

• There is not enough education, research, funding, and coordinated leadership.

• People with eating disorders are suffering and dying as a result of inaccessible, inadequate, sometimes harmful care. 

Addressing eating disorders is an issue of social justice and human rights

• Access to healthcare is a human right; eating disorder care is healthcare. 

• Marginalization and oppression increase vulnerability to eating disorders, create additional barriers to support, and increase the risk of experiencing harm in care settings. We must address marginalization and oppression in eating disorder work, and address eating disorders in social justice work. 

Change must occur

• All adults must have access to accessible, timely, safe, effective services. These should include all levels of care - primary, outreach, outpatient, intensive outpatient, hospital, and residential. Care options should be multifaceted, including dietitian services, caregiver and family support, harm reduction supports, trauma and other kinds of therapy, meal support, and practical support (e.g., housing).

• Care should be comprehensive, holistic, patient-led, longer-term, part of a continuum of services, culturally-relevant and sensitive, meaningfully trauma-informed, gender-affirming, weight-inclusive, and intersectional.

• People with lived and living experience have expertise.

• Provincial government, health authorities, community organizations, and people with lived and living experience of eating disorders must collaborate together.

Ways That We Can All Commit to Take Action:

• Educating ourselves and our community about eating disorders and what we can do

• Challenging assumptions and stereotypes we may hold about eating disorders.

• Contacting our elected officials to call for improved support and care for people with eating disorders.

• Raising awareness to our coworkers and community partners about the current lack of services and supports for adults with eating disorders.

• Participating in online trainings such as Body Brave eating disorder training opportunities.

• Collaborating with organizations, such as CMHA, VIVED, NIED, and NEDIC, to advocate for and improve services for people with eating disorders.

• Offering specialized supports for people with eating disorders at our organization/business.

• Ensuring our general services/supports are accessible and inclusive to people with eating disorders.

• Challenging fatphobia, diet culture, and wellness culture in our space.

• Shifting from number and size-centric measures of wellness (e.g., diagnostic criteria, weight, BMI, calories) to holistic, person-defined measures.

• Ensuring an equitable, safe environment to people of often-marginalized identities (e.g., queer, racialized, gender diverse, Indigenous, and disabled clients).

• Wearing purple and promoting EDAW.

• Extending accommodations to employees and volunteers who disclose they have an eating disorder or are caring for a loved one with an eating disorder.

• Removing barriers to accessing services wherever possible, including cost barriers, diagnostic criteria, age limits, geographic restrictions, and externally-defined requirements like “recovery oriented” or “stable.”

• Recognizing we will encounter people with eating disorders knowingly and unknowingly in our work, and committing to approaching all in a supportive way. 

• Including attention to eating disorders in our work on [mental health/fitness/wellness/food security/trauma/queer healthcare/caregiving support].

VIVED Virtual Town Hall - Summary & Next Steps

Reflections

Vancouver Island Voices for Eating Disorders (VIVED) held a virtual town hall on September 29th, 2022. The aim of the event was to create opportunities and inspiration for improved adult eating disorder care on Vancouver Island, as well as relevant tertiary services in B.C.

We at VIVED extend our deepest gratitude to all of our panelists, without whom we would not have been able to do this event. Your courage, authenticity, and strength is greatly appreciated. We also want to thank those who supported the event through planning, sharing, and attending. It is through conversations like these—ones that are often uncomfortable and challenging—that we truly grow.

This is certainly not the end of the conversation—it is only the beginning, and more opportunities are on the horizon.

The Current Situation

“We are in absolute crisis management”
- Tara F, person with lived and living experience (PWLLE)

At the town hall, panelists reported that services for adults with eating disorders on Vancouver Island are extremely limited. Services that do exist are often inadequate in terms of duration, intensity, and treatment modality - largely due to a lack of funding and resources.

In addition, adults face multiple barriers to accessing treatment. These include narrow eligibility criteria, long wait lists, geographical distance, and high costs (for any private services). Panelists also noted that their eating disorder diagnosis itself is a stigmatizing label which creates an added barrier to accessing care, and may be exacerbated by other social positions of marginalization. Panelists who identified as Indigenous, parents, diagnosed with co-morbid physical and mental health conditions, living in poverty, using substances, and/or older, described facing compounded barriers. They also acknowledged that those who are racialized, live in larger bodies, have a non-restrictive eating disorder diagnosis, and/or are gender diverse, also face more barriers.

In addition to inaccessibility, many adults described experiencing trauma in current systems of care, stemming from paternalistic, compliance-based, punitive, and “one-size-fits-all” models. Two panelists noted that outpatient services through the Ministry of Child and Family Development (MCFD) and inpatient care specific to eating disorders - which is presently only available in Vancouver in the form of 7 beds for all of B.C. and the Yukon, and takes place at the Catholic-based St. Paul’s hospital, both have harmful colonial legacies. Another panelist characterized many services as carceral, colonial, and/or fatphobic. 

“Things look good on paper. We talk about coming through a trauma-informed lens. But it’s not there. We’re using the language, but the actions of the system aren’t making allowances for that.” - Tara F., PWLLE

The inaccessibility, inadequacies, and the harms that exist in current care services - largely due to a lack of funding and resources - are having a significant, detrimental impact on adults with eating disorders, their families, and the healthcare system on Vancouver Island and the province of B.C.

"Why can’t I be treated as a whole person? I want to get better. And yet here I am sick and getting sicker. I’ve exhausted all publicly available eating disorder treatments in BC. And I’m watching my friends die because they waited for treatment that never came.” - Sara M, PWLLE

While many panelists with lived and living experience lauded clinicians and decision-makers they had worked with, who advocated strongly on their behalf, positive systemic change has not been forthcoming. Current, evidence-based, and relevant information regarding adults with eating disorders on Vancouver Island, in BC, and Canada is extremely limited. Layers of bureaucracy and the silo-ing of services make it challenging for those in leadership positions, within government, health authorities, the public, and other services to clearly understand the scope and reality of current services, what’s lacking, and what’s needed.

“It is just as messy as it appears… we are trying to repair the system as we fly.” - Adam Olsen, MLA for Saanich North and the Islands

Right now, people with lived and living experience - along with their support persons - are fighting for their lives. And as panelist Jonathan Morris noted, in a functional system, receiving care would not require “individual, heroic efforts.” 

“Tonight underscores the moral imperative for us to find ways to change" - Jonny Morris, CEO of CMHA BC

What is needed

Panelists had many tangible recommendations for change. 

Panelists called for more practitioners who have the skills to work with eating disorders. This would require:

• Training that is co-created, delivered, and evaluated by those with lived and living experience, alongside professionals.

• Enhanced continuity of care.

• Greater integration and less silo-ing of services.

Panelists named many types of eating disorder care they have had or would benefit from, that are not currently publicly available and accessible. These included:

• Timely, accessible, adequate access to acute services on the Island.

• Increased availability and diversity of outpatient services for adults on the Island, including day programs (or “partial hospitalization”), outside the jurisdiction of the MCFD. This would require accountability if current funding specific to adult outpatient services for adults with eating disorders were to be absorbed by the regional health authority.

• Multi-faceted care, including (for example) general practitioners with familiarity in treating eating disorders, occupational therapy, dietetic support, spiritual care, family therapy, trauma therapies, individual counselling, meal support, outreach, and alternative therapies (art therapy, etc.)

• Incorporation of harm reduction, palliative, and/or quality of life focuses in care, highlighted as a viable and meaningful pathway to healing for adults with long-standing eating disorders, where other approaches have not been of benefit to the person.

Community-based, upstream, and stepped levels of care that support people in their communities and daily lives. This would help prevent individuals and families from needing to take time off work, leave their families, face financial challenges, and cycling through multiple rounds of treatment.

Panelists called for care that it is:

• Comprehensive

• Holistic

• Patient-partnered or led

• Longer-term, with a continuum of services

• Culturally relevant and sensitive

• Trauma-informed

• Gender-affirming

• Weight-inclusive

• Intersectional 

Panelists noted these intentions sometimes exist on paper, but are rarely meaningfully defined and implemented.

"What bothers me so deeply is that very clearly people who are living with this terrible disorder have the solutions that our government needs to deploy in order to support you...I am committed to still asking questions, encouraging colleagues in government to get it right. Clearly there is enough information out there to develop services that serve the public and people who need them."

- Adam Olsen, MLA Saanich North & the Gulf Islands

How we get there

"We are in this together, all of us. We all want the same thing. Not a single person here who wants worse, or even — I would hazard — the status quo." - Kat P, PWLLE

Panelists had clear ideas of how their recommendations could be implemented:

• Collaboration and communication among service providers, government, and others working to address service issues and limitations—not inappropriately restricted by privacy legislation.

• Engaging people with lived and living experience in decision-making, planning, and implementation of services, education, etc.

• Acknowledging adequate, accessible, and human-centered care for adults with eating disorders as a human rights issue.

“I do have the capacity to know what is best for me." - Sara M., PWLLE

VIVED’s next steps: Call for Collaboration

Based on what we heard, VIVED will be taking the following actions:

1. Advocating for immediate implementation of publicly-funded and accessible interim services for adults with eating disorders on Vancouver Island, including dietitians, meal support, counselling, outpatient groups, outreach, and medical monitoring, as well as fast-tracked approvals to out-of-province and out-of-country care.

2. Calling on partners to develop a planning committee that involves all relevant stakeholders to meet regularly to understand, plan, implement, and evaluate adult eating disorder supports.

3. Continuing to collect information on the current eating disorder care system.

4. Partnering with interested groups, including the Canadian Mental Health Association (B.C. Division), National Initiative for Eating Disorders (NIED), the National Eating Disorder Information Centre (NEDIC), and others with lived and living experience.

5. Supporting each other, and ourselves, to survive and thrive in this challenging situation.

To be part of our next steps, email us at vanislevoicesforeds@gmail.com or contact us through social media.

• Facebook: VIVED's Facebook page

• Instagram: @VanIsleVoicesforEds

• TikTok: @vanislevoicesforeds

Letter Writing Campaign

Send a letter to your elected representative regarding the service cuts to the South Island Eating Disorders Program (SI EDP). We have created a fillable letter template that you can send to your local MLA in the South Island region, the Minister of Mental Health and Addictions (MoMHA), and the Minister of Child & Family Development (MCFD).

If you do not live in the South Island region, you can still write a letter to the Minister of Health, and Minister of Mental Health & Addictions as well as the Minister for Child & Family Development. The letter can be written regarding your concerns about eating disorder treatment for adults in B.C. and the service changes occurring in the South Island region.

Guidelines:

• If you don’t know your constituency, you can look it up here: https://www.leg.bc.ca/learn-about-us/members

• When contacting your MLA (if you are in the South Island region), it is important to introduce yourself as a constituent.

• Leave a voicemail, send an email, write a letter.

• Don’t be afraid to follow up! It takes persistence to create change.

Here is a sample letter:

• There is a link to a .docx or .rtf file listed with the contact information for your MLA below. Click one of those links to download the sample letter.

• In your download folder, open the file in Microsoft Word or your preferred word processing application. If you are using Microsoft Word:

  • By default, the .docx file will open in protected view because it was downloaded from the internet. Click the Enable Editing button at the top of the page.

  • Make sure to fill in the form fields with your information.

• Please ensure to personalize the letter. An original letter by one passionate person is far more powerful than a pile of identical letters.

• Print three extra signed copies for the Minister of Health, Minister of Mental Health and Minister of Children and Family Development

• Copy and paste the letter into your email application to send an email.

South Island MLAs

Hon. Murray Rankin, QC
MLA for Oak Bay-Gordon Head
219-3930 Shelbourne Street,
Victoria, BC V8P 5P6
Ph: (250) 472-8528
E: murray.rankin.mla@leg.bc.ca
Download: .docx | .rtf

Ms. Grace Lore
MLA for Victoria-Beacon Hill
1084 Fort Street,
Victoria BC V8V 3K4
Ph: (250) 952-4211
E: grace.lore.mla@leg.bc.ca
Download: .docx | .rtf

Hon. Rob Fleming
MLA for Victoria-Swan Lake
1020 Hillside Avenue,
Victoria, BC V8T 2A3
Ph: (250) 356-5013
E: rob.fleming.mla@leg.bc.ca
Download: .docx | .rtf

Hon. Mitzi Dean
MLA for Esquimalt-Metchosin
104-1497 Admirals Road,
Victoria, BC V9A 2P8
Ph: (250) 952-5885
E: mitzi.dean.mla@leg.bc.ca
Download: .docx | .rtf

Prem. John Horgan
MLA for Langford-Juan de Fuca
122-2806 Jacklin Road,
Victoria, BC V9B 5A4
Ph: (250) 391-2801
E: john.horgan.mla@leg.bc.ca
Download: .docx | .rtf

Hon. Lana Popham
MLA for Saanich South
260-4243 Glanford Avenue,
Victoria, BC V8Z 4B9
Ph: (250) 479-4154
E: lana.popham.mla@leg.bc.ca
Download: .docx | .rtf

Mr. Adam Olsen
MLA for Saanich North and the Islands
9828 Fourth Street,
Sidney, BC V8L 4T9
Ph: (250) 655-5600
E: adam.olsen.mla@leg.bc.ca
Download: .docx | .rtf

Print Three Signed Copies of Your letter and mail to:

Hon. Adrian Dix
Minister of Health
Room 327 Parliament Buildings,
Victoria, BC V8V 1X4
Ph: (250) 953-3547
E: hlth.minister@gov.bc.ca

Hon. Sheila Malcolmson
Minister of Mental Health and Addictions
Room 247 Parliament Buildings,
Victoria, BC  V8V 1X4
Ph: (250) 952-7623
E: mh.minister@gov.bc.ca

Hon. Mitzi Dean
Minister of Children and Family Development
Room 134 Parliament Buildings,
Victoria, BC  V8V 1X4
Ph: (250) 387-1977
E: mcf.minister@gov.bc.ca

online petition to address the recent service cuts facing adults with eating disorders in the south island region.

Please sign and share!

“To the Honourable Legislative Assembly of the Province of British Columbia, in Legislature Assembled:

The petition of the undersigned, Vancouver Island Voices for Eating Disorders of Vancouver Island, B.C., states our request that the Honourable House take urgent action to support adults struggling with eating disorders in our community, who are facing devastating service cuts.

In November 2021, the South Island Eating Disorder Program (SI EDP) in Victoria, B.C. stopped accepting new referrals for adult clients and services were further limited for those patients currently on the clinic's caseload. Services are only being provided to current patients as long as they're involved with provincial services through Providence healthcare (St. Paul's inpatient program and the Discovery/Vista residence in Vancouver, B.C.)

The Eating Disorders Program has been gradually limiting access to individualized services over the past few years, but with the COVID-19 pandemic, the South Island program is experiencing a dramatic jump in demand for services with no ability to provide it. The program is severely under-funded, under-staffed, and their resources are stretched beyond capacity. As a result, what little resources exist have been prioritized for youth and adult patients are now being turned away.

Because adult outpatient services for eating disorders are provided through the Ministry of Child Development in the South Island region, the adult population will never be a priority. Youth and adults have different needs and capacities, but adults are not less capable of change or less deserving of support. These individuals are valuable members of our community, and they deserve support that allows them to participate in society.

Community-based/outpatient treatment has been proven to lead to improved health outcomes and cut long-term healthcare and social assistance costs. Allowing individuals to find the support they need in their own community is critical to sustain recovery and prevent treatment-cycling.

Without accessible community-based support, patients' only option is to seek support through the adult tertiary program at St. Paul’s hospital in Vancouver, B.C. A program which itself, has very limited resources to support an entire province of patients.

Eating disorders affect people of all ages, races, sexual orientations, genders, socioeconomic statuses, backgrounds, and frequently accompany other co-morbid mental illnesses. Given that eating disorders can lead to significant disability, have the highest death rate of any mental illness outside of the opioid crisis, and are the third most common mental illness in Canada, your willingness to act is a vital step towards change.

Your petitioners respectfully request that the Honourable House move adult outpatient eating disorder funding and services in the South Island region from the jurisdiction of the Ministry of Child and Family Development to the Ministry of Health (which would be delivered through Island Health).

Other critical ways we need to take action include:

• Increasing education and training for healthcare professionals that focuses on eating disorders, weight stigma, cultural competence, harm reduction practices for eating disorders, and trauma-informed care.

• Investment in provincial and community-based services for adults to provide stepped-levels of care to patients and families transitioning in their care needs to avoid cycles of relapse.

• Investment in research for eating disorders to ensure treatment and support options are evidence-based.”

Collecting a Narrative - Gathering personal impact statements regarding recent changes to the South Island Eating Disorder Program.

In learning about the changes coming to the South Island Eating Disorder Program, we want to hear about how this impacts you as an individual as well as how it impacts your wider circle of loved ones.

Getting these more in-depth responses will help us piece together a broader narrative. Our hope is to bring this collection of personal statements together to present it to Go Public (an investigative segment run by CBC news.)

Please adhere to BEAT media guidelines when sharing - https://www.beateatingdisorders.org.uk/media-centre/media-guidelines/

The fillable form can be found here.

National Eating Disorders Awareness Week (Canada) - February 1-7, 2022

February 1-7 is National Eating Disorders Awareness Week (EDAW) in Canada. This year's campaign, "Everyone has a role to play," aims to recognize that we all have a role to play in eating disorder prevention and recovery.

Depending on who we are in a person's life, the specifics of our role as a supporter might differ. Still, whether we are a friend, family member, professional, or otherwise - learning about and supporting someone through their struggles can be pivotal in their recovery.

What are some of the ways we can support people in their recovery?

1. By LEARNING about eating disorders

2. By LEANING into discomfort

3. By LISTENING closely

4. By paying careful attention to LANGUAGE

5. By letting the person LEAD where possible

Let’s explore each of these a bit further…

LEARNING ABOUT EATING DISORDERS:

There are a variety of professional resources and materials to explore further learning about eating disorders (see the resource and educational materials pages on our website). However, voices of lived experience are one of the most valuable forms of knowledge, and no list of resources is complete without them.

LEANING INTO DISCOMFORT:

To support those living with eating disorders, we need to lean into uncomfortable conversations: whether it is with ourselves, our loved ones, our patients, our practices, our healthcare systems, or our cultures. There is no healing without exploring the hard topics, doing the deeper, reflective work, dismantling oppressive systems, and unpacking our own biases.

LISTENING CLOSELY:

There is no greater gift we can give to those on their healing journey than that of listening closely. This may take practice, but truly hearing voices of lived experience, recognizing the struggles that individuals face (without simply reducing them to those struggles), and honouring that people are the experts of their own lives, is vital to healing.

PAYING CAREFUL ATTENTION TO LANGUAGE:

Language can be both empowering and disabling. Often times, it is the connotations around certain words and phrases that can be stigmatizing, hurtful, and disruptive to therapeutic connection. The language we use with ourselves and our own relationships to nourishment and our bodies can have a huge impact on those in our lives who are working on recovery from an eating disorder. Be mindful and attentive to what language you use and how it feels for each person.

LETTING THE INDIVIDUAL LEAD WHERE POSSIBLE:

Eating disorders are serious mental illnesses and balancing autonomy with safety can be challenging for loved ones and professionals to navigate. Sometimes there is seemingly not a lot of room for choice; however, offering even small choices where possible and doing our utmost to work collaboratively with a person is critical.

World Eating Disorders Action Day 2021 - #equity4eatingdisorders

June is just around the corner, and that means it is almost time for World Eating Disorder Action Day (WEDAD) on June 2nd!

Why is this day important? Because while awareness is critical, ACTION is what is desperately needed.

We have made a great deal of progress when it comes to our understanding and treatment of eating disorders and disordered eating, but there is much farther to go.

This year’s theme is #equity4eatingdisorders

This highlights a very important and present issue in the world today because it recognizes privilege, disadvantage, intersectionality, and ongoing disparities between different groups of people.

Eating disorders ARE a political and social justice issue; we cannot separate action for eating disorders from things like racism ✊🏿, disability activism ♿️, poverty, socioeconomic factors, justice, feminism 💪🏼, fat activism, LGBTQIA+ 🏳️‍🌈 ⚧ activism, and systemic inequalities ⚖️

Stay tuned and feel free to join the conversation on this important day highlighting activism. We will be sharing different content (ours and others) on our social media channels and encouraging conversation that we would love you to join in!

Of course, WEDAD is simply a focal point for the action that needs to be undertaken EVERY. SINGLE. DAY. 👏🏻 if we are to keep pushing for real and positive change!

Raise your voice and let’s get to work! 🎤

Documentary short - a message for supporters

In November 2018 we were given the opportunity to create a documentary short with Stacey Maria & Sarah Rzemieniak. Thank you to Robyn Unwin Media and Beacon Community Services for making this video possible.

Op-eds & Published Pieces by Members

• Victoria News Article - Massive Bed Shortage for People with Eating Disorders

• Times Colonist Article - Fat Stigma exists; so does Thin Privilege

• Love Our Bodies, Love Ourselves (Jessie’s Legacy) Blog Post - Recovery & Choice

• Beating Eating Disorders Blog Post (written by a VIVED member) - Navigating the Holidays

• Looking Glass Blog Posts (written by VIVED members) - Beauty Culture, Navigating the Holidays, Imagining Others (and Ourselves) Complexly