A recent article in Health Magazine reported that trying to pay for a child’s eating disorder treatment is bankrupting some families. According to research from Harvard’s Strategic Training Initiative for the Prevention of Eating Disorders and the Academy for Eating Disorders, the average cost of a hospital stay for a patient with an eating disorder is $19,400—more than double the average $8,900 treatment cost for hospital stays related to schizophrenia and the $8,800 average for alcohol-related hospitalizations.
The only explanation that was offered for the discrepancy was that patients with eating disorders require a large treatment team of specialists, including a psychiatrist, a therapist and a nutritionist and stays tend to be longer.
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My first two inpatient admissions for anorexia, in 1987 and 1988 were six months and four months respectively. This was before the era of managed care, and I had a great deal of weight to regain before I was at a healthy weight. My admission both times was at an inpatient facility in New Jersey about an hour from my home in Queens, NY. My mother said it was the only place that had an open bed. She was desperate at the time because I was slowly killing myself.
The Renfrew Center, known for its residential centers for eating disorders, had just opened its doors in 1985. The residential level of care may have been a relatively new concept in the eighties and not as widely available as it is now.
I’d be hospitalized six or seven more times for my anorexia and always at the inpatient level, never at a residential facility. Perhaps I would have benefited from an extended stay at one, but it never occurred to me or my family. My last admission in 2012 — I’d presented myself because an outpatient facility had told me I was too sick to be outpatient and my outpatient psychiatrist wouldn’t treat me until I got help for the anorexia which was active. I was on the unit a couple of days, when the head psychiatrist told me my insurance didn’t consider me sick enough to be inpatient. I told them to discharge me because I’d already run up a bill in the several thousands of dollars. I literally had no place to go.
Again, according to research from Harvard’s Strategic Training Initiative for the Prevention of Eating Disorders, eating disorders cost the US economy 64.7 billion dollars from September 2019 through October 2019. That number includes not only the costs of actually treating the eating disorder but the overall societal costs such as lost productivity.
After my second eating disorder hospitalization in 1988, I didn’t only lose my job at one of the leading packaged goods organizations in the country, I lost a career. In the eight years I’d been working since college, I climbed up from a secretary to a Consumer Development Promotion Manager. The Americans with Disabilities Act wasn’t passed until 1990, so I had no protection from being let go for a psychiatric condition.
One situation cascaded into another and I got swept away in a psychiatric tsunami. Losing my career triggered a severe depressive episode and I was unable to work. I attended a day program in New York City, where I cowered in the corner and did not participate. Early one morning before the sun rose, I awoke and attempted suicide by overdosing. When I didn’t die, I went into the program. They noticed me acting strangely. When I told them what I had done they took me to the emergency room. It was during the ensuing psychiatric hospitalization that I was diagnosed with borderline personality disorder.
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The New York Times published an article in April titled “Eating Disorders in Teens Have ‘Exploded’ in the Pandemic.” The author, Lisa Damour writes, “As a psychologist who cares for adolescents I am well aware of the prevalence of eating disorders among teenagers. Even still, I am stunned by how much worse the situation has become in the pandemic.”
Insurance companies have to do better.
Thanks for reading,