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Chapter 8 Section G: People with mental health conditions and other disabilities

8G.1: Introduction

This section has information about having a mental health condition and other coexisting conditions or disabilities. Coexisting conditions used to be called ‘dual diagnosis’ or ‘co-morbidity’. However, the contemporary preferred language now is ‘coexisting disability or impairment’.

There is information about having a mental health condition and:

8G.2: Intellectual Disability

Intellectual disability is a condition which impacts a person’s overall mental abilities, for example abstract thinking, the ability to socialise or to manage various areas of life. It’s not always easy to identify mental illness or a mental health condition in a person with intellectual disability. There may be a number of reasons for this. People with intellectual disability:

  • can’t always describe their symptoms to a health practitioner or psychiatrist
  • may not be able to communicate very well or at all verbally
  • may have symptoms that are different from those described in the diagnostic guidelines for mental illnesses
  • may be wrongly assumed to have behavioural problems because of their intellectual disability rather than a mental illness
  • may demonstrate body language that is difficult to interpret
  • may have physical health conditions that produce symptoms similar to mental illness; and/or
  • may experience side effects from medication that confuses health professionals or support workers.

The NSW Council for Intellectual Disability is the peak body representing the rights and interests of people with intellectual disability in NSW. Its website has factsheets and information both in standard and in ‘easy’ English, which can be accessed by clicking here.

The NSW Council for Intellectual Disability can also provide a confidential information and referral service on matters relating to intellectual disability. It has developed a comprehensive information database that has the details of many services and resources available to people with intellectual disability and their families, advocates and service providers.

Click here to go to CID website or contact the NSW Council for Intellectual Disability at:

Freecall: 1800 424 065*
Phone: (02) 9211 1611
Fax: (02) 9211 2606
Street address: Level 1, 418A Elizabeth Street

Click here to access links to a range of disability advocacy services in NSW.

For free legal advice about intellectual disability issues, contact the Intellectual Disability Rights Service (IDRS). IDRS gives free legal advice and information to people with an intellectual disability or others acting on their behalf in NSW. Initial advice is provided over the phone by appointment.

Click here to go to the IDRS website.

IDRS also runs the Justice Advocacy Service (JAS). The JAS supports young people and adults with cognitive impairment who are in contact with the NSW criminal justice system, including as victims, witnesses and suspects/defendants to exercise their rights and fully participate in the process.

For more information about the JAS, click here.

To get a support person or legal advice for people with intellectual disability in police custody, please call 1300 665 908* or 9265 9300.

* Mobile phone calls to freecall numbers (numbers starting with 1800) and to local call numbers (numbers starting with 13 or 1300) are charged to the caller at the usual mobile rate.

8G.3: Acquired brain injury

Synapse is Australia’s Brain Injury Organisation which provides targeted research, and specialist housing, services and support for Australians impacted by brain injury and disability.

Synapse uses the term ‘brain injury’ to refer to any type of brain disorder or neurological issue which is sustained rather than influenced by developmental conditions. There are a wide range of causes, and the long-term effects differ for each person because the brain is a very complex organ made up of many different parts.

An acquired brain injury (ABI) is an injury to the brain that has occurred after birth. ABI is not hereditary, congenital (present from birth), degenerative (a condition becoming worse over time) or induced by birth trauma. Examples of traumatic ABI include those injuries to the brain caused by an external physical force to the head. This can happen as a result of a motor vehicle accident, assault, domestic violence or a fall.

Non-traumatic acquired brain injury can result from tumour, brain infection, aneurysm or anorexia, alcohol or drug misuse, a stroke, or a disease such as Huntington’s disease.

More information about acquired brain injury can be found at:

People with mental health conditions who also have ABI may find that this can affect access to services and treatment.

Services that support people experiencing mental health conditions and psychosocial disability and services for people with ABI tend to be different organisations. Often these different services and agencies don’t have specialist knowledge and insight into the causes, symptoms and treatment of the ‘other’ condition.

There are some limited services that may be able to help a person with both a mental illness and a brain injury to get coordinated services for both of their conditions.

For more about acquired brain injury and mental illness, click here. For information about advocacy services for people with acquired brain injury and mental illness, click here.

8G.3.1: Acquired brain injury and mental health conditions

There are various ways ABI can be linked to mental illness:

  • Some mental illnesses may be either based on or associated with a physical condition or biological process related to the ABI
  • Mental illness can develop as a direct result of the brain injury because of damage of specific areas of the brain
  • Some people with ABI have psychological problems that may be made worse by their injury
  • Some people with ABI can develop mental illness in reaction to the traumatic stress associated with the accident that caused their injury or ongoing negative experiences linked to the injury; and/or
  • Some people who experience psychological difficulties may self-medicate (using non-prescription drugs or alcohol) to alleviate distress, which may cause a non-traumatic ABI.

8G.3.2: Advocacy services for people with mental health conditions and a brain injury or developmental disabilities

Synapse, Australia’s Brain Injury Organisation, provides support services for individuals with a brain injury and their carers. They acknowledge the daily challenges that can arise and work to understand your situation and provide the information, advice and practical support you need at every stage of life.

For further information about Synapse please click here.

Synapse can be contacted in Sydney and Gosford by calling 1800 673 074* Monday to Friday from 9am – 5pm.

There are a number of disability advocacy services in NSW that can provide individual advocacy support for people with mental health conditions who also have an acquired brain injury and other disabilities.

Disability Advocacy NSW (DA) works in the Hunter, New England, Central West, Hawkesbury-Nepean and Mid North Coast regions of NSW Australia. They can assist you with general advocacy information and resources, and with advocacy matters in relation to the NDIS. DA has two important ways it can help people with a disability and family with the NDIS: General Advocacy Support and External Merits Review Support of NDIS decisions (NDIS Appeals).

To read more, click here.

Advocates seek to assist people with a disability who have been unfairly treated. As a guideline, a person with a disability is treated unfairly if treated contrary to: law, human rights, policy, standards or well accepted conventions (such as procedural fairness/natural justice).

Advocates can:

  • directly advocate on behalf of a person, or providing information and advice so that a person can advocate for themselves (e.g. dealing with a landlord, support when going to court, support in dealing with the police, support in getting professional legal advice, negotiating a better deal from a government department, dealing with guardianship and financial management orders, dealing with problems at work, school, TAFE or Uni, etc)
  • link a person with other relevant services (e.g. helping a person get legal advice from a solicitor)
  • talk over a problem (e.g. advocate can best help by simply listening and helping to think through options for moving forward); and
  • support a person take formal action on matters related to disability discrimination or making a complaint against a service provider (e.g. assisting a person to make a complaint with the Anti-Discrimination Board).

Advocates cannot:

  • provide legal advice (but where appropriate, advocates may help you get legal advice from a qualified legal practitioner)
  • provide casework services (e.g. finding accommodation, applying for services, managing services, etc)
  • provide advocacy services when a government disability caseworker can provide advocacy support and that caseworker does not have a conflict of interest (e.g. advocates can help a person with a disability with a pension problem if the disability

For more information about their offices across NSW, click here.

Disability Advocacy NSW can be contacted at:
Telephone (02) 4927 0111
Freecall: 1300 365 085*
Facsimile: (02) 4927 0114
Head office address:
Suite 3, Level 2,
408 King Street, Newcastle West, NSW 2302

*Mobile phone calls to freecall numbers (numbers starting with 1800) and to local call numbers (numbers starting with 13 or 1300) are charged to the caller at the usual mobile rate.

People with Disability Australia (PWDA) is a national disability rights, advocacy and representative organisation that is made up of, led and governed by people with disability. They have a cross-disability focus, which means they represent the interests of people with all kinds of disability.

PWDA’s Wayfinder Hub gives people with disability and their families easy access to the information, advice and referrals they need to understand choices, link to appropriate supports and make informed decisions about the life they want. The Hub is open to the community to contact via phone, email or internet chat for assistance on any aspect of disability information.

They can also help to provide individual advocates who can represent the rights of a person with disability and help sort out their complaint, issue or problem. Advocacy support can include going to meetings with or for the person, writing letters, making phone calls or help them lodge complaints.

PWDA’s advocacy services are:

  • non-legal;
  • issue-based;
  • short to medium term; and
  • for people with disability who have serious and urgent issues.

PWDA also provides information to people with disability about how to advocate for themselves. PWDA provides a range of brochures, including for Aboriginal and Torres Strait Islanders, in community languages (including Arabic, Chinese, Spanish, Vietnamese) and in Auslan.

These service is available to people with all kinds of disability no matter where they live in New South Wales.

Click here to go to the People with Disability Australia website.

People with Disability Australia can be contacted at:

Phone: (02) 9370 3100
Freecall: 1800 422 015*
Fax: (02) 9318 1372
Teletypewriter (TTY): (02) 9318 2138
TTY Freecall: 1800 422 016*
Street address: Tower 1, Level 10. Lawson Square Redfern NSW 2016
Postal address: PO Box 666

*Mobile phone calls to freecall numbers (numbers starting with 1800) and to local call numbers (numbers starting with 13 or 1300) are charged to the caller at the usual mobile rate.

8G.3.3: Developmental Disability

Developmental disability refers to a group of conditions due to impairment in physical, learning, language or behaviour areas. Examples of development disabilities include intellectual disability, attention deficit hyperactivity disorder (ADHD), autism spectrum disorders, behavioural disorders, Tourette syndrome, cerebral palsy, Down syndrome, and fetal alcohol syndrome. These conditions begin during the early years of a person’s life, may impact day-to-day functioning and usually last throughout a person’s lifetime.

Most specific areas of disability have organisations that support people and the families and carers. These organisations may provide information and resources. Some examples include:

Many people who live with these conditions experience mental illness and other coexisting conditions in greater numbers than the community in general.

8G.4: Epilepsy

Epilepsy is not a mental illness but is a common neurological condition in the Australian population. Epilepsy occurs regardless of age, gender, cultural or socio-economic background. Epilepsy can develop at any stage of life, but it is more common in children, adolescents, and people over sixty (60). People with epilepsy experience sudden recurrent episodes of sensory disturbance, loss of consciousness, or convulsions. These episodes are related to abnormal electrical activity in the brain which are called ‘seizures’. Some seizures are severe and are easily recognised as a seizure, whilst others are subtle and may not be noticed by most people.

Epilepsy is usually effectively treated with Anti-Epileptic Drugs (AEDs), which help manage convulsions. While AEDs will not cure epilepsy, they can help to control or minimise seizure activity. With regular medication and a healthy lifestyle, most people with epilepsy are able to live full and active lives. Many people living with epilepsy experience good seizure control through appropriate use of medication. Taking one AED is called ‘monotherapy’ and the use of a combination of medications is called ‘polytherapy’. The aim is to achieve optimal seizure control using the most appropriate medication with the fewest side effects.

Epilepsy Action Australia is the largest community managed provider of specialist epilepsy services for people with epilepsy and other seizure disorders, their carers, families and the broader community. Highly skilled nurse educators and service consultants assist thousands of children, adults and their families accept and adjust to a life with epilepsy.

They also provide up-to-date and easy to understand information on the condition and related topics and support services tailored to individual needs. For example, Epilepsy Action Australia provides online tools, fact sheets and resources; hosts online communities which help people connect with others; and websites tailored to different age-groups and circumstances. They also provide products such as seizure monitors and wearable technology designed to help keep you safe and alert others when you need assistance.

People with mental health conditions sometimes have epilepsy as a coexisting condition, and their treatment plan will have to take this factor into account.

Follow this link to find further resources.

Epilepsy Action Australia
Free-call line: 1300 374 537
Mail: PO Box 879
Epping NSW 1710

*Mobile phone calls to freecall numbers (numbers starting with 1800) and to Local call numbers (numbers starting with 13 or 1300) are charged to the caller at the usual mobile rate.

The Epilepsy Foundation assists individuals and organisations who support, care for or work with people who live with epilepsy.

The Epilepsy Foundation’s Information Line (InfoLine) operates Monday to Friday between 9.00am and 5.00pm. The InfoLine is staffed by Epilepsy Support Workers with expertise in how epilepsy affects health, well-being and daily living issues incorporating person-centred, self-management strategies. They can arrange interpreting services for people from non-English speaking backgrounds.

The Epilepsy Foundation provide:

  • support services that can assist people with advice and information about epilepsy
  • advice about risk management and living well with epilepsy
  • individualised support for people living with epilepsy who require assistance with accessing supports and community resources
  • development of tailored Epilepsy Management Plans
  • evidence-based and person-centred epilepsy education and training programs designed for families, schools, communities and the workplace
  • a number of peer support groups for families, young people and adults living with epilepsy; and
  • NDIS support, including the development of epilepsy management plans and epilepsy training, but do not provide support coordination services.

Visit the Epilepsy Foundation’s NDIS page for more information.

People can self-refer to the services or be referred in confidence by any health professional.

8G.5: Dementia

Dementia is not a mental illness but describes a collection of symptoms that are caused by disorders affecting the brain. It is not one specific disease. Dementia affects thinking, behaviour and the ability to perform everyday tasks. Brain function is affected enough to interfere with the person’s normal social or working life. People with dementia may have difficulty solving problems and controlling their emotions. They may also experience personality changes. Dementia is usually progressive, which means it gradually spreads throughout the brain resulting in a person’s symptoms becoming worse over time.

People with dementia may also have or may develop mental health conditions, such as mood and perceptual disturbances (relating to the ability to become aware of something through the senses). These symptoms may be treated with mood stabilising or anti-psychotic medication.

Most people with dementia are older, but it is important to remember that not all older people get dementia. It is not a normal part of ageing. Dementia can happen to anybody, but it is more common after the age of sixty-five (65) years. People in their 40s and 50s can also develop dementia.

Dementia Australia NSW advocates for the needs of people living with all types of dementia, and for their families and carers. They provide support services, education and information.

Dementia Australia NSW delivers national dementia programs and services including:

  • the National Dementia Helpline;
  • early intervention programs such Living with Memory Loss;
  • the National Younger Onset Dementia Key Worker program;
  • Dementia and Memory Community Centres;
  • counselling;
  • carer support groups;
  • education for family carers; and
  • public awareness activities and a national resources program.

Follow this link to find resources about the programs listed above.

National Dementia Helpline: 1800 100 500*
National Dementia Helpline Email:

National website
For NSW locations and contact information follow this link.

*Mobile phone calls to freecall numbers (numbers starting with 1800) and to Local call numbers (numbers starting with 13 or 1300) are charged to the caller at the usual mobile rate.

8G.6: Personality Disorder

Personality disorder refers to an individual’s long-term pattern of thinking, behaviour and emotions that cause them distress and makes it difficult for them to function in everyday life. People living with personality disorders find it hard to change their behaviour or adapt to different situations. They may have trouble sustaining work or forming positive relationships with others.

There are several different types of personality disorders. More common personality disorders include Borderline Personality Disorder, Obsessive Compulsive Personality Disorder and Narcissistic Personality Disorder. Unfortunately, these disorders often attract stigma, and can lead to people being discriminated against in the community and in services. This is mainly because people with a personality disorder tend to experience difficulties with interpersonal relationships.

Depending on the specific condition, some people with a personality disorder may appear withdrawn, distressed and emotional, and others behave in ways that seem odd or eccentric. The one thing that these people have in common is that their symptoms are often severe enough to affect many different areas of their life. People often develop early signs of a personality disorder in adolescence. People with personality disorders often have high rates of coexisting mental health conditions such as depression, anxiety and/or substance use issues.

Due to the nature of these disorders, it can be difficult for people to recognise that they have a problem or to seek help. Treatment is available for people living with personality disorders. Different models of psychotherapy and other ‘talking therapies’ can help a person develop insight into their condition, better manage their symptoms and relate more positively to others. The first step in seeking help is to visit a General Practitioner or mental health professional and arrange a mental health assessment.

To find out more about personality disorders, their diagnosis and treatment, and other support services that may be available, click on the following links:

  • The Project Air Strategy for Personality Disorders is a partnership between the University of Wollongong, the NSW Ministry for Health and Local NSW Health Districts. It has helpful factsheets about personality disorders and trains service providers to improve treatment for personality disorders. It does not provide services direct to consumers.
  • Australian Government Department of Health webpage on personality disorders.
  • Head to Health is an Australian government mental health online resource that can help you find digital mental health services. Head to Health brings together apps, online programs, online forums, and phone services, as well as a range of digital information resources. To read more about personality disorders click here.
  • is an online youth mental health service for young people, their carers and support persons.
  • Sane Australia is a non-government advocacy and support organisation for people with mental health conditions, their families and carers. It provides information, fact sheets and guides about a range of mental health conditions, including personality disorders.
  • The best ways to get support for a personality disorder is to visit a General Practitioner, Community Health Centre, or Community Mental Health Centre.

People with personality disorders may be at risk of harming themselves or others. You can call Lifeline on 13 11 14, or dial triple zero (000) if you or someone you know has attempted to or is at risk of attempting to harm themselves.

8G.7: Eating Disorders

Eating disorders, such as Anorexia Nervosa and Bulimia Nervosa are mental health conditions that have an adverse impact on physical and mental health. For children, adolescents and young people in particular this can have serious consequences for their development. Eating disorders constitute a very significant public health challenge.

Eating disorders and disordered eating together affect large numbers of the Australian population. Binge eating disorders and other specified eating disorders are the most common, while anorexia nervosa and bulimia nervosa each occur in much smaller numbers.

Many people with eating disorders also present with at least one other lifetime psychiatric disorder. Among adolescents, many individuals with bulimia nervosa, individuals with binge eating disorder, and individuals with anorexia nervosa have one or more coexisting psychiatric conditions at some point in their lives. The most common and significant coexisting conditions experiences are mood, anxiety and substance use disorders. The only psychiatric disorder that commonly co-occurs with anorexia nervosa is oppositional defiant disorder.

Severe eating disorders are not simply ‘lifestyle choices’ being pursued by an individual. They often represent a very serious mental health condition that may involve perceptual disturbance (for example, a false belief that the person is overweight) and a related severe disturbance of mood.

In this section, we provide an overview of common forms of eating disorder and provide links to sources of additional information, treatment and support services for people with an eating disorder, their families and carers.

8G.7.1: Anorexia Nervosa

Anorexia Nervosa is a life threatening eating disorder and a serious mental health condition that involves severe intentional weight loss. It has one of the highest death rates of all mental illnesses, with up to 20% of people who develop the disorder dying within 20 years. However, with treatment, most people are able to recover from anorexia nervosa, particularly if treatment begins early in the development of the illness. Anorexia nervosa is a condition that affects both men and women.

People with anorexia nervosa engage in severely restricted eating and may compulsively exercise. One type of anorexia nervosa emphases the restriction of food consumption. These people are likely to restrict intake of certain types of food such as carbohydrates or high-fat food, become very focussed about counting their kilojoule (calorie) intake, skip meals and exercise more than needed.

Another type of anorexia nervosa includes either excessive food consumption (binge eating) followed by purging (vomiting). It could also include purging following the consumption of normal portions, or small amounts of food. People with the binge eating and purging type of anorexia nervosa have similar symptoms to the restricting type, but they also have behaviours that include binge eating followed by a sense of loss of control, purging following binging or other eating, and compensating for the excess food eaten with techniques such as vomiting, laxatives, enemas and diuretics. Men with anorexia nervosa may also use steroids to achieve a muscular and toned body shape.

Untreated and ongoing anorexia nervosa can result in serious health problems including osteoporosis (weakened bones), slowed growth in young people, infertility, disorders of the bowel and gut, problems with concentration and thinking, problems with decision-making, and social, emotional and educational problems.

Treatment for anorexia nervosa needs to include both physical and psychological health interventions. Multi-disciplinary interventions which may involve contributions from a psychiatrist, psychologist, nutritionist, family therapist, social worker, and occupational therapist are likely to be most effective. Family-based treatment is the most effective treatment recommended for children and adolescents. Cognitive Behavioural Therapy (CBT) is considered the treatment of choice for people with anorexia. With the support of decades’ worth of research, CBT is a time-limited and focused approach that helps a person understand how their thinking and negative self-talk and self-image can directly impact their eating and negative behaviours. CBT aims to change the underlying behaviours and patterns of thinking that have contributed to the development and continuation of the disorder. Other treatment responses may include supplements to achieve better bone strength and psychiatric medications to help stabilise mood.

Most people with anorexia nervosa are treated outside hospital, however, if the condition is severe, temporary treatment in hospital may be necessary. Treatment of anorexia nervosa can be challenging if the person refuses to accept treatment and their condition is severe. In these circumstances, if the person has become so cognitively impaired by the condition that they are unable, due to disability, to make decisions regarding their healthcare and treatment, it may be possible to obtain a Guardianship Order which provides or enables substitute consent to treatment to be given.

If the person’s condition is associated with acute symptoms of mental illness (for example, delusions about their body, or a severe disturbance of mood), it may be possible for them to be admitted to a mental health facility for mental health treatment as an involuntary patient. Involuntary treatment may include medication, movement restriction, dietary plans, psychological therapies and re-hydration. Sometimes involuntary treatment for a person with anorexia nervosa in a mental health facility involves nasogastric feeding, where a narrow feeding tube is placed through a person’s nose down into their stomach to give them fluids, medication and liquid food.

A Community Treatment Order is a legal order made by the Mental Health Review Tribunal. A CTO for anorexia may include the condition that the consumer must follow a particular dietary plan prescribed by a doctor, and compliance to this dietary plan could be measured by monitoring of weight or other vital observations (for example, blood pressure, heart rate, temperature). For more information about Community Treatment Orders, click here.

For more information about Guardianship and substitute decision making follow this link.

For more information about compulsory mental health treatment follow this link.

For more information about eating disorders, treatments, and support services follow this link.

8G.7.2: Bulimia Nervosa

Bulimia nervosa is an eating disorder and severe mental health condition. People with bulimia nervosa binge eat at least one a week and feel that they have no control over the amount of food they consume or the ability to stop eating. They may then try to ‘compensate’ for their food intake using methods such as vomiting, using laxatives and diuretics, fasting, excessively exercising, and using medications inappropriately to control body weight. This cycle of binging and exercising is associated with feelings of shame, guilt and self-disgust. The behaviours can become compulsive and lead to fixation on food and obsessive thinking about food, diet and body image.

Ongoing bulimia nervosa can cause physical health problems which may include sore throat, indigestion, heart burn and acid reflux, stomach and intestinal ulcers, and/or chronic problems with the gut such as constipation or diarrhoea from the use of laxatives These problems can lead to complications such as prolapsed bowel, osteoporosis (weakened bones), infertility in both men and women, irregular heartbeat or a slow heart rate that can lead to heart failure, and electrolyte imbalance from purging which can cause severe dehydration, damaging nerves, muscles and organs.

People with bulimia nervosa tend to have a body weight close to the healthy weight range (as compared with people with anorexia nervosa for example). This can make bulimia nervosa difficult to detect and diagnose.

The primary treatment for bulimia nervosa often combines psychotherapy, antidepressants, and nutritional counselling and needs to include both physical and psychological health interventions. Multi-disciplinary interventions which may involve contributions from a psychiatrist, psychologist, nutritionist, family therapist, social worker, and occupational therapist are likely to be most effective. Family-based treatment is the most effective treatment recommended for children and adolescents.

Once a person is medically stable, work can begin to address the underlying issues associated with bulimia. This may include addressing any traumatic event or facts on the person’s life that triggered the development of bulimia. While there is no single factor that is responsible for the development of bulimia, there are a number of issues that can increase a person’s likelihood of having an eating disorder. These factors may include, but are not limited to:

  • Genetics: research has demonstrated that genetic make-up and certain genes can influence the development of character traits and eating disordered behaviours
  • Family History: having a family member who has had an eating disorder can contribute to an increased risk for developing an eating disorder
  • Trauma/Abuse: having a history of emotional, physical, or sexual abuse can trigger the progression of an eating disorder; and/or
  • Environment: the surroundings we live in, including external stressors and pressures, can influence eating disorder development.

For more information about eating disorders, treatments, and support services see next section below.

8G.7.3: Treatment and support services for people with eating disorders, their families and carers

The best way to obtain further information about and access to treatment for an eating disorder is by approaching a General Practitioner, Community Health Centre or Community Mental Health Centre.

If you, or someone you know, is in an emergency situation you should call triple zero 000 to obtain emergency service assistance.

People with eating disorders may experience feelings of hopelessness, anxiety, depression and self-disgust. If you, or someone you know is experiencing these feelings due to an eating disorder, you can call:

Lifeline for assistance on 13 11 14
Lifeline operates 24 hours a day, seven days a week

*Mobile phone calls to freecall numbers (numbers starting with 1800) and to local call numbers (numbers starting with 13 or 1300) are charged to the caller at the usual mobile rate.

Lifeline also has a variety of online resources, including tool kits and fact sheets about preventing suicide which may be of assistance. You can obtain access to these resources by following this link.

InsideOut is Australia’s national institute for research and clinical excellence in eating disorders. They provide a range of information and other resources that seeks to transform the treatment landscape for eating disorders in Australia. The Institute comprises a team of expert researchers, clinicians and public policy makers dedicated to addressing the needs of people experiencing eating disorders.

The Centre for Eating and Dieting Disorders (CEDD) is a Sydney University based service and support centre that operates on the basis of a collaboration with the Sydney Local Health District and funding from NSW Health’s Mental Health Branch.

CEDD’s website includes a wide range of information and referral points, as well as toolkits and self and other educational resources, relevant to people living with eating disorders, their families and carers and for clinicians working with them.

You can find CEDD’s website by following this link.

The NSW Eating Disorders Toolkit is a manual that assists health professionals in applying best-practice principles in mainstream inpatient settings in NSW. For example, the Toolkit aims to improve access to practical information, to facilitate consultation with specialist staff and to improve consistency of care for children and adolescents with eating disorders across NSW. To access the toolkit, click here.

The Butterfly Foundation represents all people affected by eating disorders and negative body image – a person with the illness, their family and their friends. It is a leading national voice in supporting the needs of our community, and highlights the realities of seeking treatment for recovery, and advocates for improved services from both government and independent sources.

Butterfly operates a National Helpline that includes support over the phone, via email and online. The Helpline is staffed by trained counsellors experienced in assisting with eating disorders and body image issues. They also provide a wide range of programs for service providers and recovery groups.

To read about their services and programs follow this link

You can contact the Butterfly Foundations ED HOPE National Helpline support line on 1800 33 4673 Monday to Friday from 8am to 9pm or email:

8G.8: Disability and physical health

People living with a diversity of disabilities are at greater risk of mental health problems than other members of the community. Many factors contribute to this association including the life consequences of disability, the poor health of people living with mental health conditions and the cyclical relationship that exists between disability, social exclusion and mental health problems. There is a poor understanding of the relationship between mental health and other disabilities and the need for collaboration and integration of health care delivery across the service system.

Having a mental health condition has been shown to influence both the likelihood of illness or impairment and the probability that an illness or impairment will have a disabling effect. The physical health of people with mental health conditions is particularly poor. Mental health conditions have been shown to increase the risk of many problems including heart disease, diabetes, stroke, HIV/AIDS and tuberculosis and to contribute to accidental and non-accidental injuries. This is partly due to the associations between mental health conditions and lifestyle risk factors such as obesity, smoking and the negative side effects of psychiatric medications including heart disease.

For those with an existing illness or impairment, having a mental health condition is associated with even worse outcomes (such as complications and poor functioning). Evidence shows that people living with mental health conditions do not receive the same level of treatment care and support as other people. Often the physical health of people with living with a mental health condition are accorded less priority than other patients, for reasons including stigma and discrimination. They may be at greater risk of non-adherence to medical and behavioural treatment programs.

There are several physical health initiatives in NSW and some examples are:

YMCA Brightside Mental Health and Wellbeing Program – this program run by the YMCA encourages people with mental health issues to participate in a health and fitness training program at a YMCA health club. It promotes exercise as a way recovering for people in early or recovery phases of mental illness. The free program runs for sixty (60) days with unlimited access to the YMCA’s gym facilities during this time.

Collaborative Centre for Cardiometabolic Health in Psychosis, Inpatient and Outpatient Clinics – provided information on how to deliver cardiometabolic and lifestyle services to improve the global health outcomes. The Metabolic Clinic at Concord Hospital aims to improve the physical health of people living with serious mental illness.

Fitness Australia – Lift for Life – is a unique resistance training program designed for adults with (or at risk of developing) type 2 diabetes and other chronic conditions. Lift for Life participants get an individualised program is it’s perfect for any age and any fitness level.

Flourish – Back On Track Health – This program focuses on health promotion and prevention, including physical health and wellbeing conversations in everything you do. It aims to support people to maintain a reflective and responsive approach towards their physical health and wellbeing; learn new skills to review, identify and self-manage their own physical health and wellbeing, and take action by regularly accessing primary health care services, particularly General Practitioners, to address their health concerns.

Linking physical health and mental health …it makes sense initiative is provided in a number of different community languages. The fact sheet highlights the important link between physical and mental health.

Neami Health Prompt – is Australia’s first physical health needs identification tool designed specifically for a community mental health setting. To find a service in NSW click here.

NSW Cancer Council, Tackling Tobacco Program: Action on Smoking and Disadvantage. Tackling Tobacco is a step-by-step program that aims to reduce smoking related harm amongst the most socio-economically disadvantaged groups in NSW. Through Tackling Tobacco, the program helps community service organisations to address smoking, to give their clients the support they need to quit, and to de-normalise smoking in the community.

One Door – Integrated approach to health care – The Health Care team includes psychologists, social workers, mental health nurses, exercise physiologists and dietitians. To make an appointment with one of One Door’s psychologists, dietitians or exercise physiologists, visit your General Practitioner and ask for a Medicare-approved mental health care plan or chronic disease management plan, then contact us to make an appointment.

State-wide Disability Service (SDS) – a government service that addresses the support needs of offenders with disabilities (including intellectual disability, acquired brain injury, autism spectrum disorder, dementia, sensory/physical disability and frailty from age). SDS is a multidisciplinary team that works with all offenders with a disability whether in custody or in the community. SDS provides assessments, behaviour management, connects offenders to programs and pre-release planning.

Many of the Mental Health Coordinating Council’s member organisation run physical health programs. Ask your General Practitioner, case worker or support worker where services local to you are situated.

Updated July 20, 2020