Canadians with eating disorders can face such long wait times for publicly funded treatment spots that many patients depend on personal assets and private funding to get access to facilities.
Many end up with deep debt after emerging from treatment for psychological disorders. So Ingrid Davidson has turned to online fundraising at Indiegogo to generate cash to pay for her care.
"I'm dying ... and there's no help," says Ingrid Davidson, a 23-year-old diagnosed with anorexia, depression and an anxiety disorder.
"It makes me so upset that so many people are suffering so greatly, and there is no help — unless they're able to wait for months for funded treatment or they're able to pay."
According to the National Eating Disorder Information Centre, the prevalence of anorexia (self-starvation) and bulimia (binging and purging) is estimated to be 0.3 per cent and one per cent among adolescent and young women, respectively.
"Prevalence rates of anorexia and bulimia appear to increase during the transition from adolescence to young adulthood," says the centre, a non-profit organization that raises awareness about the different types of eating disorders, including through its Eating Disorder Awareness Week that starts Feb. 2 this year.
Davidson, who has relapsed into an eating disorder first diagnosed in 2009,is now living in a Hamilton hospital and hoping to use the campaign to generate $60,000 for specialized private in-patient treatment before the disorder kills her.
Davidson admitted herself to the hospital when she learned a publicly funded outpatient program couldn't accept her until March. While she didn't want her precise weight revealed, her her body mass index dropped below what is considered a healthy range.
She is enrolled in the hospital's mood disorders inpatient program, which helps patients control mood disorder symptoms. But, she says it is not equipped to deal with her severe eating disorder. St. Joseph's Healthcare only has an outpatient eating disorder program, which offers weekly group therapy sessions.
Davidson says she's accustomed to long waits for publicly funded spaces. It once took about a year and a half for her name to move to the top of Homewood Health Centre's wait list for an in-patient eating disorders treatment program. At Homewood, patients get weighed regularly, eat supervised meals in a communal dining hall and attend multiple therapy groups daily.
Scarcity of publicly funded spaces
Homewood, Canada's largest in-patient treatment centre for people with eating disorders, has 21 beds allotted for patients struggling with eating issues, centre spokesman Ric Ament wrote in an email.
Ward beds are fully funded by OHIP, Ontario's health insurance program. Beds in semi-private or private rooms carry additional costs of $260 a day and $310 a day, respectively, for Ontario patients, who must pay the added costs or have their supplementary health insurance plans do so, Ament wrote.
Ament declined to specify how many of each bed exist in the program, but said there were more semi-private and private beds than publicly supported ward beds.
The waiting list both for privately and publicly funded beds is generally long, he wrote.
In Manitoba, CBC News has learned, patients can wait up to a year for publicly funded treatment — even in an outpatient program.
The Ontario Ministry of Health and Long-Term Care has made steps towards improving wait times. It has almost tripled its investment in eating disorders treatment since 2003-04, wrote ministry spokesman David Jensen in an email.
Thanks to the funding, the province will have the most publicly funded beds for in-patient treatment in Canada, he wrote — 24 adult beds and 24 pediatric beds. Jensen did not say how many beds currently exist or when the new beds will be available.
Private treatment costs thousands
The scarcity of beds makes long wait times, like Davidson's, "very typical," said Aziza Kajan, an employee at Hope's Garden, a support centre in London, Ont., for people with eating disorders.
The centre's site lists average wait times for various programs across Canada, ranging from several weeks to years depending on the intensity of treatment.
Patients willing to pay out of pocket or with supplementary health insurance for treatment at Homewood wait about two to five months before being admitted, according to the centre's site, while patients relying on OHIP wait between two and three years.
Kajan explains this discrepancy by saying fewer people can afford to pay privately, so the queue is shorter, while there's a backlog for in-demand publicly funded spaces.
Long wait times for publicly funded spots mean people who need treatment but can't afford to pay for it themselves don't get the help they need, said Kajan.
$35K of debt for 1st bout of treatment
In 2012, when Homewood finally offered Davidson a spot after about 18 months of waiting, she learned it was not for one of the coveted OHIP-funded beds.
Davidson's mother, 55-year-old home-care worker Susan Nelson, acquired a nearly $35,000 line of credit to pay for her daughter's treatment.
"It was at the point where I was dying and we had no option," Davidson says of her mother's sacrifice. Her mother is now "seriously in debt."
Davidson spent 3-1/2 months at Homewood, and left the healthiest she had ever been.
"My head was in such a different place," she recalls, explaining how she was no longer constantly preoccupied with food. "It was so different, so different. It was amazing."
But she quickly relapsed, unable to find enough support from services after Homewood's 24/7 care.
While she waited two months for another bed to open up at Homewood, Davidson's eating disorder escalated. Sometimes she would go as long as 72 hours without eating.
"I was almost dead," she explains. "I could have had a heart attack really easily."
She spent December 2012 in Homewood's care, but her mother couldn't afford to pay for further treatment.
After she left, she continued seeing a psychologist, but wasn't making much progress. She moved to Toronto and was put on a wait list for an outpatient program at a hospital. The program can't accommodate her until March, she says.
"I honestly don't think I would make it," she says. "I really, really don't think that I would make it until March."
$60K fundraiser a last resort
Even if she did, Davidson is convinced the outpatient day program won't be enough support for the severity of her illness and that another extended stay is her best chance for a full recovery.
Homewood has told Davidson and her mother that a spot could become available in the next several weeks.
"This is one of the worst feelings any parent can imagine," Nelson wrote on Indiegogo for the fundraising campaign, which she hopes raises $60,000 by Feb. 27. So far, nearly $33,000 has been raised.