title: Bridging the gap: does a specialist eating disorder service, aimed at developing a continuum of community care, make a difference?
abstract: OBJECTIVE
  In 2010, the authors identified in a separate publication, Mind the evidence gap, the sparse evidence-base for the treatment of adult anorexia nervosa and barriers to accessing care. We report on the ensuing development, implementation and first 18-month results of a novel eating disorder service bridging the primary and specialist continuum of care in Victoria, Australia.
  
  
  METHODS
  Using literature review, stakeholder, and consumer and carer consultation, a model for a community eating disorder service was developed and then implemented. All patients entering the service were then assessed at intake and, if they gave consent, at 12 month follow-up.
  
  
  RESULTS
  From December 2010 to July 2012, 208 patients accessed The Body Image Eating Disorders Treatment and Recovery Service (BETRS). Fifty-three per cent had a diagnosis of anorexia nervosa and the mean number of co-morbid psychiatric diagnoses was two. Twenty-three per cent attended a day patient programme and showed a significant improvement in their body mass index. Measures of depression, anxiety and eating disorder symptomatology showed a concomitant, significant decrease.
  
  
  CONCLUSIONS
  The development of BETRS has led to markedly improved access and effectiveness of specialist services in the region.
authors.affiliation: Mental Health Clinical Service Unit, Austin Health, Heidelberg, VIC, Australia. richard.newton@austin.org.au
authors.forename: John
authors.initials: J
authors.lastname: Newton
authors.forename: Peter
authors.initials: P
authors.lastname: Bosanac
authors.forename: Sam
authors.initials: S
authors.lastname: Mancuso
authors.forename: David
authors.initials: D
authors.lastname: Castle
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000856:Anorexia Nervosa / Q000523:psychology / Q000628:therapy*; D001007:Anxiety / Q000150:complications / Q000628:therapy; D015992:Body Mass Index; D003156:Community Mental Health Services / Q000458:organization & administration*; D003863:Depression / Q000150:complications / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care
keywords: anorexia nervosa; day programme; treatment