A woman with a serious eating disorder says a nurse at a hospital in Clarenville, N.L., told her to get something to eat and return to the emergency department if she didn't feel better.
Carla Lamb, 31, is now now calling on Eastern Health to put more emergency mental-health services in the region.
Lamb, who has the self-starvation disorder anorexia and the binge-and-purge disorder bulimia, said she had an illness relapse last week, and felt she was in crisis mode.
Worried that she might harm herself, Lamb called the Eating Disorder Foundation of Newfoundland and Labrador and spoke with a counsellor who told her to go straight to a hospital emergency department.
'I have anorexia and bulimia. With that came a lot of other physical and mental problems. It's so important that mental health, eating disorders, these things are all as painful and cause as much internal damage' - Carla Lamb
"I was in a lot of pain, physically and mentally. I was ready to start cutting myself and needed to speak to somebody ... and I needed to know that I was safe. I didn't feel safe," said Lamb.
She said a triage nurse at the Cross Memorial Hospital in Clarenville told her to go and get something to eat, and return to emergency if she didn't feel better.
"She said, 'We've got five more people that definitely are ahead of you. Can you go get some supper and come back?' I don't want supper, I am here for an eating disorder. I'm hungry and I told you that but it doesn't mean that I can eat," she said.
Lamb said because the nurse couldn't see any injuries, she felt she wasn't taken seriously.
After she returned home, Lamb said if it weren't for her husband, she might have seriously harmed herself.
Lamb believes Eastern Health needs to do more to ensure front-line staff know how to deal with mental illnesses and eating disorders.
"I have anorexia and bulimia. With that came a lot of other physical and mental problems. It's so important that mental health, eating disorders, these things are all as painful and cause as much internal damage. Look at my liver, all these things, it's not OK. I can't see the ribs in my back right now. For some reason that was a pride for me that you could see that. There needs to be the right people at the front line to help."
Layers of clothing hide tiny frame
Lamb covers her tiny body in layers of clothing, and wears bulky scarves over her neck and chin, which she considers fat.
"No 31-year-old should weigh 70-something pounds. I dream — or let's call them nightmares I guess — about food, and how hungry I am. I dream about cooking and it's such a struggle. Every day, everything I smell, eating in front of people is terrifying."
Lamb has had some heavy-hitting treatment in the past, but about 10 years ago, she hit rock bottom and realized her life was in danger.
"I couldn't walk up the stairs, I couldn't get off the floor. I am stuck on a floor throwing up for no reason whatsoever. Not because I ate, [but] because my body just rejected everything about me. I couldn't open my eyes at times because there was so much swelling. Bulimia. Malnutrition."
For the last five years, Lamb has been in and out of hospital in St. John's, where she continues to see physicians and counsellors.
Last summer, she went to the Homewood Health Centre in Ontario, where Lamb said she was forced to eat and to keep her food down. After living years with the disorder, Lamb said she struggled to eat the amount of food she was served, and added she was under constant surveillance.
Lamb felt she couldn't stay at the rehab centre, as she was not ready to gain weight. When she did gain some, the mental part of her illness got worse.
Eastern Health apologizes
The day after Lamb went to emergency, she called Eastern Health to tell the health authority about how she was treated.
After leaving a couple of messages, a few days later, someone did contact her.
"They wished they could help me more, but, because I wasn't in the greater metro area, there wasn't much they could do. There's nobody out here to help us."
In an email sent to CBC, Eastern Health said Clarenville has a community mental-health and addictions team, and it sees people based on the level of urgency, but it is not classified as an emergency service. The health authority said the [Dr. G.B. Cross] hospital has a psychiatrist on call, and the triage staff is trained in screening for mental-health concerns.
Meanwhile, the Association of Psychology in Newfoundland and Labrador has reacted to Lamb's story. In a release sent to CBC on Wednesday, president Dayle Denney said members felt "disappointment and concern that the individual in question was unable to receive the psychological and medical care she urgently needed to treat her eating disorder."
Denney added the "incident is evidence of the challenge Newfoundlanders and Labradorians face in accessing psychological care."
The association said there is currently one psychologist for every 2,000 people in the province.
Psychologist Michelle Neary of the Memorial University Counselling Centre said that Lamb's experience speaks to the need for more education and awareness, not only for health-care providers.
"And that could be fitness consultants, it could be teachers in the school system, it could be health professionals," said Neary.
"I think it's really important for all of us to have a good understanding of what eating disorders are like and how eating disorders can present, and the kinds of challenges that they really face in terms of being able to address their issues."
Neary said studies show that three per cent of women will experience an eating disorder at some point in their lives. She added that it is one of the most difficult illnesses to treat effectively.
Lamb is a massage therapist, but has been on leave for four years. She has vowed that she will never return to the hospital in Clarenville, and will instead take the two-hour drive to St. John's to seek medical assistance.