Project HEAL’s allocation of resources is rooted in our value of equity.

To us, this means we aim to make decisions with and for beneficiaries that center those with the most need. Project HEAL’s Equity Considerations illuminate our thoughts and ethos when parsing out the resources made available to us through our HEALers Circle partners and donors.

Project HEAL’s equity considerations

Project HEAL’s Equity Matrix shows how we:

  • define equity

  • make equitable decisions

  • utilize the resources from our partners and donors

application review

When a person navigating an eating disorder, disordered eating, diet culture, or similar concerns comes to Project HEAL for care, they apply for three core types of assistance: treatment placement, cash assistance, or insurance navigation. The graphic below outlines our process for reviewing, assessing, and making decisions based in equity.

1. ASSESSMENT

Either through Project HEAL, a separate provider, or a self-assessment, an applicant will receive and report their eating disorder diagnosis and recommended level of care.

2. APPLICATION

With this insight in place, an individual submits a holistic application for support through our website.

4. NOTIFICATION

All applicants will be contacted about next steps by the second half of the following month. This timeline is an estimate, and the exact timing of our responses will depend largely on the amount of applications we receive, negotiation of equity considerations, and available resources.

3. REVIEW

Project HEAL reviews applications on a monthly basis. At the start of each month, Project HEAL reviews the applications from the previous month. For example, an application submitted in March will be reviewed during the first half of April; applications submitted in April will be reviewed during the first half of May. This review period is where our equity considerations come into play.

TREATMENT ACCESS CONSIDERATIONS

Clinical Need

  • Clinical Complexity

    While many high acuity cases come to Project HEAL, we are unable to place all beneficiaries with higher levels of care due to limitations in our resources. We generally reserve limited spots with our treatment centers for individuals with higher clinical acuity and lower access to resources.

    Our team also navigates the difficulties of finding care options for more clinically complex beneficiaries. When a beneficiary is navigating multiple comorbidities — such as self-harm, suicidal ideation, disabilities, and other physical and mental health symptoms — providers may be more reluctant to take them on. When staff capacity and resource availability allows, Project HEAL will share additional resources and opportunities to address the multiple needs of the beneficiary. With our current resources, Project HEAL is best at supporting those whose eating disorder is the primary concern.

  • Level of Care Recommendation

    Our team provides free clinical assessments for our beneficiaries; Project HEAL offers applicants an unbiased clinical diagnosis and recommended level of care. For those who wish to be connected to care, our team will use this recommendation or that of another entity to make our decision. While the clinical recommendation guides where we place a beneficiary, we also recognize the barriers — including treatment trauma, federal/state benefits, insurance coverage, obligations such as child care, accessibility accommodations in treatment, etc. — that keep them from pursuing the level of care recommendation offered.

    Our team attempts to use the provided level of care recommendation to align our offerings with our own available resources and the support that is accessible to the individual.

APPLICANT BARRIERS

  • Applicant Needs

    Those looking for eating disorder care often have holistic needs outside of treatment access itself. Access to meeting these needs may be influenced by transportation, language, technology, disability accommodations, stable housing, food security, child care, etc.

    Project HEAL will reserve more tailored resources -- such as providers who are able to speak multiple languages -- for beneficiaries whose auxiliary needs align. When staff capacity and resource availability allows, Project HEAL will share additional resources and opportunities to address the multiple needs of the beneficiary.

  • Situational Barriers

    Related to systemic barriers, Project HEAL recognizes that beneficiaries may experience instability as a result of intimate partner/family violence, divorce, unstable housing, being a primary care taker, limited access to technology, limited computer/internet literacy, state/federal benefits being changed or halted, and other scenarios. When allocating resources, Project HEAL takes these barriers into consideration in our monthly review of applications.

  • Systemic Barriers

    The stereotypes of who has an eating disorder — white, young, female, thin, affluent — are not accurate or representative. In our allocation of resources, Project HEAL prioritizes communities underrepresented and not affirmed in the current eating disorder treatment landscape.

    This includes BIPOC, LGBTQIA+, TGNCI, low socioeconomic status, undocumented or temporary immigration status, young children/adolescents/elders, disabled folks, people who are not underweight, single parents, people with little to no formal education, residents of rural areas, etc.

    Many of these communities experience limited access to obtaining eating disorder treatment due to social stigma and systemic exclusion.

Applicant Resources

  • Individual experiences

    We honor and recognize the expertise of our beneficiaries. Many people with eating disorders have had negative experiences in treatment centers, residential programs, and other care facilities throughout their healing journeys. In our decision-making process, Project HEAL will try to collaborate with the individual to find a treatment modality that suits the needs, experiences, and preferences of the beneficiary.

    This harm reduction approach means that we do not exclusively abide by the level of care recommendation offered by clinicians, though this guides our initial approach. We consider the individual’s background, identities, knowledge, and readiness to completing their care.

  • Access to resources

    Applicants come to Project HEAL with a wide variety of access to resources. Some applicants have no insurance and experience significant social isolation; others come to us with high financial access and a deep network of community support. In our desire to support those with the greatest need, Project HEAL takes into consideration barriers such as limited insurance coverage, a lack of access to supplemental care or wellness options, and a limited or non-existent support network.

    Whenever possible, we look to optimize the applicant’s resources by offering supplemental services such meal support and referrals to support groups.

Eating disorder landscape

  • Limitations of the field

    Project HEAL often receives feedback about an insufficient cultural awareness or lack of affirming treatment practices in the field. As we prioritize communities underrepresented and not affirmed in the current eating disorder treatment landscape, this can create significant challenges in providing care for those who experience systemic, historic, and social disempowerment. While we partner with a number of providers with marginalized identities, there are not enough to meet the amount of applicants we receive. As a result, we reserve placement spots of providers who hold these experiences for those with shared identities.

    We acknowledge that the field has a long way to go before enough providers can adequately reflect and treat the diversity of folks experiencing eating disorders. Project HEAL therefore attempts to offer placements that reduce the risk of harm when accessing treatment.

  • Organizational Resource Availability

    Project HEAL has access to limited resources, and unfortunately does not have enough resources to provide support to all applicants. Project HEAL is very lucky to have a network of mission-aligned providers who are committed to treatment equity. Despite this large network, our resources are still limited relative to the widespread need for care. Minimal higher levels of care placements are available throughout the course of the year, and our outpatient providers offer support based on their availability. Our placements also come with limitations around age, gender, disability access, language access, and more.

    As such, Project HEAL prioritizes matching our limited placements with applicants who have already explored multiple treatment options and have no other way of obtaining care.

This is so much to consider when making placement decisions! These thoughts are all in the interest of moving resources to those in need. That said, anyone who needs access to care is encouraged to reach out to our team at Project HEAL.

questions to ask

These considerations and statements come from years of striving to make decisions based in equity while working hand-in-hand with our beneficiaries. We encourage providers and organizations to ask themselves the following questions to develop their own equity considerations document that aligns with their available resources, values, and mission.

    • Is offering care to an applicant going to prevent other applicants with less access to care from getting treatment in the future?

    • How can we, the provider, realistically provide the type of care and consideration necessary to support the beneficiary in their healing journey?

    • When we cannot offer the care needed, how can we utilize a harm reduction approach to still provide resources and healing opportunities to the individual?

    • Will the applicant be able to access identity-based or trauma-informed care through other networks or organizations?

    • How do we respond to immediate, situational barriers and how that might impact the individual’s healing journey?

    • When offered access to treatment, will the applicant be able to utilize the care given their auxiliary needs? If not, what other resources could we offer to increase access?

    • What harm may applicants have experienced through their healing journey that impacts their options for future care? How do we recognize and respond to that in our processes?

    • Does the client hold identities that need to be considered in their placement? How do we ensure that is considered in our process?

    • Are there support networks that can support the beneficiary in their care? How do we tap into those?

    • Are we, as an organization, culturally competent and reflective of the identities of those seeking care with us? How do we gauge that we are?

    • If we are not able to provide the care the individual needs, what compilation of other resources might we be able to offer to them?

    • How do the structures that we set up at our organization break down barriers to care and healing within the eating disorder field?