Colocating an accredited practising dietitian to an adult community mental health service: An exploratory study

Abstract

For people with severe mental illness, accredited practising dietitians may assist with a nutrition care plan that considers the medical, psychiatric, psychological, social, spiritual, and pharmacological aspects of their care. However, consumers' access to care has been limited by difficulties attending appointments and suboptimal interface between nutritional and mental health services. Therefore, the objectives of this exploratory study were to describe access to, and key stakeholder perspectives of, the accredited practising dietitian role colocated in a community mental health service. A total of 16 key stakeholders participated in one-to-one interviews. Two main themes with subthemes were derived from analysis of interviews: (i) 'building empowerment and collaboration' and included the subthemes, (a) nutrition awareness and education and (b) healthy lifestyle changes, and (ii) 'overcoming challenges to optimal nutrition and effective health care'. In addition, improved access to the role was demonstrated with 124 (79%) consumers attending at least one appointment with an accredited practising dietitian. A total of 15 (12%) consumers attended more than 10 appointments during their outpatient admission to the community mental health service. Colocating an accredited practising dietitian was perceived to build empowerment and collaboration, and overcome challenges to optimal nutrition and effective health care for consumers, carers, and clinicians. The colocation of a dietitian can empower consumers' to make health-informed decisions and support their willingness to engage with physical healthcare provision when it is prioritized alongside mental healthcare provision.

High occurrence of food insecurity in young people attending a youth mental health service in regional Australia

“…This should be a priority given the long‐term impacts on physical health 47 and education outcomes 48 for young people experiencing food insecurity over their lifespan. Most relevant for this study are the long‐term impacts on mental health, where food insecurity in childhood has been shown to be associated with a higher risk of mental health issues in adolescents and young adults 49 . Regardless of food security status, this study showed that dietary intake of fruits, vegetables and breakfast was poor, and respondents regularly consumed takeaway foods and sugar‐sweetened beverages.…”

“…Most relevant for this study are the long-term impacts on mental health, where food insecurity in childhood has been shown to be associated with a higher risk of mental health issues in adolescents and young adults. 49 Regardless of food security status, this study showed that dietary intake of fruits, vegetables and breakfast was poor, and respondents regularly consumed takeaway foods and sugar-sweetened beverages. The results of this study could be utilised by managers and funders of youth mental health services to inform changes in service delivery that support improving diet.…”

Improving physical health outcomes for people with severe mental illness: A proof‐of‐concept study of nurse practitioner candidate practice

“…Consumers found the NPCs’ practices to be positive and helpful, and reported associated physical and mental health improvements. When consumers feel supported by clinicians they can engage in healthy practices (Bartlem et al ) and this has resulted in beneficial changes in modifiable risk factors of cardiovascular and cardiometabolic diseases such as nicotine dependence (Tsoi et al ), sedentary lifestyles (Furness et al ), and poor nutritional status (Furness et al ). The consumer experiences, and cardiovascular and metabolic monitoring outcomes in the current study suggest that NPC advanced practice roles are a vital resource that can provide quality physical health care and directly serve to improve the substantial morbidity and mortality of consumers.…”

“…The poor physical health of people with severe mental illness (consumers) is a global concern (World Health Organization ). Despite increasing evidence of consumers’ poor physical health and efforts to prevent morbidity (Baxter et al ; Furness et al ; Hughes et al ), their mortality age is disproportionately younger compared with the general population (Correll et al ; Nemani et al ). Recognized co‐occurring physical health conditions for consumers include poor cardiovascular (Brobakken et al ), respiratory (Jørgensen et al ), and cardiometabolic (Yoca et al ) health.…”

Natural cause mortality of mental health consumers: A 10‐year retrospective cohort study

“…In addition, consumers are reported to have poor nutritional intake (Furness et al . 2018a) and high occurrence of hypertension (Ayerbe et al . 2018) and hyperglycaemia (Kang & Lee 2015).…”