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Mental Illness

Dietitians in Mental Health

 

People with a mental health problem are at higher risk of physical health problems.  Having depression can double the risk of developing Coronary Heart Disease 1,2.  People with mental illnesses such as schizophrenia are more likely to develop cardiovascular disease, obesity, abnormal lipid levels or diabetes 3.

In February 2011, the Government published its mental health strategy – No Health without Mental Health: A Cross-Government Mental Health Outcomes Strategy for People of all ages 4.

There were six outcomes identified within this strategy:

  • Objective 1 More people will have good mental health
  • Objective 2 More people with mental health problems will recover
  • Objective 3 More people with mental health problems will have good physical health
  • Objective 4 More people will have a positive experience of care and support
  • Objective 5 Fewer people will suffer avoidable harm
  • Objective 6 Fewer people will experience stigma and discrimination

Within outcome 3, there are a number of recommendations that have an impact on the work of dietitians:

  • Food policy, for instance development of Government Buying Standards for food which will seek to improve nutritional standards in public sector catering services as well as their sustainability.
  • Work with the Fitness Industry Association to explore ways of utilising spare capacity in their facilities to offer activities for older people.
  • Act on the various commitments in the public health White Paper to improve physical health, including that of people with mental health problems.
  • Publish a Public Health White Paper follow-up document on obesity.

In July 2012, the Government published its implementation framework for No Health without Mental Health 5.  This framework suggested that mental health providers should:

“Improve the physical health and wellbeing of people with mental health problems. This might include smoking cessation, weight management, tackling malnutrition, drug and alcohol misuse. As part of this, providers can use regular health checks and recovery-focussed healthy lifestyle care planning. Integrating physical health into decisions about prescribing and monitoring of medication is also important” 5.

Dietitians in mental health work as part of a Multi-Disciplinary Team using a recovery model to deliver dietetic interventions.  They see patients in a variety of settings including inpatient units. forensic units, community mental health resource centres (CMHRC), day centres and patients own homes.

In addition to seeing patients on a 1:1 basis, dietitians may be involved in health and wellbeing groups and weight management groups.  Dietitians also have an important role in policy development, menu design and review and pathway development within mental health settings.

For more information on the work of dietitians in mental health, please visit the Mental Health Group of the BDA’s website at:

http://www.dietitiansmentalhealthgroup.org.uk/

References: 

  1. Hemingway, H and Marmot, M (1999) Evidence based cardiology. Psychosocial factors in the aetiology and prognosis of coronary heart disease: systematic review of prospective cohort studies. British Medical Journal 318: 1460–1467;
  2. Nicholson, A, Kuper, H and Hemingway H (2006) Depression as an aetiologic and prognostic factor in coronary heart disease: a meta-analysis of 6362 events among 146 538 participants in 54 observational studies. European Heart Journal 27(23): 2763–2774.
  3. De Hert, M, Dekker, JM, Wood, D et al (2009) Cardiovascular disease and diabetes in people with severe mental illness. Position statement from the European Psychiatric Association. European Psychiatry. http://www.easd.org/easdwebfiles/statements/EPA.pdf
  4. HM Government (2011) No Health without Mental Health: A Cross-Government Mental Health Outcomes Strategy for People of all ages.  London: Department of Health http://www.dh.gov.uk/dr_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_124058.pdf
  5. HM Government (2012) No Health Without Mental Health: Implementation Framework. London: Department of Health http://www.dh.gov.uk/health/files/2012/07/No-Health-Without-Mental-Health-Implementation-Framework-Report-accessible-version.pdf

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