People living with severe mental illness are at least twice as likely to be obese as the general population, partly due to lifestyle risk factors including poor diet quality. This study aims to quantify how Australian mental health occupational therapists address the dietary issues of people with severe mental illness.
Method
A 23-item cross-sectional online survey was distributed via email to all members of Occupational Therapy Australia, with those working in mental health (an estimated 305 members) invited to participate. Response frequencies were analysed in SPSS. Open-ended comments were subjected to thematic analysis.
Results
Eight-six eligible participants (28.2% of the target population) completed the full survey. Most (81%) felt confident in providing healthy eating advice, with 76% reporting being self-educated about nutrition. Dietitian support for complex advice was seen as beneficial by 88%, but only 30% reported reasonable access to dietitians. Qualitative themes included: accessing dietitians, information and education, and putting advice into practice.
Conclusion
There is potential to enhance the credentialling and continuing education of occupational therapists and improve inter-professional collaboration with dietitians to assist the occupational therapist in achieving better health and reducing the burden of chronic disease for people experiencing severe mental illness.
AdayLACorneliusLJ (2006) Designing and Conducting Health Surveys: A Comprehensive Guide, 3rd ed. San Francisco, CA: Jossey-Bass.
2.
AminiDABarrowsCJBaumMC (2008) Occupational therapy practice framework: Domain & process 2nd ed. American Journal of Occupational Therapy62(6): 625–683.
3.
Australian Institute of Health and Welfare (2013) Allied Health Workforce 2012. National Health Workforce Series No.5, Canberra: AIHW.
4.
BarreLKFerronJCDavisKE (2011) Healthy eating in persons with serious mental illnesses: Understanding and barriers. Psychiatric Rehabilitation Journal34(4): 304–310.
5.
BassettHLloydCKingR (2003) Food cent$: Educating mothers with a mental illness about nutrition. British Journal of Occupational Therapy66(8): 369–375.
6.
BraunVClarkeV (2006) Using thematic analysis in psychology. Qualitative Research in Psychology3(2): 77–101.
7.
BrownCEGoetzJHameraE (2011) Weight loss intervention for people with severe mental illness: A randomised controlled trial of the RENEW program. Psychiatric Services62(7): 800–802.
8.
BrownCEGoetzJVan SciverA (2006) A psychiatric rehabilitation approach to weight loss. Psychiatric Rehabilitation Journal29(4): 267–273.
9.
BusheCJSlooffCJHaddadPM (2013) Weight change by baseline BMI from three-year observational data: Findings from the worldwide schizophrenia outpatient health outcomes database. Journal of Psychopharmacology27(4): 358–365.
10.
CapassoRMLineberryTWBostwickJM (2008) Mortality in schizophrenia and schizoaffective disorder: An Olmsted county Minnesota cohort: 1950–2005. Schizophrenia Research98(1–3): 287–294.
11.
CarsonNEBlakeCESaundersRP (2013) Influences on the food choice behaviors of adults with severe mental illness. Occupational Therapy in Mental Health29(4): 361–384.
12.
ChwastiakLARosenheckRAMcEvoyJP (2006) Interrelationships of psychiatric symptom severity, medical comorbidity, and functioning in schizophrenia. Psychiatric Services57(8): 1102–1109.
13.
DickersonFBrownCEKreyenbuhlJ (2006) Obesity among individuals with serious mental illness. Acta Psychiatrica Scandanavia113(4): 306–313.
14.
DipasqualeSParianteCMDazzanP (2013) The dietary pattern of patients with schizophrenia: A systematic review. Journal of Psychiatric Research47(2): 197–207.
15.
DowdingKAshSShakespeare-FinchJE (2011) Using critical incident interviews to identify the mental health knowledge, skills and attitudes of entry-level dietitians. Nutrition and Dietetics68(4): 297–304.
16.
Faulkner G, Cohn T and Remington G (2007) Interventions to reduce weight gain in schizophrenia. The Cochrane Database of Systematic Reviews 1: CD005148.
17.
Galletly CL and Murray LE (2009) Managing weight in persons living with severe mental illness in community settings: a review of strategies used in community interventions. Issues in Mental Health Nursing 30(11): 660–668.
18.
GalletlyCFoleyDLWaterreusA (2012) Cardiometabolic risk factors in people with psychotic disorders: The second Australian national survey of psychosis. Australian & New Zealand Journal of Psychiatry46: 753–761. .
19.
GaughranFLallyJ (2013) Non-pharmacological interventions reduce antipsychotic-associated weight gain in outpatients. Evidence Based Mental Health16(1): 18.
20.
GibsonRWD'AmicoMJaffeL (2011) Occupational therapy interventions for recovery in the areas of community integration and normative life roles for adults with a serious mental illness: A systematic review. American Journal of Occupational Therapy65(3): 247–256.
21.
GrbichC (2013) Mixed methodology and collaborative practices. In: LiamputtongP (ed.) Research Methods in Health 2e, Melbourne: Oxford University Press, pp. 309–322. .
22.
HaraczKRyanSHazeltonM (2013) Occupational therapy and obesity: An integrative literature review. Australian Occupational Therapy Journal60(5): 356–365.
23.
IBM (2012) IBM SPSS Statistics for Windows, Version 21.0, Armonk, NY: IBM Corp.
24.
KilbourneAMRofeyDLMcCarthyJF (2007) Nutrition and exercise behaviour among patients with bipolar disorder. Bipolar Disorders9(5): 443–452.
25.
LangJJamesCAshbyS (2013) The provision of weight management advice: An investigation into occupational therapy practice. Australian Occupational Therapy Journal60(6): 387–394.
26.
LaursonTM (2011) Life expectancy among persons with schizophrenia or bipolar affective disorder. Schizophrenia Research131(1–3): 101–104.
27.
LloydCSullivanD (2003) NEW solutions: An Australian health promotion programme for people with a mental illness. International Journal of Therapy and Rehabilitation10(5): 204–210.
28.
MahonyGHaraczKWilliamsL (2012) How mental health occupational therapists address issues of diet with their clients: A qualitative study. Australian Occupational Therapy Journal59(4): 294–301.
ParnellTWildingC (2010) Where can an occupation-focussed philosophy take occupational therapy?Australian Occupational Therapy Journal57(5): 345–348.
31.
Qualtrics (2012) Provo, Utah, USA.
32.
QuickLHarmanSMorganS (2010) Scope of practice of occupational therapists working in Victorian community health settings. Australian Occupational Therapy Journal57(2): 95–101.
33.
RatliffJCPalmeseLBReutenauerEL (2012) The effect of dietary and physical activity pattern on metabolic profile in individuals with schizophrenia: A cross-sectional study. Comprehensive Psychiatry53: 1028–1033.
34.
ReitzSMScaffaME (2013) Occupational therapy in the promotion of health and wellbeing. American Journal of Occupational Therapy67(6S): S47–59.
35.
ScanlanJNPepinGHaraczK (2015) Identifying educational priorities for occupational therapy students to prepare for mental health practice in Australia and New Zealand. Australian Journal of Occupational Therapy62(5): 268–298.
36.
SoderlundAFisherAJohanssonT (2009) Physical activity, diet and behaviour modification in the treatment of overweight and obese adults: A systematic review. Perspectives in Public Health129(3): 132–142.
37.
SoundyAWampersMProbstM (2013) Physical activity and sedentary behaviour in outpatients with schizophrenia: A systematic review and meta-analysis. International Journal of Therapy and Rehabilitation20(12): 588–595.
38.
StrassnigMBrarJGanguliR (2003) Body mass index and quality of life in community-dwelling patients with schizophrenia. Schizophrenia Research62(1–2): 73–76.
39.
TorrentCAmmannBSánchez-MorenoJ (2008) Weight gain in bipolar disorder: Pharmacological treatment as a contributing factor. Acta Psychiatrica Scandanavia118(1): 4–18.
40.
WeidenPMackellJAMcDonnellDD (2004) Obesity as a risk factor for antipsychotic noncompliance. Schizophrenia Research66(1): 51–57.
