Medical Nutrition Therapy offers opportunities to improve the physical and mental health of people living with mental illness.
Introduction: The growing population of elderly people is impacting on overstretched dental services in many countries, as many individuals are retaining natural teeth and may have dentures or implants, all of which influence the way in which the oral cavity must be cared for. A major difficulty for older residents is their decreasing level of motor and cognitive functioning to adequately self-care for their mouths. Hence, the role of the nurse is crucial. However, staff shortages, time factors and lack of awareness can lead to neglect of the mouth in this population. The loss of function is often exacerbated in individuals with mental health problems. Objectives: To improve the oral health of residents in an aged care mental health unit through the introduction of an innovative nursing intervention. Methods: Firstly, utilizing focus groups, nursing staff identified the main barriers to delivery of oral hygiene to residents as follows: lack of proper equipment; no protocol in place; lack of knowledge. Staff knowledge of oral health and hygiene was measured using a structured questionnaire before and after the intervention. A training program was devised by a dentist, dietician and nurse working in the unit. A multidisciplinary team met on several occasions to design a suitable vehicle and process to deliver oral hygiene. Oral health examinations were conducted at baseline, three months and 12 months. Interventions: Design and production of oral hygiene trolley; development of protocol for oral hygiene; staff education in oral health. Results: The program was successful in improving the oral health of residents with reductions in plaque scores, gingivitis and pocket depths. The oral hygiene protocol was positively accepted into a daily routine and the knowledge of staff in matters relating to oral health increased. Conclusions: A simple oral health intervention utilizing qualified nurses and a purpose-built oral hygiene trolley made significant improvements to the oral health of aged care residents.
Aim This rapid review of reviews aimed to determine the extent of research undertaken on the effectiveness of dietary interventions for individuals with a mental disorder. Methods Three databases (MEDLINE, Embase, Cochrane Reviews and Cochrane Trials) were searched to February 2021 for systematic reviews including experimental studies assessing the effectiveness of dietary interventions with physical or mental health related outcomes in adults or children with one or more of: severe mental illness, depression or anxiety, eating disorders, or substance use disorder. Results are presented descriptively. Results The number of included reviews was 46 (67% in severe mental illness, 20% in depression and anxiety, 7% in eating disorders, and 7% in substance use disorders). Most reviews were published since 2016 (59%), and included studies conducted in adults (63%). Interventions in the eating disorders and severe mental illness reviews were predominantly education and behaviour change, whereas interventions in the substance use disorders, and depression and anxiety reviews were predominantly supplementation (e.g. omega‐3). Twenty‐eight and twelve of the reviews respectively reported mental health and dietary outcomes for one or more included studies. Most reviews in severe mental illness, and depression and anxiety reported conclusions supporting the positive effects of dietary intervention, including positive effects on weight‐related or mental health outcomes, and on mental health outcomes, respectively. Conclusions A larger number of systematic reviews were identified which evaluated dietary interventions in individuals with severe mental illness, and depression and anxiety, compared with substance use disorders, and eating disorders. Dietary intervention is an important component of the treatment that should be available to individuals living with mental disorders, to support their physical and mental health.
Aim: This scoping review aimed to explore the extent of the evidence of experimental studies evaluating the cost effectiveness of dietary interventions in individuals with mental disorders. Methods: Five databases (CINAHL, EMBASE, MEDLINE, PsycINFO and Scopus) were searched to October 2020 for cost-analysis studies of interventions aiming to improve dietary intake in people with mental disorders. No restriction was placed on participant age, mental disorder type or intervention design. Results are presented narratively.Results: Of 2753 articles identified, 13 articles reporting on eight studies were included. Studies were RCTs (n = 5), cluster RCT (n = 1), cluster preference RCT (n = 1), and pre-post test (n = 1). Seven studies were in community settings (eg, outpatient clinics), and one study in the community housing setting. All studies were in adults, seven included male and female participants, and one included only females. Defined mental disorder diagnoses included serious/severe mental disorders (n = 3), major depression (n = 2), schizophrenia, schizoaffective disorder or first-episode psychosis (n = 1), any mental disorder (n = 1), and bulimia nervosa (n = 1). Five interventions were multi-behaviour, two were diet only and one was eating disorder treatment. Cost analyses included cost-utility (n = 3), cost-effectiveness (n = 1), cost-utility and costeffectiveness (n = 3), and a costing study (n = 1). Two studies (25%) reported positive results in favour of cost effectiveness, and four studies reported a mix of positive and neutral results. Conclusions: There is limited evidence evaluating the cost effectiveness of dietary interventions in individuals with mental disorders. Additional studies This study was conducted under the activities of the Dietitians Australia Mental Health Advocacy Working Group
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