‘An Apple a Day’?: Psychiatrists, Psychologists and Psychotherapists Report Poor Literacy for Nutritional Medicine: International Survey Spanning 52 Countries

Abstract

Nutritional interventions have beneficial effects on certain psychiatric disorder symptomatology and common physical health comorbidities. However, studies evaluating nutritional literacy in mental health professionals (MHP) are scarce. This study aimed to assess the across 52 countries. Surveys were distributed via colleagues and professional societies. Data were collected regarding self-reported general nutrition knowledge, nutrition education, learning opportunities, and the tendency to recommend food supplements or prescribe specific diets in clinical practice. In total, 1056 subjects participated in the study: 354 psychiatrists, 511 psychologists, 44 psychotherapists, and 147 MHPs in-training. All participants believed the diet quality of individuals with mental disorders was poorer compared to the general population (p < 0.001). The majority of the psychiatrists (74.2%) and psychologists (66.3%) reported having no training in nutrition. Nevertheless, many of them used nutrition approaches, with 58.6% recommending supplements and 43.8% recommending specific diet strategies to their patients. Only 0.8% of participants rated their education regarding nutrition as ‘very good.’ Almost all (92.9%) stated they would like to expand their knowledge regarding ‘Nutritional Psychiatry.’ There is an urgent need to integrate nutrition education into MHP training, ideally in collaboration with nutrition experts to achieve best practice care.

Role of diet and its effects on the gut microbiome in the pathophysiology of mental disorders

“…One of the major challenges of Nutritional Psychiatry Research is to gradually change the prevalent mindset shared by a majority of researchers and practitioners that psychiatric disorders are diseases of the brain, and do not involve the gut and its microbiome. An education of mental health professionals about the crucial role of diet and its effect on brain gut microbiome interactions, and the need for and interdisciplinary approach to this field is necessary to make progress in this area of psychiatry [ 136 ].…”

Design and pilot evaluation of an evidence-based worksheet and clinician guide to facilitate nutrition counselling for patients with severe mental illness

“…It is noted that passive dissemination strategies, such as printed educational materials, are more likely to change clinician behaviour when there is existing motivation [ 39 ]. In response to a recent survey of mental health professionals from 52 countries, 92% of respondents indicated that they were interested in expanding their knowledge of nutrition as a therapeutic approach to mental health care [ 21 ]. This high level of motivation suggests that the dissemination strategy is appropriate.…”

“…Occupational therapists could support patients in making dietary changes by working in a behavioural activation, cognitive adaptation, or goal-setting framework. Overall, mental health professionals, such as our study population - psychiatrists, are well-trained in supporting behaviour change but nutritional training is lacking [ 21 ]. Future work with other mental health care providers to introduce, modify, or implement the tool may be valuable.…”

“…Additionally, the tool should provide psychoeducation about the importance of quality nutrition as a determinant of mental health. There have been calls for increased use of nutrition in the treatment of psychiatric disorders [ 18 , 19 ]; however, it is recognized that medical doctors [ 20 ], including psychiatrists, and other mental health professionals receive limited training in nutrition [ 21 ] and that additional training and resources are needed.…”

The Development of a Nutrition Screening Tool for Mental Health Settings Prone to Obesity and Cardiometabolic Complications: Study Protocol for the NutriMental Screener

“…One potential reason is diagnostic overshadowing, "a process by which physical symptoms are misattributed to mental illness" [20]. In addition, psychiatrists and mental-health teams are insufficiently aware of the somatic comorbidities and metabolic monitoring procedures for their patients with psychiatric disorders [21,22], and they have little to no training in nutrition [22]. This leads to a lower use of general preventive-care services and of routine specialized somatic care in people with an SMI, as compared to the general population [23].…”