This role statement was created by Accredited Practising Dietitians (APDs) working in mental health.

It details the role of a dietitian working in the area of mental health.

Importance of APDs in mental health

Dietitians are increasingly recognised as key members of the mental health care team to assist in improving both mental and physical health.

Diet plays an important role for overall mental wellbeing. Healthy diets are linked with good mental health; poor diets are linked with poor mental health. Dietary support should form part of the core treatment of mental illness. When used in ongoing treatment for mental illnesses like depressive disorders, dietary support can help to prevent, treat or manage symptoms.

Mental illness and substance use often negatively impact both dietary intake and physical health. Food intake and overall health are also affected by medication side-effects (such as increased appetite), symptoms of mental illness (like low motivation and low energy) and social determinants of health. If these concerns are not addressed, they can lead to physical illnesses like cardiovascular disease and diabetes. The life expectancy of people experiencing mental illness and substance use disorders in Australia is 10-to-16 years shorter than the rest of the population, mainly due to poor physical health. Diet improvement is critical for both prevention and management of physical illness.

What all APDs in mental health can do

Entry level competencies ensure all APDs can conduct assessments, diagnose nutrition issues, and develop, monitor and evaluate interventions. This applies to individuals, groups, communities, organisations, and population and systems levels. Dietitians in mental health have specific skills to:

• Provide holistic nutrition care, taking into account key issues in mental illness, including:
  • psychotropic medication side effects and nutrient interactions
  • risk of co-existing physical health conditions, and relevant biochemical measures (including lipids, glucose, Liver Function Tests, folate, vitamin B12, vitamin D)
  • behavioural, motivational, social, and financial challenges
  • concurrent addictions and substance use, disability, or cognitive impairment
  • risk of malnutrition, disordered food/eating patterns or food insecurity
• Support lifestyle change using individualised nutrition advice and counselling, including practical strategies such as cooking groups, label reading, food budgeting, meal planning, and using visual aids and demonstrations (such as food or meal portions).
• Collaborate with clients, carers, families, GPs and all members of the multidisciplinary team to develop a realistic nutrition care plan.
• Act as a resource to other health professionals, providing information about nutrition and mental health and why dietitians are important in mental health care.

What APDs with greater experience in mental health can do

As APDs gain experience and expertise in their area of practice, they can take on more complex tasks. Dietitians experienced in mental health may:

• Provide nutrition intervention using advanced counselling techniques, such as cognitive behavioural therapy and coaching skills, to enhance lifestyle change and client outcomes.
• Use their knowledge of the side effects of prescribed medications or illicit drugs and their potential impacts on nutritional needs and food behaviours.
• Identify a decline in mental state and inform an appropriate mental health clinician.
• Understand and apply the principles of recovery oriented, strengths focused and trauma informed care to all aspects of nutrition care.
• Apply understanding of the unique and varied food service needs and specific food service guidelines for mental health populations, catering to both under and over nutrition.
• Advocate for the role of nutrition in mental health, inform policy and service development, provide training and education to other health professionals and advice on nutrition screening, assessment and discharge planning for mental health services.
• Engage in research and quality improvement projects, contributing to the emerging evidence base in nutrition and mental health, as well as policy and service development.

What APDs in mental health and addiction don’t usually do

Dietitians work closely with other professionals to ensure the best outcomes for the people they work with. However, dietitians don’t always provide the same services as non-dietitian colleagues. Unless they have further training and an extended scope of practice, dietitians in mental health and addiction don’t usually:

• Diagnose mental illness – refer to a GP or psychiatrist.
• Conduct mental health risk assessment – refer to a psychologist, social worker or doctor.
• Assess safety and functioning while cooking – refer to an occupational therapist.
• Assess physical activity capacity – refer to an exercise physiologist or physiotherapist.
• Assess swallowing difficulties – refer to a speech pathologist.

For more, download the full role statement.