Expanding collaborative care: integrating the role of dietitians and nutrition interventions in services for people with mental illness.

OBJECTIVE: This article aims to draw mental health clinicians' attention to the connections between nutrition and mental health, and the roles that Accredited Practising Dietitians play in improving mental and physical health through dietary change. METHODS: Selective narrative review. RESULTS: Unhealthy dietary practices are common in high prevalence and severe mental illness. Epidemiological evidence demonstrates that nutrients and dietary patterns impact on mental health. In addition, poor physical health is well documented in people with mental illness and the greatest contributor to the mortality gap. Dietary intervention studies demonstrate improved mental and physical health outcomes. Accredited Practising Dietitians translate nutrition science into practical advice to improve the nutritional status of patients with mental illness, and prevent and manage comorbidities in a variety of care settings. CONCLUSIONS: Medical Nutrition Therapy offers opportunities to improve the physical and mental health of people living with mental illness.

Challenges and lessons from systematic literature reviews for the Australian dietary guidelines.

In 2009-10 the Dietitians Association of Australia conducted a series of systematic reviews for the National Health and Medical Research Council to generate evidence statements to inform the revision of the Dietary Guidelines for Australians. In total 202 body of evidence statements were constructed and assigned a grading detailing the certainty with which each could be used to inform policy. This paper describes some of the challenges and insights gained from the process, specifically related to: study type, study quality assessment, the lack of quantified data, diet exposure, definition of a healthy population, generalisability and applicability, and resource allocation. It is clear that there is still a need for further refinement of the methods for evaluating evidence for nutrition policy, but the current dietary guidelines are now much more robustly evidence informed than ever before.

Survey of disability-related content in Australian dietetics programs.

AIM: Nutrition and dietetic services are an important component of healthcare for people living with a disability. The introduction of the National Disability Insurance Scheme (NDIS) in Australia is providing more opportunities for individuals to access these services from an Accredited Practising Dietitian (APD). The aim of this research was to identify how students in Australian tertiary dietetics programs are being prepared to provide these services to people with a disability. METHODS: A purpose-built questionnaire with eight open-ended questions was developed by the researchers to describe the disability-related content of university and professional placement learning opportunities and was distributed to all course conveners (or their nominated representative) of dietetics programs accredited by the Dietitians Association of Australia. The qualitative data were analysed using a descriptive approach. Responses were sorted into response category themes and counted to identify common themes. RESULTS: A representative from 14 of 18 programs (78% response rate) participated in the survey in September and October 2016. Results indicated that although 12 programs incorporate disability-related topics into the curriculum, content was inconsistent and of varying depths. Four programs offered a disability-specific placement opportunity and nine discussed the NDIS to varying degrees. CONCLUSIONS: It is important that graduates are provided with adequate learning opportunities in the area of disability to ensure that they are prepared for entry-level practise in this area. Further research may provide insight into the skills, knowledge and behaviours used by APDs working in disability to identify those that need to be strengthened in dietetics programs.