PD615 - BARRIERS AND OPPORTUNITIES IN NUTRITIONAL CARE FOR PEOPLE WITH SEVERE MENTAL ILLNESS: A MIXED METHODS STUDY IN PRIMARY CARE

PD615

BARRIERS AND OPPORTUNITIES IN NUTRITIONAL CARE FOR PEOPLE WITH SEVERE MENTAL ILLNESS: A MIXED METHODS STUDY IN PRIMARY CARE

J. J. M. Van Meel^1,*, H. ten Have², M. Kahlmann³, A. Kok¹, W. Cahn^4,5

¹Dietetics, University Medical Center Utrecht, ²Dietetics, Careyn Utrecht City, ³Faculty of Medicine, University of utrecht, ⁴Psychiatrics, University Medical Center Utrecht, ⁵Psychiatrics, Altrecht Mental Health Care, Utrecht, Netherlands

Rationale: People with Severe Mental Illness (SMI) have elevated risks of obesity and metabolic syndrome. National guidance recommends referral to specialised dietitians, yet few primary-care dietitians in the Netherlands have psychiatric expertise. This study examined barriers and opportunities in SMI nutrition care.

Methods: This nationwide mixed methods study included an online survey among primary care dietitians assessing attitudes, competencies, referral pathways and support needs, analysed descriptively. Semi‑structured interviews were conducted with people with SMI. A thematic analysis was conducted.

Results: Sixty‑eight dietitians were included in the quantitative analysis, and six people with SMI were interviewed. Dietetic consultation frequency for people with SMI was mostly monthly (39.7%) or weekly (33.8%). Referrals mainly came from general practitioners (82.4%) and mental‑health practice nurses (52.9%). Nearly all reported ≥1 support need (94.2%), most often improved collaboration with mental‑health professionals (67.6%), more time per consultation (64.7%) and enhanced skills for counselling mood instability, anxiety, apathy or low motivation (64.7%). Attitudes were positive, while self‑reported knowledge about psychotropic medication effects on weight and eating behaviour varied (median score=3; IQR 2); 63.2% were interested in joining a regional network. Interview themes were similar: participants said sufficient time increases safety, they value acknowledgement of medication‑related changes in appetite and weight, and appreciate not having to repeat their medical history.

Conclusion: Primary care dietitians are motivated to support people with SMI but face structural barriers. Improved collaboration with mental‑health professionals, more consultation time and enhanced psychosocial counselling skills may strengthen continuity and quality of nutritional care.

Disclosure of Interest: None declared