A pioneering Sydney program is tackling the nutritional and physical health of young people with severe mental illness.

Keeping the Body in Mind is possibly the first Australian initiative that works to improve the physical health outcomes of people with early psychosis.

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The program, which features an Accredited Practising Dietitian (APD) and exercise physiologist, has been shown to reduce antipsychotic-induced weight gain in clients aged between 15 and 25.

Operating out of the Bondi Junction Community Health Centre since 2012, the program has been such a success it’s now being expanded beyond the early psychosis program to all mental health services across South Eastern Sydney Local Health District.

PhD candidate and APD Scott Teasdale said the benefits of the program prove it’s time to transition more dietitians into working in the field of mental health.
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“It’s a simple concept but it’s a very challenging cohort and I think it’s time that we can start moving APDs into early psychosis as core members of the mental health team,” he said.

“Keeping the Body in Mind has been so effective that there are now three full-time mental health dietitians targeting early psychosis and established severe mental illness in South Eastern Sydney Local Health District.”

Mental health teams are traditionally formed with psychiatrists, case managers, nursing specialists, occupational therapists and social workers - all targeting the mental health recovery of the client.

While some inroads have been made in addressing the nutritional and physical health in established mental illness, this program targets the crucial initial two years of psychosis, when clients begin taking their antipsychotic medication.

The program features embedded lifestyle interventions, through an APD and an accredited exercise physiologist, as part of a multidisciplinary mental health team.

Mr Teasdale, who spoke about the program at the Dietitians Association of Australia’s recent 32nd national conference, said the program addresses the rapid weight gain that occurs as a result of antipsychotic medication.

“We’re seeing twice the rate of diabetes and two to three times the rate of obesity in these clients compared to the general population, which leads to a 15 to 20 year mortality gap,” he said.

“Their hunger significantly increases from the outset of antipsychotic use. For a lot of people it becomes insatiable and includes constant cravings for sweet foods and drinks.

“Combined with lower education levels, lower culinary skills, restricted budgets, and potentially impaired cognitive functioning, we find people experiencing psychosis consuming large amounts of cheap, convenient, processed food.

“It’s not good for their mental health and it’s obviously not good for their physical health either.”

Under the program, Mr Teasdale provides best practice intervention which ranges from one-on-one consultations to practical initiatives such as mindful eating, cooking groups and shopping tours.

“A lot of these young people do not get the opportunity to cook a meal and sit down as a family to eat, which I believe is a crucial part of therapy,” Mr Teasdale said.

“We get someone to be head chef for the day and they choose a healthy recipe that they want to learn to cook at home and we’ll all walk down to the supermarket together and get all the ingredients.

“We can educate while shopping, plus we are getting incidental activity, then we head back to the centre and cook as a team. Then they sit down as a family to eat and socialise.”

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