Dietetics Inpatient Service

Our inpatient mental health dietitians assess and provide detailed dietary plans with service users with a range of diet related conditions. All of our mental health hospitals are covered. Here are some examples of the dietary related conditions they will frequently support:

• Antipsychotic related weight gain
• Weight loss and low appetite
• Gastrointestinal conditions, such as irritable bowel syndrome, inflammatory bowel disease and coeliac disease
• Allergies
• Tube feeding
• Dietary support for pressure ulcers and/or wound healing.

They work around our service users’ priorities and focus on both physical and mental health to promote overall wellbeing. These plans are co-produced with service users, aiming to make small, realistic changes that can support long term benefits in health.

As a team, they also deliver training to different sites across the Trust. For example, Malnutrition Universal Screening Tool (MUST) training, ensuring that all service users are nutritionally screened correctly and referred to appropriate support in a timely way.

Our team also runs groups across different wards. One example of this is the weight management group, which gives practical advice around managing weight in hospital and in the long term. Anybody on the ward can join this and it's practical and interactive.

Once a referral has been made, the team will visit the ward to complete a detailed dietary assessment with both staff and service users. They then provide person specific lifestyle/dietary advice suitable to the service user.

Some commonly used tips/plans used by dietitians include:

• Food fortification: ensuring that every bite counts. Using high energy food and drinks to add calories and protein to meals, to aid weight gain to service users struggling with appetite. An example of this could be adding fortified milk (full fat milk with added milk powder) to drinks and breakfast cereals
• Supplementation: if required, they're able to prescribe Oral Nutritional Supplement (ONS) to service users who are struggling to gain weight and have tried other tips like fortification
• Weight reducing advice: this is different for everybody, but they're able to make tailored plans to aid healthy weight loss with service users struggling to control their weight
• Gastrointestinal advice: low and high fibre diets catering to specific gastrointestinal conditions, as well as the use of food and symptom diaries to monitor how certain foods may impact gastrointestinal health.

Referrals to the inpatient dietetics team must be done by ward staff. They will carry out weekly MUST screening, which assesses a service user’s risk of malnutrition and will indicate when a dietetic referral may be needed.

A dietitian referral is recommended with a MUST score of 2+. However, for service users requiring weight management advice, this threshold does not have to be met.

(Crown Copyright, 2016)

The above diagram is the Eatwell Guide. For a generally healthy, balanced diet, try to consume each of these food groups in the proportions shown on the plate. This can be over the course of the day, rather than in each meal you have. For those with more specific dietary needs, always seek the help of a health professional such as a dietitian.