Contribution of Dietitians

Dietitians apply sound, scientific, evidence-based knowledge of nutrition and diet to promote and protect health; to prevent, treat and manage illness; and to deliver good nutrition safely for those unable to eat normally.

The title ‘dietitian’ is protected under the regulations of the Health Professions Council, so can only be used by graduates whose qualification meets the requirements for registration with the Health Professions Council which sets and regulates standards for pre-registration training and continuing professional development. The Standards of Conduct, Performance and Ethics, and Standards of Proficiency are supplemented by the Code of Professional Conduct of The British Dietetic Association. There are approximately 5,000 dietitians registered with the Health Professionals Council, most of whom are working in the NHS. Many are specialists in specific branches of health care, though fewer than 5% are specialists in mental illness.

People with a mental illness have high rates of physical illness and are at an increased risk of developing and dying prematurely from coronary heart disease, cancer and obesity, all of which are critically affected by diet (1) and malnutrition is a consequence of self neglect. Medication used in treating mental illness has side effects including weight gain, hyperglycaemia, diabetes, and gastrointestinal problems which need long term dietary management. Dietitians can help reduce this additional burden both by direct intervention with service users who have complex therapeutic dietary requirements, and by training and supporting other mental health care professionals to deliver evidenced based nutrition education. In the specific area of eating disorders, skilled nutritional management is necessary for safe and effective treatment and risk management (2). A Mental Health Policy Report (3) identified a need for greater access to dietitians and everyone with diabetes should receive dietary information and support (4)

There is evidence that people with mental illnesses suffer discrimination and inequalities in health care (5) The Disability Rights Commission has launched an investigation because of the overwhelming weight of evidence pointing to disparities in health outcomes experienced by people with long term mental illness and people with learning disabilities.

Due to the small number of dietetic posts within the mental health services it is difficult for dietitians to meet the needs of service users, although these needs may be great. Most people with a mental illness who need dietetic treatment are referred to dietitians in primary or acute hospital care, who may not have the specific skills and professional support to provide the most appropriate care.