Feasibility of a targeted nutrition-risk screening tool in Australian mental health services: The NutriMental screener.

Abstract

Aims: This study aimed to test the feasibility and acceptability of mental health clinicians using a multifaceted nutrition-risk screening tool in Australian mental health settings.

Methods: A mixed-methods cross-sectional design was used. Mental health clinicians implemented the multifaceted NutriMental screener at seven sites across Australia and provided feedback via a standardised form. Primary outcomes were the feasibility, acceptability and appropriateness domains of the feedback questionnaire. Additional outcomes included association/agreement between the consumer's desire for dietetic support, clinicians' impression of need for dietetic support, and total nutrition risks reported. Directed content analysis was employed to analyse open-ended sections of the clinician feedback questionnaire.

Results: Fifty-four clinicians participated, completing the NutriMental screener with a total of 256 mental health consumers. Mean total nutrition risks reported were 6.4 ± 1.8 (out of nine). Mean implementation outcomes (out of five) were 3.1 ± 0.8 for acceptability, 3.7 ± 0.5 for appropriateness, and 4.3 ± 1.7 for feasibility. There was moderate agreement between consumer's desire for dietetic support and clinicians' impression of need for dietetic support κ = 0.32 (95% CI: 0.21-0.43), p < 0.001, and positive correlations between the number of nutrition risks reported and consumer's desire for dietetic support (r = 0.29, p < 0.001) and clinicians' impression of need for dietetic support (r = 0.29, p < 0.001). Six themes and 17 subthemes related to barriers and facilitators to the screener's implementation were identified.

Conclusion: The multifaceted risk screening tool appears to be feasible, acceptable and appropriate for use within Australian mental health services. Refinements of the NutriMental screener based on clinician feedback may further improve its implementation.