Healthy Eating in Persons with Serious Mental Illnesses: Understanding and Barriers

Objective: To explore the understanding of a healthy diet and the barriers to healthy eating in persons with serious mental illnesses. Methods: In-depth semi-structured qualitative interviews about health behaviors were conducted in 31 individuals with serious mental illnesses. Participants were recruited from a mental health center in Chicago, Illinois, and ranged in age from 30 to 61 years old. Results: Most participants described healthy eating as consuming fruits and vegetables, using low fat cooking methods, and limiting sweets, sodas, fast food, and/or junk food. Internal barriers to nutritional change included negative perceptions of healthy eating, the decreased taste and satiation of healthy foods, difficulty changing familiar eating habits, eating for comfort, and the prioritization of mental health. External barriers were the reduced availability and inconvenience of healthy foods, social pressures, and psychiatric medication side effects. Conclusions and Implications for Practice: This study revealed several modifiable barriers to healthy eating. Interventions that addressed these could aid in improving the diet and lowering the risk of cardiovascular disease in this population. Recommendations are to provide healthy eating education that is individualized, emphasizes the health consequences of poor eating, and provides opportunities to prepare and taste healthy foods. Family and friends should be included in all educational efforts. At community mental health centers and group homes, only healthy foods should be offered. Lastly, practitioners should encourage eating a healthy diet, inquire about eating in response to emotions, and explore the impact of psychiatric medications on eating behaviors.