The Breakfast Club

One of the biggest areas of need which I have found working in a secure unit is promoting healthy lifestyles, in particular healthy eating.
It has been proven that people with severe mental illness consume unhealthier diets in comparison to the general population. Also research has shown that individuals with schizophrenia consume more saturated fat and salt compared to individuals without the condition. Individuals with mental health problems are more likely to have poor eating habits, are less likely to source nutritious meals and do not tend to eat as socially as the general population (Davidson et al., 2001). Negative symptoms of mental illnesses such as self-neglect, apathy, amotivation and an increased appetite also create barriers for maintaining a healthy weight. In addition anti-psychotic medication are known to cause weight gain.

I found that at work the residents struggle with maintaining a healthy balanced diet, because of the above factors but also because of their daily routines, most of the residents on my ward for various reasons do not get out of bed until midday and so do not eat a regular three meals a day but skip breakfast and opt for larger lunches and unhealthy snacks.

I decided to try and tackle this problem by introducing a breakfast group once a week on the ward. The group started at 8.30am for residents to help prepare the food in the OT kitchen and then was served in the main dining room for all residents and staff to enjoy.
The four main aims of the group are as follows:

• To encourage a healthy diet by providing residents with the opportunity to prepare and eat a healthy breakfast.
• To encourage residents to wake up in the morning in order to have a more structured day and participate in meaningful occupations.
• To utilise the group as a way of assessing residents functional and cognitive abilities.
• To encourage social skills to develop and to build upon the existing rapport between residents and staff. 

I devised a table of different breakfast food options which the residents could choose a certain number from each week depending on what they would like to prepare and eat. Foods include: fruit salad and yoghurts, porridge, scrambled egg, muesli, bagels etc. The rationale for choosing these foods and the others was that they kick start your metabolism, provide a slow release of energy to keep you full until lunchtime whilst also being food which tastes good and holds nutritional value.

As most of the residents do not wake up in the morning or go back to bed straight after receiving their medication at 8am it took a couple of weeks and prompting to get the residents to get up and try the group whilst encouraging others to attend as well. After a few weeks more residents wanted to either help with the preparation or would just get up to join in with the eating and socialising once it was served. I was pleasantly surprised to find that those who helped and participated in the group would then stay up for the rest of the morning rather than going back to bed.
I also noticed that the residents were choosing to eat the fruit salad every week and this was one of the most popular foods on the day. It has also been evident that the residents have been choosing to eat healthier food during their meals and in particular on a Thursday when we cook a big unit meal together they have been asking for salads and healthier options.
The group has also provided a useful means for me to assess some of the residents functional and cognitive abilities in a non obtrusive  way and also in an environment which is congruent with everyday activities.

Some written feedback which I have gathered from the residents has shown the benefits which are showing after only a few weeks:

'Having this breakfast make me feel like I have a lot more energy. It keeps me full or day and I am much more alert.'

'It makes myself feel fresh and alert for the day. Its lso helping me have a balanced diet.'

'I have felt quite down the last few days but breakfast group has perked me up. It gets you going for the day.'

The breakfast group has already shown many advantages and benefits to my ward and I am looking forward to seeing how this continues and develops as the weeks go by.

Happy OTuesday,
Kate 

References:

Davidson, S., Judd, F., Jolley, D., Hocking, B., Thompson, S. & Hyland, B. (2001). Cardiovascular risk factors for people with mental illness. Australian and New Zealand Journal of Psychiatry, 35 (2), 196–202. doi:10.1046/j.1440-1614.2001.00877.x