Barriers and Facilitators of Taking a Lifestyle History and Referral to Lifestyle Interventions in Mental Health

Abstract

Background: Lifestyle interventions can improve mental and physical health in patients with mental illness, but implementing these in clinical practice seems difficult. Purpose: Investigate barriers and facilitators for mental health professionals (MHPs) in taking lifestyle histories and referring to lifestyle interventions. Methods: A cross-sectional national online survey among MHPs. All mental health care institutions, hospital psychiatry departments, associations for nurse specialists, and independent working psychiatrists’ organizations in the Netherlands were invited to participate. Ordinal regression analyses were performed to study factors associated with barriers. Results: 1524 MHPs participated. Barriers were time constraints (45.3%), lack of referral possibilities (33.2%), patient disinterest (25.4%) and lack of knowledge about: effect (25.5%), availability of interventions (57.5%), lifestyle (16.9%), and reimbursement (41.5%). Facilitators included more referral possibilities (44.9%), integration of lifestyle into clinical routine (48.3%), a dedicated tool (41.5%), organizational commitment (41.2%) and lifestyle as standard treatment component (40.3%), and more knowledge about: referral possibilities (51.4%), effect (38.1%), and reimbursement (48.1%). Older MHPs, those who consider their own lifestyle important, and those working in organizations where lifestyle interventions are available experienced fewer barriers. Conclusions: Organizations should prioritize lifestyle psychiatry by educating staff, integration into clinical routine, and increasing the availability and reimbursements of interventions.