Today, MNI provided its feedback to the Call for Evidence on the EU Initiative “A comprehensive approach to mental health”.

Nutritional care – including malnutrition screening – should be part of the support to people with mental and neurological disorders.

Disease-related malnutrition - in this context simply referred to as “malnutrition” - occurs when patients are not able to meet their nutritional needs via the normal diet due to diseases, ageing and/or side-effects of medical treatment. It is common across a variety of patient groups, e.g., in patients with cancer, gastrointestinal, respiratory, and neurological disease. Patients with neurological conditions or following a stroke may not be able to swallow or feed themselves.

Malnutrition is found to be common in people with intellectual disability and mental health problems with prevalence of underweight or of malnutrition risk of approximately 19%. As much as a third of psychiatric patients are at risk of malnutrition.

A study found that the prevalence of malnutrition and its risk in patients in mental health units differed with different diagnoses:

• ~ 12.5% in patients with bipolar disorder;
• ~ 21.1% in patients with schizophrenia;
• ~ 55.6% in patients with major depression.

Malnutrition is a condition that affects 33 million people in Europe, and it costs an estimated €170 billion a year to European countries. Malnutrition impacts individuals at all stages of life, from infancy to old age. It has a negative impact on growth and development impairment in children. In a dedicated study on malnutrition screening in hospitalised children, the highest prevalence of chronic malnutrition was seen in children with neurological disease (31%). Being at risk of malnutrition causes a higher severity of symptoms and lower functioning. It has been recognised that the nutritional status has an impact on recovery from illness, mortality, and treatment complications, such as length of hospital stays and the rate of readmissions.

Screening and early nutritional interventions for people with mental disorders is a key element of effective care: in particular, the nutritional support of those who are neurologically impaired should be addressed since the early stages of the disease.

The nutrition care of children who are neurologically impaired is a challenge for the nutrition care team: many factors should be considered in the assessment and development of a nutrition plan. For optimal care, management should be done by a multidisciplinary team including a registered dietitian. Improved nutrition status results in improved health outcomes. Many children with neurological impairment would benefit from individual nutritional assessment and management as part of their overall care. The risk of malnutrition has been completely neglected to date.Stronger EU guidance is required to address persistent inconsistencies in malnutrition screening across Europe. Screening a patient for malnutrition takes only a few minutes, using tools validated by scientific societies.

Optimal nutritional care can provide improvements in functional measures and quality of life of people with mental disorders.

Routine assessment of patients’ nutritional status should be established as part of the treatment. Where patients are unable to sufficiently feed themselves, medical nutrition - to be used under medical supervision - allows them to sustain themselves during treatment, leading to better outcomes.

Download MNI feedback to the consultation and list of scientific evidence