Our clinical careers started in community mental health in the inner city of Norfolk , VA . We worked with clients with diagnoses such as schizophrenia , depression , bipolar disorder , anxiety , and attention deficit hyperactivity disorder ( ADHD ). The mental health diagnoses were comorbid to a plethora of chronic physical health issues . Often , we accompanied these clients to their psychiatrist appointments , where the effectiveness of their medications were monitored . Additionally , these clients were involved in individual talk therapy , group therapy , and community-based counseling .
The question raised by our early work was , “ If clients are taking their medication as prescribed and are in talk therapy … what is missing ?” Answering it spurred our interest in using nutrition as a mental health intervention . Dan Siegel , MD , a clinical professor of psychiatry at the UCLA School of Medicine explains , “ The brain is the physical place where the mind resides . ... The mind is the manifestation of thought , perception , emotion , determination , memory , and imagination that takes place within the brain .” We concluded that the brain is an organ that must be provided care to function optimally .
Member Reflections
Why Using Nutrition as a Mental Health Intervention Makes Sense
Sophia Sills-Tailor , PhD , LPC , an assistant professor of Counseling at Liberty University , is independently licensed as a Licensed Professional Counselor in Virginia , the District of Columbia , and Delaware , and she is a National Certified Counselor . Dr . Sills-Tailor ’ s teaching and research interest is in treatment of trauma and supported self-healing . One or her favorite roles is being a mom to Rebecca , as well as cooking and starting home-repair projects .
Ularisi Green-Baker , PhD , LPC , is a Licensed Professional Counselor in the state of Virginia . An account manager with REACH EAP and an adjunct professor of Counseling at Liberty University , Dr . Green-Baker is also the owner of “ Live to Never Regret Counseling and Consultation .” She enjoys having fun with her husband and four sons .
Since the human brain is about 75 percent water , we often begin work with clients by helping them recognize the role that food plays on the mind and vice versa . For example , the effects of dehydration and malnutrition can both mimic and trigger mental health symptoms . Nutritional psychiatrist Uma Naidoo , MD , teaches about the connection between nutrition and mental health in her book , “ This Is Your Brain on Food .” In it , she explains that the vagus nerve — which originates in the brain stem and extends all the way to the gut — allows signals to travel directly from the brain to the gut . This is biological evidence that our mind tells our gut how to react , and our gut also modifies our brain and mind .
The first step with clients is assessment . Explore with clients their lifestyle — including sleep , eating behaviors , nutrition , exercise habits , stress levels , and coping mechanisms . Often this informs our recommendations , as many common mental health diagnoses — including bipolar disorder , anxiety disorders , depression , obsessive-compulsive disorder , schizophrenia , and ADHD — have all been linked to severe deficiencies of vitamins , minerals ,
and omega-3 fatty acids . These deficiencies can be treated with dietary interventions such as the Mediterranean , DASH ( Dietary Approaches to Stop Hypertension ), and ketogenic diets . Assessing for client nutritional needs can take place during the initial intake .
Formal screening tools can also be used to assess nutritional status . For example , the Malnutrition Screening Tool ( MST : bit . ly / 3qdMsTN ) can be administered by mental health professionals . This brief assessment helps identify if follow-up is needed by a nutritionist , dietician , or other medical professional . The Comparison Guide ( bit . ly / 3spx9dv ) gives an overview of several other tools and outlines which professionals are qualified to administer them .
As a part of psychoeducation , speak to clients about perceiving their diet as self-care , not selfdiscipline . When the focus is on control , it adds to the mental and physical depletion a client may be experiencing . Focus instead on managing mental health with self-compassion , and blend what is known about nutrition with cognitive behavioral techniques .
Talking with clients about self-compassion helps them start to challenge cognitive distortions . We can help our clients learn to give themselves grace and time as they attempt to feed their bodies to feed their minds . What we are proposing are considerations to improve their physical and mental health , not require that they resort to a restrictive and unrealistic diet ! Additionally , food journals are helpful in providing clients with a visual aid that also serves as an accountability tool . The journals can help the client track possible connections between their moods and the food and drink they consume .
Finally , when adding nutritional considerations to clinical interventions , we must be aware of the boundaries of our competence . As with training to be Licensed Clinical Mental Health Counselors ( LCMHC ), nutrition science and practice is a discipline that requires training — and years — to become proficient . You might consider working collaboratively with a registered dietician as a part of your treatment team . Any interventions we recommend as LCMHCs should be a collaborative approach that includes an LCMHC , the client , and a medical health-care provider . For additional references related to food and mental health , including food journling , visit bit . ly / 3smm5O1 .
2 The Advocate Magazine Fall 2021 American Mental Health Counselors Association ( AMHCA ) www . amhca . org