A bio-psycho-social perspective of barriers to improving the quality of nutrition in health promotion programs for persons with severe mental illness

Persons with severe mental illness (SMI) are at increased risk of developing physical illnesses. Therefore, there is a need to promote prevention programs that improve the quality of their nutrition. However, efforts to achieve this goal may face difficulties due to unique barriers they encounter. To examine the types and levels of perceived barriers affecting the promotion of healthy nutrition among persons with SMI living in community residential facilities, a mixed-methods research approach was employed. The study was conducted with 86 persons with SMI at the start of their participation in health promotion programs. The findings illuminate the impact of barriers stemming from the effects of mental illness, psychiatric medications, hospitalization, and a lack of knowledge about how to improve nutritional quality. They also highlight the role of external barriers, including a lack of companionship, insufficient support for promoting healthy nutrition, and a lack of healthy nutrition choices, in community residential facilities. The findings suggest that prevention programs should go beyond simply providing nutritional knowledge. A bio-psycho-social perspective should be adopted to address personal, social, and systemic factors that may be related to the perception of barriers, thereby helping persons with SMI overcome challenges in improving their nutritional quality.