According to the National Association of State Mental Health Program Directors Reports of 2006 and 2012, people with a Serious Mental Illness (SMI) have a lifespan decreased by 25 years compared to people without an SMI, with average age of death at 53.
They also have chronic health issues such as obesity, diabetes, hypertension and cardiovascular disease in disproportionately higher numbers than the general population. It has been described as “an epidemic within an epidemic.”
Currently, most people with an SMI do not have regular check-ups with a primary physician due to various barriers related to their SMI. A major contributing factor to their chronic illnesses is their diet. Other factors are lack of physical activity, smoking, weight gain from medications and lack of access to health care services.
Additionally, many people with SMI live in Adult Residential Facilities (ARF), dependent on operators and staff to buy and prepare their food. The licensing of these homes is at the discretion of each state.
The homes range from single-family tract housing with a handful of residents, to apartment buildings housing 50 or more. The application process to becoming licensed has no particular requirements from a nutritional standpoint for homes with less than 50 residents.
According to A. Blesi, Community Care Licensing Division Program Analyst for the Sacramento, Calif. area, the licensing application requirement is to submit a written menu consisting of three meals and two snacks, which she reviews.
She does not have a background in nutrition, but relies on “what the guidelines from the Food Pyramid are,” and looks for food and nutrition “adequacy” when reviewing applications and doing on-site inspections (Note: In June 2011, MyPyramid was replaced by MyPlate).
Blesi further explained that there is no other oversight or criteria as far as nutrition for ARFs. No nutrition education or menu planning classes are offered to owners, operators or staff, nor required of them in order to provide meals to this underserved and vulnerable population.
However, it is common knowledge among many nutritionists and mental health advocates that a whole-food, nutrient-dense diet among people with mental illness is beneficial. Conversely, the high sodium, high sugar and processed food served in many ARFs is detrimental, no only physically, but on mood and behavior as well.