Scoping survey of dietetic resourcing for eating disorders: why is the dietitian’s role marginalised in community eating disorders?

In a survey of nutritional literacy in mental health professionals spanning 52 countries and 1056 participants, all participants believed the diet quality of individuals with mental disorders was poorer compared with the general population, yet the majority of psychiatrists (74.2%) and psychologists (66.3%) reported having no training in nutrition.4 Nevertheless, many of them used nutrition approaches with their patients (58.6% recommended supplements, 43.8% recommended specific diet strategies). In 2015, in recognition of the importance of properly staffed multi-disciplinary teams to manage these complex conditions, the National Collaborating Centre for Mental Health (NCCMH) set out expected staffing levels for different professional groups, including dietetics, specifically focusing on community ED services (CEDS) for children and young people (CYP).6 Their recommendations were accompanied by funding to support implementation. In response to these concerns and to the evidence of insufficient service and funding and inequity, we conducted a scoping review of dietetic staffing in ED services in England, aiming to understand the current provision, referrals, caseload, staffing and proportion of patients seen by a dietitian in CEDS and to identify differences in provisions between adults and CYP and between regions. Health Education England has already identified uneven increases in staffing across professional groups in the under 18s mental health sector as a whole, with, for example, psychology and psychotherapy seeing increases of 22% and 18%, respectively, from 2019 to 2022, while occupational therapy saw a drop of 14%.7 Dietetics is not included separately in the report data, but the current study indicates that staffing is inadequate.