PhD Defense: From Evidence to Everyday Care Implementing and Evaluating a Lifestyle-Focused Approach in Mental Healthcare

People with mental illness live, on average, fifteen years shorter than the general population. This is mainly due to preventable physical conditions such as heart disease and diabetes. Unhealthy lifestyle habits, such as less movement, poor diet, disturbed sleep, and smoking, play a major role, and are often reinforced by psychiatric symptoms, medication side effects, and limited access to care. Yet, we know that a healthier lifestyle can support both physical and mental health.
Despite this evidence, lifestyle is still rarely part of standard mental healthcare. The reason lies in the “research-to-practice gap”: what we know from science is often difficult to apply in daily practice. As a result, people with mental illness do not fully benefit from what we already know can improve their health.
This thesis aimed to bridge that gap. The MULTI+ approach was developed and implemented in all inpatient wards of GGz Centraal, a specialist mental healthcare facility in the Netherlands. MULTI+ is an organization-wide, multidisciplinary approach aiming to improve lifestyle behavior. It covers multiple components, such as physical activity, healthy nutrition, smoking cessation, education, and teamwork. In a large, real-world study, both health outcomes and the degree of implementation were evaluated.
The work shows that improving physical and mental health in psychiatry is complex but achievable when organizations commit to it long term, support their teams, and make healthy living part of the culture of care. People with mental illness deserve care that helps them live longer, healthier, and more fulfilling lives, and that begins by making lifestyle a normal part of mental healthcare.