From evidence to everyday care:Implementing and evaluating a lifestyle-focused approach in mental healthcare

This thesis investigated the effectiveness and implementation of a lifestyle-focused approach in everyday inpatient mental healthcare. People with mental illness often experience poor physical health, partly due to unhealthy lifestyle behaviors. Although lifestyle interventions can improve both physical and mental health, they are not routinely embedded in clinical practice. The thesis evaluated the implementation of MULTI+, a multidisciplinary lifestyle-focused approach introduced across inpatient psychiatric sites in the Netherlands. MULTI+ was implemented as an organizational change rather than a fixed intervention, allowing teams to adapt lifestyle activities to their local context while working with shared core components. The research examined barriers and facilitators, the extent to which MULTI+ was delivered as intended, and how implementation differed across settings, and how differences related to outcomes. Findings show that implementation of lifestyle-focused care in mental healthcare is feasible but varies between settings. The thesis provides practical insights into how evidence-based lifestyle care can be embedded.