227 General discussion measures. However, no practical guidance is provided on how to apply this, with the result that little action is taken in this area even though an increased risk of poor oral health has been demonstrated [7]. Therefore, the insights gained from treating people with SMI should be used in the establishment of guidelines for FEP to enable preventive measures. Mental health nurses as lifestyle role models MHNs are recognized as vital role models in imparting knowledge about risk factors leading to decreased oral health in patients with psychotic disorders, as elucidated in Chapters 3 and 5 of this dissertation. MHNs play an important role in promoting healthy behaviours such as physical activity, stress management, and a nutritious diet, and in encouraging patients to avoid illicit substances to enhance overall health and quality of life [18,19]. The behaviour and personal conduct of MHNs might influence patient outcomes. MHNs are closely connected with patients, positioning them to serve as role models. However, MHNs may not yet be fully aware of this responsibility. As role models, they can significantly influence their patients’ health promotion efforts, either positively or negatively. This proximity and visibility to patients underscore the potential impact MHNs have on patient behaviour and health outcomes, highlighting the importance of MHNs’ awareness of their influential role in health care settings[20]. Overall, there are 18,500 registered MHNs and 1,600 MH nurse specialists in the Netherlands. They all have the potential to be a role model and improve oral health in mental healthcare. Research indicates that the lifestyle habits, gender, and professional roles of MHNs affect their clinical practices and the application of lifestyle psychiatry, thus impacting patient care [21]. Although MHNs are aware of the importance of health-promoting activities, they often do not know how to translate this knowledge into practice. MHNs are crucial in educating patients about healthy lifestyles, implementing tailored interventions, monitoring progress, and working in multidisciplinary teams to provide comprehensive care. They also contribute to research and advocate for the integration of lifestyle psychiatry into mental health policies [22]. Despite these roles, there is a need for MHNs to be more conscious of their responsibility in integrating physical and oral health within mental health care. A small intervention like a brochure with an awareness screener has proved feasible [23] (chapter 5 and 6). In addition to MHNs becoming aware of the importance of oral care, clinical reasoning remains a core aspect of nursing practice. Here, the North 7
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