Carol Harris discusses a range of interventions that practitioners can use to ensure safer swallowing among clients, and possibly save lives

Dysphagia, or difficulty with swallowing, can be intrinsic to a mental health problem or could pre-date it, as in cases such as neurological or muscular disorders, age, stroke or end-stage dementia.

The condition is associated with increased risk of choking, chest infections following aspiration, poor health subsequent to poor nutrition, and mortality. Additional risk factors in people with mental illness include: side effects of psychiatric medications, behavioural changes, and the effect of institutionalisation. Clients should be monitored for occurrences of dysphagia.

This article explains the nature of dysphagia and evidence for its prevalence in the adult mental health population. A checklist of practical steps is given to identify the disorder. Interventions to reduce dysphagia and associated risks are described. The need for staff training to understand, detect and manage the condition at an early stage is emphasised, and strategies to reduce associated risks are explored.