importance of food in the Sanford kitchen chairs and tables in the café

At the Sanford Café, clients begin to incorporate the social aspects of food and eating.

Chef Peter has been with Sanford Behavioral Health through a couple of kitchen moves. He has worked in the confined kitchens of historic homes and the vast, shining kitchen at Sanford West Behavioral Health Campus. He says over the years of growth at Sanford, he has also gotten “street-smart” when it comes to feeding those with addiction, eating disorders, and co-occurring mental health conditions. Indeed, he has changed how he thinks about food after working with the eating disorder dietitians and clinicians at Sanford. We sat down with Chef Peter to talk about the importance of food and the challenges and joy of personalizing food options for a diverse group of individuals with specialized needs.

The Importance of Food in Mental Health Treatment – Limelight Interview with Chef Peter

importance of food a picture of Chef Peter in the kitchen

Director of Dining Services, Chef Peter Claus, in the shining kitchen at Sanford West Behavioral Health Campus

“When I was growing up, eating was an event. It was an opportunity for the family to work together and produce a delicious meal. To communicate – talk about our day. I try to create that same atmosphere at the Sanford Café.” Chef Peter Claus

Sanford – Hi, Chef Peter. Let’s start by talking about what happens in the kitchen at Sanford Behavioral Health in 2024.

Chef Peter Claus – At Sanford West Behavioral Health Campus, we feed folks at the Detox Center, those in residential treatment for substance use disorders (SUD) and eating disorders, and also people who are in day programs staying in supportive housing. We also provide meals for those in day programs and lunch for staff members who elect to eat at the Sanford Café. There have been changes in how we manage food and nutrition at Sanford since the pandemic for two reasons. First, we have more acute cases with ongoing medical care. Second, we treat eating disorders in both residential and outpatient programs, so I am working directly with medical providers and dietitians and food is part of the treatment plan.

Sanford – What is the Sanford Café?

Chef Peter Claus – This is a beautiful facility, and Sanford Café sounds fancier than the cafeteria, right? We provide food daily for our residential and day patients (PHP) as part of their treatment. Our clients at the Detox Center have meals delivered to them every day. They are often medically and emotionally unstable at the beginning of detox and are not ready for the social aspects of eating in the café.

Our residential eating disorder patients do not come to the café either. It would be overwhelming for them to be around a large group of people while eating, especially when they are new to treatment. There is also the clinical kitchen at Sanford Comprehensive Treatment for Eating Disorders (SCTED), so often we send the components of a meal, and they prepare them on-site. We do have eating disorder clients in outpatient programs who come to the Sanford Café a couple of times a week as a meal “outing.” We have a full salad bar with 30 different options they can choose from, and registered dietitians monitor them to build appropriate plates.

Sanford – How do you manage all the food preferences, dislikes, and requirements? What do you serve?

Chef Peter Claus – We do have a four-week cycle menu, so everyone knows what is being served each day. We have a scheduled entrée every day, and typically, we try to do a second entrée just based on what we have on hand or what sounds like fun. Patient and staff requests are also part of the mix. We send food to SCTED based on individual needs. In fact, I just met with the dietitians and Rae Green (Sanford founder) yesterday to talk about food options and how to manage their needs in SCTED.

In all levels of mental health treatment, we’ve got a ton of restrictions. Some people are gluten-free, dairy-free, vegetarian, no red meat, and what have you. The restrictions seem higher than for the general population. The patients also get to choose three “dislikes.” I don’t like mushrooms, tomatoes, red meat, etc. The eating disorder patients come in with even more restrictions and requirements. Admittedly, it is hard to keep on top of things (which is why the meetings are important).

clinical kitchen eating disorder treatment importance of food

The clinical kitchen at Sanford CTED where cooking and mealtimes can be therapy.

Sanford – Could you talk a little more about the importance of food in eating disorder treatment?

Chef Peter Claus – As often as we can, we try to send meals deconstructed to the eating disorder facility. That way, the staff who are plating meals for the residents can help look over their dislikes and restrictions list and determine what is going on the plate for each client. Let’s say we are making spaghetti, and it has cooked mushrooms and onions in it. [Laughs] Well, we’ve got clients who don’t like beef, clients who don’t like mushrooms, clients who don’t like onion. So we’ll send pasta sauce, beef, meat alternatives, and vegetables on the side. That way, the eating disorder staff can use it as an exercise to prepare food and have it be part of the treatment plan.

Also, eating disorder residents might be on different kinds of calorie build-ups. So, at first, they might have a small portion and then transition to actual weight gain. And then, depending on their length of stay, the goal is for them to plate their food supervised, while other patients may need the exact portion plated for them until they’re ready to be on their own.

Sanford – It seems you have learned a lot along the way at Sanford.

Chef Peter Claus – I sure have. When I interviewed for this position, the residential eating disorder potential was not mentioned [laughs]. It is a challenge, but we have lots of ways to manage individualization with food and have fun. We have one-on-one meetings, group meetings, and online methods (spreadsheet on OneDrive) of receiving information on a weekly, biweekly, and sometimes daily basis, depending on the client’s needs. The registered dietitians meet with the eating disorder patients when they enter treatment to go over food likes and dislikes, but over the length of stay, that can change preferences. So they may swap one dislike for another.

In the morning, before we begin to prepare food, we look at a schematic of who’s eating with us and what they need. The fact we have a four-week cycle menu is helpful for diversity and planning. Our SUD clients rarely are here for more than four weeks. It does happen if someone goes from detox to residential to day programming with supportive living. With eating disorders, most individuals are here for at least a month.

Sanford – How has working with the eating disorder team changed the way you think about the food you prepare?

Chef Peter Claus – Working with eating disorders has definitely changed the way I think about food. Initially, I created a four-week cycle menu like I’ve done for many other jobs over many years of experience. But then, when we opened SCTED, I sat down with the registered dietitians and decided this probably wouldn’t work as a viable meal plan. There were just too many ingredients. However, working with dietitians, I have learned how important certain kinds of nutrition can be in recovery from a substance use disorder or other mental health condition. I do miss some of the more exotic meals we made and sometimes make them as a second option.

We are made aware when clients don’t like a particular meal, and we take it off the menu – that depends on the population at any given time. [Smiles] We try to stay flexible.

Thanks, Chef Peter!

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