Food insecurity and severe mental illness: understanding the hidden problem and how to ask about food access during routine healthcare

Smith, Jo; Ker, Suzy; Archer, Darren; Gilbody, Simon; Peckham, Emily; Hardman, Charlotte A.

doi:10.1192/bja.2022.33

Cited by 12 publications

(10 citation statements)

References 21 publications

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“…There are several clinical and policy recommendations arising from this review. At present, mental health practitioners may not prioritize asking about food insecurity (Smith, Ker, et al, 2022). There are many potential explanations for this.…”

Section: Implications For Practicementioning

confidence: 99%

“…The impact of multiple stigmas (including mental illness, food insecurity or obesity) may be a barrier for people with SMI in raising the issue of food insecurity with their mental health practitioner. Routine assessment and monitoring of food insecurity in adults with SMI is, therefore, essential, as is the development of co‐produced interventions to address this stark health inequality (Smith, Ker, et al, 2022). Furthermore, this review has identified a gap in available tools to assess food insecurity in adults with SMI.…”

Section: Implications For Practicementioning

confidence: 99%

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Food insecurity in adults with severe mental illness: A systematic review with meta‐analysis

Smith,

Stevens,

Lake

et al. 2023

Psychiatric Ment Health Nurs

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IntroductionFood insecurity in adults living with Severe Mental Illness (SMI) is an underresearched area worldwide.AimThis systematic review and meta‐analysis aimed to identify and collate evidence on food insecurity in adults with SMI, in high‐ and upper‐middle income countries.MethodA comprehensive electronic search was completed up to August 2022. Random effects meta‐analysis was undertaken to determine the prevalence and the odds ratio for food insecurity in adults with SMI. Narrative synthesis explored the data further.ResultsSixteen publications were included (13 in the meta‐analysis). The prevalence estimate of food insecurity in adults with SMI was 41% (95% CI: 29% to 53%, I2 = 99.9%, n = 13). Adults with SMI were 3.31 (95% CI: 2.03 to 5.41) times more likely to experience food insecurity than comparators without SMI (z = 6.29, p < .001, I2 = 98.9%, n = 6). Food insecurity appears to be a risk factor for developing SMI.DiscussionThis review suggests adults with SMI living in high‐ or upper‐middle income countries are more likely to experience food insecurity than the general population and that this relationship may be inverse.Implications for practiceMental health practitioners should be aware of food insecurity and support individuals with SMI to access sufficient food.

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Section: Implications For Practicementioning

confidence: 99%

Section: Implications For Practicementioning

confidence: 99%

Food insecurity in adults with severe mental illness: A systematic review with meta‐analysis

Smith,

Stevens,

Lake

et al. 2023

Psychiatric Ment Health Nurs

Self Cite

View full text Add to dashboard Cite

show abstract

“…Living with mental ill health can have a significant adverse impact on people's ability to maintain a healthy lifestyle. 11 In particular, an increased likelihood of health risk behaviours such as smoking, poor diet and physical inactivity [12][13][14][15] ; difficulties in taking up and accessing preventative services such as screening services 16 and routine dental care 17 ; difficulties associated with the practical, emotional and physical complexity of managing multiple health conditions. 18,19 In addition, some antipsychotic and antidepressant medications have metabolic side effects such as weight gain.…”

Section: Introductionmentioning

confidence: 99%

Shaping research for people living with co‐existing mental and physical health conditions: A research priority setting initiative from the United Kingdom

Taylor,

Newbronner,

Cooke

et al. 2024

Health Expectations

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IntroductionThose with severe and enduring mental ill health are at greater risk of long‐term physical health conditions and have a reduced life expectancy as a result. Multiple factors compound this health inequality, and the need for setting research priorities in this area is highlighted with physical and mental healthcare services being separate, and limited multimorbidity research.MethodsThe aim of this exercise was to work in partnership with healthcare professionals and carers, family, friends and individuals with lived experience of both mental and physical health conditions, to set research priorities to help people with mental health conditions to look after their physical health. The exercise was guided by the James Lind Alliance approach. For this, a steering group was set up, two surveys were completed and a final priority workshop was conducted.ResultsThis priority setting exercise guided by people's needs and lived experience has produced a set of well‐defined research topics. Initially, 555 research questions were suggested in the first survey, which were refined to 54 questions for the second survey. A priority setting workshop was then conducted to get the final 10 priorities.ConclusionsTaking these topics forward to improve services and treatment for both mental and physical ill health may in turn improve physical health and lessen the reduced life expectancy of those living with mental ill health.Patient or Public ContributionThis work was completed in collaboration with people who have lived experience of mental ill health and physical health conditions, as well as carers, family and friends. Their contribution has been significant for this work from piloting surveys, amending language used and educating the researchers and contributing to this paper. The initial work was completed with a steering group and continued with surveys and workshops.

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“…Although physical activity and one's food environment are integral parts of the obesogenic environment, these factors also influence mental health outcomes 10. Lack of access to healthy foods can influence food insecurity and, thus, affect population mental health outcomes 11.…”

mentioning

confidence: 99%

“…9 Although physical activity and one's food environment are integral parts of the obesogenic environment, these factors also influence mental health outcomes. 10 Lack of access to healthy foods can influence food insecurity and, thus, affect population mental health outcomes. 11 For example, a study of 160 countries found that relative food insecurity was related to more mental health symptoms and lower well-being and life satisfaction.…”

mentioning

confidence: 99%

Examining the Connection Between Health Outcomes, State Political Ideology, and Food Access in the United States

Samudra

Heboyan

2023

Journal of Public Health Management and Practice

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Objectives: To estimate the impact of county-level income, access to food, availability of health resources, socioeconomic factors, and state political ideology on population obesity and mental health in US counties. Design: We compiled a county-level data set from the US Census, County Health Rankings, USDA Food Environment Atlas, the American Community Survey, and the State Ideology Database. We specify 2 multivariable regression models for county-level obesity rate and per capita poor mental health days and control for rurality, food access, income, availability of health care resources, state political ideology, and socioeconomic characteristics. Results: We find that higher food access reduces obesity in counties; an increase in per capita full-service restaurants by 1 unit is associated with reduction in obesity rate by 1.24 points and an increase in per capita grocery stores reduces poor mental health days by 0.14. We also find that counties in liberal-leaning states tend to have lower obesity rates. Access to primary care providers (increase in primary care physicians by 1 is associated with decline in obesity rate by 1.18 points and poor mental health days by 0.11 days), and recreational facilities (increase in recreational facilities per 1000 by 1 is associated with reduction in obesity rate by 3.16 points and poor mental health days by 0.47 days) reduces obesity rates and poor mental health days. Median income is associated with decrease in obesity rate and poor mental health days. Increase in median household income by 1% is associated with reduction in obesity rate 4.75% and reduction in poor mental health days by 1.39 days. Conclusions: We find that access to food and health care at county level and state ideology through policy making affects health outcomes. Our analysis indicates that counties can improve access to food and health care by investing in these services thereby improving county-level health outcomes and save dollars in the process.

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Food insecurity and severe mental illness: understanding the hidden problem and how to ask about food access during routine healthcare

Cited by 12 publications

References 21 publications

Food insecurity in adults with severe mental illness: A systematic review with meta‐analysis

Food insecurity in adults with severe mental illness: A systematic review with meta‐analysis

Shaping research for people living with co‐existing mental and physical health conditions: A research priority setting initiative from the United Kingdom

Examining the Connection Between Health Outcomes, State Political Ideology, and Food Access in the United States

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