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Fu E, Farland G, Cohen D, Gerstler C, Margolies P, Pope L, Rotter M, Compton MT. A Group-Based, Six-Lesson Healthy Eating Curriculum for Individuals With Serious Mental Illnesses: Development and Implementation. Community Ment Health J 2024:10.1007/s10597-024-01291-6. [PMID: 38865032 DOI: 10.1007/s10597-024-01291-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 05/10/2024] [Indexed: 06/13/2024]
Abstract
As part of an intervention tailored to individuals with serious mental illnesses in residential settings that aimed to increase dietary intake of fresh vegetables and fruits, we developed and implemented a nutrition and cooking curriculum. To develop the curriculum, we assembled a Workgroup that consisted of professionals from multiple fields. The Workgroup held weekly discussions before drafting what would become the Workbook. Residential staff at partnering housing agencies taught the curriculum to residents. The curriculum Workbook contains six lessons, which are organized around two field trips to a mobile farmers market and a grocery store, and four cooking methods. The Workbook also includes instructions on using FreshConnect Checks at mobile farmers markets. The new curriculum distinguishes itself from other nutrition and culinary literacy curricula in that it delivers knowledge about fresh produce and skills in preparing fruits and vegetables in a way that is tailored to individuals with serious mental illnesses.
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Affiliation(s)
- En Fu
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, 722 W. 168th Street, Room R249, New York, NY, 10032, USA
| | - Gabriella Farland
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, 722 W. 168th Street, Room R249, New York, NY, 10032, USA
| | - Dana Cohen
- New York, State Office of Mental Health, Albany, NY, USA
| | | | - Paul Margolies
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, 722 W. 168th Street, Room R249, New York, NY, 10032, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Leah Pope
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, 722 W. 168th Street, Room R249, New York, NY, 10032, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Merrill Rotter
- New York, State Office of Mental Health, Albany, NY, USA
| | - Michael T Compton
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, 722 W. 168th Street, Room R249, New York, NY, 10032, USA
- New York State Psychiatric Institute, New York, NY, USA
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Giles EL, Eskandari F, McGeechan G, Scott S, Lake AA, Teasdale S, Ekers D, Augustine A, Le Savauge N, Lynch C, Moore H, Smith J. Food insecurity in adults with severe mental illness living in Northern England: Peer research interview findings. Int J Ment Health Nurs 2024; 33:671-682. [PMID: 38059552 DOI: 10.1111/inm.13270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 11/02/2023] [Accepted: 11/17/2023] [Indexed: 12/08/2023]
Abstract
Food insecurity means that a person does not have access to sufficient nutritious food for normal growth and health. Food insecurity can lead to many health problems such as obesity, heart disease, diabetes, and other long term health conditions. People living with a severe mental illness are more likely to experience food insecurity than people without mental illness. Peer-led in-depth interviews were conducted with adults with severe mental illness from Northern England, during which their experiences of food insecurity and strategies to tackle food insecurity were discussed. Interviews took place between March and December 2022, with interviews being transcribed and analysed using deductive and inductive thematic analysis. Thirteen interviews were conducted, finding that food insecurity in adults with severe mental illness was often a long-standing issue. Unemployment, the cost-of-living crisis and fuel poverty impacted on experiences of food insecurity. Difficulties accessing food banks such as transport, stigma, and the limited selection of available food was also discussed. Strategies to tackle food insecurity centred on making food banks more accessible and improving the quality of available food. Future research should aim to eradicate food insecurity for adults with severe mental illness, as limited research and action focuses on this population group over and above 'mental illness' or 'poor mental health'. Removing barriers to accessing food such as lack of transport, and providing food which is of adequate nutritional quality, should be prioritised, as well as tackling the stigma and accessibility issues surrounding food banks use.
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Affiliation(s)
- Emma L Giles
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
- Fuse, The Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
| | - Fatemeh Eskandari
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
- Fuse, The Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
| | - Grant McGeechan
- Fuse, The Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
- Centre for Applied Psychological Science, School of Health and Life Sciences, Teesside University, Middlesbrough, UK
| | - Steph Scott
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Amelia A Lake
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
- Fuse, The Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
| | - Scott Teasdale
- Discipline of Psychiatry & Mental Health, University of New South Wales, Sydney, New South Wales, Australia
| | - David Ekers
- Department of Health Sciences, University of York (Mental Health and Addictions Research Group), York, UK
- Flatts Lane Centre, Tees, Esk and Wear Valleys NHS Foundation Trust Flatts Lane, Normanby, Tees Valley, Middlesbrough, UK
| | | | | | | | | | - Jo Smith
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
- Fuse, The Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
- Flatts Lane Centre, Tees, Esk and Wear Valleys NHS Foundation Trust Flatts Lane, Normanby, Tees Valley, Middlesbrough, UK
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Compton MT. Food and Nutrition Insecurity: A Social Determinant Hungry for Attention by Mental Health Professionals. Psychiatr Serv 2023; 74:1303-1306. [PMID: 37221887 DOI: 10.1176/appi.ps.20220511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Food and nutrition security-healthy food being available and households being able to access and use it-is necessary for mental and overall health but is a neglected social determinant of mental health. Mental health professionals should address food and nutrition insecurity by weighing in on federal and state legislation and policies related to food and nutrition; promoting food banks and pantries, "food is medicine" initiatives, and programs offering better opportunities to afford and access whole foods and fresh produce; and addressing food and nutrition insecurity at the individual level in the clinical setting through screening, assessment, treatment, and follow-up.
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Affiliation(s)
- Michael T Compton
- New York State Psychiatric Institute and Columbia University Vagelos College of Physicians and Surgeons, New York City
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Compton MT, Cohen DE, Farland G, En Fu, Gerstler C, Pope LG, Rotter M. Improving Nutrition Security for Individuals With Serious Mental Illnesses: A Partnership of Public and Nonprofit Agencies. Psychiatr Serv 2023; 74:1092-1095. [PMID: 36916058 DOI: 10.1176/appi.ps.20220436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
In conjunction with multiple partners (state agencies, nonprofits, a university, and key stakeholders and content experts), the authors are implementing and evaluating an intervention intended to enable individuals with serious mental illnesses living in community residences (i.e., group homes) and supportive housing apartments to-with support from residential staff-access, purchase, prepare, and enjoy healthy, local produce. The three-component intervention makes fresh produce more accessible; improves its affordability; and conveys knowledge and skills related to purchasing, preparing, and eating healthy foods, especially vegetables. The intervention is being evaluated in preparation for possible larger-scale implementation and potential dissemination to other populations experiencing nutrition insecurity.
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Affiliation(s)
- Michael T Compton
- Department of Psychiatry, Vagelos College of Physicians and Surgeons (Compton, Fu, Pope), and Mailman School of Public Health (Farland), Columbia University, New York City; New York State Psychiatric Institute, New York City (Compton, Pope); New York State Office of Mental Health, Albany (Cohen, Gerstler, Rotter)
| | - Dana E Cohen
- Department of Psychiatry, Vagelos College of Physicians and Surgeons (Compton, Fu, Pope), and Mailman School of Public Health (Farland), Columbia University, New York City; New York State Psychiatric Institute, New York City (Compton, Pope); New York State Office of Mental Health, Albany (Cohen, Gerstler, Rotter)
| | - Gabriella Farland
- Department of Psychiatry, Vagelos College of Physicians and Surgeons (Compton, Fu, Pope), and Mailman School of Public Health (Farland), Columbia University, New York City; New York State Psychiatric Institute, New York City (Compton, Pope); New York State Office of Mental Health, Albany (Cohen, Gerstler, Rotter)
| | - En Fu
- Department of Psychiatry, Vagelos College of Physicians and Surgeons (Compton, Fu, Pope), and Mailman School of Public Health (Farland), Columbia University, New York City; New York State Psychiatric Institute, New York City (Compton, Pope); New York State Office of Mental Health, Albany (Cohen, Gerstler, Rotter)
| | - Cheryl Gerstler
- Department of Psychiatry, Vagelos College of Physicians and Surgeons (Compton, Fu, Pope), and Mailman School of Public Health (Farland), Columbia University, New York City; New York State Psychiatric Institute, New York City (Compton, Pope); New York State Office of Mental Health, Albany (Cohen, Gerstler, Rotter)
| | - Leah G Pope
- Department of Psychiatry, Vagelos College of Physicians and Surgeons (Compton, Fu, Pope), and Mailman School of Public Health (Farland), Columbia University, New York City; New York State Psychiatric Institute, New York City (Compton, Pope); New York State Office of Mental Health, Albany (Cohen, Gerstler, Rotter)
| | - Merrill Rotter
- Department of Psychiatry, Vagelos College of Physicians and Surgeons (Compton, Fu, Pope), and Mailman School of Public Health (Farland), Columbia University, New York City; New York State Psychiatric Institute, New York City (Compton, Pope); New York State Office of Mental Health, Albany (Cohen, Gerstler, Rotter)
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Martland R, Teasdale S, Murray RM, Gardner-Sood P, Smith S, Ismail K, Atakan Z, Greenwood K, Stubbs B, Gaughran F. Dietary intake, physical activity and sedentary behaviour patterns in a sample with established psychosis and associations with mental health symptomatology. Psychol Med 2023; 53:1565-1575. [PMID: 34420532 PMCID: PMC10009388 DOI: 10.1017/s0033291721003147] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 07/13/2021] [Accepted: 07/15/2021] [Indexed: 11/05/2022]
Abstract
BACKGROUND People with psychosis experience cardiometabolic comorbidities, including metabolic syndrome, coronary heart disease and diabetes. These physical comorbidities have been linked to diet, inactivity and the effects of the illness itself, including disorganisation, impairments in global function and amotivation associated with negative symptoms of schizophrenia or co-morbid depression. METHODS We aimed to describe the dietary intake, physical activity (PA) and sedentary behaviour patterns of a sample of patients with established psychosis participating in the Improving Physical Health and Reducing Substance Use in Severe Mental Illness (IMPaCT) randomised controlled trial, and to explore the relationship between these lifestyle factors and mental health symptomatology. RESULTS A majority of participants had poor dietary quality, low in fruit and vegetables and high in discretionary foods. Only 29.3% completed ⩾150 min of moderate and/or vigorous activity per week and 72.2% spent ⩾6 h per day sitting. Cross-sectional associations between negative symptoms, global function, and PA and sedentary behaviour were observed. Additionally, those with more negative symptoms receiving IMPaCT therapy had fewer positive changes in PA from baseline to 12-month follow-up than those with fewer negative symptoms at baseline. CONCLUSION These results highlight the need for the development of multidisciplinary lifestyle and exercise interventions to target eating habits, PA and sedentary behaviour, and the need for further research on how to adapt lifestyle interventions to baseline mental status. Negative symptoms in particular may reduce patient's responses to lifestyle interventions.
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Affiliation(s)
- Rebecca Martland
- Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, London, UK
| | - Scott Teasdale
- School of Psychiatry, University of New South Wales Sydney, High St, Kensington 2033, Australia
| | - Robin M. Murray
- Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, UK
| | - Poonam Gardner-Sood
- Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, London, UK
| | - Shubulade Smith
- Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, UK
| | - Khalida Ismail
- Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, London, UK
| | - Zerrin Atakan
- Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, London, UK
| | - Kathryn Greenwood
- Sussex Partnership NHS Foundation Trust and School of Psychology, University of Sussex, Brighton, UK
| | - Brendon Stubbs
- Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, UK
| | - Fiona Gaughran
- Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, UK
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Compton MT, Ku BS. Prevalence of Food Insecurity and Living in a Food Desert among Individuals with Serious Mental Illnesses in Public Mental Health Clinics. Community Ment Health J 2023; 59:357-362. [PMID: 35963919 PMCID: PMC10209833 DOI: 10.1007/s10597-022-01013-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 07/26/2022] [Indexed: 01/25/2023]
Abstract
Very little is known about the prevalence of food insecurity-and living in a food desert-among persons with serious mental illnesses, such as schizophrenia and major mood disorders. This study evaluated those prevalences and assessed for associations with six other variables. Surveys were conducted with 300 patients with a psychotic or mood disorder receiving outpatient services at five community mental health agencies in Washington, D.C. The prevalences of low food security and very low food security were 68.9% and 46.8%, compared to national rates of 13.7% (13.2% in Washington, D.C.) and 5.4% (4.8% in Washington, D.C.). 50.0% of participants lived in food desert census tracts, which was associated with both severe and morbid obesity (p = .02 and p = .03, respectively). Additional research, evaluation of clinical implications, and potential policy approaches to these concerning social determinants of physical and mental health, in an already vulnerable patient population, are warranted.
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Affiliation(s)
- Michael T Compton
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, 722 W. 168, Street, Room R249, New York, NY, USA.
- New York State Psychiatric Institute, New York, NY, USA.
| | - Benson S Ku
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
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Hawthorne SC, Williams-Wengerd A. Is treatment helping? How providers gauge effectiveness in treating serious mental illness. SSM - MENTAL HEALTH 2022. [DOI: 10.1016/j.ssmmh.2022.100110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Nagata JM, Ganson KT, Cattle CJ, Whittle HJ, Tsai AC, Weiser SD. Food insufficiency and mental health service utilisation in the USA during the COVID-19 pandemic. Public Health Nutr 2022; 25:76-81. [PMID: 34261566 PMCID: PMC8367866 DOI: 10.1017/s1368980021003001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 06/18/2021] [Accepted: 07/08/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To estimate the association between food insufficiency and mental health service utilisation in the USA during the COVID-19 pandemic. DESIGN Cross-sectional study. Multiple logistic regression models were used to estimate the associations between food insufficiency and mental health service utilisation. SETTING US Census Household Pulse Survey data collected in October 2020. PARTICIPANTS Nationally representative sample of 68 611 US adults. RESULTS After adjusting for sociodemographic factors, experiencing food insufficiency was associated with higher odds of unmet mental health need (adjusted OR (AOR) 2·90; 95 % CI 2·46, 3·43), receiving mental health counselling or therapy (AOR 1·51; 95 % CI 1·24, 1·83) and psychotropic medication use (AOR 1·56; 95 % CI 1·35, 1·80). Anxiety and depression symptoms mediated most of the association between food insufficiency and unmet mental health need but not the associations between food insufficiency and either receiving mental health counselling/therapy or psychotropic medication use. CONCLUSIONS Clinicians should regularly screen patients for food insufficiency, especially in the wake of the COVID-19 pandemic. Expanding access to supplemental food programmes may help to mitigate the need for higher mental health service utilisation during the COVID-19 pandemic.
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Affiliation(s)
- Jason M Nagata
- Department of Pediatrics, University of California, San Francisco, 550 16th Street, 4th Floor, Box 0110, San Francisco, CA94158, USA
| | - Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Chloe J Cattle
- Department of Pediatrics, University of California, San Francisco, 550 16th Street, 4th Floor, Box 0110, San Francisco, CA94158, USA
| | - Henry J Whittle
- Division of Psychiatry, University College London, London, UK
| | - Alexander C Tsai
- Center for Global Health, Mongan Institute, Massachusetts General Hospital; Harvard Medical School, Boston, MA, USA
| | - Sheri D Weiser
- Division of HIV, Infectious Diseases and Global Medicine, School of Medicine, University of California, San Francisco, San Francisco, CA, USA
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Tripodi E, Jarman R, Morell R, Teasdale SB. Prevalence of food insecurity in community-dwelling people living with severe mental illness. Nutr Diet 2021; 79:374-379. [PMID: 34608729 DOI: 10.1111/1747-0080.12706] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 08/30/2021] [Accepted: 08/31/2021] [Indexed: 11/29/2022]
Abstract
AIM The present study aimed to measure the prevalence and severity of food insecurity in people with a severe mental illness, defined as schizophrenia and related psychoses, and bipolar disorder; and explore relationships between food insecurity status, and sociodemographic and clinical characteristics. METHODS This cross-sectional study recruited community-dwelling people with severe mental illness receiving clozapine and/or a long-acting injectable antipsychotic medication within three mental health services in Sydney, Australia. Participants completed the 18-item Household Food Insecurity Access Scale. Sociodemographic and medical information was obtained from participants' medical records. Independent samples t-test and chi-square analyses were used to test for between group differences based on food insecurity status. Binary logistic regression analyses adjusting for age and gender were used to determine the odds ratio. RESULTS One-hundred and eighty-eight people completed the assessment: 63% were male, mean age was 49.2 ± 12.4 years, and the majority (85%) had a diagnosis of schizophrenia. Food insecurity was detected in 31% of participants. Of those who were food insecure, 12% were classified as severe, 13% as moderate and 7% as mild. Tobacco smoking was higher in food insecure people compared to food secure people (odds ratio = 3.1, 95% CI 1.3 to 7.1, p = 0.01). Food insecurity status was not associated with demographic, diagnostic or other clinical data. CONCLUSIONS Food insecurity is highly prevalent among community-dwelling people with severe mental illness receiving clozapine and/or long-acting injectable antipsychotic medication. Food security screening should be considered as routine care for this population group.
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Affiliation(s)
- Elise Tripodi
- South Eastern Sydney Local Health District, Bondi Junction, New South Wales, Australia
| | - Rebecca Jarman
- South Eastern Sydney Local Health District, Bondi Junction, New South Wales, Australia
| | - Rachel Morell
- School of Psychiatry, University of New South Wales & Mindgardens Neuroscience Network, Kensington, New South Wales, Australia
| | - Scott B Teasdale
- School of Psychiatry, University of New South Wales & Mindgardens Neuroscience Network, Kensington, New South Wales, Australia
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10
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Nagata JM, Ganson KT, Whittle HJ, Chu J, Harris OO, Tsai AC, Weiser SD. Food Insufficiency and Mental Health in the U.S. During the COVID-19 Pandemic. Am J Prev Med 2021; 60:453-461. [PMID: 33602534 PMCID: PMC9067067 DOI: 10.1016/j.amepre.2020.12.004] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 11/23/2020] [Accepted: 12/01/2020] [Indexed: 11/18/2022]
Abstract
INTRODUCTION During the COVID-19 pandemic, the rates of food insecurity and mental illness have been projected to increase in the U.S. owing to significant social and economic disruption. This study aims to estimate the prevalence of food insufficiency (often the most extreme form of food insecurity), the correlates of food insufficiency, and the associations between food insufficiency and symptoms of poor mental health in the U.S. during the COVID-19 pandemic. METHODS Cross-sectional data from 63,674 participants of the U.S. Census Household Pulse Survey were collected and analyzed in 2020. Multiple Poisson regression models were used to estimate associations with food insufficiency. RESULTS Food insufficiency rose from 8.1% to 10.0% from March to June 2020. Factors associated with food insufficiency included lower age, Black/African American or Latinx race/ethnicity, being unmarried, larger household size, recent employment loss, income below the federal poverty line, and lower education (all p<0.001). Food insufficiency was independently associated with all symptoms of poor mental health, adjusting for socioeconomic and demographic factors (adjusted RRs ranged from 1.16 to 1.42, all p<0.001). The association between food insufficiency and poor mental health was attenuated among people who received free groceries or meals. CONCLUSIONS Food insufficiency has increased during the COVID-19 pandemic and affects vulnerable populations, placing individuals at higher risk for symptoms of poor mental health. Particularly in the current crisis, clinicians should regularly screen patients for food insufficiency and mental health outcomes as well as provide support in accessing appropriate resources.
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Affiliation(s)
- Jason M Nagata
- Division of Adolescent & Young Adult Medicine, Department of Pediatrics, University of California San Francisco, San Francisco, California.
| | - Kyle T Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Henry J Whittle
- Division of Psychiatry, University College London, London, United Kingdom
| | - Jonathan Chu
- Division of Adolescent & Young Adult Medicine, Department of Pediatrics, University of California San Francisco, San Francisco, California
| | - Orlando O Harris
- Department of Community Health Systems, School of Nursing, University of California San Francisco, San Francisco, California
| | - Alexander C Tsai
- Center for Global Health, Massachusetts General Hospital, Boston, Massachusetts; Mongan Institute, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Sheri D Weiser
- Division of HIV, Infectious Diseases & Global Medicine, School of Medicine, University of California San Francisco, San Francisco, California
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11
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Pooler JA, Srinivasan M, Miller Z, Mian P. Prevalence and Risk Factors for Food Insecurity Among Low-Income US Military Veterans. Public Health Rep 2021; 136:618-625. [PMID: 33478378 DOI: 10.1177/0033354920974662] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Ensuring access to sufficient foods at all times is critical to veterans' health and well-being. Food insecurity has not been well explored in the veteran population. We examined the prevalence and predictors of food insecurity among low-income veterans, because the highest rates of food insecurity are among low-income households. We also examined rates of Supplemental Nutrition Assistance Program (SNAP) participation among subgroups at the highest risk of food insecurity. METHODS We used univariate analyses and 2011-2017 National Health Interview Survey (NHIS) data on veterans aged ≥21 with family incomes <200% of the federal poverty level to estimate the prevalence of food insecurity. We used bivariate analyses to identify correlates of food insecurity and estimate SNAP participation rates among subgroups of low-income veterans. Percentages were weighted using NHIS survey weights. RESULTS Of 5146 low-income veterans, 22.5% reported being food insecure in the previous month. Food insecurity was significantly associated with being aged <65 (33.0% aged 45-64 and 29.7% aged 21-44) compared with 15.0% and 6.4% among veterans aged 65-74 and ≥75, respectively (P < .001); unemployed compared with employed or not in the labor force (39.4%, 22.7%, and 20.2%, respectively; P < .001); in fair or poor health compared with good, very good, or excellent heath (31.8% vs 18.2%; P < .001); and having experienced serious psychological distress in the past month (56.3%) compared with not having experienced such distress (19.7%; P < .001). Although overall SNAP participation among low-income veterans was estimated to be 27.0%, participation rates were highest among veterans who had experienced serious psychological distress (44.1%), were unemployed (39.2%), and were renting their home (39.0%). CONCLUSIONS Some low-income veterans are at greater risk of food insecurity than other veterans. Postseparation programs, civilian support services, and veterans' health providers should be aware of the characteristics that place veterans at highest risk of food insecurity.
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Affiliation(s)
| | | | | | - Paula Mian
- IMPAQ International, LLC, Washington, DC, USA
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12
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Hancox LE, Lee PS, Armaghanian N, Hirani V, Wakefield G. Nutrition risk screening methods for adults living with severe mental illness: A scoping review. Nutr Diet 2021; 79:349-363. [PMID: 33416212 DOI: 10.1111/1747-0080.12652] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 11/03/2020] [Accepted: 11/06/2020] [Indexed: 11/30/2022]
Abstract
AIM Adults living with severe mental illness experience a greater burden of physical comorbidities and earlier mortality than the general population. Malnutrition, overnutrition, dysphagia, constipation and disordered eating have been observed in this population and can lead to poor nutritional status. Early identification of such conditions may reduce their impact on functional status, quality of life and health outcomes. This scoping review aimed to identify all nutrition risk screening methods published in English internationally for use with adults living with severe mental illness and ascertain which, if any, were validated for the target population. METHODS A four-step search strategy was used to search six electronic databases and grey literature, from inception to April 2020, for articles reporting nutrition risk screening methods used in this population. Information on the content and validity of screening methods was extracted and analysed by three independent reviewers. RESULTS Seventeen nutrition risk screening methods were identified, of which three were validated within a population of adults with severe mental illness. One screening method was found for both malnutrition and dysphagia risk, respectively, and three for constipation risk. No single method was found for overnutrition. Eleven screening methods were identified for disordered eating risk, of which two were validated for the target population. CONCLUSIONS Nutrition risk screening methods and their validation in adults living with severe mental illness are inadequately researched. This scoping review highlights the need for future research to develop new or validate existing screening methods specifically for the target population.
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Affiliation(s)
- Lauren E Hancox
- Nutrition and Dietetics Group, School of Life and Environmental Sciences at the Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Pui S Lee
- Nutrition and Dietetics Group, School of Life and Environmental Sciences at the Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Natasha Armaghanian
- Faculty of Medicine and Health, Kolling Institute of Medical Research, Northern Sydney Local Health District, Sydney, New South Wales, Australia
| | - Vasant Hirani
- School of Life and Environmental Science at the Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Georgia Wakefield
- Wellbeing Unit, Macquarie Hospital, Sydney, New South Wales, Australia
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Prevalence and correlates of food insecurity in community-based individuals with severe mental illness receiving long-acting injectable antipsychotic treatment. Br J Nutr 2020; 124:470-477. [PMID: 32234106 DOI: 10.1017/s0007114520001191] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
People with severe mental illness (SMI) have numerous risk factors that may predispose them to food insecurity (FI); however, the prevalence of FI and its effects on health are under-researched in this population. The present study aimed to describe the prevalence of FI and its relationship to lifestyle factors in people with SMI. This cross-sectional study recruited people with SMI receiving long-acting injectable (LAI) antipsychotic medication from community services at three sites in Sydney, Australia. Assessments were completed on physical health and lifestyle factors. χ2 Tests, independent-samples t tests and binary logistic regression analyses were calculated to examine relationships between lifestyle factors and FI. In total, 233 people completed the assessments: 154 were males (66 %), mean age 44·8 (sd 12·7) years, and the majority (70 %) had a diagnosis of schizophrenia. FI was present in 104 participants (45 %). People with FI were less likely to consume fruits (OR 0·42, 95 % CI 0·24, 0·74, P = 0·003), vegetables (OR 0·39, 95 % CI 0·22, 0·69, P = 0·001) and protein-based foods (OR 0·45, 95 % CI 0·25, 0·83, P = 0·011) at least once daily, engaged in less moderate to vigorous physical activity (min) (OR 0·997, 95 % CI 0·993, 1·000, P = 0·044), and were more likely to smoke (OR 1·89, 95 % CI 1·08, 3·32, P = 0·026). FI is highly prevalent among people with SMI receiving LAI antipsychotic medications. Food-insecure people with SMI engage in less healthy lifestyle behaviours, increasing the risk of future non-communicable disease.
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Browne J, Ponce A. Assessing Food Insecurity in Individuals with Serious Mental Illness: A Pilot Training for Community Mental Health Providers. Community Ment Health J 2020; 56:1110-1114. [PMID: 32107661 DOI: 10.1007/s10597-020-00593-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 02/21/2020] [Indexed: 11/24/2022]
Abstract
Food insecurity (FI), or limited or uncertain access to food, is a significant public health issue, especially for individuals with serious mental illness. As such, mental health providers should regularly assess FI and link individuals to resources. The purpose of this project was to create and pilot test a provider training on FI assessment at a community mental health center. Fifteen providers participated in the training and completed surveys at post-training and one-month follow-up. Results suggested success in delivering an acceptable training that conveyed the importance of FI and inspired confidence in assessment. Yet, it was not sufficient to modify providers' FI assessment behavior. A brief training can effectively teach providers about FI and promote confidence in assessment; however, it is not adequate to change behavior. Future work should examine the provider training in a larger sample and wider variety of CMHC providers and explore ways to integrate FI assessment into existing practices to address implementation barriers.
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Affiliation(s)
- Julia Browne
- Department of Psychology and Neuroscience, University of North Carolina At Chapel Hill, 235 E. Cameron Ave, Davie Hall, CB #3270, Chapel Hill, NC, 27599, USA. .,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
| | - Allison Ponce
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
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15
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Moore RC, Depp CA, Harvey PD, Pinkham AE. Assessing the Real-Time Mental Health Challenges of COVID-19 in Individuals With Serious Mental Illnesses: Protocol for a Quantitative Study. JMIR Res Protoc 2020; 9:e19203. [PMID: 32365043 PMCID: PMC7247464 DOI: 10.2196/19203] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 05/01/2020] [Accepted: 05/04/2020] [Indexed: 01/07/2023] Open
Abstract
Background The outbreak of coronavirus disease 2019 (COVID-19) has caused significant stress and mental health problems among the general public. However, persons at greatest risk for poor mental health outcomes, such as people with serious mental illness, have been largely overlooked. Objective This paper presents the protocol for a study that aims to examine the mental health impact of COVID-19 and social distancing behaviors in people with serious mental illness and the behaviors undertaken to prevent COVID-19 infection in this group. Methods Participants will include individuals with serious mental illness (eg, schizophrenia, bipolar disorder) and nonpsychiatric control participants who are currently participating in or have previously participated in several ongoing parent observational studies. Data will be collected from April 2020 through August 2020. Participants will complete phone interviews at 2 time points to assess their current emotional functioning and discuss the measures they have taken to prevent COVID-19 infection. Baseline (pre-COVID-19) mental health, sampled by ecological momentary assessment over an extended period, will be compared with current mental health, also sampled by ecological momentary assessment over an extended period. Demographic, cognitive, and psychosocial factors at baseline will be used to examine risk and resilience to current mental health and coping. Results The inclusion of participants for the first round of telephone assessments started on April 3, 2020 and will be completed by May 31, 2020. As of April 30, 2020, 101 individuals had completed these first-round assessments. The second round of telephone assessments will likely occur between June 1, 2020, and August 31, 2020. Study results will be published in peer-reviewed scientific journals. Conclusions Our findings will have broad implications for understanding the psychological consequences of COVID-19 among vulnerable persons with serious mental illness and will provide the opportunity to identify targets to reduce negative outcomes in the future. We also hope our efforts will provide a roadmap and resources for other researchers who would like to implement a similar approach. International Registered Report Identifier (IRRID) DERR1-10.2196/19203
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Affiliation(s)
| | - Colin Andrew Depp
- University of California San Diego, San Diego, CA, United States.,VA San Diego Healthcare System, San Diego, CA, United States
| | - Philip D Harvey
- University of Miami Miller School of Medicine, Miami, FL, United States.,Bruce W Carter VA Medical Center, Miami, FL, United States
| | - Amy E Pinkham
- The University of Texas at Dallas, Richardson, TX, United States.,University of Texas Southwestern Medical School, Dallas, TX, United States
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16
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Associations between food insecurity and psychotropic medication use among women living with HIV in the United States. Epidemiol Psychiatr Sci 2020; 29:e113. [PMID: 32248873 PMCID: PMC7214522 DOI: 10.1017/s2045796020000232] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
AIMS Psychotropic prescription rates continue to increase in the United States (USA). Few studies have investigated whether social-structural factors may play a role in psychotropic medication use independent of mental illness. Food insecurity is prevalent among people living with HIV in the USA and has been associated with poor mental health. We investigated whether food insecurity was associated with psychotropic medication use independent of the symptoms of depression and anxiety among women living with HIV in the USA. METHODS We used cross-sectional data from the Women's Interagency HIV Study (WIHS), a nationwide cohort study. Food security (FS) was the primary explanatory variable, measured using the Household Food Security Survey Module. First, we used multivariable linear regressions to test whether FS was associated with symptoms of depression (Center for Epidemiologic Studies Depression [CESD] score), generalised anxiety disorder (GAD-7 score) and mental health-related quality of life (MOS-HIV Mental Health Summary score; MHS). Next, we examined associations of FS with the use of any psychotropic medications, including antidepressants, sedatives and antipsychotics, using multivariable logistic regressions adjusting for age, race/ethnicity, income, education and alcohol and substance use. In separate models, we additionally adjusted for symptoms of depression (CESD score) and anxiety (GAD-7 score). RESULTS Of the 905 women in the sample, two-thirds were African-American. Lower FS (i.e. worse food insecurity) was associated with greater symptoms of depression and anxiety in a dose-response relationship. For the psychotropic medication outcomes, marginal and low FS were associated with 2.06 (p < 0.001; 95% confidence interval [CI] = 1.36-3.13) and 1.99 (p < 0.01; 95% CI = 1.26-3.15) times higher odds of any psychotropic medication use, respectively, before adjusting for depression and anxiety. The association of very low FS with any psychotropic medication use was not statistically significant. A similar pattern was found for antidepressant and sedative use. After additionally adjusting for CESD and GAD-7 scores, marginal FS remained associated with 1.93 (p < 0.05; 95% CI = 1.16-3.19) times higher odds of any psychotropic medication use. Very low FS, conversely, was significantly associated with lower odds of antidepressant use (adjusted odds ratio = 0.42; p < 0.05; 95% CI = 0.19-0.96). CONCLUSIONS Marginal FS was associated with higher odds of using psychotropic medications independent of depression and anxiety, while very low FS was associated with lower odds. These complex findings may indicate that people experiencing very low FS face barriers to accessing mental health services, while those experiencing marginal FS who do access services are more likely to be prescribed psychotropic medications for distress arising from social and structural factors.
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17
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Cohen AJ, Rudolph JL, Thomas KS, Archambault E, Bowman MM, Going C, Heisler M, O'Toole TP, Dosa DM. Food Insecurity Among Veterans: Resources to Screen and Intervene. Fed Pract 2020; 37:16-23. [PMID: 32047351 PMCID: PMC7010340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
A screener was created in the VA electronic health record clinical reminder system to facilitate an interdisciplinary approach to identifying and addressing food insecurity.
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Affiliation(s)
- Alicia J Cohen
- is a Research Scientist; is Director; is a Research Health Science Specialist; is a Social Worker; is Associate Director; all at the VA Health Services Research & Development Center of Innovation in Long Term Services and Supports at the Providence VA Medical Center in Rhode Island; is Senior Medical Advisor, Office of the Assistant Deputy Undersecretary for Health for Clinical Operations, Veterans Health Administration in Washington, DC. is Assistant Chief, Nutrition and Food Services at VA Salt Lake City Health Care System in Utah. is Executive Assistant, Office of the Assistant Deputy Undersecretary for Health for Clinical Operations, Veterans Health Administration. is a Research Scientist at the Center for Clinical Management Research, Ann Arbor VA Medical Center in Michigan. Alicia Cohen is an Assistant Professor of Family Medicine and Health Services, Policy and Practice; James Rudolph is Professor of Medicine and Health Services, Policy and Practice; Kali Thomas is an Associate Professor of Health Services, Policy, and Practice; David Dosa is an Associate Professor of Medicine and Health Services, Policy and Practice; Thomas O'Toole is a Professor of Medicine; all at the Warren Alpert Medical School of Brown University and Brown University School of Public Health in Providence, Rhode Island. Michele Heisler is a Professor of Internal Medicine and Health Behavior and Health Education at the University of Michigan Medical School and School of Public Health. Megan Bowman and Christine Going are Co- Chairs, and Alicia Cohen, Kali Thomas, and Thomas O'Toole are members of the Ensuring Veteran Food Security Work-group
| | - James L Rudolph
- is a Research Scientist; is Director; is a Research Health Science Specialist; is a Social Worker; is Associate Director; all at the VA Health Services Research & Development Center of Innovation in Long Term Services and Supports at the Providence VA Medical Center in Rhode Island; is Senior Medical Advisor, Office of the Assistant Deputy Undersecretary for Health for Clinical Operations, Veterans Health Administration in Washington, DC. is Assistant Chief, Nutrition and Food Services at VA Salt Lake City Health Care System in Utah. is Executive Assistant, Office of the Assistant Deputy Undersecretary for Health for Clinical Operations, Veterans Health Administration. is a Research Scientist at the Center for Clinical Management Research, Ann Arbor VA Medical Center in Michigan. Alicia Cohen is an Assistant Professor of Family Medicine and Health Services, Policy and Practice; James Rudolph is Professor of Medicine and Health Services, Policy and Practice; Kali Thomas is an Associate Professor of Health Services, Policy, and Practice; David Dosa is an Associate Professor of Medicine and Health Services, Policy and Practice; Thomas O'Toole is a Professor of Medicine; all at the Warren Alpert Medical School of Brown University and Brown University School of Public Health in Providence, Rhode Island. Michele Heisler is a Professor of Internal Medicine and Health Behavior and Health Education at the University of Michigan Medical School and School of Public Health. Megan Bowman and Christine Going are Co- Chairs, and Alicia Cohen, Kali Thomas, and Thomas O'Toole are members of the Ensuring Veteran Food Security Work-group
| | - Kali S Thomas
- is a Research Scientist; is Director; is a Research Health Science Specialist; is a Social Worker; is Associate Director; all at the VA Health Services Research & Development Center of Innovation in Long Term Services and Supports at the Providence VA Medical Center in Rhode Island; is Senior Medical Advisor, Office of the Assistant Deputy Undersecretary for Health for Clinical Operations, Veterans Health Administration in Washington, DC. is Assistant Chief, Nutrition and Food Services at VA Salt Lake City Health Care System in Utah. is Executive Assistant, Office of the Assistant Deputy Undersecretary for Health for Clinical Operations, Veterans Health Administration. is a Research Scientist at the Center for Clinical Management Research, Ann Arbor VA Medical Center in Michigan. Alicia Cohen is an Assistant Professor of Family Medicine and Health Services, Policy and Practice; James Rudolph is Professor of Medicine and Health Services, Policy and Practice; Kali Thomas is an Associate Professor of Health Services, Policy, and Practice; David Dosa is an Associate Professor of Medicine and Health Services, Policy and Practice; Thomas O'Toole is a Professor of Medicine; all at the Warren Alpert Medical School of Brown University and Brown University School of Public Health in Providence, Rhode Island. Michele Heisler is a Professor of Internal Medicine and Health Behavior and Health Education at the University of Michigan Medical School and School of Public Health. Megan Bowman and Christine Going are Co- Chairs, and Alicia Cohen, Kali Thomas, and Thomas O'Toole are members of the Ensuring Veteran Food Security Work-group
| | - Elizabeth Archambault
- is a Research Scientist; is Director; is a Research Health Science Specialist; is a Social Worker; is Associate Director; all at the VA Health Services Research & Development Center of Innovation in Long Term Services and Supports at the Providence VA Medical Center in Rhode Island; is Senior Medical Advisor, Office of the Assistant Deputy Undersecretary for Health for Clinical Operations, Veterans Health Administration in Washington, DC. is Assistant Chief, Nutrition and Food Services at VA Salt Lake City Health Care System in Utah. is Executive Assistant, Office of the Assistant Deputy Undersecretary for Health for Clinical Operations, Veterans Health Administration. is a Research Scientist at the Center for Clinical Management Research, Ann Arbor VA Medical Center in Michigan. Alicia Cohen is an Assistant Professor of Family Medicine and Health Services, Policy and Practice; James Rudolph is Professor of Medicine and Health Services, Policy and Practice; Kali Thomas is an Associate Professor of Health Services, Policy, and Practice; David Dosa is an Associate Professor of Medicine and Health Services, Policy and Practice; Thomas O'Toole is a Professor of Medicine; all at the Warren Alpert Medical School of Brown University and Brown University School of Public Health in Providence, Rhode Island. Michele Heisler is a Professor of Internal Medicine and Health Behavior and Health Education at the University of Michigan Medical School and School of Public Health. Megan Bowman and Christine Going are Co- Chairs, and Alicia Cohen, Kali Thomas, and Thomas O'Toole are members of the Ensuring Veteran Food Security Work-group
| | - Megan M Bowman
- is a Research Scientist; is Director; is a Research Health Science Specialist; is a Social Worker; is Associate Director; all at the VA Health Services Research & Development Center of Innovation in Long Term Services and Supports at the Providence VA Medical Center in Rhode Island; is Senior Medical Advisor, Office of the Assistant Deputy Undersecretary for Health for Clinical Operations, Veterans Health Administration in Washington, DC. is Assistant Chief, Nutrition and Food Services at VA Salt Lake City Health Care System in Utah. is Executive Assistant, Office of the Assistant Deputy Undersecretary for Health for Clinical Operations, Veterans Health Administration. is a Research Scientist at the Center for Clinical Management Research, Ann Arbor VA Medical Center in Michigan. Alicia Cohen is an Assistant Professor of Family Medicine and Health Services, Policy and Practice; James Rudolph is Professor of Medicine and Health Services, Policy and Practice; Kali Thomas is an Associate Professor of Health Services, Policy, and Practice; David Dosa is an Associate Professor of Medicine and Health Services, Policy and Practice; Thomas O'Toole is a Professor of Medicine; all at the Warren Alpert Medical School of Brown University and Brown University School of Public Health in Providence, Rhode Island. Michele Heisler is a Professor of Internal Medicine and Health Behavior and Health Education at the University of Michigan Medical School and School of Public Health. Megan Bowman and Christine Going are Co- Chairs, and Alicia Cohen, Kali Thomas, and Thomas O'Toole are members of the Ensuring Veteran Food Security Work-group
| | - Christine Going
- is a Research Scientist; is Director; is a Research Health Science Specialist; is a Social Worker; is Associate Director; all at the VA Health Services Research & Development Center of Innovation in Long Term Services and Supports at the Providence VA Medical Center in Rhode Island; is Senior Medical Advisor, Office of the Assistant Deputy Undersecretary for Health for Clinical Operations, Veterans Health Administration in Washington, DC. is Assistant Chief, Nutrition and Food Services at VA Salt Lake City Health Care System in Utah. is Executive Assistant, Office of the Assistant Deputy Undersecretary for Health for Clinical Operations, Veterans Health Administration. is a Research Scientist at the Center for Clinical Management Research, Ann Arbor VA Medical Center in Michigan. Alicia Cohen is an Assistant Professor of Family Medicine and Health Services, Policy and Practice; James Rudolph is Professor of Medicine and Health Services, Policy and Practice; Kali Thomas is an Associate Professor of Health Services, Policy, and Practice; David Dosa is an Associate Professor of Medicine and Health Services, Policy and Practice; Thomas O'Toole is a Professor of Medicine; all at the Warren Alpert Medical School of Brown University and Brown University School of Public Health in Providence, Rhode Island. Michele Heisler is a Professor of Internal Medicine and Health Behavior and Health Education at the University of Michigan Medical School and School of Public Health. Megan Bowman and Christine Going are Co- Chairs, and Alicia Cohen, Kali Thomas, and Thomas O'Toole are members of the Ensuring Veteran Food Security Work-group
| | - Michele Heisler
- is a Research Scientist; is Director; is a Research Health Science Specialist; is a Social Worker; is Associate Director; all at the VA Health Services Research & Development Center of Innovation in Long Term Services and Supports at the Providence VA Medical Center in Rhode Island; is Senior Medical Advisor, Office of the Assistant Deputy Undersecretary for Health for Clinical Operations, Veterans Health Administration in Washington, DC. is Assistant Chief, Nutrition and Food Services at VA Salt Lake City Health Care System in Utah. is Executive Assistant, Office of the Assistant Deputy Undersecretary for Health for Clinical Operations, Veterans Health Administration. is a Research Scientist at the Center for Clinical Management Research, Ann Arbor VA Medical Center in Michigan. Alicia Cohen is an Assistant Professor of Family Medicine and Health Services, Policy and Practice; James Rudolph is Professor of Medicine and Health Services, Policy and Practice; Kali Thomas is an Associate Professor of Health Services, Policy, and Practice; David Dosa is an Associate Professor of Medicine and Health Services, Policy and Practice; Thomas O'Toole is a Professor of Medicine; all at the Warren Alpert Medical School of Brown University and Brown University School of Public Health in Providence, Rhode Island. Michele Heisler is a Professor of Internal Medicine and Health Behavior and Health Education at the University of Michigan Medical School and School of Public Health. Megan Bowman and Christine Going are Co- Chairs, and Alicia Cohen, Kali Thomas, and Thomas O'Toole are members of the Ensuring Veteran Food Security Work-group
| | - Thomas P O'Toole
- is a Research Scientist; is Director; is a Research Health Science Specialist; is a Social Worker; is Associate Director; all at the VA Health Services Research & Development Center of Innovation in Long Term Services and Supports at the Providence VA Medical Center in Rhode Island; is Senior Medical Advisor, Office of the Assistant Deputy Undersecretary for Health for Clinical Operations, Veterans Health Administration in Washington, DC. is Assistant Chief, Nutrition and Food Services at VA Salt Lake City Health Care System in Utah. is Executive Assistant, Office of the Assistant Deputy Undersecretary for Health for Clinical Operations, Veterans Health Administration. is a Research Scientist at the Center for Clinical Management Research, Ann Arbor VA Medical Center in Michigan. Alicia Cohen is an Assistant Professor of Family Medicine and Health Services, Policy and Practice; James Rudolph is Professor of Medicine and Health Services, Policy and Practice; Kali Thomas is an Associate Professor of Health Services, Policy, and Practice; David Dosa is an Associate Professor of Medicine and Health Services, Policy and Practice; Thomas O'Toole is a Professor of Medicine; all at the Warren Alpert Medical School of Brown University and Brown University School of Public Health in Providence, Rhode Island. Michele Heisler is a Professor of Internal Medicine and Health Behavior and Health Education at the University of Michigan Medical School and School of Public Health. Megan Bowman and Christine Going are Co- Chairs, and Alicia Cohen, Kali Thomas, and Thomas O'Toole are members of the Ensuring Veteran Food Security Work-group
| | - David M Dosa
- is a Research Scientist; is Director; is a Research Health Science Specialist; is a Social Worker; is Associate Director; all at the VA Health Services Research & Development Center of Innovation in Long Term Services and Supports at the Providence VA Medical Center in Rhode Island; is Senior Medical Advisor, Office of the Assistant Deputy Undersecretary for Health for Clinical Operations, Veterans Health Administration in Washington, DC. is Assistant Chief, Nutrition and Food Services at VA Salt Lake City Health Care System in Utah. is Executive Assistant, Office of the Assistant Deputy Undersecretary for Health for Clinical Operations, Veterans Health Administration. is a Research Scientist at the Center for Clinical Management Research, Ann Arbor VA Medical Center in Michigan. Alicia Cohen is an Assistant Professor of Family Medicine and Health Services, Policy and Practice; James Rudolph is Professor of Medicine and Health Services, Policy and Practice; Kali Thomas is an Associate Professor of Health Services, Policy, and Practice; David Dosa is an Associate Professor of Medicine and Health Services, Policy and Practice; Thomas O'Toole is a Professor of Medicine; all at the Warren Alpert Medical School of Brown University and Brown University School of Public Health in Providence, Rhode Island. Michele Heisler is a Professor of Internal Medicine and Health Behavior and Health Education at the University of Michigan Medical School and School of Public Health. Megan Bowman and Christine Going are Co- Chairs, and Alicia Cohen, Kali Thomas, and Thomas O'Toole are members of the Ensuring Veteran Food Security Work-group
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18
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Financial hardship among individuals with serious mental illness. Psychiatry Res 2019; 282:112632. [PMID: 31690462 DOI: 10.1016/j.psychres.2019.112632] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 10/22/2019] [Accepted: 10/23/2019] [Indexed: 11/21/2022]
Abstract
This study explored financial hardship, defined as difficulty in obtaining food, shelter, or medicine in the past 12 months and its personal and clinical correlates in individuals with serious mental illness (SMI) in a sample of 271 adults with SMI newly admitted to two inner city community mental health centers. The study found that 59 percent (n = 161) reported experiencing financial hardship in the past 12 months. Patients with financial hardship were more likely to be female, to experience self-stigma, to experience medical care delays, and to use emergency services. Patients who experienced financial hardship typically had more severe psychiatric symptoms, including depressive symptoms, emotional lability, and interpersonal problems. Financial hardship persisted in nearly half of those with hardship interviewed a year later. The findings highlight the role of multiple social and economic challenges that the SMI patients face in recovery from serious mental illness and the importance of awareness of such challenges by providers treating this population. Though mental health treatment may help alleviate the psychiatric symptoms it alone is not sufficient in addressing persistent hardship. These findings highlight the need for multidisciplinary interventions in order to better serve this vulnerable population.
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19
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Costa R, Teasdale S, Abreu S, Bastos T, Probst M, Rosenbaum S, Ward PB, Corredeira R. Dietary Intake, Adherence to Mediterranean Diet and Lifestyle-Related Factors in People with Schizophrenia. Issues Ment Health Nurs 2019; 40:851-860. [PMID: 31339786 DOI: 10.1080/01612840.2019.1642426] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The purpose of this study was to examine the dietary intake of both inpatients and outpatients with schizophrenia in the Portuguese population as a potential key contributing factor to the poor physical health profiles, and understand the relationship of diet quality to other lifestyle factors. Participants of this cross-sectional study completed a semi quantitative food frequency questionnaire. Diet quality was determined by adherence to the Mediterranean Diet. In addition participants completed the International Physical Activity Questionnaire-Short-Form and Pittsburgh Sleep Quality Index. Tobacco smoking was assessed through a series of general questions. A total of 100 patients (50% inpatients and 28% female) with schizophrenia were included in the final analysis. Patients reported a high consumption of caffeine, while deficits were evident for fibre and folate intakes, when compared to the European Food Safety Authority recommendations. Both inpatients and outpatients reported poor to moderate diet quality. Smokers reported poorer diet quality when compared to non-smokers (p < 0.001). Dietary intake, and its relationship to other lifestyle components, should be considered for intervention, in order to improve physical health of people living with schizophrenia.
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Affiliation(s)
- Raquel Costa
- Research Centre in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto , Porto , Portugal
| | - Scott Teasdale
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District , Bondi Junction , Australia.,School of Psychiatry, UNSW Sydney , Australia
| | - Sandra Abreu
- Research Centre in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto , Porto , Portugal
| | - Tânia Bastos
- Centre of Research, Education, Innovation and Intervention in Sport (CIFI2D), Faculty of Sport, University of Porto , Porto , Portugal.,Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, University Institute of Maia, ISMAI , Maia , Portugal
| | - Michel Probst
- Faculty of Kinesiology and Rehabilitation Sciences, Research Group for Adapted Physical Activity and Psychomotor Rehabilitation , KU Leuven , Leuven , Belgium
| | - Simon Rosenbaum
- School of Psychiatry, UNSW Sydney , Australia.,Black Dog Institute, Prince of Wales Hospital, Sydney , Randwick , Australia
| | - Philip B Ward
- School of Psychiatry, UNSW Sydney , Australia.,Schizophrenia Research Unit, South Western Sydney Local Health District & Ingham Institute for Applied Medical Research , Liverpool , Australia
| | - Rui Corredeira
- Research Centre in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto , Porto , Portugal
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20
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Firth J, Siddiqi N, Koyanagi A, Siskind D, Rosenbaum S, Galletly C, Allan S, Caneo C, Carney R, Carvalho AF, Chatterton ML, Correll CU, Curtis J, Gaughran F, Heald A, Hoare E, Jackson SE, Kisely S, Lovell K, Maj M, McGorry PD, Mihalopoulos C, Myles H, O'Donoghue B, Pillinger T, Sarris J, Schuch FB, Shiers D, Smith L, Solmi M, Suetani S, Taylor J, Teasdale SB, Thornicroft G, Torous J, Usherwood T, Vancampfort D, Veronese N, Ward PB, Yung AR, Killackey E, Stubbs B. The Lancet Psychiatry Commission: a blueprint for protecting physical health in people with mental illness. Lancet Psychiatry 2019; 6:675-712. [PMID: 31324560 DOI: 10.1016/s2215-0366(19)30132-4] [Citation(s) in RCA: 704] [Impact Index Per Article: 140.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 04/01/2019] [Indexed: 12/20/2022]
Affiliation(s)
- Joseph Firth
- NICM Health Research Institute, Western Sydney University, Westmead, NSW, Australia; Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK; Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia.
| | - Najma Siddiqi
- Department of Health Sciences, University of York, Hull York Medical School, Bradford, UK; Bradford District Care NHS Foundation Trust, Bradford, UK
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain; Institució Catalana de Recerca i Estudis Avançats, Barcelona, Spain
| | - Dan Siskind
- Metro South Addiction and Mental Health Service, Brisbane, QLD, Australia; School of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Simon Rosenbaum
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Cherrie Galletly
- Ramsay Health Care Mental Health, Adelaide, SA, Australia; Northern Adelaide Local Health Network, Adelaide, SA, Australia; Discipline of Psychiatry, University of Adelaide, Adelaide, SA, Australia
| | - Stephanie Allan
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Constanza Caneo
- Departamento de Psiquiatría, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Rebekah Carney
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK; Youth Mental Health Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Andre F Carvalho
- Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Mary Lou Chatterton
- Deakin Health Economics, Institute for Health Transformation, Faculty of Health, Deakin University, Melbourne, VIC, Australia
| | - Christoph U Correll
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA; Department of Psychiatry, Zucker Hillside Hospital, Glen Oaks, NY, USA; Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
| | - Jackie Curtis
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia; Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, NSW, Australia
| | - Fiona Gaughran
- South London and Maudsley NHS Foundation Trust, London, UK; Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Adrian Heald
- Division of Diabetes, Endocrinology and Gastroenterology, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK; Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; Department of Diabetes and Endocrinology, Salford Royal Hospital, Salford, UK
| | - Erin Hoare
- Food and Mood Centre, Deakin University, Melbourne, VIC, Australia
| | - Sarah E Jackson
- Department of Behavioural Science and Health, University College London, London, UK
| | - Steve Kisely
- School of Medicine, University of Queensland, Brisbane, QLD, Australia; Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Karina Lovell
- Division of Nursing, Midwifery and Social Work, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK; Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Mario Maj
- Department of Psychiatry, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Patrick D McGorry
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Cathrine Mihalopoulos
- Deakin Health Economics, Institute for Health Transformation, Faculty of Health, Deakin University, Melbourne, VIC, Australia
| | - Hannah Myles
- Discipline of Psychiatry, University of Adelaide, Adelaide, SA, Australia
| | - Brian O'Donoghue
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Toby Pillinger
- South London and Maudsley NHS Foundation Trust, London, UK; Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Medical Research Council London Institute of Medical Sciences, London, UK; Institute of Clinical Sciences, Faculty of Medicine, Imperial College London, London, UK
| | - Jerome Sarris
- NICM Health Research Institute, Western Sydney University, Westmead, NSW, Australia; Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia; The Melbourne Clinic, Melbourne, VIC, Australia
| | - Felipe B Schuch
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil
| | - David Shiers
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK; Psychosis Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Lee Smith
- Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| | - Marco Solmi
- Neurosciences Department and Padua Neuroscience Centre, University of Padua, Padua, Italy
| | - Shuichi Suetani
- Metro South Addiction and Mental Health Service, Brisbane, QLD, Australia; Queensland Brain Institute, University of Queensland, Brisbane, QLD, Australia; Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, Australia
| | - Johanna Taylor
- Department of Health Sciences, University of York, Hull York Medical School, Bradford, UK
| | - Scott B Teasdale
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia; Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, NSW, Australia
| | - Graham Thornicroft
- Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - John Torous
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Tim Usherwood
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia; Department of General Practice, Westmead Clinical School, University of Sydney, Westmead, NSW, Australia
| | - Davy Vancampfort
- Department of Rehabilitation Sciences, Katholieke Universiteit Leuven, Leuven, Belgium; University Psychiatric Centre, Katholieke Universiteit Leuven, Kortenberg, Belgium
| | - Nicola Veronese
- National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy
| | - Philip B Ward
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia; Schizophrenia Research Unit, Ingham Institute of Applied Medical Research, Liverpool, NSW, Australia
| | - Alison R Yung
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK; Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Eoin Killackey
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Brendon Stubbs
- South London and Maudsley NHS Foundation Trust, London, UK; Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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21
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Food insecurity (hunger) and suicide attempts among 179,771 adolescents attending school from 9 high-income, 31 middle-income, and 4 low-income countries: A cross-sectional study. J Affect Disord 2019; 248:91-98. [PMID: 30716616 DOI: 10.1016/j.jad.2019.01.033] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2018] [Revised: 01/13/2019] [Accepted: 01/26/2019] [Indexed: 11/20/2022]
Abstract
BACKGROUND Data on food insecurity and suicide attempts in adolescence are scarce. Thus, the aim of the current study was to assess the association between food insecurity (hunger) and suicide attempts in adolescents from 44 countries. METHODS Cross-sectional, school-based data from the Global School-based Student Health Survey were analyzed. Data on past 12-month suicide attempts and past 30-day food insecurity (hunger) were collected. Multivariable logistic regression, meta-analysis, and meta-regression were conducted to assess the associations. RESULTS The final sample consisted of 179,771 adolescents attending school. The prevalence of moderate (rarely/sometimes hungry) and severe (most of the time/always hungry) food insecurity were 46.7% and 7.0%, respectively. After adjustment for potential confounders, severe food insecurity (vs. no food insecurity, i.e., no hunger) was significantly associated with higher odds for suicide attempts in 31 of the 44 countries studied with the pooled OR (95% CI) being 1.90 (1.77-2.04) (I2 = 45.2%). The associations were similar across country-income levels. However, meta-regression analysis by country showed that stronger associations were related with lower population prevalence of severe food insecurity. The pooled OR (95% CI) for moderate food insecurity (vs. no food insecurity) was 1.26 (1.21-1.32) (I2 = 29.7%). LIMITATIONS Causality cannot be established due to the cross-sectional study design. CONCLUSIONS Food insecurity (hunger) is a global problem and is associated with suicide attempts. The identification of children suffering from food insecurity (hunger) and remedying this condition may be important to improve mental health among adolescents worldwide.
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Coping with Food Insecurity Among African American in Public-Sector Mental Health Services: A Qualitative Study. Community Ment Health J 2019; 55:440-447. [PMID: 30825072 DOI: 10.1007/s10597-019-00376-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 02/01/2019] [Indexed: 10/27/2022]
Abstract
While there are high rates of food insecurity among individuals with serious mental illnesses, and among African Americans, there is very little research on the ways African Americans in public-sector mental health services cope with food insecurity. This research paper presents qualitative data from a mixed methods study on the prevalence and management of food insecurity among African Americans using public sector mental health services. We interviewed 21 people about their everyday experiences of food insecurity and strategies they used to cope. While participants reported experiencing high levels of food insecurity, they also described the use of communal strategies to help them cope, including sharing food and cooking meals jointly, which seemed to reduce the negative effects of living with high levels of food insecurity as well as a serious mental illness. Policy innovations like communal gardens and kitchens provided through public mental health services may be particularly helpful.
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Seligman HK, Berkowitz SA. Aligning Programs and Policies to Support Food Security and Public Health Goals in the United States. Annu Rev Public Health 2019; 40:319-337. [PMID: 30444684 PMCID: PMC6784838 DOI: 10.1146/annurev-publhealth-040218-044132] [Citation(s) in RCA: 82] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Food insecurity affects 1 in 8 US households and has clear implications for population health disparities. We present a person-centered, multilevel framework for understanding how individuals living in food-insecure households cope with inadequate access to food themselves and within their households, communities, and broader food system. Many of these coping strategies can have an adverse impact on health, particularly when the coping strategies are sustained over time; others may be salutary for health. There exist multiple opportunities for aligning programs and policies so that they simultaneously support food security and improved diet quality in the interest of supporting improved health outcomes. Improved access to these programs and policies may reduce the need to rely on individual- and household-level strategies that may have negative implications for health across the life course.
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Affiliation(s)
- Hilary K Seligman
- Department of Medicine and Department of Epidemiology and Biostatistics, University of California, San Francisco, California 94143, USA
- The UCSF Center for Vulnerable Populations, Zuckerberg San Francisco General Hospital, San Francisco, California 94110, USA;
| | - Seth A Berkowitz
- Division of General Medicine and Clinical Epidemiology, School of Medicine, University of North Carolina, Chapel Hill, North Carolina 27599, USA
- Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, North Carolina 27599-7590, USA;
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Castillo EG, Chung B, Bromley E, Kataoka SH, Braslow JT, Essock SM, Young AS, Greenberg JM, Miranda J, Dixon LB, Wells KB. Community, Public Policy, and Recovery from Mental Illness: Emerging Research and Initiatives. Harv Rev Psychiatry 2019; 26:70-81. [PMID: 29381527 PMCID: PMC5843494 DOI: 10.1097/hrp.0000000000000178] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
This commentary examines the roles that communities and public policies play in the definition and processes of recovery for adults with mental illness. Policy, clinical, and consumer definitions of recovery are reviewed, which highlight the importance of communities and policies for recovery. This commentary then presents a framework for the relationships between community-level factors, policies, and downstream mental health outcomes, focusing on macroeconomic, housing, and health care policies; adverse exposures such as crime victimization; and neighborhood characteristics such as social capital. Initiatives that address community contexts to improve mental health outcomes are currently under way. Common characteristics of such initiatives and select examples are discussed. This commentary concludes with a discussion of providers', consumers', and other stakeholders' roles in shaping policy reform and community change to facilitate recovery.
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Affiliation(s)
- Enrico G Castillo
- From the Center for Health Services and Society (Drs. Chung, Bromley, Kataoka, Young, Miranda, and Wells), Center for Social Medicine and Humanities (Drs. Braslow and Castillo), Division of Child and Adolescent Psychiatry (Dr. Kataoka), Department of Psychiatry and Biobehavioral Sciences (Dr. Greenberg), David Geffen School of Medicine, and School of Public Health (Drs. Miranda and Wells), University of California, Los Angeles; Los Angeles County Department of Mental Health (Dr. Castillo); RAND Corporation (Drs. Chung and Wells); Los Angeles Biomedical Research Institute (Dr. Chung); Healthy African American Families II (Dr. Chung); Health Services Research & Development Center of Innovation (Dr. Young), Desert Pacific MIRECC Health Services Unit (Drs. Bromley and Greenberg), VA Greater Los Angeles Healthcare System; Division of Behavioral Health Services and Policy Research, Department of Psychiatry, Columbia University College of Physicians and Surgeons (Drs. Essock and Dixon); New York State Psychiatric Institute (Drs. Essock and Dixon)
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25
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Brostow DP, Gunzburger E, Abbate LM, Brenner LA, Thomas KS. Mental Illness, Not Obesity Status, is Associated with Food Insecurity Among the Elderly in the Health and Retirement Study. J Nutr Gerontol Geriatr 2019; 38:149-172. [PMID: 30794096 DOI: 10.1080/21551197.2019.1565901] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVES Food insecurity, limited or uncertain access to adequate nutrition, is an increasingly recognized determinant of health outcomes and is often associated with having obesity. It is unclear, however, if this association persists in elderly populations. METHODS We conducted a cross-sectional study of 2868 participants' aged 65+ years from the Health and Retirement Study. Multivariate logistic regression was used to assess associations between food insecurity and body mass index, demographic characteristics, psychiatric history, and medical history. RESULTS Participants with overweight/obesity had a higher prevalence of food insecurity than leaner counterparts, however, weight status was not a significant predictor of food insecurity after multivariate adjustment. Instead, mental illness, current smoking status, and non-White race were all independently associated with food insecurity. DISCUSSION Beyond financial status, health care providers are encouraged to use these characteristics to identify elderly patients that may be at risk of food insecurity.
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Affiliation(s)
- Diana P Brostow
- a Denver VA Medical Center , Denver-Seattle Center of Innovation for Veteran-Centered and Value-Driven Care , Denver , CO , USA
| | - Elise Gunzburger
- a Denver VA Medical Center , Denver-Seattle Center of Innovation for Veteran-Centered and Value-Driven Care , Denver , CO , USA.,b Department of Biostatistics and Informatics , University of Colorado School of Public Health , Aurora , CO , USA
| | - Lauren M Abbate
- c Geriatric Research, Education, and Clinical Center , Denver VA Medical Center , Denver , CO , USA.,d Department of Emergency Medicine , University of Colorado School of Medicine , Aurora , CO , USA
| | - Lisa A Brenner
- e Denver VA Medical Center , Rocky Mountain Mental Illness Research Education and Clinical Center , Denver , CO , USA.,f Departments of Psychiatry, Physical Medicine and Rehabilitation, and Neurology , University of Colorado, Anschutz School of Medicine , Aurora , CO , USA
| | - Kali S Thomas
- g Providence VA Medical Center , Center of Innovation in Long-Term Services and Supports , Providence , RI , USA.,h Center for Gerontology and Healthcare Research , Brown University , Providence , RI , USA
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26
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Afulani PA, Coleman-Jensen A, Herman D. Food insecurity, mental health, and use of mental health services among nonelderly adults in the United States. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2018. [DOI: 10.1080/19320248.2018.1537868] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Patience A. Afulani
- Obstetrics, Gynecology and Reproductive Sciences Dept., School of Medicine, University of California, San Francisco, California, USA
| | - Alisha Coleman-Jensen
- Economic Research Service, United Stated Department of Agriculture, Washington, D.C., USA
| | - Dena Herman
- Department of Family and Consumer Sciences, California State University, Northridge, CA, USA
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27
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Food security among individuals experiencing homelessness and mental illness in the At Home/Chez Soi Trial. Public Health Nutr 2017; 20:2023-2033. [PMID: 28560947 DOI: 10.1017/s1368980017000489] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Individuals experiencing homelessness are particularly vulnerable to food insecurity. The At Home/Chez Soi study provides a unique opportunity to first examine baseline levels of food security among homeless individuals with mental illness and second to evaluate the effect of a Housing First (HF) intervention on food security in this population. DESIGN At Home/Chez Soi was a 2-year randomized controlled trial comparing the effectiveness of HF compared with usual care among homeless adults with mental illness, stratified by level of need for mental health services (high or moderate). Logistic regressions tested baseline associations between food security (US Food Security Survey Module), study site, sociodemographic variables, duration of homelessness, alcohol/substance use, physical health and service utilization. Negative binomial regression determined the impact of the HF intervention on achieving levels of high or marginal food security over an 18-month follow-up period (6 to 24 months). SETTING Community settings at five Canadian sites (Moncton, Montreal, Toronto, Winnipeg and Vancouver). SUBJECTS Homeless adults with mental illness (n 2148). RESULTS Approximately 41 % of our sample reported high or marginal food security at baseline, but this figure varied with gender, age, mental health issues and substance use problems. High need participants who received HF were more likely to achieve marginal or high food security than those receiving usual care, but only at the Toronto and Moncton sites. CONCLUSIONS Our large multi-site study demonstrated low levels of food security among homeless experiencing mental illness. HF showed promise for improving food security among participants with high levels of need for mental health services, with notable site differences.
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28
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Teasdale SB, Samaras K, Wade T, Jarman R, Ward PB. A review of the nutritional challenges experienced by people living with severe mental illness: a role for dietitians in addressing physical health gaps. J Hum Nutr Diet 2017; 30:545-553. [PMID: 28419586 DOI: 10.1111/jhn.12473] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
People experiencing a severe mental illness (SMI), such as schizophrenia, schizoaffective disorder, bipolar affective disorder or depression with psychotic features, have a 20-year mortality gap compared to the general population. This 'scandal of premature mortality' is primarily driven by preventable cardiometabolic disease, and recent research suggests that the mortality gap is widening. Multidisciplinary mental health teams often include psychiatrists, clinical psychologists, specialist mental health nurses, social workers and occupational therapists, offering a range of pharmacological and nonpharmacological treatments to enhance the recovery of clients who have experienced, or are experiencing a SMI. Until recently, lifestyle and life skills interventions targeting the poor physical health experienced by people living with SMI have not been offered in most routine clinical settings. Furthermore, there are calls to include dietary intervention as mainstream in psychiatry to enhance mental health recovery. With the integration of dietitians being a relatively new approach, it is important to review and assess the literature to inform practice. This review assesses the dietary challenges experienced by people with a SMI and discusses potential strategies for improving mental and physical health.
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Affiliation(s)
- S B Teasdale
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, Australia.,School of Psychiatry, University of New South Wales, Kensington, Australia
| | - K Samaras
- Department of Endocrinology, St Vincent's Hospital, Darlinghurst, Australia.,Diabetes and Metabolism Division, Garvan Institute of Medical Research, Darlinghurst, Australia
| | - T Wade
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, Australia
| | - R Jarman
- Keeping the Body in Mind Program, South Eastern Sydney Local Health District, Sydney, Australia
| | - P B Ward
- School of Psychiatry, University of New South Wales, Kensington, Australia.,Schizophrenia Research Unit, South Eastern Sydney Local Health District & Ingham Institute for Applied Medical Research, Liverpool, Australia
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