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Concept Development and Use of an Automated Food Intake and Eating Behavior Assessment Method
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A Mixed-Methods Study Exploring How Food Insecurity Screening can be Embedded in Routine Mental Health Care for

Emma Tuschick1, Emma Giles1, Jo Smith1

  • 1School of Health and Life Sciences, Teesside University, Middlesbrough, UK.

Journal of Human Nutrition and Dietetics : the Official Journal of the British Dietetic Association
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Summary

Food insecurity is common in adults with severe mental illness (SMI). Integrating screening into routine mental healthcare, co-produced with those with lived experience, is crucial for early identification and improved outcomes.

Keywords:
co‐productionfood insecuritymental healthcarepublic healthscreeningsevere mental illness

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Area of Science:

  • Mental Health Services Research
  • Public Health Nutrition
  • Health Services Integration

Background:

  • Food insecurity (FI) disproportionately affects adults with severe mental illness (SMI), impacting medication adherence and health outcomes.
  • Routine screening for FI is currently lacking in SMI healthcare settings.
  • Co-production with individuals with lived experience is key to effective FI screening integration.

Purpose of the Study:

  • To explore integrating food insecurity screening into routine mental healthcare for adults with SMI.
  • To co-produce screening methods with individuals with lived experience of SMI.
  • To enhance the acceptability and implementation of FI screening in mental health services.

Main Methods:

  • Mixed-methods exploratory study in a UK NHS mental health Trust (April-June 2025).
  • Semi-structured interviews with peer-support workers (n=4) with SMI lived experience.
  • Anonymous online survey of mental health professionals (n=40) across disciplines.

Main Results:

  • Peer workers identified missed opportunities for FI screening and preferred flexible, non-stigmatizing methods.
  • Barriers included time, stigma, and lack of training; solutions involved care planning integration and trusted relationships.
  • Most professionals recognized FI screening importance, but only 33% routinely screened; support for short, compassionate tools and training was high.

Conclusions:

  • Normalizing FI screening in mental healthcare is urgently needed.
  • FI significantly impacts mental, physical health, and recovery for individuals with SMI.
  • Flexible, relationally delivered screening, particularly by peer workers, is most acceptable.