Children and adolescents in homes facing Food Insecurity have a much higher percentage of acute care or outpatient visits for mental or substance use disorders in the past year compared to food-secure households.

Children and adolescents face a 55-per-cent higher prevalence of past-year outpatient visits, and a 74-per-cent higher rate of visits to an emergency department or hospitalization, the study says.

“This is the first study to explore the relationship between children’s mental health and food insecurity by examining linked health record and survey data, which gives us an accurate snapshot of how food-insecure children are using mental health services,” said lead author Kelly Anderson, associate professor of epidemiology and biostatistics at Schulich School of Medicine & Dentistry, Canada Research Chair in public mental health research, and adjunct scientist at ICES Western.

The study was published in CMAJ and included 32,321 Ontario children and adolescents (1-17 years), of whom 5,216 (16 per cent) were living in food-insecure households. Food insecurity was measured using a validated community health survey and responses were categorized as food-secure, marginally food-insecure, moderately food-insecure or severely food-insecure. Any level of food insecurity was compared to food-secure households.

Study findings show:

In the year prior to the survey, nine per cent of children and adolescents had an outpatient physician visit for a mental or substance use disorder, and 0.6 per cent of children and adolescents received acute care. There was also evidence of higher contact with the healthcare system as the severity of food insecurity increased;
The most common health visits were for neurodevelopmental disorders and mood or anxiety disorders, followed by social problems and other mental disorders; and,
Health service use for psychotic disorders, substance use disorders, and deliberate self-harm were rare.
“Taken together, these findings are concerning, and we need strong public policy to support families who face food insecurity,” said senior author Salimah Shariff, staff scientist at ICES Western. “Public mental health strategies must also be improved and targeted to youth specifically to help reduce the strain on the public mental health system.”

One limitation of the study is that the findings may not be generalizable to First Nations groups and individuals living in remote areas, where food insecurity is particularly prevalent. Additionally, there is missing data for mental health services used outside the public health-care sector, such as community-based mental health programs, school-based psychologists and private therapists.

Nevertheless, this is the first study to examine the link between food insecurity and mental health among children and adolescents in Ontario and is consistent with findings that show a higher prevalence of psychiatric symptoms and self-reported diagnoses among Canadian youth experiencing food insecurity.