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

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