267688 Food Insecurity, Nutritional Risk and Utilization of Psychiatry Emergency Services

Monday, October 29, 2012

Christina Mangurian, MD , Department of Psychiatry, University of California, San Francisco, San Francisco, CA
Lauren McGuire , Department of Psychiatry, University of California, San Francisco, San Francisco, CA
Nina Sreshta , School of Medicine, University of Cincinnati, Cincinnati, OH
Hilary Seligman, MD, MAS , Division of General Internal Medicine, University of California San Francisco, San Francisco, CA
Andrea Lopez , Division of General Internal Medicine, University of California San Francisco, San Francisco, CA
Introduction: Food Insecurity (FI), or the limited availability of nutritionally adequate food, and nutritional risk (NR) are associated with increased risk of mental illness. However, the prevalence of FI among people with severe mental illness (SMI), who die 25 years earlier than the general population, is unknown. We sought to determine this prevalence and whether FI and NR were associated with increased utilization of psychiatric emergency services (PES).

Methods: We administered a survey to 111 urban outpatient mental health clinic SMI clients. Two measures were used to assess FI and NR. We determined PES utilization from the local safety net hospital EMR . We examined the association between FI and NR with utilization of PES using chi-square and one-way ANOVA tests.

Results: Prevalence of FI was 71%; and 7% were at low NR, 14% at moderate NR, and 79% at high NR. High FI participants had greater mean number of PES visits than food secure participants (1.93 vs 0.74, p=0.04). After adjusting for demographic variables, high FI participants had an estimated 1.2 more PES visits in the previous year than food secure participants, although this was not statistically significant (p=0.3).

Discussion: The prevalence of FI and NR is substantially higher in the SMI population (71% and 79%, respectively) compared to the general population (14% and 50%, respectively). FI may be associated with high utilization of PES services. Further research is needed to determine the generalizability of these findings and whether interventions to decrease FI prevent psychiatric exacerbations.

Learning Areas:
Chronic disease management and prevention
Clinical medicine applied in public health
Public health or related research
Social and behavioral sciences

Learning Objectives:
1. Evaluate the rate of Food Insecurity and Nutritional Risk in a high risk population (individuals with Severe Mental Illness)compared to the general population; 2. Identify the risk factors for Food Insecurity and Nutritional Risk in this population; and 3. Determine if Food Insecurity and Nutritional Risk in individuals with severe mental illness are assocaited with illness exacerbation and increased utilization of psychiatric emergency services.

Keywords: Food and Nutrition, Mental Illness

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the principle investigator of an NIMH grant aimed at improving the medical health of people with severe mental illness.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 3185.0: Addressing Food Security, Food Access, and Nutritional Needs of Underserved and Disadvantaged Communities