Open AccessMental and substance use disorders and food insecurity among homeless adults participating in the At Home/Chez Soi study
Author(s) -
James Lachaud,
Cília Mejía-Lancheros,
Ri Wang,
Kathryn Wiens,
Rosane Nisenbaum,
Vicky Stergiopoulos,
Stephen W. Hwang,
Patricia O’Campo
Publication year - 2020
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0232001
Subject(s) - food insecurity , intervention (counseling) , mental health , psychiatry , multinomial logistic regression , substance use , mental illness , mood , housing first , substance abuse , medicine , psychology , alcohol use disorder , environmental health , food security , clinical psychology , alcohol , biology , ecology , agriculture , biochemistry , chemistry , machine learning , computer science
Background Few studies have examined how food insecurity changes over time when living with severe mental disorders or substance use disorders. This study identifies food insecurity trajectories of homeless adults participating in a trial of a housing intervention and examines whether receiving the intervention and having specific mental and substance disorders predict food insecurity trajectories. Materials and methods We studied 520 participants in the Toronto site of the At Home/Chez-Soi project. Food insecurity data were collected at seven times during a follow-up period of up to 5.5 years. Mental and substance use disorders were assessed at baseline. Food insecurity trajectories were identified using group based-trajectory modeling. Multinomial logistic regression was used to examine the effects of the intervention and mental and substance use disorders on food insecurity trajectories. Results Four food insecurity trajectories were identified: persistently high food insecurity , increasing food insecurity , decreasing food insecurity , and consistently low food insecurity . Receiving the intervention was not a predictor of membership in any specific food insecurity trajectory group. Individuals with major depressive episode, mood disorder with psychotic features, substance disorder, and co-occurring disorder (defined as having at least one alcohol or other substance use disorder and at least one non-substance related mental disorder] were more likely to remain in the persistently high food insecurity group than the consistently low food insecurity group. Conclusion A persistently high level of food insecurity is common among individuals with mental illness who have experienced homelessness, and the presence of certain mental health disorders increases this risk. Mental health services combined with access to resources for basic needs, and re-adaptation training are required to enhance the health and well-being of this population.