Food Insecurity, Neighborhood Disorder, and Homelessness among People with Serious Mental Illness

TL;DR

This study finds that food insecurity and poor neighborhood conditions are common among people with serious mental illness and are linked to worse mental and physical health.

Contribution

The study uniquely examines social determinants of health among individuals actively engaged in mental health treatment.

Findings

64% of participants experienced food insecurity and 93% lived in disordered neighborhoods.

Food insecurity and neighborhood disorder were associated with poorer mental and physical health outcomes.

Homelessness was not significantly linked to health outcomes in this sample.

Abstract

The health effects of social conditions such as income, education, and employment have been demonstrated to be persistent and wide-reaching. In this study, we examine the effect of social determinants of health, those conditions in which people live, among individuals with serious mental illnesses (SMI) who are actively engaged with mental health services. Using a sample of 203 clients at a community mental health clinic, this study (1) explores the prevalence of three social determinants of health: food insecurity, homelessness, and neighborhood disorder, and (2) assesses their associations with five outcomes of health, including mental health (overall mental health and life satisfaction) and physical health (overall physical health, number of chronic health conditions, and perceived daily limits). Our findings demonstrated that food insecurity and neighborhood disorder were prevalent within our sample of people with SMI (64% and 93% respectively), while homelessness was not (7%). Furthermore, a series of OLS regressions showed food insecurity and neighborhood disorder to be associated with poor mental and physical health, while homelessness was not significantly associated with any outcomes. These findings suggest that individuals with SMI who are actively engaged in treatment have increased risk of food insecurity and poor neighborhood conditions, which in turn may negatively impact their overall health. We suggest that mental health service providers be aware of the influence of social conditions on their patients and that clinics may be uniquely positioned to identify and intervene for individuals at risk of experiences that may be detrimental to their recovery.

The online version contains supplementary material available at 10.1007/s10597-025-01533-1.