Food insufficiency and mental health service utilization in the U.S. during the COVID-19 pandemic

Objective: To estimate the association between food insufficiency and mental health service utilization in the U.S. during the COVID-19 pandemic. Design: Cross-sectional study. Multiple logistic regression models were used to estimate the associations between food insufficiency and mental health service utilization. Setting: U.S. Census Household Pulse Survey data collected in October 2020. Participants: Nationally representative sample of 68,611 U.S. adults. Results: After adjusting for sociodemographic factors, experiencing food insufficiency was associated with higher odds of unmet mental health need (adjusted odds ratio [AOR] 2.90; 95% CI 2.46-3.43), receiving mental health counseling or therapy (AOR 1.51; 95% CI 1.24-1.83), and psychotropic medication use (AOR 1.56; 95% CI 1.35-1.80). Anxiety and depression symptoms mediated most of the association between food insufficiency and unmet mental health need but not the associations between food insufficiency and either receiving mental health counseling/therapy or psychotropic medication use. Conclusions: Clinicians should regularly screen patients for food insufficiency, especially in the wake of the COVID-19 pandemic. Expanding access to supplemental food programs may help to mitigate the need for higher mental health service utilization during the COVID-19 pandemic.