Supporting people with Severe Mental Illness who face food insecurity to access a nourishing meal

Sally Smith, Peer Lead for Research, Tees, Esk and Wear Valleys NHS Foundation Trust (TEWV)

I have met many wonderful and interesting people on the inside of a psychiatric ward. The immediacy and depth of connection between peers in there was an unexpected comfort in the most challenging of environments.

Illustration by Sally Smith

I remember lots of the stories shared in the smoking corners of gardens. We often reflected on how misunderstood we felt in the ward and in the world.

One young woman was desperate to stay on the ward as she knew that was the only way she was certain of ongoing access to food. Her cupboards empty, her benefits paused, she was terrified about discharge. I was unsure how much Dialectical Behavioural Therapy or anti-depressants would help: wouldn’t anyone feel miserable with no food or money?

I remember physical health checks on the ward being introduced. Being weighed and measured, compared to the graphs…. and yet being given medication that makes you want to eat sugar out of the bag, being locked on a ward with no way to exercise, offered beige food four times a day and feeling so damn lousy and desperate that motivation to even clean your teeth was a challenge.

It felt cruel and shaming. It certainly never helped me to change anything.

In my mind it is no surprise that the mortality gap for people with severe mental illness (SMI) continues to rise, the challenges and barriers around nutrition that people living with SMI face continue to go unseen. No amount of lessons on what makes a healthy plate will make avocado cost less than crisps, and no knowledge of a healthy Body Mass Index (BMI) will reduce the intense effects of psychiatric medication.

And perhaps this is more of an issue than ever with austerity and the cost-of-living crisis exacerbating people’s struggles.

Increasing accessibility of affordable healthy food to adults living with SMI in Middlesbrough

With this perspective in mind, I was delighted to join the team working on this National Institute for Health and Care Research (NIHR) Communities study as a peer researcher. With co-production and the voice of lived experience running throughout the project, we are seeking to develop practical solutions for people living with SMI who face food insecurity in Middlesbrough.

The project is a collaboration, bringing together lived experience with the best bits of Tees, Esk and Wear Valleys NHS Foundation Trust (TEWV), Teesside University and Middlesbrough Environmental City, a charity dedicated to promoting healthy and sustainable living.

Over a period of 16 weeks, we plan to co-design and co-develop a nutritious meal with surplus fresh ingredients from local Eco shops (social supermarkets) that would otherwise go to waste.

With the support of the food scientists at Teesside University, this will then be turned into a healthy ready meal and distributed back to Eco shops in Middlesbrough. Aiming to be an appetising, nourishing and accessible meal for local people battling severe mental illness, who for whatever reason may struggle to cook the fresh ingredients themselves.

Through the design and delivery group we are hopeful that there may be additional benefits for all participants and the collaborating organisations, for example:

• The opportunity to learn some cooking skills and explore recipes that are good to cook on a budget.
• The opportunity to develop peer relationships amongst the delivery group that support connection and foster hope for change.
• The opportunity for organisations to learn from one another’s strengths and take a fully bio-psycho-social lens on mental health difficulties.

We are currently in the recruitment phase for participants and a collaboration of this type has not been without substantial challenge. It is has not been easy to marry NHS language and expectations and academic protocols with how a community organisation runs. It has not always been easy to find middle ground between the clinical expertise and lived experience expertise. However, I look forward to sharing the progress we make as the delivery team becomes established.

 

Research published by the project team

This study published today explores food insecurity prevalence and the experiences of adults with Severe Mental Illness (SMI) living in Northern England.

This systematic review paper found that people with SMI are more likely to experience food insecurity.

Another recently published paper identified strategies to tackle food insecurity centred on making food banks more accessible and improving the quality of available food available.