Tirfessa, Kebede, Lund, Crick, Medhin, Girmay, Hailemichael, Yohannes, Fekadu, Abebaw and Hanlon, Charlotte (2017) Food insecurity among people with severe mental disorder in a rural Ethiopian setting: a comparative, population-based study. Epidemiology and Psychiatric Sciences. ISSN 2045-7960

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Abstract

Aim: In low-income African countries, ensuring food security for all segments of the population is a high priority. Mental illness is associated consistently with poverty, but there is little evidence regarding the association with food insecurity. The aim of this study was to compare the levels of food insecurity in people with severe mental disorders (SMD) with the general population in a rural African setting with a high burden of food insecurity.

Method: Households of 292 community-ascertained people with a specialist-confirmed diagnosis of SMD (including schizophrenia and bipolar disorder) were compared to 284 households without a person with SMD in a rural district in south Ethiopia. At the time of the study, no mental health services were available within the district. Food insecurity was measured using a validated version of the Household Food Insecurity Access Scale. Disability was measured using the World Health Organisation Disability Assessment Schedule 2.0.

Result: Severe household food insecurity was reported by 32.5% of people with SMD and 15.9% of respondents from comparison households: adjusted odds ratio 2.82 (95% confidence interval 1.62 to 4.91). Higher annual income was associated independently with lower odds of severe food insecurity. When total disability scores were added into the model, the association between SMD and food insecurity became non-significant, indicating a mediating role of disability.

Conclusion: Efforts to alleviate food insecurity need to target people with SMD as a vulnerable group. Addressing the disabling effects of SMD would also be expected to reduce food insecurity. Access to mental health care integrated into primary care is being expanded in thisdistrict as part of the Programme for Improving Mental health carE (PRIME). The impact of treatment on disability and food insecurity will be evaluated.

Item Type:	Article
Keywords:	Food Insecurity, Disability, Severe Mental Disorder, sub-Saharan Africa, Psychosis
Schools and Departments:	Brighton and Sussex Medical School > Global Health and Infection
Research Centres and Groups:	Wellcome Trust Brighton and Sussex Centre for Global Health Research
Depositing User:	Esther Garibay
Date Deposited:	18 Jan 2018 11:32
Last Modified:	16 May 2018 01:00
URI:	http://srodev.sussex.ac.uk/id/eprint/72957

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