Increasing Access to Healthy, Affordable Food for Adults Living with Severe Mental Illness in Teesside: A Co‐Produced Feasibility Study

Background: Over 50% of adults with Severe Mental Illness (SMI) living in Northern England experience food insecurity (1). Meanwhile, 10.7 million tonnes of surplus food are wasted annually by the UK food industry (2). This co-produced feasibility study aimed to co-design, pilot and evaluate an innovative solution to improve the diets of people living with SMI in Teesside.

Methods: A mental health NHS Trust circulated a recruitment advert. Adults with SMI (n=3) attended 15 weekly group sessions to co-develop, cook, and evaluate four meals prepared using surplus food from the charity network, Fare Share. Data were collected between January and April 2024 on participants’ pre- and post-intervention food insecurity status and diet diversity, with feasibility assessed through a focus group, attendance, and attrition rates. One meal was selected and processed in the food science laboratory at Teesside University. Frozen ready meals were subsequently distributed to three social supermarkets in Teesside, with customers (n=30) evaluating the acceptability of the product through a survey. Quantitative data were analysed using descriptive statistics and qualitative data using thematic analysis (focus group) and content analysis (survey). Ethical approval for this study was obtained from the North-East Newcastle and North Tyneside 1 Research Ethics Committee (Reference: 23/NE/0126); and the Health Research Authority and Health and Care Research Wales (IRAS ID: 328144).

Results: The ready meal group attendance rate was 95.6%, and the attrition rate was 0%. A mean reduction in the US Department of Agriculture Adult Food Security Module score (3) of 0.33 (SD:0.58) was observed for group participants, indicating a slight reduction in food insecurity. A mean increase in Household Dietary Diversity Score of 1.67 (SD:0.58) suggested small improvements in participants’ diet diversity. Focus group themes included positive impacts on participants’ mental wellbeing, social interactions, and overall diet quality from attending the group. Social supermarket customers rated the ready meal highly, with 93.3% (n=28) advising that they would recommend the product to another person.

Discussion: The 15-week group intervention appeared feasible, acceptable and had positive impacts on participants’ food security, diet quality and wellbeing. The social supermarket survey data indicates a positive reaction from customers to the frozen ready meal. Limitations in this exploratory work include the small sample size. Further planned research includes co-creating and piloting a food insecurity intervention for people with SMI with a larger sample and scaling-up the ready meal development to test further meal options using surplus food.

Conclusion: This exploratory feasibility study suggests that a group meal planning and cookery intervention using surplus food to create a healthy, affordable frozen ready meal appears feasible and acceptable for people with SMI experiencing food insecurity and social supermarket customers.

References:
(1) Smith J, Eskandari F, McGeechan GJ, Teasdale SB, Lake AA, Ker S, et al. Food insecurity in adults with severe mental illness living in Northern England: A co-produced cross-sectional study. Nutrition & Dietetics. 2024, https://doi.org/10.1111/1747-0080.12868 (2) WRAP. Action on Food Waste 2022 [cited 2024 7th August]. Available from: https://www.wrap.ngo/taking-action/food-drink/actions/action-on-food-waste (3) U.S. Department of Agriculture (2012) U.S. Adult Food Security Module: Three-stage Design, with Screeners. Economic Research Service, USDA. [cited 2024 11 September]. Available from: https://www.ers.usda.gov/media/8279/ad2012.pdf