This is considerably higher than the national average of 18%.

Also known as food poverty, food insecurity is the lack of financial resources needed to ensure that a person has reliable access to enough food to meet their dietary, nutritional and social needs.

The research, involving Newcastle University, was the first of its kind in the UK and funded by the National Institute for Health and Care Research (NIHR). Experts worked with people who have lived experience of SMI, including bipolar disorder, schizophrenia and related psychoses.

Health and care inequalities

The aim of the research was to learn more about their experience of food insecurity and find out how people living with SMI can be supported to access healthy, affordable food.

The results showed the prevalence of food insecurity in the North of England, with 50.4% of the sample revealing they had experienced it.

Dr Steph Scott, Lecturer in Public Health and Qualitative Methods at Newcastle University, said: "This research lays bare stark and tangible impacts faced by those in the North of England as a result of health and care inequalities.

“It is incredibly exciting to see the recommendations from this project built upon within a new Programme Grant, by working in partnership with social supermarkets across Middlesbrough."

The North West had the highest rate of food insecurity, followed closely by the North East and Humber.

The findings also showed that food insecurity in this population is often a long-rooted experience, including instances where it has been within families for generations.

The study lasted 18 months and recruited more than 130 people from the North East, North West, North Cumbria and Yorkshire and Humber. It included a survey and interviews led by people with lived experience of SMI.

The research was hosted by Tees, Esk and Wear Valleys NHS Foundation Trust in collaboration with Fuse, the Centre for Translational Research in Public Health (Teesside University and Newcastle University) and Equally Well UK (a collaborative hosted by the Centre for Mental Health).

Jo Smith, consultant dietitian (clinical academic) for Tees, Esk and Wear Valleys NHS Foundation Trust and Teesside University, said: “During the COVID-19 pandemic, people with SMI told us they were struggling to access enough food.

“We heard stories of people wanting to stay in hospital for longer because they would not be able to eat when they return home.

“One reason that people with SMI struggle to access healthy food is they don’t always have the skills, equipment, knowledge and/or motivation to prepare a meal from fresh ingredients.

“We know that food insecurity can lead to a range of additional health problems and people living with SMI are at particularly high risk of experiencing food insecurity.

“A particular concern is that people with children were far more likely to have food insecurity, and one person told us that their friend had to sell electrical items so they could feed their children.”

Potential solutions

The researchers and clinicians are now embarking on a further year-long research study looking specifically at potential solutions to tackle food insecurity and improve diets in Middlesbrough.

Millions of tonnes of high-quality fruit and vegetables go to waste every year from supermarkets and the food system. Despite a large amount being made available through social supermarkets, such as Eco Shops, there is still a lot not utilised as people lack the knowledge and equipment to cook them or use them in meals.

Researchers will work with people living with SMI to develop a range of nutritious recipes that can be transformed into ready meals and made available in social supermarkets across the town.

A new partnership has been developed to deliver this research including Tees, Esk and Wear Valleys NHS Foundation Trust, Teesside University and community organisation Middlesbrough Environment City. It is being funded by the NIHR Programme Development Grant programme.

The findings will be used to develop a further funding application to scale up the production of ready meals using surplus food, helping a range of vulnerable groups improve their diet.

Commenting on the new research, Jo Smith added: “The most commonly recommended intervention to address food insecurity was education on healthy eating, cookery skills and budgeting, followed by increased access to affordable food, food parcels, food vouchers and delivered meals.

“The new Programme Development Grant funding will allow us to build on our research findings, and pilot one solution to helping people with SMI in Middlesbrough get better access to healthy, affordable food.

“We also want to see mental health practitioners having conversations about food insecurity with people who have SMI, so they can signpost people to local support services.”

Professor Emma Giles, Professor of Integrating Physical and Mental Health at Teesside University and co-lead of the Behaviour Change Research Cluster in Fuse, the Centre for Translational Research in Public Health, said: “Our previous research found that people with SMI want to see support, interventions and/or policies to be put in place to support them to access enough food, but also accessing food that is of a good nutritional quality.

“The ongoing research trialling the repurposing of fruits and vegetables into a ready meal is one intervention that may address a lack of access to food but also diet quality.”