Work

Food insecurity assessment tools in adults living in high-income countries and their potential applicability to severe mental illness: A systematic review

Year: 2026

Type: review

Abstract: Background Individuals with Severe Mental Illness (SMI) are disproportionately affected by poor physical health, food insecurity (FI), and low income. Screening tools help healthcare professionals identify people experiencing FI. However, it remains unclear whether validated FI assessment tools have been evaluated in adults with SMI. This review aimed to synthesise evidence on the validity and reliability of FI assessment tools used in adults and whether any have been validated in, or may warrant further evaluation for, adults with SMI. Methods Seven databases identified 650 papers. Screening resulted in 34 articles for full-text sifting. Papers were included if they involved FI screening tools, reported reliability, validity, sensitivity, or specificity, and involved adults aged 18+ in high-income countries. Included papers were critically appraised and narrative synthesis was performed due to heterogeneity in study designs and outcome reporting. Results Twenty-five studies met the inclusion criteria; none evaluated or validated an FI assessment tool specifically in adults with SMI or other mental health populations. Across general adult populations, several tools demonstrated promising psychometric properties, including the two-item Household Food Security Scale and two-item food security questionnaire. However, heterogeneity in populations, methods and outcome reporting limited direct comparison between tools. Conclusion No FI assessment tool identified was validated specifically for adults with SMI. Tools demonstrate varying psychometric performance in other adult populations, but their applicability to SMI populations cannot be assumed. Further research should evaluate the validity, reliability, feasibility and acceptability of promising tools in adults with SMI before routine implementation in mental health settings.

Source: Next research.

DOI: 10.1016/j.nexres.2026.102538

Authors: Emma Tuschick, Emma L Giles, Lee Copping, Kerry Derbyshire, Jo Smith

Institutions: Teesside University, North Tees and Hartlepool NHS Foundation Trust, Tees, Esk and Wear Valleys NHS Foundation Trust

Language: English

Topic: Food Security and Health in Diverse Populations

Subfield: Public Health, Environmental and Occupational Health

Field: Medicine

Domain: Health Sciences

SDGs: Good health and well-being, Reduced inequalities, Zero hunger, No poverty

Open Access status: hybrid

Estimated APC paid: $2,500