• Kelly K Anderson, Kristin K Clemens, Britney Le, Lixia Zhang, Jinette Comeau, Valerie Tarasuk, and Salimah Z Shariff.
• Departments of Epidemiology and Biostatistics (Anderson, Clemens), Psychiatry (Anderson), and Medicine (Clemens), Schulich School of Medicine and Dentistry, Western University; ICES Western (Anderson, Clemens, Le, Zhang, Shariff); Children's Health Research Institute (Anderson, Comeau); Lawson Health Research Institute (Anderson, Clemens, Shariff); Arthur Labatt Family School of Nursing (Shariff), Western University, London, Ont.; Department of Sociology (Comeau), King's University College, London, Ont.; Department of Nutritional Sciences (Tarasuk), University of Toronto, Toronto, Ont. kelly.anderson@schulich.uwo.ca.
• CMAJ. 2023 Jul 24; 195 (28): E948E955E948-E955.

BackgroundFood insecurity is a serious public health problem and is linked to the mental health of children and adolescents; however, its relationship with mental health service use is unknown. We sought to estimate the association between household food insecurity and contact with health services for mental or substance use disorders among children and adolescents in Ontario, Canada.MethodsWe used health administrative data, linked to 5 waves of the Canadian Community Health Survey, to identify children and adolescents (aged 1-17 yr) who had a household response to the Household Food Security Survey Module. We identified contacts with outpatient and acute care services for mental or substance use disorders in the year before survey completion using administrative data. We estimated prevalence ratios for the association between household food insecurity and use of mental health services, adjusting for several confounding factors.ResultsThe sample included 32 321 children and adolescents, of whom 5216 (16.1%) were living in food-insecure households. Of the total sample, 9.0% had an outpatient contact and 0.6% had an acute care contact for a mental or substance use disorder. Children and adolescents in food-insecure households had a 55% higher prevalence of outpatient contacts (95% confidence interval [CI] 41%-70%), and a 74% higher prevalence of acute care contacts (95% CI 24%-145%) for a mental or substance use disorder, although contacts for substance use disorders were uncommon.InterpretationChildren and adolescents living in a food-insecure household have greater use of health services for mental or substance use disorders than those living in households without food insecurity. Focused efforts to support food-insecure families could improve child and adolescent mental health and reduce strain on the mental health system.© 2023 CMA Impact Inc. or its licensors.

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