Food insufficiency and mental health service utilisation in the USA during the COVID-19 pandemic

To estimate the association between food insufficiency and mental health service utilisation in the USA during the COVID-19 pandemic. Cross-sectional study. Multiple logistic regression models were used to estimate the associations between food insufficiency and mental health service utilisation. US Census Household Pulse Survey data collected in October 2020. Nationally representative sample of 68 611 US adults. After adjusting for sociodemographic factors, experiencing food insufficiency was associated with higher odds of unmet mental health need (adjusted OR (AOR) 2·90; 95 % CI 2·46, 3·43), receiving mental health counselling or therapy (AOR 1·51; 95 % CI 1·24, 1·83) and psychotropic medication use (AOR 1·56; 95 % CI 1·35, 1·80). Anxiety and depression symptoms mediated most of the association between food insufficiency and unmet mental health need but not the associations between food insufficiency and either receiving mental health counselling/therapy or psychotropic medication use. Clinicians should regularly screen patients for food insufficiency, especially in the wake of the COVID-19 pandemic. Expanding access to supplemental food programmes may help to mitigate the need for higher mental health service utilisation during the COVID-19 pandemic.