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Opinion: Medicaid and SNAP cuts are exacerbating the intertwined problems of hunger and mental illness

Article excerpt

“No one built a psychiatric unit to solve hunger,” writes clinical dietician Cole Hanson. But patients come anyway.

The patient had come in for suicidal ideation. When I asked about his eating habits beforehand and access to food, routine for a psychiatric nutrition consult, he told me he’d lost his SNAP eligibility a few weeks earlier. It was something about a documentation deadline he hadn’t been notified about, or just another thing lost in the mix of making ends meet. Since then, he’d been getting by on what he could. He spent the last of his cash on a motel and dry cereal, which was all he ate for a few weeks. After his money and food ran out, he said, pretty simply, that the hospital made sense. He was hungry, thought through his options, and figured this was better than “Plan B”: ending his life due to hopelessness and a lack of food.

As a clinical dietitian at a large urban hospital, part of my job is coordinating with social work and physicians of all stripes on nutrition support and food access: figuring out what patients need to eat, and occasionally what they’re going to eat after discharge. (Sidebar: We could all do worse than the Mediterranean diet.) Meals on Wheels referrals, pantry connections, SNAP enrollment support, the clinical and the logistical blur into each other because food insecurity doesn’t really stop at the point of discharge. Prior to my current role, I spent several years in public health dedicated to ending hunger and food insecurity for families. I’ve spent my career like the ferryman on the river: navigating hunger’s effects upstream, downstream, and working people across to something better.

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