Children suffer from ‘dire’ mental health due to poor diets says British Medical Assocation boss

Poor diets are causing an increase in mental health related problems among children and low-income families are being hit particularly hard, a leading GP and medical expert has warned.

Professor Sir Sam Everington, Vice President of the British Medical Association (BMA) told the Standard that the prescription of anti-depressants for children had “massively increased” during the Covid pandemic and that the mental health picture for young people was “dire” as a result of poor access to nutrition and health inequality.

Mental health disorders in children aged between seven and 16 increased from 12% to 18% in 2022, new figures published by NHS digital suggest.

“I think it is much tougher for people on low incomes. At our health centre, we run the local food bank. I never thought I’d see the day with one of the richest countries in the world, where you have food banks, and even nurses coming to food banks.” Sir Sam said.

He was speaking as health leaders launched a new initiative to prescribe fruit and vegetables to families in two London boroughs in a bid to increase access to healthy food for poorer communities.

The ‘Fruit and Veg Prescription’ project, spearheaded by London-based Alexandra Rose Charity, aims to tackle health-related inequality and food poverty in Tower Hamlets and Lambeth.

The £250, 000 pilot, which is funded by local authorities and a charitable foundation, launched last month. The war in Ukraine has caused food prices to soar and fresh food inflation has reached a record 13.3 per cent.

Jonathan Pauling, chief executive at Alexandra Rose Charity, told the Standard that the initiative hoped to address the “large number of long-term health concerns and health issues that have a direct relationship to the quality of people’s diets”.

“We are living in a situation in the UK where it’s three times cheaper to fill yourself and your family up on calories from unhealthy food than it is to get your calories from healthy food,” he said.

The 12-month project, supported by the Impact on Urban Health, a charity that helps tackle health inequalities, will focus on families and individuals from low-income backgrounds.

“People on low incomes who might have long-term health conditions find it hard to manage those by improving their diet and the quality of their nutrition because it’s really expensive to do so, and much cheaper and much easier to eat food that’s possibly not as good for managing your long-term health condition.”

As part of the scheme, 122 residents have been prescribed Rose vouchers to spend on fruit and veg at participating local retailers and market traders.

The group consists of those who have or who risk developing chronic health conditions like high blood pressure, diabetes and mental health problems. It will also support people who are struggling financially.

In Tower Hamlets, recipients get up to £6, and in Lambeth, £8, per week. There is an additional £2 per week for families.

The project was designed in partnership with the Bromley-by-Bow Centre in Tower Hamlets, and The Beacon Project in Lambeth. The latter is one of the earliest pioneers of social prescribing, a central government funded health practice which looks at treating the lifestyle and environmental factors that may contribute to a disease.

Emphasising the practice’s importance, Sir Sam, who is also the chair of the NHS Tower Hamlets Clinical Commissioning Group, said: “As somebody who’s led on social prescribing nationally for over thirty years now, we realise very early on is that what we were trained to do just wasn’t enough, and there was 80 per cent missing and that was all to do with lifestyle, jobs, employment, and environment. If you didn’t do that as a GP, you weren’t going to be effective. You had to go beyond the traditional prescribing.”

Earlier this year, the government introduced a National Food Strategy encouraging pilots like this to be rolled out across the UK over the next five years. Some doctors criticised the proposals stating it would risk medicalising food by treating it as a medical concern and stigmatising unhealthy food.

But Sir Sam denied that the project would do this.

“The risk is the medicalisation that we’ve done of everything else in society. We medicalise mental health all the time,” he said.

“We’ve over medicalised everything. Fruit and veg is a far better medicine than a lot of things I can prescribe. So, how’s that medicalisation? What it’s also about is where we get the greatest success with patients in terms of managing their illnesses is if they manage it themselves.”

The inspiration for the project came from fruit and veg prescription in the United States, Mr Pauling said.

“It’s been an aim of ours for many years to try and replicate that here, and we just needed the right moment in time, the right circumstances, the right partners but also the funding to do so.”

The charity has been running a similar scheme for nine years called, ‘The Rose Voucher for Free Fruit and Veg’. Operating in eight locations across the UK, it has worked with children’s centres and early years’ providers to help mothers and families with young children to eat a healthier diet.

Speaking about the shift to supporting low-income families in these two boroughs, he said: “It’s been successful in helping early years settings and children’s centres to engage families on a regular basis, so they keep coming in every week to pick up the vouchers, and that allows them to engage with a wide range of services that those centres offer but it’s also improved health and well-being.

“It’s reduced stress and anxiety around being able to afford food, and it’s had a really good impact on the health and diet of children growing up in the first four years of their lives. [The local authorities] knew about our track record of delivering work in this space.

“The reason we changed is that we’ve evidenced over those nine years that a voucher for incentivising you to be able to have more fruit and veg in your diet has a wide range of health and well-being impacts on families.”

He added: “We’ve seen the evidence, so we know that it works but we were only working with a more targeted audience. We know the rest of the population also has challenges around diet and nutrition, so the reason we are doing this is to show how it would work with people who have older children, who might be single, who might be of an older age, whose children have left home, and they might be suffering from long term health conditions; they might be suffering from mental health issues around anxiety and depression, and they’re also struggling financially.”

The charity is using baseline surveys to track how often participants consume fruit and veg, how accessible they are to them, and how they feel about their diet. The surveys will be repeated and compared in six months’ time and analysed to determine whether consumption of unhealthily has declined.

Residents in Tower Hamlets are also offered cooking sessions where they can learn new recipes and the skills to create healthy meals. Results from this will also be compared with its Lambeth cohort, which hasn’t expressed a similar need.

The project looks to expand beyond its year-long test but calls for support.

“We don’t want to walk away from this project but if the evidence is there that it works, I think that people will get behind it.

“We’re very happy to trail-blaze at the moment, but it would be great if the government wants to develop this type of work as well because there’s huge potential for it,” said Mr Pauling.

The project also benefits local traders. The vouchers cannot be used at supermarkets as this would detract from its charitable aspect.

“These guys own their own businesses, they’re out in the rain and snow and heatwaves, day in, day out, throughout the year, serving healthy food at the most affordable prices. Fruit and veg at a market are much cheaper than at a supermarket.

“That’s a significant part of our healthy food infrastructure that needs support, and that’s why we partner with them.

“But also, they understand the communities that they work in, so if you go into Tower Hamlets, the diversity of food you get there is much different than when you go to Brixton, and that’s because the market traders understand what the cultural tastes are of the local community.

“You get better diversity of produce in markets than you will at most supermarkets that you find around London,” Mr Pauling said.