Taking the long view: The shifting impacts of food aid on mental health over time, and the implications for mental health governance

We draw on in-depth qualitative longitudinal research with 62 people using food aid to explore the impact on their mental health, identifying multiple ways in which food aid organisations both support and damage mental health. Organisations adopting an inclusive and democratic approach, in which barriers to entry are low and opportunities for social contact and support are prioritised, are most beneficial to the mental health of service users. Nevertheless, the scope for positive impact is markedly lower among service users with pre-existing mental health conditions. We find that experiences can vary markedly longitudinally, with deteriorations and improvements in people's mental health over long time periods connected to their experiences of food aid. We ask a – sociological – question concerning contemporary responsibility for mental health amid state retrenchment and the growing importance of food aid in a pluralist welfare landscape. Utilising the concept of biopower, we show how food aid services embody responsibilities for mental health that previously primarily belonged to the state. The scope for organisations to wield power over hunger and mental health is, however, ultimately constrained by diminishing organisational resources. Methodologically, our evidence underlines the value of longitudinal approaches in illuminating the variable and situated nature of lived experiences, and illustrates the importance of exploring lived experiences of different models of food aid. While some food aid organisations may offer social connection that is beneficial to mental health, food aid is no replacement for a fit-for-purpose mental health system and social security which protects people from poverty.