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

A man who came to the hospital for suicidal thoughts revealed he had recently lost his eligibility for the Supplemental Nutrition Assistance Program, or SNAP, due to a missed documentation deadline. This loss forced him to rely on whatever food he could find, eventually leading him to seek help at the hospital instead of considering more drastic measures. His experience highlights how recent policy changes affecting both Medicaid and SNAP are worsening the connection between hunger and mental illness. The patient's situation is not unique. As a clinical dietitian at a large urban hospital, I regularly coordinate with social workers and physicians to ensure patients receive adequate nutrition and access to food resources. My work often involves connecting individuals with programs such as Meals on Wheels, local pantries, and assistance with enrolling in SNAP. Food insecurity does not end at the point of discharge, it follows patients home, complicating their recovery and overall well-being. Food insecurity and severe mental illness share a complex, bidirectional relationship. A 2023 systematic review published in the Journal of Psychiatric and Mental Health Nursing found that adults with schizophrenia, bipolar disorder, and major depression frequently experience food insecurity. These conditions are common among inpatients on psychiatric units. In 2025, PLOS Mental Health published research showing that food insecurity can directly cause anxiety and depression, not merely correlate with them. An analysis of over 2,300 emergency department patients at a major urban public hospital found that those facing food insecurity were significantly more likely to visit the ED multiple times annually, with anxiety and depression playing a key role in this pattern. This reality is familiar to those working in psychiatric wards over the past few decades. However, the situation is deteriorating due to new federal policies. The One Big Beautiful Bill, signed on July 4 of last year, reduced Medicaid funding by $863 billion over ten years. The Congressional Budget Office projected that 10 million people would lose coverage directly as a result. SNAP also faced substantial reductions, totaling $295 billion. Additionally, work requirements for SNAP now apply to individuals up to age 64, compared to 54 previously. New documentation rules for Medicaid eligibility redeterminations require updates every six months instead of annually, increasing administrative burdens and potentially pushing eligible individuals off the rolls. The American Psychological Association warned that these cuts will "disproportionately damage access to behavioral health services." Medicaid covers a quarter of all behavioral health spending in the U.S., and its enrollees are more likely to suffer from behavioral health disorders than those with private insurance. There is no equivalent replacement for Medicaid in the legislation, leaving many without essential coverage. The impact of these cuts extends beyond individual cases. One in five patients visiting emergency departments screen positive for food insecurity across multiple urban studies. Unstable blood sugar levels and medication noncompliance become more prevalent among those struggling to afford basic necessities. The interplay between hunger and mental health creates a cycle that is difficult to break, especially when critical safety nets are being dismantled. These developments underscore the growing strain on healthcare systems already stretched thin. Without robust support for both physical and mental health, the consequences for vulnerable populations will continue to worsen. The challenge lies not only in addressing immediate needs but in rebuilding systems that provide long-term stability and resilience.