People often deny having meant what the audience understood. Such denials occur in both interpersonal and institutional contexts, such as in political discourse, the interpretation of laws and the perception of lies. In practice, denials have a wide range of possible effects on the audience, such as conversational repair, reinterpretation of the original utterance, moral judgements about the speaker, and rejection of the denial. When are these different reactions triggered? What factors make denials credible? There are surprisingly few experimental studies directly targeting such questions. Here, we present two pre-registered experiments focusing on (i) the speaker’s incentives to mislead their audience, and (ii) the impact of speaker denials on audiences’ moral and epistemic assessments of what has been said. We find that the extent to which speakers are judged responsible for the audience’s interpretations is modulated by their (the speakers’) incentives to mislead, but not by denials themselves. We also find that people are more willing than we expected to revise their interpretation of the speaker’s utterance when they learn that the ascribed meaning is false, regardless of whether the speaker is known to have had incentives to deceive their audience. In general, these findings are consistent with the idea that communicators are held responsible for the cognitive effects they trigger in their audience; rather than being responsible for, more narrowly, only the effects of what was “literally” said. In light of our findings, we present a new, cognitive analysis of how audiences react to denials, drawing in particular on the Relevance Theory approach to communication. We distinguish in particular: (a) the spontaneous and intuitive re-interpretation of the original utterance in light of a denial; (b) the attribution of responsibility to the speaker for the cognitive effects of what is communicated; and (c) the reflective attribution of a particular intention to the speaker, which include argumentative considerations, higher-order deniability, and reputational concerns. Existing experimental work, including our own, aims mostly at (a) and (b), and does not adequately control for (c). Deeper understanding of what can be credibly denied will be hindered unless and until this methodological problem is resolved. These possibilities raise important questions about commitment and credibility in language use. What factors make denials credible? What kind of cognitive reactions do audiences have to different types of denial? Such questions are important not only because answering them would shed light on the cognitive processes involved in communication; but also because denials and strategic use of language have a pervasive role in our daily life, and its consequent influence in domains such as politics and the law.There is always a gap, however small, between what is linguistically encoded in a sentence and what is communicated by the speaker when using that sentence in context —as GriceThere are few experimental studies that directly target these issues, despite the important role that denials and deniability play in human interaction. Most of previous research on deniability and implicit communication consists of theoretical contributions, stemming from a widely spread assumption that denying what was implied should be more credible than denying what was explicitly expressed . Deniabi2 For instance, she might have been at the same time asking for the permission to go out with her friends. We hypothesised that if the audience is aware of these incentives, this will impact on the credibility of the denial, as measured by the interpretation and re-interpretation of utterances, and moral assessments of the speaker’s communicative behaviour. Our results are partially consistent and partially inconsistent with these predictions. We find that the ascription of the speaker’s responsibility is indeed modulated by their incentives to mislead their audience (§2). However, their denial did not make a difference. We also find that people are more willing than we expected to revise their interpretation of the speaker’s utterance when they learn that the ascribed meaning is false, regardless of whether the speaker is known to have had incentives to deceive their audience (§3). This pattern of results is consistent with the idea that communicators are held responsible for the cognitive effects they trigger in their audiences.Given the relative dearth of studies directly targeting audience reactions to denials, here we present two pre-registered experiments targeting the question of what cognitive effects denials can have (§2 and §3). We focus in particular on (i) the role of speaker’s incentives to mislead their audience, and (ii) the impact of speaker’s denials on their audiences’ moral and epistemic reactions. We adopted this particular focus because these are cases where speakers’ incentives to mislead their audience may be relevant factors in determining what audiences might infer. In particular, we reasoned that prior incentives to mislead the audience can provide background information that shapes the interpretation of a denial , and thuIn light of our results, we distinguish three types of cognitive processes that impact on how people react to a denial (§4). These are: (a) the spontaneous and intuitive re-interpretation of the original utterance in light of a denial; (b) the attribution of responsibility to the speaker for the cognitive effects of what is communicated; and (c) the reflective attribution of a particular communicative intention to the speaker, that is based on the evidence that one has to claim that that the speaker lied or intentionally misled their audience.Experiment 1 was designed to test the hypothesis that the audience holds the speaker responsible for the cognitive effects of their communicative act in view of their (the speaker’s) incentives to mislead the audience. When such incentives are present, the speaker’s denial should be implausible, and as such it should not mitigate their (the speaker’s) responsibility. Here, we operationalised responsibility as the social consequences that the speaker is called to pay in terms of moral blameworthiness.We reasoned that a mitigation of the speaker’s ascribed responsibility can be considered a reliable proxy for the audience’s acceptance of the denial, and in turn, for the presence of plausible deniability. Thus, we measured the speaker’s ascribed responsibility by asking the participants to rate the speaker’s blameworthiness for misleading the audience. If blame ratings were negatively affected or not affected by the presence of a denial, i.e., if participants would maintain or increase the severity of their blameworthiness judgement in the presence of a denial, that would suggest that such denial was deemed not plausible.We thus predicted that the speaker’s incentives to mislead the audience would cause an increase in their perceived blameworthiness. We also predicted that the speaker’s denial of the meaning the audience had initially ascribed to the utterance  would lead participants to blame the speaker with less severity if the speaker had no incentive to mislead the audience in the first place.https://osf.io/jkn57.The study was pre-registered on Open Science Framework, with sample size, planned analyses and participants exclusion criteria specified. The pre-registration document is available at via Amazon MTurk , and 11 additional participants were also included in the analysis since they completed the survey before we closed the survey collector. Being above the age of 18 was the only criteria for participant selection. Each participant provided informed consent before the experiment and were paid $0.40 for their participation. Participants who failed the attention check were excluded (N = 4), thus the final sample resulted in 507 participants : 252 participants were assigned to the incentive condition  and 255 participants were assigned to the no-incentive condition .A power analysis that was conducted with RStudio 1.1.463  by usingThe methods used in this and in the following study are in accordance with the international ethical requirements of psychological research and approved by the EPKEB  in Hungary.We created four different scenarios which followed the following structure:•Context part depicted a social situation between a speaker and a listener, and included information about the speaker’s incentives to mislead the audience: in the incentive condition, the speaker was described as having incentives to let their listener believe something, whereas in the no-incentive condition the speaker did not have any incentive or have disincentives to do so.•Dialogue part included the question of the listener about an event; the speaker’s response to the question was an utterance (X) which yielded an ascribed meaning (Y). The dialogue part was identical in all conditions.•Negation part included the information that the listener realises that Y is false. This part was identical in all conditions.•Denial part included the dialogue in which the listener confronts the speaker by stating that “I thought you said Y” and the speaker denied having meant that Y (ascribed meaning), and offered an alternative intended meaning (Z) for their utterance X: “I didn’t say that. I just meant Z”. Then, the denial part was present only in the denial condition.https://osf.io/bmqk4/.As suggested by 4 The factors were “incentives” (incentive vs. no-incentive) and “denial” . Participants were randomly presented with one unique scenario manipulated according to one of four different conditions: incentive and denial, incentive and no-denial, no-incentive and denial, and no-incentive and no-denial.Experiment 1 used a 2 × 2 between-subject design.If you were listener, how much would you blame the speaker for misleading you?” .After reading scenarios, participants responded to two questions: an attention check, which was a multiple-choice question designed to check the reliability of the participant’s answer, and a blame question, which was a 6-point Likert scale question designed to measure the moral reaction of the participant see . The attWe expected that both the “incentives” and the “denial” factors, as well as their interaction, would cause a significant effect on the moral reaction of the participants. We predicted that participants would blame the speaker in the incentive condition more than in the no-incentive condition, and they would blame the speaker less in the denial condition than in the no-denial condition. However, if the denial was not deemed plausible, as we reasoned would be the case in the incentive condition, we predicted that in the denial condition participants would blame the speaker more, or at least not less, than in the no-denial condition.5 Before the analysis, we thus checked the distributions of participants’ responses and detected such difference across scenarios.6 Thus, we added “scenario” as a random factor and switched to multilevel ordered logistic regression model that is a significantly better fit compared to a model with the intercept only, χ2  = 145.64, p < 0.001.In our pre-registered analyses, we planned to use an ordered logistic regression model to test our hypothesis and to include the “scenario” variable as a random factor in case the descriptive statistics showed different distributions of responses across scenarios.We ran our multilevel ordered logistic regression in Stata 17 . The resThe estimated odds ratio of prior incentives points out that participants tended to blame the speakers 1.858 times more (95% CI: 1.185–2.912) by rating higher when the speakers had prior incentives to mislead the audience. However, we could not observe any significant effect of denial on the participants’ rating level.Consistent with our prediction, our results reveal that participants’ moral judgements were sensitive to the speaker’s incentives: participants blamed the speakers for a false ascribed meaning significantly more severely when speakers had incentives to do so see . On the We assumed that ascribing responsibility to the speaker for having misled the audience, i.e., judging them as blameworthy, is mediated by an interpretation process about speaker’s meaning; and hence that when a denial is offered, the ascription of responsibility should be mediated by a re-interpretation process about speaker’s meaning . If an ascribed meaning is plausibly deniable, its denial should first lead to re-interpretation. We designed Experiment 2 to test the hypothesis that the speaker’s prior incentives to mislead the audience are salient contextual assumptions that might block the audience’s re-interpretation of the speaker’s intended meaning.interpretation question. The interpretation question offers two possible interpretations for what the speaker meant , with degrees of uncertainty. If the participants choose the ascribed meaning over the alternative meaning more frequently when the speaker’s incentives are present than when they are not, this would suggest that the speaker’s prior incentives affect the re-interpretation of what the speaker meant. Additionally, if the participants choose the alternative meaning more often when denial is present, but not when it is absent, that would suggest the denial was plausible. We hence predicted that when the speaker had prior incentives to mislead the audience their denial would not be deemed as plausible, and thus it would not lead to an update of the interpretation of the speaker’s utterance; whereas when the speaker did not have any incentives to mislead their audience, their denial would lead to a re-interpretation of the speaker’s utterance in favour of the alternative proposed.We measure perceived speaker meaning by asking participants an https://osf.io/jkn57.The study was pre-registered on OSF.io, with sample size, planned analyses and participants exclusion criteria specified. The pre-registration document is available at via Amazon MTurk . The only criteria for participants was being above 18. Each participant was asked for their consent before starting the experiment and was compensated with $0.40. We excluded data from participants who failed the attention check question (N = 38), resulting in 752 participants ; 370 in the incentive condition  and 382 in the no incentive condition .A statistical power of 95% with α = 0.05 was calculated by the “Basic Functions for Power Analysis (pwr)” package  of RStudTo maintain comparability with the previous study, we used the same four scenarios that were used in Experiment 1. However, contrary to Experiment 1, we additionally manipulated the negation part in order to isolate the effect of denial on re-interpretation. The scenarios followed the structure below.•Context part depicted a social situation between a speaker and a listener, and included information about the speaker’s incentives to mislead the listener.•Dialogue part included a question of the listener about an event; the speaker’s response to the question was an utterance (X) which yielded an ascribed meaning (Y). The dialogue part was identical in all conditions.•Negation part included the information about the listener realising that Y is false. The evidence that Y is false was present in the negation condition and absent in the no-negation condition.•Denial part included the dialogue in which the listener confronts the speaker by stating that “I thought you said Y” and the speaker denied having meant that Y (ascribed meaning), and offered an alternative meaning (Z) for their utterance X: “I didn’t say that. I just meant Z”. As in Experiment 1, the denial part was present only in the denial condition.https://osf.io/bmqk4/.Experiment 2 used a 3 × 2 between-subjects design. The factors were “incentives” (incentive vs. no incentive), “denial” , and “negation” (negation and no-negation). Participants were randomly presented with one unique scenario manipulated according to one of six different conditions: incentive and denial, no-incentive and denial, incentive and negation, no-incentive and negation, incentive and no-negation, no-incentive and no-negation.When [speaker] said utterance (X), did [speaker] mean ascribed meaning (Y) or alternative meaning (Z)?” .After reading the scenario, participants responded to two questions: the attention check, and the interpretation question, which was a multiple-choice question with five independent levels and designed to check which meaning is understood to be conveyed by the speaker, the ascribed or the alternative meaning, and with how much certainty. The interpretation question was the same for every scenario under all conditions: “We hypothesised that the speaker’s incentives to mislead the audience would impact the plausibility of their denial, thus we expected an interaction between the “denial” and the “incentives” factors. We further expected that the “negation” factor may have an additional significant effect alone on participants’ responses without the presence of the speaker’s denial. We thus predicted:•A significant effect of “incentives”: participants would choose the alternative meaning more often in the no-incentive conditions than in the incentive conditions.•An interaction between “denial” and “incentives” factors: participants would choose the alternative meaning more often in the denial condition than in the no denial condition, but only in the no-incentive conditions.•A significant effect of “negation”: participants would choose the alternative meaning more often in the negation conditions than in the no-negation condition.7 We ran two separate models with the same dependent but different independent variables for the ease of the analysis: (1) a denial model that included the “incentives” factor, the “denial” factor, and their interaction, (2) a negation model that included the ‘incentives’ factor, the ‘negation’ factor, and their interaction. In both of our models, we chose the “speaker clearly meant the ascribed meaning” level of dependent variable as our base category value. Both of our models improved their fit when we added the ‘scenario’ as a random effect and switched to multilevel multinomial logistic regression, denial model, χ2  = 5.28, p = 0.022, and negation model, χ2  = 13.30, p = 0.001. Additionally, both of our models fit significantly better compared to model with the intercept only; denial model, χ2  = 92.74, p < 0.001, and negation model, χ2  = 79.03, p < 0.001.To test our hypothesis, we pre-registered that we will use a multinomial logistic regression model to analyse a categorical dependent variable, i.e., participants’ responses to interpretation question in our model, with more independent factors, i.e., “incentives”, “negation” and “denial” factors.We ran both of our multilevel multinomial logistic regression models in Stata 17 . The resContrary to our prediction, the speaker’s incentives to mislead the audience did not affect participants’ interpretation of the intended meaning overall. No significant effect of “incentives” was found. However, the presence of denial did have a significant effect on the participants’ responses. This suggests that participants are disposed to think that they misinterpreted the intended meaning and to accept the alternative as the originally intended meaning. Thus, the denial model did not confirm our prediction regarding the effect of the speaker’s incentives on their re-interpretation process. Our results suggest that, as proposed by Also, as we predicted, when participants were provided with the information that the ascribed meaning was false, this affected participants’ assessments of the intended meaning see . The newCollectively, these results show that people are able and willing to retrospectively ascribe a different informative intention to the speaker. When presented with relevant information such as a denial or a negation of their ascribed meaning, the re-interpretation process occurs. Perhaps surprisingly, we did not find evidence that the interpretation and re-interpretation processes are sensitive to the speaker’s incentives to mislead the audience; participants were rather inclined to revise their interpretation in both situations.Our findings show that a satisfactory account of plausible deniability relies on disentangling multiple facets of audiences’ reactions to denials. In particular, the dissociation we observed between moral (§2) and epistemic (§3) reactions towards denials was unpredicted and is puzzling. While participants’ moral reaction have been found to be influenced by the speaker’s incentives to mislead the audience, but not by their (the speaker’s) denial, the opposite was found for participants’ epistemic reactions; that is, participants’ reported willingness to re-interpret speaker meaning was influenced by their (the speaker’s) denials, and other evidence that the initially ascribed meaning was false, but not by their incentives to mislead. In light of these findings, here we re-analyse deniability, making distinctions that have not been clearly made in the previous literature on the topic. These distinctions are inspired in particular by the Relevance Theory approach to communication and cognition e.g., , but couIt is essential to distinguish a communicator’s intended meaning from what could be called the “ascribed” meaning; that is, the meaning the audience ascribes to the utterance. Denials are statements from the communicator about how the meaning ascribed by the audience differs from the communicator’s intended meaning. Such mismatches between intended meaning and ascribed meaning occur all the time in ordinary communication, and humans have developed and use a wide array of mechanisms for “repairing” dialogue when this occurs . These iAt least three possible reactions should be distinguished. These are not mutually exclusive, and will in some cases co-occur with one another.a. Audiences may re-interpret the original utterance, potentially in line with the new interpretation offered by the speaker.I did not have sexual relations with that woman”, former US president Bill Clinton offered the alternative interpretation for which the definition of “sexual relations” was thought not to include the specific interactions he admittedly had with Lewinsky. Reinterpretations typically require increasing the saliency of some contextual assumptions that were neglected when the communicative act was initially produced. If the new alternative interpretation meets a better trade-off in terms of cognitive utility compared to the old interpretation, then the re-interpretation successfully occurs and the denial can be perceived as plausible  attributed on numerous contextual cues that might be harder to use as evidence in an argument about intended meaning. More generally, reasoning on ascribed meaning is likely to ensure that denials are accepted more often than not because of the widely shared intuitions that one has a privileged access to one own’s thoughts and intentions, and thus it is not possible to really know what others think —or that 8: Jordan Belford (Leonardo DiCaprio) implicitly attempts to bribe an FBI agent (Kyle Chandler) by stating “I’d do that [providing information about a millionaire stock trade] for anybody who needs a proper guidance.” Once confronted by the FBI agent, , Belford denies having had such intention . The FBI agent appears to hold the intuitive belief that Jordan Belford’s denial is implausible, maintaining the inferred informative intention of a bribe proposal , but at the same time may lack the confidence to publicly attributing this informative intention following Jordan’s denial, in particular in front of third parties—and indeed the immediate accusation of bribe is not acted upon . During the whole interaction, in any case, the FBI agent is clearly taking a moral stance against the broker , which is of course unaffected by his (Belford)’s denial attempt.These three possible cognitive reactions can be present simultaneously. Consider, for example, the famous yacht scene from “The Wolf of Wall Street”Existing experimental work, including our own, does not adequately control for judgements informed by reflective beliefs about possible deniability, i.e., possibility (c) above. In the two studies we have presented here, we investigated the effect of speaker’s denials and speaker’s incentives to mislead the audience on moral and epistemic evaluations. As we reported in §2–3, our results are only partially in line with these predictions. We suggest this may be because our experimental designs have conflated reaction (c) with either of the other two. Our intention was to target reactions (a), intuitive reinterpretation, and (b), responsibility ascription. However, we may have additionally triggered reaction (c), reflective beliefs, in particular argumentative considerations and participants’ judgements about possible deniability instead.Partly because we expected that epistemic and moral reactions would be consistent, we reason that the mismatch that we found between the reported re-interpretations and the ascriptions of responsibility may be due to the interference of such reflective beliefs. More specifically, we suggest that participants’ reported epistemic judgements (a) could have been conflated with other argumentative considerations (c). Such argumentative considerations would have prevented participants from engaging in an explicit accusation about speaker’s intentions. However, these considerations may have had less impact on participants’ moral judgements (b); or they may even have been consistent with such judgements. In fact, and regardless of their actual intention to mislead, the favourable outcome for the speaker  is good enough evidence for defending an explicit disapproval of the speaker’s incompetent behaviour.The difficulty of keeping these different reactions apart in experimental design is one that may have recurred in other recent research on deniability . Future The important general point is that plausible deniability involves strategic cognition for both speakers and audiences. The speaker attempts not to produce evidence to be accused of lying, while the audience assesses whether the speaker has or had the intention to mislead. Thus, while audience may modulate their (re-)interpretation of what is said in view of the speaker’s intentions, discussing a denial involves not only re-interpretation of the speaker’s informative intention, but engagement in discussion or argument about those intentions.; and since speakers can always claim privileged access to their own past intentions, the audience may strategically avoid this outcome. A good cognitive description of plausible deniability must account for these different processes.https://osf.io/jkn57.The datasets presented in this study can be found in online repositories. The names of the repository/repositories and accession number(s) can be found below: The studies involving human participants were reviewed and approved by United Ethical Review Committee for Research in Psychology (EPKEB). The patients/participants provided their written informed consent to participate in this study.FB: conceptualization, methodology, validation, data curation, writing – original draft, writing – review and editing, visualization, and project administration. FBB: software, validation, formal analysis, investigation, data curation, writing – original draft, visualization, and funding acquisition. TS-P: validation, writing – original draft, and writing – review and editing. CH: conceptualization, resources, writing – review and editing, supervision, and funding acquisition. All authors contributed to the article and approved the submitted version.


The Russia's military invasion to Ukraine has created a complex humanitarian emergency and the largest refugee crisis in Europe since World War II (WWII) . ComplexIn this field report author reflects on the experience of remotely responding to a humanitarian crisis in Ukraine to draw preliminary conclusions on prioritized MH needs, available resources, and the barriers to accessing care. Understanding what has gone right may serve as an important lesson for MH providers and humanitarian agencies when planning responses to aiding Ukraine and the future emergencies.Due to the ongoing armed conflict, verifiable data is scarce, it is hard to get, and many of my references are coming from personal sources, ubiquitous reports by my colleagues, and social media. Therefore, the results must be treated with caution. The situation in Ukraine remains politically complicated, and some responders chose against using their names.betrayal. Few believed in a real possibility of an attack on the neighboring nation which shares deep historical, cultural, religious, and family ties. Reports about filtration camps, war rape, and kidnapping of Ukrainian children were interpreted as unambiguous evidence of genocidal intent by the Russia's government  symptoms in refugees  were so prevalent and severe that, they invoked suspicion of poisoning. However, poison was ruled out by the International Red Cross workers, who suggested interpreting them as a stress reaction . GI streveterans , and alsveterans . For exaveterans .By the end of March, when the reality started sinking in, depression, stresses of resettlement, and worries about the future came to the forefront. People were grieving personal losses, the loss of homes, and life before the war. Mental exhaust, emotional numbness, indifference, and disregard for their own lives, was seen in the refusals to go to shelters or to relocate to a safer place. Some struggled to control anger and rage. Increased irritability and family conflicts undermined family supports at a time when they are most needed. For many, the experience of fleeing and being separated from their family members was extremely traumatic especially when they had to make the decision about leaving behind enlisted men or frail family members.Many children have witnessed shelling, destruction, and killings; some have been wounded, have lost, or been separated from their parents. Others witness to rape and torture. Parents reported to me and other providers the worsening of the conduct, traumatic attachment problems, and behavioral regression, i.e., acting younger than their age. Usually quiet and obedient children could become either clingy or defiant and act out an uncontrollable rage and anger, physically attacking their parents or peers. Other children presented with emotional detachment: they appeared “eerily quiet and apathic.” There were numerous reports of reoccurrence of enuresis in older boys and girls .More recently, psychosocial providers have noticed that somehow people “are getting used to the war,” and chronic or preexisting psychological problems such as family discord or problematic drinking have started to (re)surface .As it often happens during humanitarian crises, persons with special needs are especially vulnerable . They haEven with the extensive help of volunteers, the elderly, chronically ill, or persons with physical or mental special needs often were unable to relocate, access the health care, medications, and meet other basic needs. Some stayed behind because they were afraid to leave their familiar surroundings or did not want to be a burden to their family. They were not able to receive lifesaving medical treatment and have been suffering and dying of preventable causes.Russia's aggression has left citizens of Ukraine shocked and traumatized. It has also highlighted their resilience and strengthened national cohesion. Many named family, cultural values, faith, and their love for Ukraine as main sources of strength and inspiration for perseverance.memories of surviving WWII have been helping Ukrainians to survive the current war: elders, for example, have been teaching younger generations how to recognize the sounds of shelling, how to know when the danger is over, and where to find the safest places to hide.The widespread psychoeducation increased the public's awareness of MH needs, educated about psychological trauma, and sensitized the public to recognizing trauma reactions. It helped raise awareness and destigmatize MH issues and formed a demand for trauma services.In recent decades Ukraine has accumulated many well-trained MH professionals and crisis workers. A the spirit of volunteering has run exceptionally strong. Sometimes risking their own lives, volunteers have been checking on those in need, delivering food and medications. After relocation, refugees have immediately started volunteering themselves and sharing their resources. Many of those who earlier fled Belarus and Russia to escape political persecution have been helping with transportation and language services, babysitting, and connecting with health care.In Ukraine, The initial MH response was marked by frantic and at times chaotic efforts by overworked MH responders to meet as many needs as possible. But only 2 months later, we saw an entirely different landscape in MH services provision. Although the systems of psychosocial support still face challenges, the professional community in Ukraine was able to come together in a very short time, overcome their differences, self-organize, and take charge in coordinating MH response, requesting specialized training and professional assistance when needed.MH and psychosocial support providers in Ukraine, often traumatized and lacking safety themselves, have stepped in to provide psychological support and psychoeducation about coping with extreme stress and severe trauma. They have been bearing witness, advocating for the needs of the people they serve, and raising their voices against the war. The overall response to this humanitarian crisis has demonstrated the strong commitment of Ukrainian MH providers to their professional mission. This self-determination and the capacity to self-organize in response to pressing humanitarian needs indicates the maturation of a helping profession and helps to cement its role as an integral part of society.A tremendous amount of work has been done, and a lot has been accomplished, but many barriers remain. Finding bilingual resources has been a sensitive issue. Although the Russian language is commonly spoken in Ukraine, the war has understandably made a trigger for some Ukrainians.Despite the widespread use of social media, many have not been aware of the available psychosocial resources or how to access them; vital information is spread mostly by word of mouth.Ukrainian health and MH care systems had been functioning well-before the war. These systems were able to cushion most needs, but the availability of facilities, medications and logistics were compromised by the war.Services offering has remained fragmented. Fragmentation in is an affliction that has traditionally hindered the effectiveness of humanitarian response. It adds to confusion, makes it difficult to navigate the system, and reduces efficiency in accessing scarce resources .Emerging technologies have transformed MH response to this emergency.Accelerated digitalization of services during the COVID-19 pandemic has provided an unexpected advantage and expanded the access to MH practice and education. Telemedicine has allowed providing MH services remotely to communities that are otherwise difficult to reach, that are dispersed, or where it may not be safe to travel.Immediately after the invasion, the biggest challenge was connecting those in need with the providers. Almost instantaneously, existing virtual chats and support groups started accommodating requests from Ukraine and new ones started emerging on Telegram and Facebook. They aimed at real-time matching of on-site needs with local and remote resources. In these designated channels, anyone with war-related MH problems could post about their urgent needs, and self-appointed MH providers from different backgrounds – and often residing in different countries – would respond to these inquiries in real time.https://www.facebook.com/groups/myrazam.info/). This model has proven itself useful in the aftermath of the invasion in Ukraine. Examples include: СвітлоЧат – Психологічна допомога українцям під час війни , and Психологическая помощь Украина .The 2020 political crisis in Belarus led to the emergence of self-managed self-help chat groups. They have continued offering their capacity, MH resources, and the services to Ukrainians in need  and GotoHelp (https://gotohelp.eu/). Although promising, further research into these innovative practices is needed before recommending their broader implementation.Absent centralized guidance and often traumatized and unsafe themselves MH professionals in Ukraine have assumed responsibility for the psychological well-being of the community. In addition to providing care for the victims of atrocities, they have taken a lead in organizing community support and have become an inspiration and a driving force in shaping community resilience and recovery.The response in Ukraine has demonstrated that public awareness of the psychological effects of trauma has strengthened community resilience and significantly reduced stigma of reaching out for MH help.Lessons from this response underscored the importance of increasing trauma and Psychological First Aid competencies for MH and psychosocial providers, teachers, health care workers, and volunteers.Many who most need aid will not reach out . The comThe presence of the advanced health care systems and well-trained medical and MH cadres in Ukraine created unexpected challenge for humanitarian medical and psychosocial aid agencies. It highlighted the shortcomings of the traditional giving-receiving model based on the inherently in-built power differential . New modInternational professional community shall prioritize supporting local MH providers, which includes funding and technical support. In the spirit of humanitarian accountability, it is important that determination of the priorities, scope and scale of relief efforts is established in closed consultation with local providers who are to lead the response . The valIt is never too early to think about the future, even while war rages on. Although wars don't last forever, they do manage to sever communal, family, and professional ties. When the world is divided, MH professionals can play a key role in reminding both sides about humanitarian values, compassion, and caring—essential to building a peaceful future. Only then is there hope for a violence-free future.The author confirms being the sole contributor of this work and has approved it for publication.The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.


To explore and provide contextual meaning around issues surrounding food insecurity, namely factors influencing food access, as one domain of food security.A community-based, qualitative inquiry using semi-structured face-to-face interviews was conducted as part of a larger sequential mixed-methods study.Cayo District, Belize, May 2019–August 2019.Thirty English-speaking individuals  between the ages of 18–70, with varying family composition residing within the Cayo District.Participants describe a complex interconnectedness between family- and individual-level barriers to food access. Specifically, family composition, income, education and employment influence individuals’ ability to afford and access food for themselves or their families. Participants also cite challenges with transportation and distance to food sources and educational opportunities as barriers to accessing food.These findings provide insight around food security and food access barriers in a middle-income country and provide avenues for further study and potential interventions. Increased and sustained investment in primary and secondary education, including programmes to support enrollment, should be a priority to decreasing food insecurity. Attention to building public infrastructure may also ease burdens around accessing foods. Globally, one hallmark indicator of food insecurity is undernourishment. Undernourishment, as one form of malnutrition in children, can lead to underweight, wasting and growth stunting. Longitudinally, these can lead to increased risk of metabolic and CVD in adulthood, decreases in cognitive ability and reproductive performance, and intergenerational health and economic consequences,5. Common mental disorders, such as anxiety and depression, have also been linked to food insecurity,7. Due to the devastating nature of these consequences combined, the FAO and affiliated organisations have established ending hunger, achieving food security and improved nutrition, and promoting sustainable agriculture by 2030 as one of the Sustainable Development Goals, Goal #2 End Hunger. One target of this goal is to ‘ensure access by all people, in particular the poor and people in vulnerable situations, including infants, to safe, nutritious and sufficient food all year round’.Food insecurity is uncertain availability or access to high quality, nutritious food, as conceptualised by the FAO’s Food Insecurity Experience Scale, and the prevalence of child stunting has held steady at 15·0 % between 2015 and 2018,9. Stunting has decreased but still remains above other Central American (12·9 %) and Caribbean nations (8·3 %). At the same time, the prevalence of overweight in Belizean children (7·3 %) is higher than other Central American (6·9 %) and Caribbean nations (7·0 %),10. In the adult population, diabetes (17 %) and obesity (22·4 %) are prevalent. As such, Belize experiences a double burden of malnutrition,12, but may also experience the so-called ‘Obesity Paradox’, which suggests that food insecurity can increase risk of obesity due to reliance on low-quality, highly processed foods that are often cheaper than healthier options,14.Food insecurity can result in both undernourishment due to lack of access to food and overnourishment because of reliance on cheap, calorically dense foods. In Belize, the prevalence of child undernourishment remains higher than other Central American countries. Though Belize classifies as a middle-income county, over 40 % of the population lives in poverty, and 15 % lives in extreme poverty,16. Belize experienced two major economic slowdowns between 2006 and 2011, coinciding with a rise in the prevalence of undernourishment in the population. A 2016 FAO report estimated Belize’s ‘moderate or severe food insecurity’ prevalence (eating less than should due to lack of money or other resources) at 28 %, and approximately 9 % of this group experiences ‘severe food insecurity’ (going an entire day without eating due to lack of money or other resources),18. One recent study indicates that food insecurity in Belize is significantly related to education level. This is consistent with documentation that suggests that education is a major factor worldwide. However, research on food insecurity in Belize is very limited, and there have been no studies to our knowledge that have involved a thorough exploration of factors related to food insecurity in Belize. For this present study, we conducted a qualitative inquiry in the Cayo District, Belize, to provide an in-depth, contextually rich description of issues leading to and arising from food insecurity. These findings will inform a discussion at the broader environmental and policy levels in Belize and to aid in development of tailored intervention strategies that will ease subsequent health issues.Less developed countries tend to have higher levels of food insecurity. As a follow-up, this present study sought to provide contextual meaning around food security issues in Belize. Thirty in-depth interviews were conducted with Belizean residents of the Cayo District.This qualitative inquiry, conducted in 2019, is the second phase of a larger community-driven sequential mixed-methods study and builds upon the findings from a cross-sectional community-based survey distributed in the Cayo District, Belize in 2017The Cornerstone Foundation, a Belizean non-governmental, community-based organisation, initiated this study in 2017 to understand more comprehensively needs around food among the community and individuals they serve. The Cornerstone operates as a humanitarian and social service organisation, primarily in the twin towns of San Ignacio and Santa Elena, though its service area extends to the entirety of the Cayo District. With its mandate to protect and care for vulnerable children, one of the Cornerstone’s primary services involves providing hot lunches for local school children; however, this organisation also operates a food pantry from which it feeds hungry families, seniors and individuals facing homelessness or substance abuse issues. With the bulk of its programming focused on supplementing food to those facing food insecurity in its community, Cornerstone staff partnered with an Oakland University faculty member, who has an ongoing working relationship with the organisation, and Oakland University Master of Public Health students to investigate food security issues in its service area.Participants were recruited using word-of-mouth snowball sampling with the use of a financial incentive equivalent to $20 USD. Word-of-mouth recruitment started with Cornerstone staff as the key informants and dispersed into their social networks and into the community of people they serve. All interviews were conducted in English, lasted approximately 15–30 min, and were recorded by a student who was working with Cornerstone during a practicum placement. Potential participants were provided the contact information of this student at Cornerstone, and willing participants, aged 18 and older, who were food gatekeepers (responsible for food purchasing and food preparation) made interview appointments at the Cornerstone office or other public locations, such as businesses or the local market. Data collection took place until participants repeated similar ideas, and no new themes were emerging from interviews, thus achieving data saturation. and was designed using select models of health behaviour theories to elicit responses rooted in these theories, namely the Health Belief Model, the Social Cognitive Theory and the Theory of Planned Behaviour. In building upon previous work, these three theories support a line of questioning around perceived barriers, self-efficacy and perceived behavioural control to provide additional insight into factors affecting food security and food access. The primary prompt for the food availability section read, ‘Tell me about your food’. Each question had optional follow-up questions depending on the loquacity of the participant . The food access domain contained the questions, ‘What things make it easy or hard for people in your community to get access to healthy food?’ and ‘What sort of foods do you and your family prefer? Are you able to eat those preferred foods? Why or why not?’ This domain contained questions that were geared to reveal any potential perceived barriers and facilitators to food access, reflecting a component of the Health Belief Model and the Theory of Planned Behaviour. The food utilisation section asked participants to describe their typical individual or family meals, foods they choose to purchase and methods of food preparation in addition to inquiring whether participants felt in control of eating healthy. This question of control was intended to reveal participant self-efficacy and perceived behavioural control for healthy eating and is rooted in the Social Cognitive Theory and the Theory of Planned Behaviour.As this research was part of a larger sequential mixed-methods study, formative work was conducted to develop the interview guide and overall protocol. Through cognitive interviewing and in a participatory fashion, Cornerstone staff and several community members reviewed and revised the interview guide to ensure cultural appropriateness, relevancy of topics and high face validity of questions. The interview guide structured three of its domains – availability, access, and utilisation – to mirror three components of food security. An interdisciplinary four-member team with backgrounds in public health, health behaviour, nutrition, social work and nursing conducted a thematic analysis through a process of manual coding. Each member read all transcripts and generated initial codes across a series of three identical transcripts, using a blended approach of inductive and theoretical coding. For example, some codes and themes were generated without an existing coding framework, similar to grounded theory where themes are generated from the data themselves, while other codes and themes were linked to theoretical frameworks . Codes and potential themes were discussed among members, and two members then (re)coded and collated codes into themes across all interviews. Members continually reviewed and revised codes and themes as a group until agreement was reached. During the overall coding process, Cornerstone staff occasionally provided more context around a code or theme, for example, describing distinct educational costs associated with levels of attendance at different schools in the Cayo District. A conceptual model of themes was generated to describe food access and security in the Cayo District  family composition and individual-level barriers, (ii) income, (iii) education, (iv) employment and (v) issues involving transportation and distance to foods see Fig. . Overall‘….when there’s too much members, too much siblings in a family, like for example in my family we are 14 kids and a single mother. And, uh, my mom had to, you know, work three jobs and it’s still not enough to feed the kids, so I would say a little bit of poverty in our community and the lack of not having both parents sometimes. It’s a part of the stress that it creates when you can’t bring enough food for the children or the children would not eat enough, because of the shortage of food that they have.’ Though participants were not directly asked about their family composition, the theme of family makeup emerged, especially having a large family with many children, as a factor in accessing food. Some individuals had households with a significant number of children in the family, while others were led by a single parent or had only one working adult in the household. In nearly all instances, family makeup was tied to being able to afford food and provide for everyone in the household. This illustrative quote describes this phenomenon:‘One family, I would say is the family across from my house, my neighbor. They lost their mother last year, last October, and she left behind two small kids and their fathers, both of them drink, yeah. So, mostly we are the ones that get to feed them. It’s really unfortunate because there’s one that don’t have that support in the family.’ In the case of single parenting or having a single provider in the family, participants described different circumstances that led to difficulty in accessing food. For example, some families experienced the death of a parent which influences the care of children:‘But right now, like I tell you, my husband go to jail, so I no buy food for them [the children]. But if there’s somebody that come and give them, yes….we eat it. We don’t pick, because we don’t have enough to pick and choose, so what they give us, we eat it….’ Other families have experienced the incarceration of a parent and provider, influencing not only food purchasing but also food preference when they are left with little choice due to lack of money:‘You know, some of these teenage girls that are mothers, like they don’t have any assistance from the father of the child, you know, because of so many issues going on’ Some households have experienced difficulties due to lack of assistance from one parent, which then compounded difficulties in accessing food:‘Some people don’t have the money to buy the food, because, some people are really, really poor, poor. They can’t afford food.’ A consistent theme around income and financial status appeared among interview participants influencing their ability to afford food. Some participants recognised that there are people in their community living in poverty which makes food access difficult in general:‘Here in our country we work for little, a minimum wage, and when we go to buy, it’s too high for us. It’s why we can’t afford like everything.’ Participants expanded on this and recognised that many people work for little wages, thus making it difficult to access foods:‘A lot of people live in the poor class of society in Cayo and in Belize on a whole. So is it more of the income. Housing has become a little more expensive that it was. Utilities have become a lot more expensive. Even gasoline and fuel has become very expensive in Belize. So, it is the income.’ Others cited increasing costs of living in Belize around services and goods as a contributing factor of poverty and food insecurity:‘The income of the family is not enough and the prices are high…Everything here has tax. And the tax is too high. And the income is low.’ Many participants overwhelmingly went on to discuss taxes on foods:‘I don’t eat them [fruits and vegetables] daily, which is kind of sad but I do enjoy fruits a lot, but I cannot afford them, but they’re kind of like, they’re kind of pricey.’ Additionally, there was some differentiation among participants in the ability to afford food that they preferred:‘Okay, I do not provide for her [my daughter] as often as I would like. I would say two Fridays out of the month, we do not eat until nighttime after my husband gets his pay, because it isn’t enough with the rent and the bills and things….So, sometimes I have to cut back from me, so I could have for her to eat….’ Some individuals also expressed how the inability to afford foods, or running out of money between paychecks, leads to meal skipping, cutting back on food between paychecks and ultimately food insecurity:‘the lack of um education, because if you’re not educated, now you can’t have a job. At first, you could get a job easily just by your experience, but now they call more the education level, so sometimes the kids don’t have education, but they have to work more hours to have more money to buy food for the family…’ Education and access to education for children, in general, were also frequently mentioned themes, tied to future employment opportunities and higher income levels, which influenced ability to access and purchase foods:‘There have been families in my community that I’ve seen that some of them, some of the kids, stop going to school, because the parents have no money to send them to school, and so they stop going to school, and they start selling goods on the street.’ Participants noted that some families cannot afford the cost associated with school, including tuition and supply costs, resulting in dropout and limited employment opportunities:‘Some people don’t have food to feed their kids to send them to school, so they don’t really want to send their kids on empty stomachs to school. And they, I would say, the bus fare to go to school. Sometimes, they don’t have that, too. Participants also mentioned that some families cannot afford to feed their children either before or at school or pay for bus fare costs associate with travel to and from school:‘And because like here, if you don’t have, even if you have a high school diploma, if it’s not a well-recognized school or a religious school, they look at it as just a piece of paper, like literally. Because then you have, uh for example [name of local school]. That’s a very good school, a religious school. And then you have um, I’d say [name of school in Belize City], I’m comparing to a school in Belize City. You know, if I came from [school in Belize City] and somebody else came from [local school] and we went to apply for a job, best believe that other person will get that job, not me.’ Furthermore, participants mentioned that there is a perception around reputations of schools throughout the country and how attendance at different schools can influence hiring opportunities:‘They’re [the government] not injecting capital into human resource, where people can get a better education at a more affordable cost, and they could become an asset to society in the future.’ Participants also noted that accessible and affordable education, supported by the government, is important to a society:‘There is enough food, but there isn’t enough people who have the money to buy the food, because we have a lot of people that don’t have access to jobs.’ Interview participants consistently discussed employment opportunities in Belize, citing various difficulties with gaining employment, and thus being unable to purchase foods. For example, in general terms, participants stated that there were not enough jobs available:‘There’s not enough jobs. So, I believe that we Belizeans, we live with what we have. If we have a job, we try to do our best, and we try to keep what we have, because it’s very hard to get a lot of jobs. We have lots of foreigners coming and they will do work for a lower price. And we Belizeans, that’s the reason that the Belizeans are not getting the jobs, because the foreigners come, no? And they get the job, because [they work for less].’ Expanding on this, one participant described difficulties getting jobs due to migration into Belize:‘Sometime you have to work hard and when you go to the store, the things [are] expensive. Sometimes the money not enough to buy foods. And that’s $12 for a whole chicken and need the rice. So, I see it hard like that.….it’s hard to get a job.’ Additionally, some participants described how jobs that are available do not pay enough to purchase needed food because prices are high:‘….majority of the people in Belize here does not have jobs to support the family, so the foods are expensive…there’s a shortage [of jobs]…. Because we sometimes don’t have the…get the education. Like we don’t have. Belize you have, like most of the jobs you have here is more for people who went through college, and so maybe this is a poor country and majority of the children here don’t get that education and to go to finish college and get a job like that.’ Tying multiple challenges together, individuals discussed how they were unable to get jobs because of the difficulty in getting an education, ultimately, resulting in being unable to afford foods:‘lot of people in Cayo—myself included—live very far from the market and there’s only really one major market and that’s here near to us, where we are right now. People have to come all the way from the villages, and travel all the way on buses or even bicycles. Sometimes we walk all the way down here just to get food….I would say the pricing is good, but the consistency isn’t especially on the weekends where there probably are only two buses that run for a day, or three at max…For those persons who can have a ride, a lot of people hitchhike. A lot of people ride their bicycles and that’s a long, long journey…If you have a vehicle it’s easier, but most people don’t.’ Though all participants were residents of the Cayo district, there was a divergence between participants on issues around transportation and distance. For those living in the villages farther from the two major city and town centres (Belmopan and the twin towns of San Ignacio and Santa Elena), there were major issues in accessing foods as the majority of individuals rely on public transportation (buses or taxis) or bicycles:Okay, right now they at this point in time, there are more buses than there were like, let me see, four years back maybe. To Santa Familia you get like a bus every hour. There’s a bus every hour. They go as far as Spanish Lookout…But, to the villages like rural villages, for example Cristo Rey and San Antonio, it would be more difficult for people, because there would be maybe one hour they only three schedules for the day. So, if you don’t really catch that bus at one, you have to catch the other one ‘til about three o’clock…’ Though bus scheduling seems to have improved in recent years, individuals expand on the difficulties in accessing transportation to outlying villages around the major market:‘some of them live very, very far. Way in like bushes…we have to go all in those bushes, sometimes like little, like little roads to reach…Because I think maybe it’s too far or maybe it’s because the roads are bad, and one time even when we went back there, we just got stuck in the bus. The bus got stuck in the big hole with muds right there. We had to stay there ‘bout an hour trying to get it out. Then we were nowhere that had service for phone, nothing. We were like stranded ‘til we got it out.’ For the majority that do rely on public transportation, rough travel on unpaved roads is a challenge:‘some of them don’t have access to transportation to get to these places. For someone that’s working, $2 isn’t much for a cab, $2 isn’t much. But for someone that’s not working, it’s very expensive, because in the city, the shuttle is a dollar, right, but they don’t have any dollar buses here, you know. So, it would be much harder.’ Additionally, the expense of paying for transportation is another burden for individuals:‘Yeah, some of them, the kids live very far out and maybe lunch time, they cannot go home for a lunch, because early in the morning, they have to get a bus bring them to school. Then at like 3:30 when they come out, they have to catch that bus to go back home, because they don’t have money to pay a taxi and they live far, like out in the, like some of them live in the bushes.’ Compounding difficulties with transportation in general, families with children experience financial and logistical challenges for their children travelling back and forth for school and lunch recess, as one individual described:‘we are walking distance from the market, so we would go down to the market and buy whatever we’re going to use for the day, and that’s the way we eat. We eat the freshest of vegetables that we could get.’ In contrast, for those living closer to the city or town centres where the main markets are located, described the ease of being able to walk to the market:. Individuals highlight a complex and nuanced interplay of individual- and family-level barriers to food access, which ultimately drive and contribute to food insecurity. While these concepts are presented separately in the results, the conceptual map generated through group coding and thematic analysis shows the interplay between these barriers and their contributions to food insecurity.To our knowledge, this qualitative study is the first to provide contextual meaning around food security in the Cayo District, Belize, building from our previous quantitative findings and underscoring the importance of engaging in mixed-methods research,3. Participants indicate this is widespread and not localised to a small group of individuals, which is supported by income data in Belize. Poverty and its relationship to food access has been shown to be significant driver of food insecurity. Exacerbating this are unemployment rates within in the Cayo District (13·6 %), which experiences the highest rates of all districts, compared to nationwide rates (9·4 %).In this present study, individuals cite difficulties affording food, having to stretch food among family members or missing meals until the next paycheck due to these various individual- and family-level barriers, all of which are hallmarks of food insecurity and highlight the complexity of family composition and its contribution to food insecurity and malnourishment in a household–33. Additionally, single-parent households, particularly female-led, experience additional burdens and greater vulnerability,33. Family size in Belize is typically larger than family size in other Central American and Caribbean countries which may contribute to difficulties in accessing food. Specifically, family sizes in the Cayo District, especially in the rural areas, are larger than most districts, though these numbers are slowly decreasing.Though not specifically asked, nearly every individual placed family composition within the interaction between employment, income, and education and their broader relationship to food security. These qualitative findings complement previous findings. Belize’s primary educational system (approximate ages 6–13) is compulsory and supported by public funds; however, there are significant fees associated with attendance. Both large and small families often struggle with paying fees and it is common for children to drop out before completion,37. For children who can complete their primary education, families are then faced with significant burden of paying for secondary education, which is not free. Approximately 40 % of children aged 13–16 years in Belize do not attend secondary school, thus reducing employment opportunities and long-term earnings. Specifically, the Cayo District has the highest proportion of children (30 %) not attending school. Often, these children will not have necessary skills or meet employer educational requirements for hiring or advancement in many industries.Compounding these matters, participants emphasise a troubling issue around access to education which is known to drive employment opportunities, earning power, and ultimately, food security. Contrary to what so many other countries face in gender disparities around education, this offers some long-term hope in Belize that women will go on to tertiary schooling and have greater standing in higher paying jobs. Women with higher educational levels also tend to have smaller families which allows them to invest more in each child,39. Additionally, women with higher nutritional knowledge have been linked to fostering a healthier home food environment,40, since women and mothers are usually responsible for family meal preparation and food purchasing as food gatekeepers–43. Certainly though, aligning with the United Nations Sustainable Development Goal 4, equitable and inclusive educational investment for all children and young adults will be beneficial in Belize to create a more qualified workforce and informed population. A focus on developing a more robust scholarship system or pay-gradient scale for tuition, while also investing in a national school-meal programme, would significantly ease burdens on multiple fronts for families.Though study participants, who were primarily women, emphasised challenges around access to education and its relationship to food access, they did not describe gender differences in access to education. This is supportive of data showing that Belize experiences gender parity in primary schooling and recent favouring towards girls in secondary schooling. For those living in the town centre area, walking is readily accessible. However, for people living farther out, transportation challenges arise. Belize has several bus companies that operate in each district, but, as participants mention, routes are designated to main roads and run on limited schedules. Travel on rough roads makes a trip incredibly time consuming or nearly impossible, particularly during rainy season, when roads are muddy and bridges are washed out. Additionally, climate changes and recent climate events have been shown to have catastrophic impacts, resulting in areas being completely cut off from transportation and food deliveries and people fleeing and losing their homes. The challenges around transportation and distance that our study participants cite are not unlike what other communities in the region face, and until there is considerable investment in public infrastructure, like road and bridge building and flood management, these challenges will persist–48.This study confirms our earlier notion that transportation and distance to food sources and schooling are a significant contributor to food access and overall food insecurity in the Cayo District. School closures have severely impacted learning opportunities and access to school feeding programmes for thousands of children. We believe the COVID-19 pandemic has only exacerbated issues described here and recovery will take years. Continuing this line of inquiry to understand the extent COVID-19 has impacted individuals and the food landscape in Belize will inform future economic and policy decisions.Data from this study were collected before the COVID-19 pandemic and our intent was to provide contextual meaning around food security. The pandemic has severely decimated the tourism industry in Belize that, for many, provides income and job opportunities. With mandatory lockdowns and travel restrictions, like what most countries have experienced, unemployment rates have soaredThere are several limitations to this study. First, interviews were conducted in the town’s centre, and therefore, we did not adequately gain perspectives from individuals living out in the rural villages beyond access to public transportation or within a reasonable walking or bicycling distance to the towns’ centre. We suspect these individuals experience even greater challenges around food security. Second, all of our participants were English speakers; therefore, future studies should be carried out with Spanish-speaking populations also, or individuals living in the Cayo District who are immigrants from other Central American countries. These individuals may be more at-risk for food insecurity.The findings of this study provide contextually rich descriptions of issues contributing to food insecurity among individuals in the Cayo District, Belize, namely individual- and family-level barriers to food access. Through group coding and thematic analysis, we have generated a simple conceptual map that describes barriers to food access and food security. Immediate attention to developing more robust educational scholarship and financial support systems would improve the situation on multiple fronts for individuals and families. Not only would it encourage attendance for children at school, but it would also impact and reduce other barriers that affect food security. Additionally, investment in public infrastructure would lessen transportation burdens to access food. However, future work is needed to explore Belize’s rich and ever-changing cultural, political and economic situation, both pre- and post-COVID-19 pandemic. Understanding these systematic challenges can help to situate the country in terms of population-level food security and provide avenues for change.