["Journal of School Health, Volume 96, Issue 7, July 2026. ", "\nABSTRACT\n\nBackground\nYouth mental health problems are rising nationally. Virginia ranks among the lowest states in youth mental health access and has concentrated pockets of food insecurity (FI), underscoring the urgency of policy responses. FI is a known risk factor, yet surveillance often relies on single‐item measures. We introduce a multidimensional Food Insecurity Index (FII) to examine associations with adolescent mental health.\n\nMethods\nWe analyzed 2023 Youth Risk Behavior Surveillance System data from Virginia (n = 1866) and the United States (n = 10,724). The FII combined five indicators capturing acute scarcity and chronic dietary compromise. Survey‐weighted logistic regression estimated adjusted odds ratios (AORs) for persistent sadness or hopelessness.\n\nResults\nEach 1‐point increase in FII was associated with higher odds of persistent sadness or hopelessness in Virginia (AOR = 1.066, 95% CI: 1.005–1.130) and nationally (AOR = 1.087, 95% CI: 1.062–1.112). Female students had higher odds than males, and bullying was a strong correlate. A dose–response pattern was observed.\n\nImplications for School Health Policy, Practice, and Equity\nIntegrating FI screening with nutrition and behavioral health supports may help identify and address overlapping risks.\n\nConclusions\nMultidimensional FI is consistently associated with poorer mental health among high school students.\n"]