Research Snapshot: Substance use linked to mental health problems in early adolescents

What you need to know

There is a substantial overlap between mental health and substance use problems among youth who are in mid-to-late adolescence. There is less information about the co-occurrence of these problems in early adolescence, when many mental health problems tend to start. To understand the relationship, researchers conducted a school-based survey among students in grades 7 and 8 in four regions of Ontario. They found that substance use was associated with concurrent self-reported mental health problems and low levels of service use for these problems.

 

This Research Snapshot is based on the article, “Early adolescent substance use and mental health problems and service utilisation in a school-based sample” published in The Canadian Journal of Psychiatry in 2019.  Read it below or download the PDF.

Research Snapshots are brief, clear language summaries of research articles, presented in a user-friendly format.

What is this research about?

Research has shown substantial overlap between mental health and substance use problems in mid-to-late adolescence. There is less information about the co-occurrence of these problems in early adolescence, when many mental health problems tend to start.

To understand the relationship between substance use, mental health problems, and use of mental health services in this age group, researchers administered a survey to a school-based sample of early adolescents.

What did the researchers do?

The researchers looked at the survey responses to an in-class pencil-and-paper survey on mental health and substance use in the previous 12 months from 1,360 students in grades 7 and 8 in four regions of Ontario. Seven school boards participated in 2011, and six other school boards participated in 2013.

Surveys were anonymous to increase the validity of self-reports of stigmatized and/or illegal behaviours. To assess internalising and externalising mental health problems, the researchers used the Global Assessment of Individual Needs – Short Screener, a validated screening tool. Demographic, substance use, and service use items were adapted from the Ontario Student Drug Use and Health Survey.

What did the researchers find?

The researchers found a link between mental health and substance use problems, specifically with cannabis and additional substances other than alcohol. The relationship was stronger among girls than boys. Students who used cannabis had 10-times the likelihood of having mental health problems.

Students with both substance use or substance use problems and mental health problems had more severe mental health problems than those who did not use any substances. Both mental health and substance use problems predicted use of mental health services, particularly treatment that lasted more than six sessions. This link was especially strong for those who said they had had suicidal thoughts in the previous 12 months.

The researchers also found that about 60% of students with mental health problems and 30% of those who had suicidal thoughts had not received mental health services in the previous 12 months.

The researchers have followed this group of youth over time and subsequent articles are expected to be published examining these issues over the longer period.

How can you use this research?

The findings from this study may be useful in the development and evaluation of prevention and early intervention approaches that are tailored to the needs of youth at differing developmental stages, of different genders, and with different mental health and substance use presentations.

Limitations of the research

Although the Global Assessment of Individual Needs – Short Screener has been validated in clinical studies of early-to-mid adolescents, it has not been tested for specificity (or true negative rate) in a non-clinical setting, such as in a classroom. It’s possible that the students may have reported more temporary problems in the classroom setting.

The study had several other limitations, including its cross-sectional design, which does not allow the researchers to determine the direction of the relationship between substance use and mental health problems. It also does not identify other factors that may have increased the risk of having concurrent problems.

Finally, the students’ self-reports were not validated by an independent rater.

About the researchers

Elizabeth Brownlie,1,2 Joseph H. Beitchman,1,2 Gloria Chaim,1,2 David A. Wolfe,2,3,4 Brian Rush,1,2,5 Joanna Henderson1,2

  1. Margaret and Wallace McCain Centre for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, Ontario
  2. Department of Psychiatry, University of Toronto, Toronto, Ontario
  3. Centre for Prevention Science, Centre for Addiction and Mental Health, Toronto, Ontario
  4. Centre for Research and Education on Violence against Women and Children at the Faculty of Education, Western University, London, Ontario
  5. Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario

Keywords 

early adolescence, substance use, mental health, comorbidity, service utilisation

 

This Research Snapshot is based on the article, “Early adolescent substance use and mental health problems and service utilisation in a school-based sample” published in The Canadian Journal of Psychiatry in 2019. https://doi.org/10.1177/070674371878493