Substance use and internalizing symptoms among high school students and access to health care services: results from a population-based study

Abstract

Objectives To examine co-occurring mental health problems among a population-based sample of high school students in Ontario, Canada, to understand their prevalence, associated risk factors, and relationship with mental health service access and utilization. Methods The data were derived from the 2013 Ontario Student Drug Use and Health Survey, a biennial survey of students attending publicly funded Ontario schools, from a subsample of students who completed both the internalizing and substance use portions of the survey (n = 2945). Rates of co-occurring problems were calculated for the previous 12 months. Service use for students with co-occurring problems was also calculated for the past 12 months. Odds ratios were estimated using binary logistic regression models correcting for the survey design. Results In an adjusted model, youth with internalizing symptoms were 2.40 times more likely and youth with substance use problems were 2.24 times more likely to have accessed mental health services during the past 12 months than youth without these problems. Youth with co-occurring internalizing and substance use problems were 6.74 times more likely (95% CI 4.66-9.76, p < 0.001) to have accessed mental health services during the past year compared with youth without co-occurring problems, but only 52.8% of youth with co-occurring problems (95% CI 45.6-59.9%) used mental health services. Conclusions The findings suggest that just over half of Ontario students in grades 9 through 12 who have co-occurring internalizing and substance use problems are utilizing mental health services. Further research should examine the factors related to service use in this population in order to better inform policy and program development.

The associations of comorbid substance use disorders and psychiatric conditions with adolescent brain structure and function: A review

“…These neural findings are highly congruent with the epidemiological literature: Externalizing disorders have been more consistently linked with SUD than internalizing disorders [44]. However, less attention has been paid to the comorbidity of SUD and internalizing disorders, hence more work is needed to better characterize this relationship [14]. Some neural processes in adolescence seem to play a more consistently strong role in the development of substance use than in psychopathology.…”

“…While less attention has been paid to SUD among adolescents with internalizing disorders than for those with externalizing disorders, cooccurrence between the two is quite common [14]. A recent epidemiological study in Ontario, Canada found that 12% of high school students had both internalizing symptoms and a history of SUD [14]. Converging evidence from longitudinal studies have indicated that depression predisposes adolescents to SUDs [44].…”

Increases in Serious Psychological Distress among Ontario Students between 2013 and 2017: Assessing the Impact of Time Spent on Social Media

“…Compared to those who reported using social media 1 or fewer hours per day (the reference group, whose probability of distress increased between 2013-2017), the AOR of those who reported using social media 7 or more hours per day decreased from 3.47 in 2013 to 1.38 in 2017. increase of 65% is unprecedented, and translates to more than 150,000 students who suffered from a probable mental health disorder in 2017. 8 Given the adverse outcomes associated with serious psychological distress, 1,[60][61][62] it is extremely important to identify the mechanisms contributing to these recent increases.…”

Virtual Reality and Web-Based Growth Mindset Interventions for Adolescent Depression: Protocol for a Three-Arm Randomized Trial

“…Results will gauge the promise of the VR Personality Project as a brief, highly engaging, and mechanism-targeted intervention for reducing adolescent depressive symptoms. Given the increasing levels of adolescent depressive symptoms in recent years [2] and variable efficacy and accessibility of existing interventions [3,8], results of this trial may suggest a promising new approach, using immersive VR technology, to reducing depression in youth.…”