Understanding the complexity, patterns, and correlates of alcohol and other substance use among young people seeking help for mental ill-health

Soc Psychiatry Psychiatr Epidemiol. 2023 Oct;58(10):1457-1467. doi: 10.1007/s00127-023-02444-w. Epub 2023 Mar 13.

Abstract

Purpose: Use of alcohol and other substances is a multifaceted issue impacting young people across multiple life domains. This paper aims to elucidate patterns of substance use and associated demographic and clinical factors among young people seeking treatment for their mental health.

Methods: Young people (12-25 years old) were recruited from five youth-specific primary mental health ("headspace") services in Australia. Self-reported substance use and harms in the past 3 months were measured using WHO-ASSIST. Network analyses were conducted to evaluate interrelationships between use and harms associated with different substances. Subgroups were then identified based on whether participants reported using high centrality substances, and associated demographic and clinical factors were assessed with multinomial logistic regression.

Results: 1107 youth participated. 70% reported use of at least one substance in the past 3 months, with around 30% of those reporting related health, social, legal or financial problems. Network analysis highlighted substantial interconnections between use and harm indicators for all substances, with amphetamine-type stimulants (ATS) and cannabis being high central substances. Higher levels of substance use and harms were reported in subgroups with ATS or cannabis use and different risk factors were associated with these subgroups.

Conclusions: Findings highlight the importance of screening for substance use in youth primary mental healthcare settings, offering a key opportunity for early intervention. Clinicians should be aware of the inner connections of use and harms of different drugs and the role of cannabis and amphetamine use as a marker for more substance use profiles.

Keywords: Alcohol and drug use; Alcohol and substance use; Mental ill-health; Substance use harms; Youth mental health.

MeSH terms

  • Adolescent
  • Adult
  • Amphetamine
  • Central Nervous System Stimulants*
  • Child
  • Ethanol
  • Humans
  • Mental Health
  • Risk Factors
  • Substance-Related Disorders* / epidemiology
  • Substance-Related Disorders* / therapy
  • Young Adult

Substances

  • Central Nervous System Stimulants
  • Amphetamine
  • Ethanol