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.
Résumé
Objectifs
Examiner les troubles de santé mentale concomitants dans un échantillon populationnel d’élèves du secondaire en Ontario, au Canada, pour comprendre la prévalence de ces troubles, les facteurs de risque associés et leurs liens avec l’accès et le recours aux services de santé mentale.
Méthode
Nos données sont dérivées du Sondage sur la consommation de drogues et la santé des élèves de l’Ontario de 2013, une enquête bisannuelle auprès des élèves fréquentant l’école publique dans la province; elles proviennent d’un sous-échantillon d’élèves ayant rempli à la fois les parties du sondage sur l’intériorisation et sur la consommation de substances (n = 2 945). Les taux de problèmes concomitants ont été calculés pour les 12 mois antérieurs. L’utilisation des services par les élèves présentant des problèmes concomitants a aussi été calculée pour les 12 mois antérieurs. Les rapports de cotes ont été estimés au moyen de modèles de régression logistique binaires après correction du plan de sondage.
Résultats
Selon un modèle ajusté, les jeunes présentant des symptômes d’intériorisation étaient 2,40 fois plus susceptibles, et les jeunes présentant des problèmes de consommation de substances, 2,24 fois plus susceptibles, d’avoir eu accès à des services de santé mentale au cours des 12 mois antérieurs que les jeunes ne présentant pas de tels problèmes. Les jeunes ayant des problèmes concomitants d’intériorisation et de consommation de substances étaient 6,74 fois plus susceptibles (IC de 95 % : 4,66-9,76, p < 0,001) d’avoir eu accès à des services de santé mentale au cours de l’année antérieure que les jeunes sans problèmes concomitants, mais seulement 52,8 % des jeunes ayant des problèmes concomitants (IC de 95 % : 45,6 %-59,9 %) avaient utilisé des services de santé mentale.
Conclusions
Ces résultats indiquent qu’un peu plus de la moitié des élèves de l’Ontario de la 9e à la 12e année ayant des problèmes concomitants d’intériorisation et de consommation de substances ont recours aux services de santé mentale. Il faudrait pousser la recherche pour examiner les facteurs liés à l’utilisation des services dans cette population afin d’éclairer l’élaboration des politiques et des programmes.
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Acknowledgements
We want to thank the research support from Ms. Lindsay Williams, Alisha Williams, Connor Ostoich, and Geneva Mason.
Funding
This work was supported by the Canadian Institutes of Health Research [grant number EKT-121928]. Dr. Cheung is supported by the Bell Canada Chair in Adolescent Mood and Anxiety Disorders and the Ontario Mental Health Foundation New Investigator Fellowship. Dr. Kozloff is supported by a NARSAD Young Investigator Grant from the The Brain and Behaviour Research Foundation.
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Cheung, A.H., Cook, S., Kozloff, N. et al. Substance use and internalizing symptoms among high school students and access to health care services: results from a population-based study. Can J Public Health 110, 85–92 (2019). https://doi.org/10.17269/s41997-018-0144-4
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DOI: https://doi.org/10.17269/s41997-018-0144-4