Concurrent mental and substance use disorders in Canada
Health Reports
Abstract
Based on results of the 2012 Canadian Community Health Survey–Mental Health, 1.2% of Canadians aged 15 to 64 (an estimated 282,000) experienced mental and substance use disorders concurrently in the previous year (at least one mood/anxiety disorder and one substance use disorder).
Demographic, socioeconomic, health status and service use characteristics of the concurrent disorder group were compared with those of people who had only a mood/ anxiety disorder or only a substance use disorder. Those with concurrent disorders had consistently poorer psychological health and higher use of health services and were more likely to report partially met/unmet needs than the substance use disorder group, even when demographic and socioeconomic factors and number of chronic health conditions were taken into account.
Apparent similarities in health status, service use and partially met/unmet needs between the concurrent disorders and mood/anxiety disorder groups did not persist in multivariate analysis.
The findings suggest that the complexity of concurrent disorders contributes to poorer psychological health outcomes and higher health service use, compared with having only a mood/anxiety disorder or a substance use disorder.
Method
This study uses the 2012 Canadian Community Health Survey–Mental Health to examine the demographic and socioeconomic characteristics, health status and health care service use of people with concurrent disorders, and compares them with people who had a mood/anxiety or a substance use disorder only. Respondents with concurrent disorders are defined as those who, in the past 12 months, had at least one mood/anxiety disorder and at least one substance use disorder. The mood/anxiety disorders are major depressive episode, bipolar I/bipolar II disorder and generalized anxiety disorder. The substance use disorders are alcohol, cannabis and other drug abuse or dependence. Estimates are calculated for the household population aged 15 to 64 in the 10 provinces.
Findings
Individuals who have both a mental and substance use disorder at the same time are more likely to experience poor psychological health, use more health services and report unmet needs than a person with only one type of disorder.
These findings are from a new study on the prevalence of concurrent disorders in Canada, released in today’s Health Reports. The study is the first to use the 2012 Canadian Community Health Survey—Mental Health to examine the demographic and socioeconomic characteristics, health status and health care service use of people with concurrent disorders. The study estimates that 282,000, or 1.2% of Canadians aged 15 to 64, experienced mental and substance use disorders concurrently in the previous year, that is, at least one mood/anxiety disorder and at least one substance use disorder.
Almost all (91%) of those with concurrent disorders reported high psychological distress, significantly more than those with a mood/anxiety (79%) or a substance use (34%) disorder alone.
Overall, individuals with concurrent disorders were more likely (76%) to use health services, such as care for mental health or substance use, compared with those who had a mood/anxiety (67%) or substance use (21%) disorder alone. Despite higher use, these individuals had greater odds of reporting unmet or partially met needs for mental health care after controlling for demographic and socio-economic factors and number of chronic conditions.