University students’ perceptions of the link between substance use and mental health

Young adulthood can be a vulnerable time for young people. Young adults have the highest levels of alcohol use and related harms among all age groups. Mental health symptoms are also most likely to first present during late adolescence and early young adulthood. But what connection, if any, is there between mental health and substance use for this age group? And what does this mean for post-secondary students?

Rates of mental health concerns and psychological distress symptoms are high among Canadian university students. Data from the 2013 National College Health Assessment Survey showed that 10% of university students have been diagnosed with depression, and 11% diagnosed with anxiety in the past 12 months. Many more students report distress symptoms which can cause significant dysfunction or impairment for young people and may be precursors to later mental health problems. For example, in the last 30 days, 35% of students reported overwhelming anxiety and 40% felt very exhausted.

Research suggests that youth with mental health problems are two to three times more likely to have problems with substance use, and vice versa. Although these issues tend to co-occur, it is not always clear which comes first. Youth with mental health problems may use substances to cope with symptoms of the mental health issue that they find disruptive or uncomfortable. For example, someone suffering from social anxiety may drink to feel more comfortable in social situations.

Alternatively, substance use can create problems that trigger or exacerbate mental health symptoms. For example, alcohol use increases the chances of being a victim of sexual assault or poor-decision making, which could impact mental health. It is also possible that both substance use and mental health symptoms are caused by similar risk factors, such as environmental triggers like stress or trauma, therefore increasing the likelihood of co-occurrence.

But do young people perceive there to be a link between substance use and mental health?

In focus groups, our research lab asked university students about the link between mental health and substance use. Most students believed that mental health influenced student’s use of substances reporting that using substances to cope with stress and other negative situations or emotions, such as bad grades or break-ups, is a common and accepted practice among students. Students reported that support from friends regularly included suggestions of getting “wasted” to “forget about your problems.” However, students did not identify a bi-directional link; meaning they see few mental health consequences from substance use, although some students noted that going out and drinking sometimes prevented them from meeting their deadlines or getting their work done, which increased their levels of stress. Students appear to know that substance use is not a “healthy” way to cope with their stress and problems, but noted that it has the fastest effects and is accepted and encouraged among peers.

Students seem to underestimate the impacts of both mental health and substance use on their overall health and academic success. Would greater discussions in post-secondary settings about the links between these issues help students better understand the relationship between substance use and mental health?

Kara Thompson, CARBC

Author: Kara Thompson, Postdoctoral Fellow, Dalhousie University

**Please note that the material presented here does not necessarily imply endorsement or agreement by individuals at the Centre for Addictions Research of BC.

Building healthier habits with accessible CBT

Sometimes we seek escape and solace from a pint of beer, a smoke, or even a bucket of Ben & Jerry’s to help us deal with life’s challenges. For some, it’s a daily routine of self-management; for others, it’s a battle between life and death. How we use substances is often linked to how we manage our mental health.

According to the Canadian Mental Health Association (CMHA), about half of those with addictions have mental illnesses and vice versa. Depression and anxiety are known risk factors and consequences of substance use problems.

A common and effective approach to managing substance use, as well as depression and anxiety, is cognitive-behavioural therapy (CBT). CBT helps provide a set of positive coping skills, and is the principle behind CMHA’s Bounce BackTM: Reclaim Your Life program, funded by the BC Ministry of Health, and available for free across BC by doctor referral.

The program uses a telephone-based adaptation of CBT to teach participants how thoughts, emotions, behaviours, and the external environment affect one another in every situation. It is designed to help people experiencing symptoms of mild to moderate depression, but also helps them learn to build a healthy relationship with substance use. Participants explore questions such as: Why do I feel the way I do? Am I using alcohol or other drugs just to get a good night’s sleep? What would recovery look like?

By exploring these and other questions participants learn to identify positive and negative consequences of actions, gain insight into what might be leading them to turn to substances, develop problem-solving skills and take more control of their own lives.

CBT has been shown to be effective but freely accessible CBT treatments are mostly limited to online information rather than practitioner-guided therapy.

Programs like Bounce BackTM offers a way to make CBT more available to people. The program provides province-wide, community-based access and integrates with primary care through family physician referral. Keys to the success of the program include support from the Ministry of Health and Doctors of BC Practice Support Program, making CBT a standard resource for BC residents.

Like any intervention, CBT and Bounce BackTM have their limitations While these types of low-intensity CBT treatment that use the relapse-prevention approach and behavioural strategies, may only have a small effect on substance use, they do show a large improvement in overall psychosocial adjustment. Therefore, making the benefits of CBT available to people across the province is a worthy goal.

To learn more about CBT visit Visions Journal’s issue on CBT from Here to Help.
To learn more about Bounce BackTM, visit

Author: Sophy Zhang, Bounce Back Program Assistant at Canadian Mental Health Association, BC Division

**Please note that the material presented here does not necessarily imply endorsement or agreement by individuals at the Centre for Addictions Research of BC.