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.

Why are BC high school students making healthier choices?

Teens sometimes get a bad rap for being careless with their bodies and minds. But according to McCreary Centre Society’s 2013 Adolescent Health Survey, published in February 2014, most of the 30,000 BC youth surveyed say they are healthy or very healthy (87 percent), and 8 out of 10 report good or excellent mental health (81 percent). The majority also said they feel cared for, competent and confident about their future.

Along with feeling good about themselves and their world, more young people are steering clear of alcohol and other drugs. Survey results show substance use rates have been declining over the last 10 years, and the majority of students in Grades 7 through 12 say they have never experimented with alcohol, cannabis (marijuana) or tobacco.

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Source: Smith, A., Stewart, D., Poon, C., Peled, M., Saewyc, E., & McCreary Centre Society (2014). From Hastings Street to Haida Gwaii: Provincial results of the 2013 BC Adolescent Health Survey. Vancouver, BC: McCreary Centre Society.

Part of what’s driving this decline is that young people are waiting longer before trying drugs. For example, 35 percent of young people who have ever tried alcohol waited until they were 15 or older (compared to only 20 percent in 2003), and of those who have ever tried cannabis, 41 percent waited until they were 15 or older (compared to 28 percent in 2003).

Equally positive, youth who are choosing to use alcohol or other drugs seem to be taking fewer risks. For example, 2 percent of those who had ever used alcohol said they had driven after drinking in the past month, down from 6 percent in 2008 and 8 percent in 2003. There was also a decrease in impaired driving among youth who had ever used cannabis, although 9 percent had done so in the past month.

So, why are BC youth making healthier choices? A number of protective factors seem to be at play including family connectedness. For instance, youth who felt their family paid attention to them were less likely to drive after drinking than those who did not experience such attention (2 percent vs. 6 percent). They were also less likely to have been a passenger in a vehicle with someone who had been drinking (15 percent vs. 33 percent).

Having someone to confide in seems to make a difference too. Students with supportive adults in their lives are less likely to have used alcohol (43 percent vs. 54 percent). And, among students who had tried alcohol, those with an adult they could turn to were less likely to report binge drinking in the past month (37 percent vs. 42 percent). Youth in government care who had a supportive teacher or other caring adult in their lives were also less likely to binge drink in the past month.

What exactly does this mean for parents, teachers and other caring adults in young peoples’ lives? Many teens are making healthy and positive decisions and we can continue to support and acknowledge the positive decisions they are making. For teens who are struggling to maintain their health or happiness, we can make a difference by reaching out to them. Finally, we must continue leading by example. By being happy and healthy adults, we show young people that health itself is a worthy life-long goal.

For more information about the results from the 2013 BC Adolescent Health Survey: http://www.mcs.bc.ca/pdf/From_Hastings_Street_To_Haida_Gwaii.pdf

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Author: Nicole Bodner, Centre for Addictions Research of BC

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