Young people seeking support for mental ill-health experience high levels of problematic substance use, but may be reluctant to accept targeted treatment, new research has revealed.
The new study, led by Orygen and published in Early Intervention in Psychiatry, found that of young people who attended headspace centres for mental health concerns who also used substances (such as alcohol, tobacco and cannabis), 65 per cent met the criteria for at least one substance use disorder (SUD) – indicating serious problems related to their use.
Lead author, Ellie Ahounbar, said that concerningly, despite the high rates of ‘disorder-level’ substance use amongst these young people, participants had previously declined targeted support to help deal with their substance use.
“We were really surprised to find just how many of the young people we assessed met the threshold for substance use disorder – and many met criteria for more than one substance,” Ahounbar said.
“Despite acknowledging problems related to their use, young people declined referral to substance-specific treatment, suggesting they may be comfortable seeking mental health support but unwilling to address their use of drugs and alcohol, at least via existing treatment pathways.”
Ahounbar said primary mental health care offered a significant opportunity to help young people with emerging substance use disorder, but currently the system was not set up to offer integrated care.
“We know that up to 75 per cent of lifetime mental health disorders onset by the age of 25 – and this period of adolescence and young adulthood is also a time when people are most likely to experiment with substances,” Ahounbar said.
“While not everyone develops problematic substance use, this research shows that there is a high prevalence of serious substance-related problems amongst those seeking mental health support – meaning we have the opportunity to identify those at risk and intervene early.
“Identifying and supporting those at risk of a substance use disorder – or those already experiencing it – as early as possible could reduce harmful long-term impacts on young people’s lives and health.”
Senior author and Head of Substance Use Research at Orygen, Associate Professor Gill Bedi, said developing integrated interventions was vital for harm reduction, and taking a proactive approach to early intervention was key.
“When it comes to supporting people with problematic substance use, there is often a mentality that people have to ‘hit rock bottom’ before they get help,” A/Prof Bedi said.
“We know many people struggle with their substance use for 10 to 20 years before they seek treatment, but if we could more effectively identify and help young people when they present to mental health services, we could save them so many years of struggle.
“Young people who need support are showing up in all kinds of places – in headspace centres, in emergency departments, at police stations – and by missing the chance to proactively intervene and prevent more serious consequences, we’re letting these young people down.”
Next steps include further investigation into why young people are reluctant to engage with substance-specific care or treatment – despite acknowledging their issues with substance use – and if better integrating substance use care into mental health treatment could be part of the solution.
More about the study:
- The study recruited 79 young people aged 12-25 years who were seeking treatment for mental ill-health across 4 headspace centres in North-West Melbourne, and who also used substances.
- 65 per cent of participants met the criteria for a current substance use disorder.
- Young people with substance use disorder experienced more severe depression and anxiety symptoms.
- The study highlights the need for integrated early identification and care models within youth mental health services to address the impact of substance use disorder, and to reduce the impacts on young people’s development, functioning and mental health.