Self-Medication of Mental Health Problems: New Evidence from a National Survey

University of Arkansas at Little Rock, Little Rock, Arkansas, United States
Health Services Research (Impact Factor: 2.78). 03/2005; 40(1):117-34. DOI: 10.1111/j.1475-6773.2005.00345.x
Source: PubMed


To evaluate the association between past 30-day use of alcohol, marijuana, and other illicit drugs and past year unmet need for and use of mental health care.
A subsample of 18,849 respondents from the 2001 National Household Survey on Drug Abuse and the 2002 National Survey on Drug Use and Health. Subjects were between the ages of 18 and 65 years and had least one past year mental disorder symptom and no past year substance dependency.
Logistic regressions of past 30-day substance use on past 12-month unmet need for mental health care and past 12-month use of mental health services controlling for clinical and sociodemographic characteristics. Predicted probabilities and corresponding standard errors are reported.
Use of illicit drugs other than marijuana increased with unmet need for mental health care (4.4 versus 3.2 percent, p=.046) but was not reduced with mental health-care use. Heavy alcohol use was not associated with increased unmet need for mental health care, but was higher among individuals with no mental health care use (4.4 percent versus 2.7 percent, p<.001). By contrast, marijuana use did not appear associated with either unmet need or mental health care use.
Substance use varies with past year unmet need for mental health care and mental health care use in ways consistent with the self-medication hypothesis. Results suggest that timely screening and treatment of mental health problems may prevent the development of substance-use disorders among those with mental disorders. Further research should identify subgroups of individuals for whom timely and appropriate mental health treatment would prevent the development of substance-use disorders.

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Available from: Katherine M Harris, Oct 04, 2015
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    • "In homeless populations, 77 % of those with mental illness also report substance abuse (Koegel et al. 1999). Comorbidity is particularly problematic because co-occurring substance use decreases the likelihood of receiving mental health treatment (Harris and Edlund 2005; Koegel et al. 1999). We are unaware of research investigating the association between misuse of prescription medications to mental health care utilization, but the prevalence of prescription drug misuse has risen in recent years (Birnbaum et al. 2011; Currie et al. 2011) and deserves investigation in relationship to mental health service utilization. "
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    ABSTRACT: There is significant unmet need for mental health treatment among homeless men, but little is known about the correlates of treatment utilization in this population. Within the framework of the Behavioral Model for Vulnerable Populations, this study examines predisposing, enabling and need factors that may be associated with mental health care utilization. Participants were a representative sample of 305 heterosexually active homeless men utilizing meal programs in the Skid Row region of LA. Logistic regression examined the association between predisposing, enabling and need factors and past 30 day mental health service utilization on Skid Row. Results indicated that while need, operationalized as positive screens for posttraumatic stress disorder or depression, was associated with recent mental health care utilization, predisposing and enabling factors were also related to utilization. African-American homeless men, and those men who also reported substance abuse treatment and drop-in center use, had increased odds of reporting mental health care utilization.
    Community Mental Health Journal 03/2014; 50(8). DOI:10.1007/s10597-014-9718-7 · 1.03 Impact Factor
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    • "One of the main factors that has driven opinion leaders in the mental health sector to call for greater intersectoral collaboration has been a perception that services in other sectors are not directing sufficient attention to the needs of clients with mental disorders (Chitsadesan & Bailey, 2006; Herrman & Harvey, 2005; King et al., 2006; Waghorn et al., 2004; Whiteford, 1994) and that an unacceptable proportion of people with mental health treatment needs are not being identified and referred to specialist services (Andrews, Henderson, & Hall, 2001; Chitsadesan & Bailey, 2006; Glazebrook, Hollis, Heussler, Goodman, & Coates, 2003; Harris & Edlund, 2005; Karlin & Fuller, 2007). Consistent with this view there has been a strong emphasis in the mental health literature over many years on increased identification through screening in order to increase rates of referral and treatment (Bailey & Tarbuck, 2006; Glazebrook et al., 2003; Harris & Edlund, 2005; Karlin & Fuller, 2007; Whiteford & Buckingham, 2005), and to facilitate prevention (Klein et al., 2001; Navon, Nelson, Pagano, & Murphy, 2001) as well as the development of more communitybased programs tailored to the special needs of clients with mental disorders (King et al., 2006; Waghorn et al., 2004). It is beyond the scope of this article to assess the merits of this approach. "
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    Social Science & Medicine 03/2009; 68(7):1213-20. DOI:10.1016/j.socscimed.2009.01.001 · 2.89 Impact Factor
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    • "Fifth, providers make it clear that socioeconomic status, not just culture, is important in determining the social context of illness, help seeking, and recovery. It is well documented that people suffering from substance abuse problems report self-medicating to address the depression of unemployment, alienation, or school problems or to labor more hours or get through the workday, or engage in drug trafficking to support themselves (Corcoran & Corcoran, 2001; Finch, Catalano, Novaco, & Vega, 2003; Harris & Edlund, 2005; Trujillo, 2006; Willging, Trujillo, & La Luz, 2004). These are strong factors not to be overlooked, especially in a rural context of severe economic decline and absence of livelihood opportunities. "
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