Estimated rates of co-occurring mental illness among adolescents with substance use disorders range from 60 to 75 percent.1 Among adolescents with no prior substance use, the rates of first-time use of drugs and alcohol in the previous year are higher in those who have had a major depressive episode than in those who did not.2 Other commonly documented co-occurring mental disorders include conduct disorder, oppositional defiant disorder, attention-deficit/hyperactivity disorder, anxiety, and post-traumatic stress disorder.3
- Youth who experience a major depressive episode were twice as likely to begin using alcohol or an illicit drug, compared to youth who had not experienced a major depressive episode.4
- Youth who experienced serious depression were twice as likely to use alcohol as their peers who had not been seriously depressed. Over 29 percent of youth who had not used alcohol previously initiated alcohol use following a major depressive episode within the past year, compared with 14.5 percent of youth who had not experienced a major depressive episode in the past year.5
- Similarly, many more youth who had not previously used illicit drugs did so after a major depressive episode. Sixteen percent of youth who had not used an illicit drug in the past year initiated illicit drug use after a major depressive episode, compared with 6.9 percent of youth who had not experienced a major depressive episode in the past year.6
There is always much speculation about what presents first in the youth’s life, the substance use or the mental health challenges. It can happen either way and what we do know is that undiagnosed mental health problems can lead to self-medicating with substances.
This report presents the findings of a two-year project intended to document and summarize the experiences of youth with co-occurring mental health and substance abuse problems and their families. The purposes of this study were to offer youth and their families the opportunity to reflect on and give voice to their experiences, to identify their successes and concerns, and to formulate recommendations so that a national audience might learn from their experience and improve services. The work was funded by the Substance Abuse and Mental Health Services Administration (SAMHSA) in the U.S. Department of Health and Human Services and conducted by two family-run organizations — the Federation of Families for Children’s Mental Health, Alexandria, Virginia, and Keys for Networking, Inc., Topeka, Kansas.
1 Turner, Muck, Muck, Stephens, & Sukumar, 2004; Hoffmann, Bride, MacMaster, Abrantes, & Estroff, 2004
2 Substance Abuse and Mental Health Services Administration [SAMHSA], 2010
3 Turner et al., 2004; Hoffman et al., 2004; Shrier, Harris, Kurland, & Knight, 2003
4 SAMHSA, 2010
5 SAMHSA, 2010
6 U.S. Department of Health and Human Services, 2007