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Though mental health and substance use concerns often co-occur, few studies have characterized patterns of co-occurrence among adolescents in clinical settings. The current investigation identifies and characterizes these patterns among adolescents presenting to an outpatient mental health service in Ontario, Canada. Data come from cross-sectional standardized patient intake assessments from 916 adolescents attending an outpatient mental health program (January 2019–March 2021). Latent profile analysis identified patterns of substance use (alcohol, cannabis, (e-) cigarettes) and emotional and behavioral disorder symptoms. Sociodemographic and clinical correlates of these patterns were examined using multinomial regression. Three profiles were identified including: 1) low substance use and lower frequency and/or severity (relative to other patients in the sample) emotional and behavioral disorder symptoms (26.2%), 2) low substance use with higher emotional and behavioral disorder symptoms (48.2%), and 3) high in both (25.6%). Profiles differed in sociodemographic and clinical indicators related to age, gender, trauma, harm to self, harm to others, and service use. Experiences of trauma, suicide attempts, and thoughts of hurting others increased the odds of adolescents being in the profile high in both substance use and symptoms compared to other profiles. These findings further document the high rates of substance use in adolescents in mental health treatment and the profiles generally map onto three out of four quadrants in the adapted four-quadrant model of concurrent disorders, indicating the importance of assessing and addressing substance use in these settings. [ABSTRACT FROM AUTHOR]

Background: To determine: (a) the feasibility and acceptability of administering a standardized electronic assessment of substance use and other mental health concerns to youth admitted to an inpatient psychiatric unit, and (b) the prevalence and clinical correlates of substance use in this sample. Methods: The sample included 100 youth between the ages of 13 to 17 years admitted to an inpatient psychiatric unit in Ontario, Canada between September and November 2019 (78% response rate). Youth data were comprised of electronic self-reported assessments (during hospitalization and 6-months following) and chart reviews (99% consented; historical and prospective). Frontline staff completed a self-report survey assessing their perceptions of the need for standardized substance use assessments, training, and interventions on the unit (n = 38 Registered Nurses and Child and Youth Workers; 86% response rate). Analyses included descriptive statistics, correlations, regression, and qualitative content analysis. Results: Feasibility of standardized youth self-reported mental health and substance use assessments was evident by high response rates, little missing data, and variability in responses. 79% of youth had used at least one substance in their lifetime; 69% reported use in the last 3 months. Substance use was positively correlated with severity of psychiatric symptoms (τb 0.17 to 0.45) and number of psychiatric diagnoses (τb 0.17 to 0.54) at index. Based on prospective and retrospective data, substance use was also positively related to mental health symptom severity at follow-up and repeat mental health related hospital visits. Frontline staff reported a need for standardized assessment, training, and interventions on the unit, indicative of acceptability. Conclusions: This study demonstrated the feasibility, acceptability and clinical importance of administering a standardized mental health and substance use assessment among youth experiencing psychiatric hospitalization. [ABSTRACT FROM AUTHOR]

Background: While substance use and mental health symptoms commonly co-occur among adolescents, few population-level studies have examined profiles of co-occurrence to inform tailored prevention and early interventions.Methods: A multilevel latent profile analysis was conducted on a representative sample of 11,994 students in 68 secondary schools to: 1) identify distinct profiles of co-occurring substance use and mental health symptoms; 2) identify types of schools based on student profiles; and 3) explore school correlates of student profiles and school types, including school climate, belonging, and safety.Results: Five student profiles and three school types were identified. Among students, 57.6 % were in a low substance use and mental health profile, 22.5 % were in a high mental health but low substance use profile, 9.7 % were in a heavy drinking and cannabis use profile, 3.7 % were in a heavy drinking and smoking profile, and 6.5 % were in a high substance use and mental health profile. Positive school climate, belonging, and safety increased the odds of students being in the low profile, with belonging yielding larger effects among females. Among schools, 28 % had low, 57 % had moderate, and 15 % had high levels of student substance use and comorbid mental health symptoms. Rural schools were disproportionately represented in higher risk school types.Conclusions: The identified student substance use and mental health symptom profiles can serve as targets for tailored prevention and early interventions. Results support examining school-based interventions targeting school climate, belonging, and safety with potential benefits to both substance use and mental health. [ABSTRACT FROM AUTHOR]

Purpose: This systematic review summarizes and critically appraises the existing literature on brief interventions (BIs) for cannabis use among emerging adults.Methods: Eligible BIs were operationalized as 1-2 sessions focused exclusively on cannabis use for samples with mean ages between 15 and 30. Outcomes related to cannabis use, other substance use, mental health, help-seeking, or functional status were included. Two independent reviewers screened a total of 3638 records, identifying 244 studies for full-text screening. In total, 32 BIs in 26 primary studies with 6318 participants were included.Results: Participants were typically not seeking treatment and using cannabis at least once a month. Most interventions were motivational, single sessions, and delivered in person. Few discussed concurrent psychiatric conditions. Pooling results at 1-3 months post-intervention, BIs compared to passive control slightly reduced symptoms of cannabis use disorder (SMD -0.14 [95% CI -0.26 to -0.01]) and increased the odds of abstinence (OR 1.73 [95% CI 1.13-2.66]). Other outcome results often favored BIs but were not significant. Results of studies comparing types of BIs (k = 8) or BIs to longer interventions (k = 1) are discussed narratively. Quality assessment suggested low to very low-quality evidence.Conclusions: This review indicates that BIs targeting non-treatment seeking emerging adults result in significant reductions in symptoms of cannabis use disorder and an increased likelihood of cannabis abstinence, however evidence is of low quality. [ABSTRACT FROM AUTHOR]