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APHA Scientific Session and Event Listing

Karen A. Urbanoski, PhD (candidate), Brian Rush, PhD, and John Cairney, PhD. Centre for Addiction and Mental Health, University of Toronto, 33 Russell Street, Toronto, ON M5S 2S1, Canada, 416-535-8501 x6121, karen_urbanoski@camh.net

Previous analysis of a Canadian health survey found that fully half of those meeting the criteria for both substance dependence and mental illness in the same year reported an unmet need for care, compared to 20% of those with either disorder alone. The present study examines these associations in more detail, including the self-reported reasons for not obtaining care. Subjects are a subset of respondents from a 2002 Canadian national mental health survey, who met criteria for mood, anxiety or substance use disorders based on an adaptation of the WMH-CIDI (n=3,699). Analyses examined unmet need by substance dependence (SD), mental illness (MI), and comorbidity (SD/MI). Those with SD/MI were less likely than others to prefer to self-manage their symptoms and more likely to report that they did not get around to seeking help or that care was unavailable. The odds of unmet need were greatest for SD/MI and remained significantly elevated after adjusting for past-year service use, sociodemographic factors, and measures of well-being (OR=3.25, p<.001, reference = SD). The results suggest that the association between comorbidity and perceived unmet need in Canada is not due to a unique preference to self-manage symptoms, which could potentially contribute to substance use through self-medication. Further, it was not accounted for by greater exposure to the healthcare system, sociodemographic profile, or lower well-being. The finding that unmet need in this population was associated with difficulties in initiating care deserves further attention, with efforts made to increase awareness and availability of care where needed.

Learning Objectives: At the conclusion of the session, the participant will be able to

• Articulate how the self-reported reasons for not satisfying a perceived need for mental health or addiction care differ by diagnostic profile in the general population of Canada.
• Discuss the correlates of this perceived unmet need in the general population of Canada.
• Evaluate potential explanations for the association between perceived unmet need for care and comorbid substance use and mental disorders.

Keywords: Care Seeking, Co-morbid

Presenting author's disclosure statement:

Not Answered