Examining alcohol, tobacco and other drug use among high school students by mental health status: A local level evaluation of data from two Drug Free Communities grantees in MA

Background:  SAMHSA Drug Free Communities (DFC) grantees have demonstrated significant reductions in alcohol, tobacco, and marijuana use among middle and high school aged youth.  It is known that those experiencing poorer mental health are more likely to report substance use, thus localities implementing prevention programs, such as those funded by DFC, have a vested interest in evaluating their efforts in relation to the mental health of their target population.   

Methods:  Using local-level health survey data collected from high school students in two DFC grantee communities in Eastern MA in 2008 (n=1,521 and n=1,327) and 2013 (n=1,604 and n=1,400), we examined 5-year change in substance use stratified by mental health status.  A three-category mental health indicator (‘healthy’, ‘moderate’, ‘poor’) was constructed based upon the mental health questions contained in each survey (Pride and YRBS, respectively).

Results:  Analyses confirmed that rates of substance use were significantly lower among students in the ‘healthy’ category.  5-year declines in use were observed across all three mental health categories for most substances examined, including lifetime and 30-day use of cigarettes, alcohol and illicit drug use. Results for marijuana use were less consistent. The full results of our statistical analyses will be presented and the construction and face-validity of our mental health indicators will be discussed.  

Conclusions:  Our evaluation examined existing student level data collected in two DFC grantee communities and yielded evidence that youth-focused substance abuse prevention activities may have a broad impact within the target population.  Such work can be used to inform and improve ongoing prevention activities.