Mental health service use: A comparison of treated and untreated individuals with substance use disorders in Ontario

Objective: To determine the prevalence of and factors associated with menta l health service use in the past year among respondents with an alcohol or other drug use disorder in a general population survey of Ontario adults. Method: Data were obtained from the 1990/1991 Mental Health Supplement to t he Ontario Health Survey, which used the University of Michigan Composite I nternational Diagnostic Interview (UM-CIDI). The current study examined 436 respondents aged 15-64 years who met Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R) criteria for a substance use disorder in the p ast year. The 82 respondents who used services for a mental health or subst ance abuse problem during the past year were compared with the 354 nonusers . Illness severity, disability, health beliefs and attitudes, and predispos ing or enabling factors were examined in bivariate and logistic regression analyses. Results: Twenty-two percent of respondents used services in the past year. Having concurrent disorders (comorbidity), troubled relationships with othe rs, and dysfunction in main activity,feeling comfortable talking to a profe ssional about mental health problems, being older and an urban resident, no t working or being in school, and having a biological parent with an alcoho l or drug problem were all associated with service use. Conclusions: The results suggest that individual determinants, such as seve rity of illness, disability, attitudes, and predisposing or enabling variab les, all have a role in predicting service use among individuals in the gen eral population who suffer from alcohol and other drug disorders.