Australian Institute of Health and Welfare 2021. Alcohol, tobacco & other drugs in Australia. Cat. no. PHE 221. Canberra: AIHW. Viewed 14 June 2021, https://www.aihw.gov.au/reports/alcohol/alcohol-tobacco-other-drugs-australia
Australian Institute of Health and Welfare. (2021). Alcohol, tobacco & other drugs in Australia. Retrieved from https://www.aihw.gov.au/reports/alcohol/alcohol-tobacco-other-drugs-australia
Alcohol, tobacco & other drugs in Australia. Australian Institute of Health and Welfare, 16 April 2021, https://www.aihw.gov.au/reports/alcohol/alcohol-tobacco-other-drugs-australia
Australian Institute of Health and Welfare. Alcohol, tobacco & other drugs in Australia [Internet]. Canberra: Australian Institute of Health and Welfare, 2021 [cited 2021 Jun. 14]. Available from: https://www.aihw.gov.au/reports/alcohol/alcohol-tobacco-other-drugs-australia
Australian Institute of Health and Welfare (AIHW) 2021, Alcohol, tobacco & other drugs in Australia, viewed 14 June 2021, https://www.aihw.gov.au/reports/alcohol/alcohol-tobacco-other-drugs-australia
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More information is available in the People with mental health conditions fact sheet.
Mental health is fundamental to the wellbeing of individuals, their families and the population as a whole (ABS 2018). According to the 2019 National Drug Strategy Household Survey (NDSHS) estimates, 16.9% of the general population aged 14 and over had been diagnosed or treated for a mental health condition in the previous 12 months. This increased from 15.9% in 2016 (AIHW 2020). The proportion of people aged 18 and over experiencing high or very high levels of psychological distress also increased, from 11.7% in 2016 to 14.0% in 2019 (AIHW 2020).
Increasing literacy and awareness around mental illness in Australia may partially explain these reported increases (National Mental Health Commission of NSW 2015), however, there are likely to be other factors involved including changing trends and patterns in alcohol and other drugs use.
There is a complex relationship between mental health and alcohol and other drug use. A mental illness may make a person more likely to use drugs to provide short-term relief from their symptoms, while other people have drug problems that may trigger the first symptoms of mental illness (AIHW 2020). It is often difficult to determine whether mental illness preceded substance use or vice versa. In particular, self-reported survey data (such as that reported in the NDSHS) do not establish a causal link between mental health conditions and drug use (AIHW 2020).
Tobacco smoking has declined among people with mental health conditions or high or very high psychological distress, but remains higher among these groups than people without mental health conditions (AIHW 2020). According to 2019 NDSHS estimates:
The mechanisms linking tobacco smoking with mental health conditions are complex; however it is understood that people may perceive smoking to be helpful in relieving or managing the psychiatric symptoms associated with their disorder (Minichino et al. 2013). It has also been shown that people with mental health conditions may find smoking cessation difficult. However, upon quitting, they are likely to experience improvements in their mood, general wellbeing, mental health and quality of life (Greenhalgh, Stillman & Ford 2018).
Figure MENTALHEALTH1: Tobacco use, by self-reported mental health condition psychological distress and smoking status, people aged 18 and over, 2010 to 2019 (per cent)
The figure shows that, between 2010 and 2019, the proportion of daily smokers who reported having a mental health condition steadily decreased from 26.5% in 2010 to 20.2% in 2019. Among people who had never smoked, the proportion of people with a self-reported mental health condition changed from 42.3% in 2010 to 49.1% in 2019.
New Australian guidelines to reduce health risks from drinking alcohol were released in December 2020. Data for alcohol risk in this report are measured against the 2009 guidelines. NDSHS data relating to the updated guidelines are available here.
People with mental health conditions or high or very high levels of psychological distress are more likely to drink at risky levels than people without these conditions. The 2019 NDSHS findings showed that:
Figure MENTALHEALTH2: Proportion if abstainers and people exceeding the lifetime and single occasion risk guidelines, by self-reported mental health condition and psychological distress and drinking status, people aged 18 and over, 2010 to 2019 (per cent)
The figure shows that the proportion of people with a self-reported mental health condition was highest among those who exceeded single occasion risky drinking levels (30.9%) or exceeded lifetime risk (21.3%).
The NDSHS found that, in 2019, compared with people without mental health conditions, people with a mental health condition were:
Figure MENTALHEALTH3: Recent illicit drug use, by self-reported mental health condition and psychological distress and drug type, people aged 18 and over, 2010 to 2019 (per cent)
The figure shows that the proportion of people who had recently used any illicit drug and experienced psychological distress increased between 2010 and 2016 (from 25.2% to 30.8%). This pattern was true for cannabis, cocaine and ecstasy.
Use of specific illicit drugs among people with mental health conditions and high psychological distress has varied across time and by drug type. Between 2016 and 2019:
Estimates from the 2020 IDRS showed that 47% of participants self-reported that they had experienced a mental health problem in the previous 6 months, stable from 2019 (Peaock et al. 2021). The most commonly reported mental health problems were depression (70%) and anxiety (55%). Over half (53%) of these people had seen a mental health professional in the previous 6 months, down from 67% in 2019 (Peacock et al. 2021).
ABS (Australian Bureau of Statistics) 2018. National Health Survey: First Results, 2017–18. ABS cat. no. 4364.0.55.001. Canberra: ABS. Viewed 12 December 2018.
AIHW (Australian Institute of Health and Welfare) 2020. National Drug Strategy Household Survey 2019. Drug statistics series no. 32. Cat. no. PHE 270. Canberra: AIHW. Viewed 31 July 2020.
Greenhalgh, EM., Stillman, S., & Ford, C 2018. 7.12 Smoking and mental health. In Scollo, MM and Winstanley, MH [editors]. Tobacco in Australia: Facts and issues. Melbourne: Cancer Council Victoria. Viewed 19 February 2019.
Minichino A, Bersani FS, Calo WK, Spagnoli F, Francesconi M, et al. 2013. Smoking behaviour and mental health disorders--mutual influences and implications for therapy. International Journal of Environmental Research and Public Health, 10(10):4790–811.
National Mental Health Commission of NSW 2015. National Surveys of Mental Health Literacy and Stigma and National Survey of Discrimination and Positive Treatment: A report for the Mental Health Commission of NSW. Sydney: Mental Health Commission of NSW.
Peacock A, Uporova J, Karlsson A, Price O, Gibbs D, Swanton R et al. 2021. Australian Drug Trends 2020: Key findings from the National Illicit Drug Reporting System (IDRS) interviews. Sydney: National Drug and Alcohol Research Centre, UNSW.
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