Jody Wolfe, Elaine Hyshka, and T. Cameron Wild
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UNMET NEED FOR HARM REDUCTION SERVICES AND MENTAL AND PHYSICAL HEALTH AMONGST A SAMPLE OF PEOPLE REPORTING PAST-YEAR ADDICTION PROBLEMS Jody Wolfe, Elaine Hyshka, and T. Cameron Wild Addiction and Mental Health Research Laboratory, School of Public Health, University of Alberta Public Health 2014 May 28, 2014
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UNMET NEED FOR HARM REDUCTION SERVICES AND MENTAL AND PHYSICAL HEALTH AMONGST A SAMPLE OF PEOPLE REPORTING PAST-YEAR ADDICTION PROBLEMS . Jody Wolfe, Elaine Hyshka, and T. Cameron Wild Addiction and Mental Health Research Laboratory, School of Public Health, University of Alberta - PowerPoint PPT Presentation
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UNMET NEED FOR HARM REDUCTION SERVICES AND MENTAL AND PHYSICAL HEALTH AMONGST A SAMPLE OF PEOPLE REPORTING PAST-YEAR ADDICTION PROBLEMS Jody Wolfe, Elaine Hyshka, and T. Cameron WildAddiction and Mental Health Research Laboratory, School of Public Health, University of AlbertaPublic Health 2014May 28, 2014
Population burden of addiction problems in Canada
Harm reduction as part of a tiered model of care for people living with addiction problems
Need for harm reduction services across the population
Research Questions• What is the level of unmet need for harm reduction services
amongst the general population of Albertans reporting past year [diagnosed or undiagnosed] addiction problems?• Are those with unmet needs for harm reduction services experiencing
more distress than those who have no unmet needs for harm reduction services?
GAP-MAP • Data drawn from 2013 GAP-MAP study• Gap analysis of public mental health and addictions programs (GAP-
MAP) in Alberta• Examined population need, program availability, and current level of
investment in provincial addiction and mental health services.
Methods• Single stage, stratified cluster sample design • Random digit dialing • Computer Assisted Telephone Interviews measured• Demographics• Health service utilization• Physical and mental health
• N= 6,000 Alberta adults• MANOVA used to assess differences between individuals reporting
unmet needs and those with no unmet needs on six measures of psychiatric and physical health.
RESULTS
Perceived Need for Harm Reduction Services
All Alberta adults 3,059,008
Perceived a need for harm reduction services
36,708
1.2%
Perceived Need for Harm Reduction Services
All Alberta adults 3,059,008
Unmet need for harm reduction services
7,357
3.7%
6.5%
Met criteria for a diagnosed or undiagnosed addiction
198,836
Patterns of Service Use
Measures of Well-BeingScale Description Scoring
Personal Well-being Index (PWI), 9 items
Self-rated satisfaction with life domains (e.g., financial, health, community affiliation, etc.); ratings on a scale of 0-10,
Average of all items then multiplied by 10; higher scores reflect greater well-being
Kessler-6 (K6), 6 items
Frequency of experiencing 6 symptoms of mental ill-health, (e.g., hopelessness, nervousness, and feeling sad) in the past four weeks on a scale ranging from 0 (none of the time) to 4 (all of the time)
Sum of all items with higher scores reflecting more distress
General Health Questionnaire-12 (GHQ-12), 12 items
Frequency respondents have experienced 12 symptoms (e.g., feeling under strain, losing sleep, lost confidence, feeling unhappy, etc.); rated on a scale ranging from 0 (more so than usual) to 3 (much less than usual)
Sum of all items with higher scores reflecting poorer mental health
Measures of Well-BeingScale Description Scoring
Patient Health Questionnaire-9 (PHQ9), 9 items
Frequency of experiencing symptoms of depression in the past month
Summed, with higher scores reflecting greater depressive symptomology
Alcohol Use Disorders Identification Test (AUDIT), 10 items
Self-report measure used to identify hazardous and harmful drinking
Higher scores reflect more problematic drinking habits
Self-Rated Physical Health, 1 item
“In general would you say your physical health is…,” rated on a 5-point scale
Higher score reflects poorer perceived physical health
Self-Rated Mental Health, 1 item
“In general would you say your mental health is…,” rated on a 5-point scale
Higher score reflects poorer perceived mental health
Unmet Need for Harm Reduction Services and Elements of Well-Being
• *Differences between those with and without unmet need for were statistically significant (p<.01) except PWI (p=.056) and GHQ-12 (p=.397)
Limitations• Considerably underestimates need for harm reduction
services in Alberta• Does not enable substance-specific analysis
Conclusions• Harm reduction needs exist across the population• Unmet need associated with poorer health and reduced service use
for individuals with addiction problems• Additional research is needed to better understand this need
• Incorporating harm reduction services into mental health and addiction treatment systems and/or expanding access to harm reduction in Alberta could help connect more people with addictions to health and social services.
Thank you
GAP Analysis of Public Addiction and Mental Health Programs: Final ReportWild, Wolfe, Wang, and Ohinmaa (2014)http://www.health.alberta.ca/documents/GAP-MAP-Report-2014.pdf
