HIV-Related Stigma among African, Caribbean, and Black Youth in Windsor, Ontario

HIV-related stigma has been shown to undermine prevention, care, treatment, and the well-being of people living with HIV. A disproportion burden of HIV infection, as well as elevated levels of HIV-related stigma, is evidenced in sub-Saharan African (SSA) and African-diasporic populations. 

This study explores factors that influence HIV-related stigma among 16- to 25-year-old youth residing in a Canadian city who identify as African, Caribbean, or Black. Stigma, as rooted in cultural norms and beliefs and related social institutions, combined with insights from research on stigma in SSA and African-diasporic populations, guided the development of a path analytic structural equation model predicting levels of HIV-related stigmatizing attitudes. The model was tested using survey responses of 510 youth to estimate the direct and indirect influences of ethno-religious identity, religious service attendance, time in Canada, HIV/AIDS knowledge, HIV-testing history, sexual health service contact, and gender on HIV-related stigma. 

Statistically significant negative associations were found between levels of stigma and knowledge and HIV-testing history. Ethno-religious identity and gender had both direct and indirect effects on stigma. African-Muslim participants had higher levels of stigma, lower knowledge, and were less likely to have been tested for HIV infection than other ethno-religious groups. Male participants had higher levels of stigma and lower knowledge than women. Time in Canada had only indirect effects on stigma, with participants in Canada for longer periods having higher knowledge and less likely to have been tested than more recent arrivals. 

While the strength of the effect of knowledge on stigmatizing attitudes in this research is consistent with other research on stigma and evaluations of stigma-reduction programs, the path analytic results provide additional information about how knowledge and HIV-testing function as mediators of non-modifiable characteristics such as gender, ethnicity, religion, and time in a country.

Purchase full article at:   http://goo.gl/MpX55Z

By:  Mihan R1, Kerr J1,2, Maticka-Tyndale E1; ACBY Team.

• 1 Department of Sociology, Anthropology, and Criminology , University of Windsor , Windsor , ON , Canada.
• 2 Health Promotion and Behavioral Sciences, School of Public Health and Information Sciences , University of Louisville , Louisville , KY , USA. 
• AIDS Care. 2016 Mar 17:1-6. 

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The Use of a Brief Mental Health Screener to Enhance the Ability of Police Officers to Identify Persons with Serious Mental Disorders

Police agencies in Canada and elsewhere have received much criticism over how they respond to persons with serious mental disorders. The adequacy of training provided to police officers on mental health issues and in particular on recognizing indicators of serious mental disorders has been a major concern. 

This paper describes the process that led to the development of a new brief mental health screener (interRAI Brief Mental Health Screener, BMHS) designed to assist police officers to better identify persons with serious mental disorders. The interRAI BMHS was developed in collaboration with interRAI, an international, not-for-profit consortium of researchers. The government of Ontario had previously partnered with interRAI to develop and implement the Resident Assessment Instrument for Mental Health (RAI-MH), the assessment system mandated for use on all persons admitted into inpatient psychiatric care in the province. Core items on the interRAI BMHS were obtained through analysis (N=41,019) of RAI-MH data together with input from representatives from health care, police services, and patient groups. 

Two police services in southwestern Ontario completed forms (N=235) on persons thought to have a mental disorder. Patient records were later accessed to determine patient disposition. The use of summary and inferential statistics revealed that the variables significantly associated with being taken to hospital by police included performing a self-injurious act in the past 30days, and others being concerned over the person's risk for self-injury. Variables significantly associated with being admitted included abnormal thought process, delusions, and hallucinations. 

The results of the study indicate that the 14-variable algorithm used to construct the interRAI BMHS is a good predictor of who was most likely to be taken to hospital by police officers and who was most likely to be admitted. The instrument is an effective means of capturing and standardizing police officer observations enabling them to provide more and better quality information to emergency department (ED) staff. 

Teaching police officers to use the form constitutes enhanced training on major indicators of serious mental disorders. Further, given that items on the interRAI BMHS are written in the language of the health system, language acts as common currency between police officers and ED staff laying the foundation for a more collaborative approach between the systems.

Full article at:   http://goo.gl/4FA5EB

By:  Hoffman R1, Hirdes J2, Brown GP3, Dubin JA4, Barbaree H5.

• 1Ministry of Community Safety and Correctional Services, Ontario Police College, 10716 Hacienda Road, Aylmer, Ontario N5H 2T2, Canada; Faculty of Applied and Professional Studies, School of Criminology and Criminal Justice, Nipissing University, 100 College Drive, Box 5002, North Bay, Ontario P1B 8L, Canada. Electronic address: Ron.Hoffman@sympatico.ca.
• 2School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, Ontario N2L 3G1, Canada.
• 3Faculty of Applied and Professional Studies, School of Criminology and Criminal Justice, Nipissing University, 100 College Drive, Box 5002, North Bay, Ontario P1B 8L7, Canada.
• 4Department of Statistics and Actuarial Science, School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, Ontario N2L 3G1, Canada.
• 5Division of Forensic Psychiatry, Department of Psychiatry, University of Toronto, Toronto, Ontario M5T 1R, Canada; Waypoint Centre for Mental Health Care, 500 Church Street, Penetanguishene, Ontario L9M 1G3, Canada. 
• Int J Law Psychiatry. 2016 Apr 1. pii: S0160-2527(16)30044-9. doi: 10.1016/j.ijlp.2016.02.031.

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Bisexuality, Poverty & Mental Health: A Mixed Methods Analysis

Highlights

• Poverty is associated with poor mental health among bisexual people.
• Poverty is also associated with experiences of discrimination among bisexuals.
• Multiple pathways may link bisexuality, poverty, and mental health.
• Lack of affordable culturally competent services may sustain the disparities.

Bisexuality is consistently associated with poor mental health outcomes. In population-based data, this is partially explained by income differences between bisexual people and lesbian, gay, and/or heterosexual individuals. However, the interrelationships between bisexuality, poverty, and mental health are poorly understood. 

In this paper, we examine the relationships between these variables using a mixed methods study of 302 adult bisexuals from Ontario, Canada. Participants were recruited using respondent-driven sampling to complete an internet-based survey including measures of psychological distress and minority stress. A subset of participants completed a semi-structured qualitative interview to contextualize their mental health experiences. 

Using information regarding household income, number of individuals supported by the income and geographic location, participants were categorized as living below or above the Canadian Low Income Cut Off (LICO). Accounting for the networked nature of the sample, participants living below the LICO had significantly higher mean scores for depression and posttraumatic stress disorder symptoms and reported significantly more perceived discrimination compared to individuals living above the LICO. 

Grounded theory analysis of the qualitative interviews suggested four pathways through which bisexuality and poverty may intersect to impact mental health: through early life experiences linked to bisexuality or poverty that impacted future financial stability; through effects of bisexual identity on employment and earning potential; through the impact of class and sexual orientation discrimination on access to communities of support; and through lack of access to mental health services that could provide culturally competent care. 

These mixed methods data help us understand the income disparities associated with bisexual identity in population-based data, and suggest points of intervention to address their impact on bisexual mental health.

Purchase full article at:   http://goo.gl/qFio1c

By:  Ross LE1, O'Gorman L2, MacLeod MA3, Bauer GR3, MacKay J4, Robinson M4.

• 1Dalla Lana School of Public Health, University of Toronto, 155 College St. Room 560, Toronto, Ontario, M5T 3M7, Canada; Social & Epidemiological Research Department, Centre for Addiction & Mental Health, 33 Russell St. Room T406, Toronto, Ontario, M5S 1R8, Canada. Electronic address: l.ross@utoronto.ca.
• 2School of Rural and Northern Health, Laurentian University, 935 Ramsey Lake Rd., Sudbury, Ontario, P3E 2C6, Canada.
• 3Department of Epidemiology & Biostatistics, Schulich School of Medicine & Dentistry, Western University, Kresge Building Room K201, London, Ontario, N6A 5C1, Canada.
• 4Social & Epidemiological Research Department, Centre for Addiction & Mental Health, 33 Russell St. Room T406, Toronto, Ontario, M5S 1R8, Canada. 
• Soc Sci Med. 2016 Mar 10;156:64-72. doi: 10.1016/j.socscimed.2016.03.009

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Treatment of Prescription Opioid Disorders in Canada: Looking at the 'Other Epidemic'?

The magnitude and consequences of prescription opioid (PO) misuse and harms (including rising demand for PO disorder treatment) in Canada have been well-documented. 

Despite a limited evidence-base for PO dependence treatment, opioid maintenance therapy (OMT) - mostly by means of methadone maintenance treatment (MMT) - has become the de facto first-line treatment for PO-disorders. For example in the most populous province of Ontario, some 50,000 patients - large proportions of them young adults - are enrolled in MMT, resulting in a MMT-rate that is 3-4 times higher than that of the United States. 

MMT in Ontario has widely proliferated towards a quasi-treatment industry within a system context of the public fee-payer offering generous incentives for community-based MMT providers. Contrary to the proliferation of MMT, there has been no commensurate increase in availability of alternative (e.g., detox, tapering, behavioral), and less intrusive and/or costly, treatments which may provide therapeutic benefits at least for sub-sets of PO-dependent patients. 

Given the extensive PO-dependence burden combined with its distinct socio-demographic and clinical profile (e.g., involving many young people, less intensive or risky opioid use), an evidence-based 'stepped-care' model for PO dependence treatment ought to be developed in Canada where MMT constitutes one, but likely a last resort or option, for treatment. Other, less intrusive treatment options as well as the best mix of treatment options should be systematically investigated and implemented. 

This case study has relevance and implications for evidence-based treatment also for the increasing number of other jurisdictions where PO misuse and disorders have been rising.

Full article at:   http://goo.gl/EPWqtR

By:  Fischer B1,2,3,4, Kurdyak P5,6,7, Goldner E8, Tyndall M9,10, Rehm J11,12,13,14.

• 1Social and Epidemiological Research Department, Centre for Addiction & Mental Health (CAMH), Toronto, ON, M5S 2S1, Canada. bfischer@sfu.ca.
• 2Department of Psychiatry, University of Toronto, Toronto, ON, M5T 1R8, Canada. bfischer@sfu.ca.
• 3Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, ON, M5T 1R8, Canada. bfischer@sfu.ca.
• 4Centre for Applied Research in Mental Health & Addiction (CARMHA), Simon Fraser University, Vancouver, V6B 5K3, Canada. bfischer@sfu.ca.
• 5Social and Epidemiological Research Department, Centre for Addiction & Mental Health (CAMH), Toronto, ON, M5S 2S1, Canada. paul.kurdyak@camh.ca.
• 6Department of Psychiatry, University of Toronto, Toronto, ON, M5T 1R8, Canada. paul.kurdyak@camh.ca.
• 7Mental Health and Addictions Program, Institute for Clinical Evaluative Science (ICES), Toronto, ON, M4N 3M5, Canada. paul.kurdyak@camh.ca.
• 8Centre for Applied Research in Mental Health & Addiction (CARMHA), Simon Fraser University, Vancouver, V6B 5K3, Canada. egoldner@sfu.ca.
• 9B.C. Centre for Disease Control (BCCDC), Vancouver, BC, V5Z 4R4, Canada. mtyndall@bccdc.ca.
• 10Department of Medicine, University of British Columbia, Vancouver, BC, V5Z 1M9, Canada. mtyndall@bccdc.ca.
• 11Social and Epidemiological Research Department, Centre for Addiction & Mental Health (CAMH), Toronto, ON, M5S 2S1, Canada. jtrehm@gmail.com.
• 12Department of Psychiatry, University of Toronto, Toronto, ON, M5T 1R8, Canada. jtrehm@gmail.com.
• 13Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, ON, M5T 1R8, Canada. jtrehm@gmail.com.
• 14Dalla Lana School of Public Health, University of Toronto, Toronto, ON, M5T 3M7, Canada. jtrehm@gmail.com.
• Subst Abuse Treat Prev Policy. 2016 Mar 8;11(1):12. doi: 10.1186/s13011-016-0055-4. 

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Public Opinions About Supervised Smoking Facilities for Crack Cocaine & Other Stimulants

BACKGROUND:

The purpose of this study was to estimate awareness and opinions about supervised smoking facilities (SSFs) for smoking crack cocaine and other stimulants and make comparisons with awareness and opinions about supervised injection facilities (SIFs) in Ontario, Canada.

METHODS:

We used data from a 2009 telephone survey of a representative adult sample. The survey asked about awareness of, and level of support for, the implementation of SSFs and SIFs. Data were analysed using statistical models for complex survey data, which account for stratified sampling and incorporate sampling weights.

RESULTS:

A total of 1035 participated in the survey. Significantly fewer had knowledge about SSFs (17.9 %) than about SIFs (57.6 %). Fewer strongly agreed with implementation of SSFs (19.6 %) than SIFs (28.3 %). Just over half (51.1 %) of participants somewhat agreed or disagreed, 15.7 % strongly agreed, and 10.6 % strongly disagreed with implementing both SSFs and SIFs.

CONCLUSIONS:

Members of the public in Ontario had little knowledge of SSFs compared to SIFs. Recent federal government changes in Canada may provide the leadership environment necessary to ensure that innovative, evidence-based harm reduction programs such as SSFs are developed and implemented.

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By:  Strike C1, Rotondi NK2, Watson TM3, Kolla G4, Bayoumi AM5,6,7,8.

• 1Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Canada. carol.strike@utoronto.ca.
• 2Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 30 Bond Street, Toronto, Canada. nooshin.rotondi@gmail.com.
• 3Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Canada. tara.watson@utoronto.ca.
• 4Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Canada. gillian.kolla@utoronto.ca.
• 5Centre for Research on Innercity Health, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 30 Bond Street, Toronto, Canada. ahmed.bayoumi@utoronto.ca.
• 6Department of Medicine, University of Toronto, 1 King's College Circle, Toronto, Canada. ahmed.bayoumi@utoronto.ca.
• 7Institute of Health Policy, Management, and Evaluation, University of Toronto, 155 College Street, Toronto, Canada. ahmed.bayoumi@utoronto.ca.
• 8Division of General Internal Medicine, St. Michael's Hospital, 30 Bond Street, Toronto, Canada. ahmed.bayoumi@utoronto.ca. 
• Subst Abuse Treat Prev Policy. 2016 Feb 9;11(1):8. doi: 10.1186/s13011-016-0052-7.

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Using a Delphi Process to Define Priorities for Prison Health Research in Canada

OBJECTIVES:

A large number of Canadians spend time in correctional facilities each year, and they are likely to have poor health compared to the general population. Relatively little health research has been conducted in Canada with a focus on people who experience detention or incarceration. We aimed to conduct a Delphi process with key stakeholders to define priorities for research in prison health in Canada for the next 10 years.

SETTING:

We conducted a Delphi process using an online survey with two rounds in 2014 and 2015.

PARTICIPANTS:

We invited key stakeholders in prison health research in Canada to participate, which we defined as persons who had published research on prison health in Canada since 1994 and persons in the investigators' professional networks. We invited 143 persons to participate in the first round and 59 participated. We invited 137 persons to participate in the second round and 67 participated.

PRIMARY AND SECONDARY OUTCOME MEASURES:

Participants suggested topics in the first round, and these topics were collated by investigators. We measured the level of agreement among participants that each collated topic was a priority for prison health research in Canada for the next 10 years, and defined priorities based on the level of agreement.

RESULTS:

In the first round, participants suggested 71 topics. In the second round, consensus was achieved that a large number of suggested topics were research priorities. Top priorities were diversion and alternatives to incarceration, social and community re-integration, creating healthy environments in prisons, healthcare in custody, continuity of healthcare, substance use disorders and the health of Aboriginal persons in custody.

CONCLUSIONS:

Generated in an inclusive and systematic process, these findings should inform future research efforts to improve the health and healthcare of people who experience detention and incarceration in Canada.

Below:  Per cent agreement by participants in a Delphi process in 2015 that each topic* is a priority for prison health research in Canada,† N=67 participants. MRSA, methicillin-resistantStaphylococcus aureus. *Abbreviated titles for topics were used in this Figure. Full titles for each topic are provided in table 2; the full titles were used for the second round of the Delphi. †Sorted by the percent of participants who strongly agreed and agreed.

Full article at:   http://goo.gl/IfpdHp

By:  Kouyoumdjian FG1, Schuler A1, McIsaac KE2, Pivnick L3, Matheson FI1, Brown G4, Kiefer L5, Silva D6, Hwang SW1.

• 1Centre for Research on Inner City Health, St. Michael's Hospital, Toronto, Ontario, Canada.
• 2Centre for Research on Inner City Health, St. Michael's Hospital, Toronto, Ontario, Canada Dalla Lana School of Public Health, Toronto, Ontario, Canada.
• 3Faculty of Medicine, McMaster University, Hamilton, Ontario, Canada.
• 4Department of Family Medicine, Queen's University, Kingston, Ontario, Canada.
• 5Dalla Lana School of Public Health, Toronto, Ontario, Canada Ontario Ministry of Community Safety and Correctional Services, Toronto, Ontario, Canada.
• 6Centre for Research on Inner City Health, St. Michael's Hospital, Toronto, Ontario, Canada Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada.
• BMJ Open. 2016 Jan 14;6(1):e010125. doi: 10.1136/bmjopen-2015-010125. 

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Online Outreach Services among Men Who Use the Internet to Seek Sex with Other Men (MISM) in Ontario, Canada: An Online Survey

Background

Men who use the Internet to seek sex with other men (MISM) are increasingly using the Internet to find sexual health information and to seek sexual partners, with some research suggesting HIV transmission is associated with sexual partnering online. Aiming to “meet men where they are at,” some AIDS service organizations (ASOs) deliver online outreach services via sociosexual Internet sites and mobile apps.

Objective

To investigate MISM's experiences and self-perceived impacts of online outreach.

Methods

From December 2013 to January 2014, MISM aged 16 years or older were recruited from Internet sites, mobile apps, and ASOs across Ontario to complete a 15-minute anonymous online questionnaire regarding their experience of online outreach. Demographic factors associated with encountering online outreach were assessed using backward-stepwise multivariable logistic regression (P<.05 was considered significant).

Results

Of 1830 MISM who completed the survey, 8.25% (151/1830) reported direct experience with online outreach services. Encountering online outreach was more likely for Aboriginal versus white MISM, MISM from Toronto compared with MISM from either Eastern or Southwestern Ontario, and MISM receiving any social assistance. MISM who experienced online outreach felt the service provider was 

• friendly (130/141, 92.2%), 
• easy to understand (122/140, 87.1%), 
• helpful (115/139, 82.7%), 
• prompt (107/143, 74.8%), and 
• knowledgeable (92/134, 68.7%); 
• half reported they received a useful referral (49/98, 50%). 
• Few MISM felt the interaction was annoying (13/141, 9.2%) 
• or confusing (18/142, 12.7%). 

As a result of their last online outreach encounter, MISM reported the following: 

• better understanding of (88/147, 59.9%) and 
• comfort with (75/147, 51.0%) their level of sexual risk; 
• increased knowledge (71/147, 48.3%); and 
• feeling less anxious (51/147, 34.7%), 
• better connected (46/147, 31.3%), and 
• more empowered (40/147, 27.2%). 

Behaviorally, they reported 

• using condoms more frequently (48/147, 32.7%) 
• and effectively (35/147, 23.8%); 
• getting tested for HIV (43/125, 34.4%) 
• or STIs (42/147, 28.6%); 
• asking for their partners’ HIV statuses (37/147, 25.2%); 
• and serosorting (26/147, 17.7%). 

Few MISM reported 

• no changes (15/147, 10.2%) 
• and most would use these services again (98/117, 83.8%). 

Most MISM who did not use online outreach said they did not need these services (1074/1559, 68.89%) or were unaware of them (496/1559, 31.82%).

Conclusions

This is the first online outreach evaluation study of MISM in Canada. Online outreach services are a relatively new and underdeveloped area of intervention, but are a promising health promotion strategy to provide service referrals and engage diverse groups of MISM in sexual health education.

Full article at:   http://goo.gl/6pYu6G

By:  David J Brennan, MSW, PhD, ¹ Nathan J Lachowsky, PhD,^1,2,3 Georgi Georgievski, HBSc,¹ Brian R Simon Rosser, MPH, PhD,⁴ Duncan MacLachlan,⁵ James Murray, MEd,⁶ and Cruising Counts Research Team¹

¹University of Toronto, Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada

²University of British Columbia, Faculty of Medicine, Vancouver, BC, Canada

³British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada

⁴University of Minnesota, School of Public Health, Minneapolis, MN, United States

⁵Ontario HIV Treatment Network, Toronto, ON, Canada

⁶Ontario Ministry of Health and Long Term Care, AIDS Bureau, Toronto, ON, Canada

David J Brennan, University of Toronto, Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON, M5S1V4, Canada, Phone: 1 416 978 3273, Fax: 1 416 978 7072, Email: ac.otnorotu@nannerb.divad.

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Sexual Motives in Heterosexual Women With and Without Sexual Difficulties

Previous research indicates that women with sexual problems may have different reasons for engaging in sex than women who are not experiencing sexual problems. 

The current study investigated whether reasons for sex differed by women reporting high versus low overall sexual functioning, as assessed by the FSFI. As low desire and inability to achieve orgasm are the two most commonly reported sexual problems for women, the study also investigated whether women with and without problems specifically related to sexual desire or orgasm cited different reasons for sex. 

The sample was comprised of 446 heterosexual women between the ages of 18 and 61 who completed an online questionnaire assessing reasons for sex and sexual functioning. Women with low sexual functioning overall were more likely to endorse insecurity reasons for sex, while women with high sexual functioning overall were more likely to endorse physical reasons for sex. 

Women experiencing low desire specifically were less likely to endorse emotional and physical reasons for sex than women without desire difficulties. Women experiencing orgasm difficulties specifically were more likely to endorse insecurity reasons for sex than women without orgasm difficulties. 

The variance accounted for was low in all cases. This research offers insights into the important but limited role sexual functioning may play in the broader context of women's sexual motivations.

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By:  Watson E1, Milhausen RR2, Wood J3, Maitland S4.

• 1 University of Guelph, Family Relations and Applied Nutrition , 50 Stone Rd East, MacDonald Institute , Guelph , Ontario , Canada.
• 2 University of Guelph, Family Relations and Applied Nutrition, Macdonald Institute , 50 Stone Rd., Guelph , Ontario , N1G 2W1 Canada.
• 3 University of Guelph, Psychology, Blackwood Hall , 50 Stone Rd., Guelph , Ontario , Canada.
• 4 University of Guelph, Family Relations and Applied Nutrition, MacDonald Institute , 50 Stone Rd., Guelph , Ontario , N1G 2W1 Canada.
• J Sex Marital Ther. 2016 Jan 6:0. [Epub ahead of print] 

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"Why Are You Pregnant? What Were You Thinking?": How Women Navigate Experiences of HIV-Related Stigma in Medical Settings During Pregnancy and Birth

Having children is a growing reality for women living with HIV in Canada. It is imperative to understand and respond to women's unique experiences and psychosocial challenges during pregnancy and as mothers including HIV-related stigma. 

This qualitative study used a narrative methodological approach to understand women's experiences of HIV-related stigma as they navigate health services in pregnancy (n = 66) and early postpartum (n = 64). 

Narratives of women living with HIV expose the spaces where stigmatizing practices emerge as women seek perinatal care and support, as well as highlight the relationship between HIV-related stigma and disclosure, and the impact this has on women's pregnancy and birthing experiences.

Purchase full article at:   http://goo.gl/a8wEfv

By:   Greene S Msw PhD1, Ion A MSc1, Kwaramba G1, Smith S1, Loutfy MR Md Frcpc Mph2.

• 1 School of Social Work , McMaster University , Hamilton , Ontario , Canada.
• 2 Women's College Research Institute, Women's College Hospital , University of Toronto , Toronto, Ontario, Canada. 

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Problem Gambling among Ontario Students: Associations with Substance Abuse, Mental Health Problems, Suicide Attempts, and Delinquent Behaviours

This paper describes gambling problems among Ontario students in 2009 and examines the relationship between gambling problems and substance use problems, mental health problem indicators, and delinquent behaviors. 

Data were derived from the Ontario Student Drug Use and Health Survey of Ontario students in grades 7-12. Gambling problems were measured as 2 or more of 6 indicators of problem gambling. In total 2.8 % of the students surveyed endorsed two or more of the problem gambling items. The odds of problem gamblers reporting mental distress was 4.2 times higher than the rest of the sample and the odds of problem gamblers reporting a suicide attempt were 17.8 times greater than the rest of the sample. 

In addition compared to the rest of the students, delinquent behaviors were also more common among problem gamblers, including theft (OR = 14.5), selling marijuana (OR = 19.6), gang fights (OR = 11.3) and carrying a handgun (OR = 11.2). 

In a multivariate analysis, substance-use problems, mental health problems, and the participation in a variety of delinquent behaviors remained significantly associated with youth problem gambling behavior. Students who report problem gambling behaviors show increased substance abuse, mental health, and delinquency/criminal problems that are similar to those seen among adult problem gamblers. 

The association between these problems suggests that these problems could be addressed in a unified manner.

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By:  Cook S1, Turner NE2,3, Ballon B4,5, Paglia-Boak A6, Murray R7, Adlaf EM8,9, Ilie G10, den Dunnen W11, Mann RE12,13.

• 1Department of Sociology, University of Toronto, Toronto, ON, Canada. steven.cook10@me.com.
• 2Centre for Addiction and Mental Health, 33 Russell Street, Rm. T524, Toronto, ON, M5S 2S1, Canada. Nigel_Turner@camh.net.
• 3Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada. Nigel_Turner@camh.net.
• 4Centre for Addiction and Mental Health, 33 Russell Street, Rm. T524, Toronto, ON, M5S 2S1, Canada. Bruce.Ballon@camh.ca.
• 5Department of Psychiatry, University of Toronto, Toronto, ON, Canada. Bruce.Ballon@camh.ca.
• 6Centre for Addiction and Mental Health, 33 Russell Street, Rm. T524, Toronto, ON, M5S 2S1, Canada. Angela.Boak@camh.ca.
• 7Centre for Addiction and Mental Health, 33 Russell Street, Rm. T524, Toronto, ON, M5S 2S1, Canada. Robert.Murray@camh.ca.
• 8Centre for Addiction and Mental Health, 33 Russell Street, Rm. T524, Toronto, ON, M5S 2S1, Canada. eadlaf@sympatico.ca.
• 9Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada. eadlaf@sympatico.ca.
• 10St. Michael's Hospital, Toronto, ON, Canada.
• 11Department of Psychology, University of Ottawa, Ottawa, ON, Canada.
• 12Centre for Addiction and Mental Health, 33 Russell Street, Rm. T524, Toronto, ON, M5S 2S1, Canada. Robert.Mann@camh.ca.
• 13Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada. Robert.Mann@camh.ca. 

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