title: Substance use and mental illness among nurses: workplace warning signs and barriers to seeking assistance.
abstract: BACKGROUND
  Although some studies have examined the prevalence of substance use among nurses, few have assessed substance use in the workplace or early cues for identifying these health conditions. Primary data collected as part of a larger program evaluation were examined with the purpose of better understanding (a) the context and perceived consequences of substance use and mental illness among nurses and (b) barriers and opportunities for earlier identification and treatment of these issues among nurses, their colleagues, and employers.
  
  
  METHODS
  Anonymous surveys were mailed to 441 active and recent participants of a peer health assistance program in the summer of 2010. The survey examined drug-related behaviors in the workplace; behavioral cues that may permit earlier identification of substance use and mental illness; perceptions of barriers to seeking assistance; and strategies for preventing problems and overcoming barriers to seeking assistance.
  
  
  RESULTS
  Responses were received from 302 nurses (69%). Nearly half (48%) reported drug or alcohol use at work, and two fifths (40%) felt that their competency level was affected by their use. More than two thirds of respondents thought their problem could have been recognized earlier. The most highly rated barriers to seeking assistance for substance use and mental illness included fear and embarrassment and concerns about losing one's nursing license. Respondents recommended greater attention be paid to early identification of risk factors during nurses' professional training as a prevention strategy.
  
  
  CONCLUSIONS
  Findings from this study provide preliminary data that can be used by schools of nursing and health care employers to improve early identification of nurses' substance use and mental illness treatment needs. These data also suggest a need for more research to explore the prevention and early identification of co-occurring disorders in health care settings where nurses practice.
authors.affiliation: a OMNI Institute , Denver , Colorado , USA.
authors.forename: Alexa
authors.initials: A
authors.lastname: Cares
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Pace
authors.forename: Jean
authors.initials: J
authors.lastname: Denious
authors.forename: Lori A
authors.initials: LA
authors.lastname: Crane
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003463:Cues; D042241:Early Diagnosis; D061345:Early Medical Intervention; D005239:Fear; D005260:Female; D006801:Humans; D008004:Licensure; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D008875:Middle Aged; D009726:Nurses / Q000523:psychology / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care; D015995:Prevalence; D011363:Professional Impairment / Q000523:psychology / Q000706:statistics & numerical data*; D015397:Program Evaluation; D012752:Shame; D019966:Substance-Related Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000534:rehabilitation; D011795:Surveys and Questionnaires; D017132:Workplace; D055815:Young Adult
keywords: Alcohol; barriers to seeking assistance; drugs; mental illness; nurses; peer health assistance program; substance use; worksite warning signs