title: Co-occurrence of substance use related and mental health problems in the Finnish social and health care system.
abstract: OBJECTIVE
  Many studies have noted that substance abuse and mental health problems often occur simultaneously. The aim of the work reported here was to study the co-occurrence of mental health problems and problems related to substance use in a sample of clients visiting the Finnish social and health care services for issues related to substance use. We collected background information on the clients and considered the parts of the treatment system in which these clients were treated.
  
  
  METHODS
  Survey data on intoxicant-related cases in the Finnish health care and social services were gathered on a single day in 2011. During the 24 hours of data collection, all intoxicant-related cases were reported and data were obtained for 11,738 intoxicant-related cases. In this analysis we took into account the clients' background variables, mental health variables, information on the treatment type and the main reasons for the client being in treatment. The χ(2) test, Fisher's exact test and binary logistic regression analysis were used.
  
  
  RESULTS
  Half of the visiting clients had both substance use related and mental health problems. The strongest factors associated with the co-occurrence of substance use related and mental health problems were female sex, younger age and single marital status. Clients with co-occurring problems were more often treated in the health care services, whereas clients with only substance use related problems were primarily treated in specialized services for the treatment of substance abuse.
  
  
  CONCLUSIONS
  It is important to identify clients with co-occurring substance use related and mental health problems. In this study, half of the clients presenting to the Finnish social and health care treatment system had both these problems.
authors.affiliation: Department of Health/Alcohol and Drugs Unit, National Institute for Health and Welfare, Helsinki, Finland kristiina.kuussaari@thl.fi.
authors.forename: Kristiina
authors.initials: K
authors.lastname: Kuussaari
authors.affiliation: Department of Welfare/Equality and Inclusion Unit, The Social Inclusion Coordination Project, National Institute for Health and Welfare, Tampere, Finland.
authors.forename: Tanja
authors.initials: T
authors.lastname: Hirschovits-Gerz
mesh_terms: D000328:Adult; D015897:Comorbidity; D005260:Female; D005387:Finland / Q000453:epidemiology; D006296:Health Services / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000628:therapy; D008875:Middle Aged; D012947:Social Work / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000628:therapy; D055815:Young Adult
keywords: Co-occurring problems; Finland; mental health; substance abuse; treatment system