Estimating the Prevalence of Mental and Substance Use Disorders: A Systematic Approach to Triangulating Available Data to Inform Health Systems Planning

Abstract

Objective: To estimate the prevalence of specific mental and substance use disorders (MSUDs), by age and sex, as a first step toward informing needs-based health systems planning by decision-makers. Methods: We developed a conceptual framework and a systematic methodology for combining available data sources to yield prevalence estimates for specific MSUDs. Data sources used included published, peer-reviewed literature from Canada and comparable countries, Canadian population survey data, and health administrative data from British Columbia. Several well-established methodologies including systematic review and meta-analyses of published prevalence estimates, modelling of age- and sex-specific distributions, and the Global Burden of Disease severity distribution model were incorporated in a novel mode of triangulation. Results: Using this novel approach, we obtained prevalence estimates for 10 MSUDs for British Columbia, Canada, as well as prevalence distributions across age groups, by sex. Conclusion: Obtaining reliable assessments of disorder prevalence and severity is a useful first step toward rationally estimating service need and plan health services. We propose a methodology to leverage existing information to obtain robust estimates in a timely manner and with sufficient granularity to, after adjusting for comorbidity and matching with severity-specific service bundles, inform need-based planning efforts for adult (15 years and older) mental health and substance use services.

Reading Between the Lines: A Pursuit of Estimating the Population Prevalence of Mental Illness Using Multiple Data Sources

“…Vigo and colleagues introduced an approach to combining estimates from many different data sources using meta-analysis and triangulation. 1 This approach offers the ability to provide timely estimates that are informed from various Canadian and international data sources, including evidence from survey and health administrative data. Furthermore, the authors introduce the idea of contextualizing estimates of mental illness by disorder class, age, sex, and presenting severity fractions that are informed by the Global Burden of Disease framework.…”

“…As such, we must work to compare and contrast various approaches, including the triangulation approach introduced by Vigo and colleagues, which has moved this field forward. 1 …”

“…Recently, there have been a number of suggested approaches, including both a Bayesian and now a triangulation approach from Vigo et al, which have helped to move this discussion forward. 1,2 One of the greatest challenges of this work is establishing common measurement and determining whether various data sources are measuring the same underlying construct. One method for testing this is to use linked data to measure concordance across sources.…”

“…Recently, there have been a number of suggested approaches, including both a Bayesian and now a triangulation approach from Vigo et al, which have helped to move this discussion forward. 1 , 2 …”

The Burden of Mental Illness and Evidence-informed Mental Health Policy Development

“…As we pass the first anniversary of the COVID-19 pandemic, there has been greater attention on and concern about the impact of the pandemic on the mental health of Canadians. 1 This is understandable given that the pandemic has increased risk factor exposure (social isolation, financial stress, anxiety related to infection risk, etc.) for all Canadians.…”