Long-Term Outcomes of Adolescent Outpatient Treatment for Substance Use Problems: Exploring the Co-occurrence of Mental Health and Substance Use Problems

Abstract

Background Adolescents with substance use problems (SUP) constitute a group expected to face increased mental health problems (MHP). SUP can exacerbate mental health issues while also serving as a coping mechanism. Understanding the interplay between psychological, substance-related, and social factors is crucial for shaping effective interventions for this demographic. This article presents a three-year follow-up study with adolescents who had outpatient treatment for SUP, focusing on MHP and psychiatric conditions. Objective This study aims to determine the prevalence of ongoing SUP and MHP in adolescents who received outpatient treatment at a specialized substance use clinic three years post-treatment initiation. Additionally, it seeks to explore psychosocial risk factors distinguishing adolescents with solely MHP from those with both MHP and persistent SUP (co-occurring problems) three years post-treatment initiation. Method The study utilizes a longitudinal design, combining structured interview data at intervention onset with national register data at one- and three-years post-treatment initiation. A total of 451 adolescents participated, with 29% females and a median age of 17 years. Descriptive statistics and gender distribution of outcome groups are presented, alongside logistic regressions to assess the predictive value of risk factors for psychiatric conditions, substance use, and co-occurring conditions. Results Nearly three-quarters of enrolled youth show no ongoing SUP, and one-third exhibit indications of MHP three years after treatment initiation. Risk factors diverge when distinguishing adolescents with MHP from those with co-occurring problems at the three-year mark post-treatment. School problems, depression, female gender, and low primary drug use increase the likelihood of solely exhibiting MHP. Conclusions Integrated outpatient clinics like Maria clinics could play a crucial role in early detection and management of both SUP and MHP. The findings offer hope, suggesting positive outcomes regarding substance use even for individuals with heavy risk loads or severe SUP.