Adversities and impact on mental health

The overlapping nature of these issues often leads to highly complex and challenging circumstances, requiring an integrated approach to support children, young people, and families effectively. Understanding these intersections is critical to addressing the unique needs of those impacted and promoting their safety, wellbeing, and long-term recovery.

Substance use 

The relationship between mental health, alcohol and other substances is complex. People who experience mental health challenges are more likely to use alcohol and other substances, and vice versa. This co-occurrence can complicate diagnosis, treatment, and recovery, as each condition can influence the other (Australian Institute of Health and Welfare (e)). 

Experiencing a mental health issue or condition can make a person more likely to use substances and people may use substances which contributes to the development of low mental health and wellbeing or illness. There are also instances where a person may experience both issues without one causing or contributing to the other (Australian Institute of Health and Welfare (e)). Refer to Substance use among people aged 18 years and over according to mental health status for current statistics. 

People may feel these substances help with feelings of anger, stress, worry and sadness, they are not an effective solution and can negatively affect mental health and wellbeing in both the short and long-term (Think Mental Health).  

Alcohol has a depressant effect on the body and can negatively affect thoughts, feelings and actions. Alcohol causes changes in the brain, which can lead to the depletion of chemicals that naturally help to reduce anxiety, leaving a person more stressed, anxious or depressed and feeling they need more alcohol to cope with those feelings (Think Mental Health). 

The co-occurrence of mental illness and substance use can lead to significantly poorer health and social outcomes. Individuals with both conditions are at a higher risk of frequent hospitalisations, homelessness, and difficulties maintaining employment or relationships. Additionally, this combination increases the likelihood of self-harm and suicide, highlighting the critical need for comprehensive and integrated support.

Effective treatment for co-occurring mental illness and substance use disorders requires integrated care that addresses both conditions simultaneously. Integrated care ensures the complex relationship between mental health and substance use is managed holistically, improving the likelihood of positive outcomes and long-term recovery.

Young people, mental health and alcohol and other substances

Young people experiencing mental health needs, such as anxiety or depression, are more likely to use alcohol or other drugs to cope. Also, young people who use alcohol or other substances may find this triggers their first experience of low mental health symptoms (Alcohol and Drug Foundation). 

Co-occurring mental health needs and alcohol and other drug use or dependence can affect each young person differently. Alcohol and other drug use in young people can escalate when their mental health needs are present or untreated, and vice versa. This can worsen the symptoms both for substance use and mental ill health (Alcohol and Drug Foundation).

If a young person is experiencing mental ill health, they may use alcohol and other drugs to reduce their symptoms and experience temporary relief.  But, once the effects of the drug subside, mental health symptoms can be intensified. This can lead to a cycle of using more and building a tolerance to alcohol and other drugs

Disability

Children and families living with disability often face additional risk factors that can increase the likelihood of mental health challenges. These risks include discrimination, social isolation, limited employment opportunities, and financial hardship. Barriers to accessing appropriate support and stigma can make these challenges worse.

When disability and mental health challenges overlap, they can create complex vulnerabilities for both children and their families. For example, a child with a disability may experience mental health challenges due to social isolation, stigma, or difficulties accessing appropriate support. Similarly, a parent or caregiver with both a disability and mental health concerns may face significant barriers in providing consistent care, managing stress, and meeting the complex needs of their child. 

These overlapping factors often exacerbate one another, creating a cycle of disadvantage that can increase risks within the household.

Key considerations for assessing risk

Children with disabilities and mental health challenges require specialised care, which can be physically, emotionally, and financially demanding for parents. The presence of both disability and mental health issues may increase the risk of neglect or inadequate care if parents are overwhelmed or unsupported.
Children with disabilities and mental health challenges are more vulnerable to abuse or neglect due to their increased dependence on caregivers, communication barriers, or difficulty recognising or reporting abuse. 

Parents with co-occurring disabilities and mental health challenges may struggle with parenting responsibilities, which may lead to inconsistent care or unsafe environments. Explore both if these challenges affect the child’s safety and wellbeing, and the parent’s strengths and potential for improvement with support.

Families dealing with the intersection of disability and mental health may also face additional challenges, such as intergenerational trauma, poverty, or systemic barriers to accessing services. They may face heightened stigma and social isolation, which can limit their access to support networks and resources. 

When disability and mental health challenges coexist, plan interventions to address both needs together to reduce stress for families and improve the safety and wellbeing of the child. This includes:

• access to integrated services to provide mental health support tailored for people with disabilities
• disability services that consider mental health needs.