Concurrent Experience of Self-Reported Mental Health Symptoms and Problematic Substance Use During the First Two Years of the COVID-19 Pandemic Among Canadian Adults: Evidence from a Repeated Nationwide Cross-Sectional Survey

This study was aimed at identifying the prevalence of concurrent experience, poor mental health and problematic substance use, and its associated factors, among Canadian adults during the COVID-19 pandemic. A nationwide repeated cross-sectional sample of 14,897 Canadian adults (quota-sampled, weighted) were recruited on ten occasions between October 2020 and March 2022 using online panels. Concurrent experience was defined as mild to severe symptoms of depression (Patient Health Questionnaire-9) and/or anxiety (Generalized Anxiety Disorder-7) AND meeting screening criteria for problematic cannabis (Cannabis Use Disorder Identification Test-Revised) and/or problematic alcohol use (Alcohol Use Disorder Identification Test). Multivariable binary logistic regression models were fitted to identify the associated factors of concurrent experience using Stata v14.2 SE software. The pooled prevalence of concurrent experience was 17.12%, and 45.54% of the participants reported at least one experience (mental health symptoms or problematic substance use). The highest prevalence of concurrent experience per province was reported in Saskatchewan (19.4%) and the lowest in Quebec (13.6%). Younger adults, male respondents, those identifying as 2SLGBTQ+, self-reporting ethnocultural minority status, diagnostic history of mental health and substance use disorder, suicidal ideation, and lower ability to handle unexpected/difficult situations were significantly associated with concurrent experience during the COVID-19 pandemic in Canada. This analysis showed that the COVID-19 pandemic significantly impacted mental health and substance use in interrelated ways. Data-driven province-specific interventions might be helpful toward a client-centered and integrated mental health and substance use care system in Canada.