Relation of Mental Health to Alcohol and Substance Use Among Texas College Students

We examined the effect of mental health problems and difficulties on alcohol, tobacco, and other drug (ATOD) use among college students by using the 2013 Texas College Survey of Substance Use (n=11,216), which includes the K6 screening scale for severe mental illness (SMI). Students' K6 scores were used to classify them into 3 groups: those likely to have SMI (9% with scores ≥ 13), those with some mental health problems (36%), and those without mental health issues (55% with scores ≤ 4). Questions regarding ATOD use were analyzed using these 3 groups. Alcohol use was not significantly associated with K6 scores, although problematic alcohol behaviors as measured by the CAGE test were. Higher cigarette use was significantly associated with higher K6 scores. Finally, both higher marijuana and higher drug use (across 9 other individual drugs) were significantly associated with higher K6 scores. Although higher K6 scores were associated with higher rates of drug use, most students with high K6 scores did not use drugs. However, given the higher level of risk, drug and alcohol interventions should be made available for those students who receive mental health counseling.