Alcohol can contribute to the development of mental health problems as well as exacerbating pre-existing mental health difficulties. A recent Irish report, Alcohol and youth mental health – the evidence base,1 profiled drinking behaviour and psychological health in 6,085 12–19-year-olds in 72 randomly selected post-primary schools in Ireland to determine the association between drinking behaviour and mental health and to identify risk and protective factors associated with adolescent drinking. Participants completed the My World Survey – Second Level (MWS–SL), which contains a battery of psychometrically reliable instruments assessing risk and protective factors of psychological health. 

Alcohol consumption among students

Overall, 49% reported never drinking alcohol, while 22% drank alcohol less than once a month, 18% drank alcohol monthly and a further 10% drank alcohol weekly. Alcohol consumption increased as students progressed through school; 83% of first-year students were non-drinkers, compared to 9% of sixth-years. Patterns for males and females were broadly similar. The typical volume of alcohol consumed per drinking occasion among 1st, 2nd and 3rd years was 1–2 drinks. Among 4th years, 38% consumed 3–4 drinks, while 69% of 6th years consumed at least five drinks, with 14% consuming 10 or more drinks on a typical drinking occasion. This steady progression was most evident among females. Binge drinking was defined as six or more standard drinks on a single drinking occasion. Overall, 30% reported never binge drinking, with rates ranging from 63% of 1st years and 10% of 6th years. According to the AUDIT (Alcohol Use Disorders Identification Test) criteria, 10% of junior cycle students and 35% of senior cycle students had a harmful pattern of drinking. 

Alcohol and mental health

On the Depression, Anxiety and Stress Scale (DASS), 11% displayed mild levels of depression, 11% displayed moderate levels, 4% severe levels and 4% very severe levels. A strong association was observed between harmful drinking and severity of depression. Among junior cycle students, 2% were classified as possibly being alcohol dependent and 12% of these as having severe depression. Similar patterns were observed for those in the senior cycle, and the patterns observed for depression were also evident for anxiety and stress. Protective factors such as personal competence, family cohesion and life satisfaction were significantly related to alcohol behaviour; those with harmful drinking patterns had lower levels of these protective factors than those who did not drink in a harmful manner. 

Conclusions

The results indicate that alcohol consumption among adolescents is associated with mental difficulties and the authors conclude that addressing alcohol behaviour may reduce the risk of mental health difficulties and may also increase protective factors. They state that this will require a multi-faceted approach involving parents, schools and the wider community and that international research suggests that key interventions include school strategies focusing on strengthening personal and social protective factors; family approaches such as increasing family cohesion; and community strategies such as reducing alcohol availability through regulation. 

1. Fitzgerald A and Dooley B (2013) Alcohol and youth mental health – the evidence base. Psychiatry Professional, 2(1): 6–8. www.drugsandalcohol.ie/21265