Preventing Substance Use and Mental Health Disorders
Examining Shared
Risk and Protective Factors
Learning Objectives
 Define
shared risk and protective
factors
 List 3 reasons for addressing shared
risk and protective factors
 List at least 3 strategies for
overcoming common barriers to
collaboration around shared factors
Review: Risk and Protective Factors
 Risk
factor: a characteristic at the biological,
psychological, family, community, or cultural
level that precedes and is associated with a
higher likelihood of problem outcomes
 Protective factor: a characteristic associated
with a lower likelihood of problem outcomes or
that reduces the negative impact of a risk
factor on problem outcomes
Source: National Research Council and Institute of Medicine. (2009). Preventing mental,
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emotional, and behavioral disorders among young people: Progress and possibilities (O’Connell,
M.E., Boat, T., & Warner, K. E., Eds.) Washington, D.C: National Academies Press.
Shared Factors
 Early
predictors that relate to and/or
influence the occurrence of both substance
abuse and mental health disorders
 Focus
on factors across life-span
 Socio-ecological
Framework
Handout 1: Shared Risk and Protective Factors
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Examples of Shared Risk Factors
SocioEcological
Level
Shared Risk Factors
Data Sources
Society
•
•
Prejudice/discrimination
Lack of cultural identify
• Community surveys
Community
•
•
Chronic community stress
Problems/difficulties in
school
• Uniform Crime Reports
• School records
• National Survey of Children’s
Health (NSCH)
Relationship
•
•
Parental substance use
Child abuse/maltreatment
(ACEs handout)
• National Survey on Drug Use and
Health (NSDUH)
• Monitoring the Future (MTF)
Individual
•
•
Illness/poor physical health
Poor social/problem
solving skills
• Behavioral Risk Factor
Surveillance System (
• NSDUH, MTF
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Examples of Shared Protective Factors
SocioEcological
Level
Shared Protective Factors
Data Sources
Society
•
Culture
• Surveys
Community
•
Availability of or opportunities for
social activities (clubs, school or
community sports)
• NSCH, Youth Risk Behavior
Survey
Relationship
•
•
Parental support and bonding
Access to mentors
• NSCH
• NSCH, YRBS
Individual
•
•
Religiosity/spirituality
Stable housing
• NSCH, NSDUH
• U.S. Census
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Example of a Shared Risk Factor: Family
Disruption
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Shared Risk Factor
States/Tribes/Jurisdictions
Epidemiology Focus
Family
Disruption
Heavy
Alcohol Use
Depression
Substance Abuse Problem
Mental Disorder
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Example: Influence of a Factor Across the
Lifespan
Social Support
Suicide
Attempts in
Adolescence
Substance
Abuse in Young
Adulthood
Mental Illness
in Older
Adulthood
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Example of Shared Consequences: Substance Use, Depression and
Suicide
9
Substance
Use
Other
Risk Behaviors
(Alcohol-Related
Consequences)
Depression
SuicideRelated
Behavior3
Shared Factors, Shared Interventions
10
Shared
R/P
Factors
Mental Health (MH)
Disorders
Substance Use (SA)
Disorders
Risk/Protective
Factors
Shared
Interventions
Risk/Protective
Factors
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Shared Risk/Protective Factors:
Examples from the Community
Considerations and Caveats
 The
relationship
between factors and
outcomes may be
mediated by other
factors
 Mental disorders are
risk factors for
substance abuse and
vice versa
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Considerations and Caveats
factors and
protective factors
tend to cluster
(cont.)
 Risk
 Risk
factors and
protective factors
can have a
cumulative effect
Abuse
Neglect
Family
Dysfun
ction
ACEs
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Getting Ready to Collaborate
Readiness to Engage in Collaboration
Adaptation of Stages of Community Readiness,Tri- Ethnic Center for Prevention Research, Colorado State
University
Poll:
What is your community’s current
stage of readiness to work
together to address shared
factors?
a) No awareness/denial
b) Vague awareness
c) Pre-planning
d) Preparation
e) Initiation
Strategies to Increase Readiness to
Collaborate
No Awareness
Raise awareness of the connection between substance abuse and
other
behavioral disorders
Denial
Raise awareness that substance abuse prevention and other
behavior health providers can collaborate
Vague Awareness
Increase motivation to take action to increase collaboration
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Strategies to Increase Readiness to
Collaborate
Pre-Planning
Detail possible efforts or actions that promote collaboration
Preparation
Create an action plan for collaboration and commit to moving
forward
Implementation
Implementing an approach to collaborate
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Planning: Examples of Successful
Behavioral Health Collaborations
19
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Strategies for Overcoming Common
Barriers to Collaboration
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Final Poll:
Over the next several months,
I will…
a) Learn more about the connection
between substance abuse
prevention and other behavioral
health issues in my community
b) Determine what is already
happening in my community
regarding substance abuse
prevention and other behavioral
health issues
c) Reach out to a new partner
d) Educate the community on both
issues
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