2. The association between mental health and alcohol use in racial and ethnic groups: A secondary data analysis across studies

Mental health and alcohol use are closely linked. In the UK, alcohol use has typically been shown to be higher in White British groups but these patterns may not be consistent when considering those with a mental health problem. This study aimed to determine whether the relationship between psychological distress and alcohol use differs across ethnic groups.

A secondary analysis of the 2007 and 2014 Adult Psychiatric Morbidity (APMS) (N=14,949), SouthEast London Community Health (SELCoH) (N=1,695), and Next Steps (N=7,707) surveys was conducted. Alcohol use was measured using the Alcohol Use Disorder Identification TestConsumption, categorised as non-drinker, low-risk drinker, and increased-risk drinker. Psychological distress was measured using either the Clinical Interview Schedule-Revised or General Health Questionnaire-12 depending on the survey. Data analyses examined the association between psychological distress and alcohol use, stratified by ethnic group and survey. Multinomial logistic regression models were conducted with low-risk drinking as the reference category.

Across all three surveys, those meeting criteria for psychological distress were significantly more likely to be non-drinker (APMS-Odds Ratio (OR)=1.53,95% Confidence Interval (C=1.35-1.74; SELCoH-OR=2.18,95%CI=1.45-3.26; Next Steps-OR=1.62,95%CI=1.33-1.97) but only in the White British ethnic group. The odds of increased-risk drinking was significantly higher among participants with psychological distress among White British groups in the APMS (OR=1.19,95%CI=1.07-1.33) and among Black African groups in SELCoH (OR=11.46,95%CI=3.54- 37.07). No significant associations between psychological distress and increased-risk drinking were found for any ethnic group using the Next Steps survey, but numbers were small.

The established association between psychological distress and alcohol use was not consistent across ethnic groups. The study was limited by the small numbers of participants from racial and ethnic groups in UK secondary data sources.