The experience of alcohol use in young people with severe mental illness: an interpretive phenomenological analysis

Poorer health for Australians living with a mental illness is a public health concern. There is a high prevalence of comorbid substance misuse in people living with severe mental illness (SMI), and alcohol misuse is a key factor in cardiovascular disease, cancer and obesity. Research suggests a better understanding of how people with SMI use substances such as alcohol is needed. The present study aimed to explore the experience of young people with SMI who use alcohol. Participants (n=8, aged 18-25) were residents of a medium term mental health treatment facility, and completed interviews and self-report questionnaires. Data was analysed using an interpretive phenomenological analysis approach, with five superordinate themes emerging: mental health and wellbeing; alcohol as a means to navigate the social world; alcohol to control internal states; alcohol to feel normal; and ambivalence about alcohol use. Questionnaire data suggested alcohol was the most commonly used substance amongst participants, participants tended to understate their alcohol consumption in interview, and alcohol was most frequently used for social and enhancement reasons. Alcohol use was seen as an important social tool, a way to control aspects of life that SMI had impacted, and a way to feel normal around peers. The results aid understanding of how and why young people in Australia with a SMI use alcohol and may assist with future interventions to reduce alcohol related harm. Interventions for young people with a SMI who misuse alcohol should take a holistic approach and explore the function of alcohol in the young person’s life.