The prevalence of distress, depression, anxiety, and substance use issues among Indigenous post-secondary students in Canada

Abstract
This study aimed to estimate the prevalence of mental illness and substance use among Indigenous students attending Canadian post-secondary institutions. We obtained data from the National College Health Assessment – American College Health Association Spring 2013 survey, which includes 34,039 participants in 32 post-secondary institutions across Canada. We calculated prevalence estimates with 95% confidence intervals (CI). We compared Indigenous and non-Indigenous students using age- and sex-adjusted prevalence ratios (PR) obtained from Poisson regression models. Of the total sample, 1,110 (3.3%) post-secondary students self-identified as Indigenous. Within the past 12 months, Indigenous students had higher odds of intentionally injuring themselves (PR¼1.53, 95% CI¼1.27–1.84), seriously considering suicide (PR¼1.32, 95% CI¼1.12–1.56), attempting suicide (PR¼1.74, 95% CI¼1.16–2.62), or having been diagnosed with depression (PR¼1.26, 95% CI¼1.08–1.47) or anxiety (PR¼1.18, 95% CI¼1.02–1.35) when compared with non-Indigenous students. Indigenous students also had higher odds of having a lifetime diagnosis of (PR¼1.31, 95% CI¼1.17–1.47) when compared with non-Indigenous students. Indigenous students were more likely to report binging on alcohol (PR¼1.10, 95% CI¼1.02–1.19), using marijuana (PR¼1.21, 95% CI¼1.06– 1.37), and using other recreational drugs (PR¼1.32, 95% CI¼1.06–1.63) compared to non-Indigenous students. This study demonstrates that Indigenous students at post-secondary institutions across Canada experience higher prevalence of mental health and related issues compared to the non-Indigenous student population. This information highlights the need to assess the utilization and ensure the appropriate provision of mental health and wellness resources to support Indigenous students attending post-secondary institutions.