The associations between social determinants of health, mental health, substance-use and recidivism: a ten-year retrospective cohort analysis of women who completed the connections programme in Australia

Table 7 Mediation of the effect of social determinants of health on substance-use through mental health

Relationship ^a	Total effect	Direct effect (SE)	p-value	Indirect effect (SE)	Confidence intervals ^b		Conclusion
Relationship ^a	Total effect	Direct effect (SE)	p-value	Indirect effect (SE)	Lower bound	Upper bound	Conclusion
Housing—> Mental health—> Substance-use	− 0.21	0.12 (0.26)	0.64	− 0.33 (0.10)	0.16	0.57	Full mediation
Employment—> Mental health—> Substance-use	− 0.22	− 0.32 (0.46)	0.48	0.10 (0.13)	− 0.13	0.36	No mediation
Financial—> Mental health—> Substance-use	0.51	0.37 (0.24)	0.12	0.15 (0.07)	0.03	0.30	Full mediation
Education—> Mental health—> Substance-use	0.71	− 0.19 (0.50)	0.70	0.90 (0.14)	− 0.17	0.38	No mediation
Domestic violence—> Mental health—> Substance-use	1.81	1.24 (0.63)	0.05	0.57 (0.23)	0.21	1.10	Partial mediation
Child-custody—> Mental health—> Substance-use	0.54	0.36 (0.30)	0.24	0.18 (0.10)	0.01	0.39	Full mediation
Social support—> Mental health—> Substance-use	0.84	0.48 (0.27)	0.07	0.36 (0.11)	0.18	0.59	Full mediation

Bold: Significance was determined if the entire interval lies on one side of the null hypothesis value (i.e., 0). This indicates statistical significance at the chosen significance level (i.e., 95% confidence level)
SE = standard error
^a Adjusted for admission year and age
^b10,000 bootstrap samples were used for percentile confidence intervals

ISSN: 1477-7517