Is Substance Abuse an Issue? Perceptions of Male and Female Community-Based Mental Health System Consumer-Survivors Rick Csiernik Received: 28 February 2006 / Accepted: 6 September 2006 / Published online: 28 October 2006 # Springer Science + Business Media, LLC 2006 Abstract Despite our increasing knowledge of the complexity of concurrent disorders the majority of research has involved either institutionalized or specific clinical populations and there have been limited opportunities to directly examine issues at the community level particularly if any differences exist between women and men. Using four standardized instruments, 150 male and 150 female community-based consumer-survivors in the London, Ontario area were interviewed. Eight focus group sessions including 65 individuals were also conducted. Differences between male and female respondents included primary diagnosis, history of family mental illness, family substance abuse, social supports and problematic parental substance abuse. While the overall level of functioning was similar for both sexes, men reported more problems with substance use while women reported a greater overall problem severity. Surprising was the lack of importance of substance abuse issues in respondents’ lives, particularly among focus group members as only four comments regarding substance abuse were made in over 10 h of dialogue. The findings support the belief that specific services by sex are required for this population though the likelihood of attending such programs would be increased if rudimentary income, housing and transportation needs were addressed. Keywords Male–female differences . Substance abuse . Consumer perceptions Introduction Co-occurring mental health and substance abuse disorders have gradually and at times grudgingly emerged as a significant health and social issue in Canada to the point where provincial and national initiatives and task forces have been created to examine treatment concerns in greater depth (British Colombia Inter-ministry Task Group, 1999; Centre for Addiction and Mental Health, 2001; Comité permanent de lutte à la toxicomanie, 1997, 2000; Ontario Ministry of Health, 1999). While there has been little direct examination of Int J Ment Health Addiction (2007) 5:29–37 DOI 10.1007/s11469-006-9041-9 R. Csiernik (*) Social Work, King’ s University College at The University of Western Ontario, 266 Epworth Avenue, London, ON, Canada, N6A 2M3 e-mail: csiernik@mountaincable.net