Mental health

Introduction

Psychological distress has a major effect on the ability of people to work, study, and manage their day-to-day activities. Around one in 10 Australians report having a long-term anxiety-related problem or mood (affective) problem. Of these, 32 per cent report being daily smokers and 15 per cent report consuming alcohol at levels of high risk.[1]

The Kessler 10 (K10) measure of self-reported psychological distress is included in the New South Wales Population Health Survey to monitor the mental health of people aged 16 and over.[2] The K10 measure is a 10-item questionnaire that measures non-specific psychological distress based on questions about the level of nervousness, agitation, psychological fatigue and depression in the most recent 4-week period. Responses to the questionnaire are classified into 4 categories: low psychological distress, when the K10 score is 10-15; moderate psychological distress, when the K10 score is 16-21; high psychological distress, when the K10 score is 22-29; and very high psychological distress, when the K10 score is 30 or higher. The Kessler 10 Plus (K10+) measure contains additional questions to assess functioning and related factors. At both the population level and individual level the K10 measure is a barometer for psychological distress without identifying its cause.

It is important for people with mental illness to participate effectively in the community. Under the State Plan, as part of the NSW Government's commitment to increasing rates of community participation among people with mental illness, the New South Wales Population Health Survey monitors community participation among people with psychological distress by comparing their K-10 score with their level of community participation.[3]

In 2006, the New South Wales Population Health Survey asked adult respondents the following K10 questions: In the past 4 weeks, about how often did you feel tired out for no good reason? In the past 4 weeks, about how often did you feel nervous? In the past 4 weeks, about how often did you feel so nervous that nothing could calm you down? In the past 4 weeks, about how often did you feel hopeless? In the last 4 weeks, about how often did you feel restless or fidgety? In the past 4 weeks, about how often were you so restless that you could not sit still? In the past 4 weeks, about how often did you feel depressed? In the past 4 weeks, about how often did you feel that everything was an effort? In the past 4 weeks, about how often did you feel so sad that nothing could cheer you up? In the past 4 weeks, about how often did you feel worthless?.

Respondents who scored 16 points and above were asked the K10+ questions: In the last 4 weeks, how many days were you totally unable to work, study, or manage your day-to-day activities because of these feelings? Aside from those days, in the last 4 weeks, how many days were you able to work, study, or manage you day-to-day activities, but had to cut down on what you did because of these feelings? In the last 4 weeks, how many times have you seen a doctor or other health professional about these feelings? In the last 4 weeks, how often have physical health problems been the main cause of these feelings?

Results

High or very high psychological distress

Overall, in 2006, 68.0 per cent of adults had low levels of psychological distress, 21.3 per cent had moderate levels, 7.7 per cent had high levels, and 3.0 per cent had very high levels.

Overall, in 2006, adults were unable to work or study or manage their day-to-day activities on 0.56 days in the last 4 weeks (0.63 days for males and 0.49 days for females). Adults had to cut down on what they did on 0.80 days in the last 4 weeks (0.69 days for males and 0.90 days for females). Adults saw a doctor or other health professional about their psychological distress 0.16 times in the last 4 weeks (0.17 times for males and 0.16 times for females).

Overall, in 2006, 10.7 per cent of adults had high or very high levels of psychological distress. A significantly higher proportion of females (11.9 per cent) than males (9.4 per cent) had high or very high levels of psychological distress. Among females, a significantly lower proportion aged 65-74 years (6.9 per cent) and 75 years and over (5.8 per cent) had high or very high levels of psychological distress, compared with the overall adult female population. Among males, a significantly lower proportion aged 65-74 years (3.7 per cent) and 75 years and over (4.2 per cent) had high or very high levels of psychological distress, compared with the overall adult male population.

The proportion of adults with high or very high levels of psychological distress did not vary significantly between urban and rural areas; however, a higher proportion of adults in the Sydney South West Health Area (13.4 per cent), and a lower proportion of adults in the Northern Sydney & Central Coast Health Area (6.5 per cent), had high or very high levels of psychological distress, compared with the overall adult population. Psychological distress increased with socioeconomic disadvantage. A higher proportion of adults in the most disadvantaged quintile (14.0 per cent), and a lower proportion of adults in the least disadvantaged quintile (6.1 per cent), had high or very high levels of psychological distress, compared with the overall adult population. There has been no significant variation in the proportion of adults with high or very high psychological distress between 1997 and 2006.

Adults with high or very high psychological distress said their distress was due to physical problems: all of the time (15.5 per cent), most of the time (11.3 per cent), some of the time (20.2 per cent), a little of the time (17.0 per cent), and none of the time (36.0 per cent).

Community particpation

Overall, in 2006, 56.9 per cent of adults with high or very high levels of psychological distress attended a community event at least once in the last 6 months. There was no significant variation between females and males. A significantly higher proportion of adults aged 25-34 years (69.8 per cent), and a significantly lower proportion aged 65-74 years (40.2 per cent) and 75 years and over (37.5 per cent), attended a community event at least once in the last 6 months, compared with the overall adult population. There was no significant variation between rural areas and urban areas; however, a higher proportion of adults in the Greater Southern Health Area (75.1 per cent) attended a community event at least once in the last 6 months, compared with the overall adult population. There was no variation by level of socioeconomic disadvantage.

Overall, in 2006, 33.2 per cent of adults with high or very high levels of psychological distress helped out at a local group or organisation at least once in the last 3 months. There was no significant variation between females and males. A significantly lower proportion of adults aged 75 years and over (19.0 per cent) helped out at a local group or organisation at least once in the last 3 months, compared with the overall adult population. A significantly higher proportion of adults in rural areas (39.9 per cent) than urban areas (30.3 per cent) helped out at a local group or organisation at least once in the last 3 months. A higher proportion of adults in the North Coast (48.3 per cent) and Greater Southern (46.2 per cent) Health Areas helped out at a local group or organisation at least once in the last 3 months, compared with the overall adult population. There was no variation by level of socioeconomic disadvantage.

Overall, in 2006, 37.0 per cent of adults with high or very high levels of psychological distress were active members of a local organisation or church or club. There was no significant variation between females and males, among age groups, between urban areas and rural areas, among health areas, or by level of socioeconomic disadvantage.

References

Australian Bureau of Statistics. National Health Survey 2004-05: Summary of Results, Australia, Catalogue no. 4364.0. Canberra: Australian Bureau of Statistics, 2002. Available online at www.abs.gov.au (accessed 10 May 2007).
Kessler RC, Andrews G, Colpe LJ, Hiripi E, Mroczek DK, Normand S-LT, Walters EE, Zaslavsky A. Short screening scales to monitor population prevalences and trends in nonspecific psychological distress. Psychological Medicine 2002, 32(6): 959-976.
Premier's Department. State Plan: A new direction for New South Wales. Sydney: NSW Government, 2006. Available online at www.nsw.gov.au/stateplan (accessed 22 June 2007).

Graphs

Source:	New South Wales Population Health Survey 2006 (HOIST). Centre for Epidemiology and Research, NSW Department of Health.
Print version:	Although this page can be printed directly from your web browser, a higher quality version is available as a PDF file that can be printed or viewed on screen.
Produced by:	Centre for Epidemiology and Research, Population Health Division, NSW Department of Health.
Last updated on:	1 July 2007