4327.0 - National Survey of Mental Health and Wellbeing: Users' Guide, 2007  
Latest ISSUE Released at 11:30 AM (CANBERRA TIME) 11/02/2009   
   Page tools: Print Print Page Print all pages in this productPrint All RSS Feed RSS Bookmark and Share Search this Product

INTRODUCTION


BACKGROUND TO THE SURVEY

OVERVIEW

The National Survey of Mental Health and Wellbeing (SMHWB) was conducted by the Australian Bureau of Statistics (ABS) from August to December 2007. The survey collected information from approximately 8,800 Australians aged 16-85 years. The survey provides information on the prevalence of selected lifetime and 12-month mental disorders, by the major disorder groups:

  • Anxiety disorders (eg Social Phobia);
  • Affective disorders (eg Depression); and
  • Substance Use disorders (eg Alcohol Harmful Use).

The survey also provides information on the level of impairment, health services used for mental health problems, physical conditions, social networks and caregiving, as well as demographic and socio-economic characteristics.

A summary of the findings from the survey are presented in the National Survey of Mental Health and Wellbeing: Summary of Results (cat. no. 4326.0). For users who wish to undertake more detailed analysis of the survey data, special tabulations are available on request. Two confidentialised unit record files (CURFs) will be released on the ABS website <www.abs.gov.au> in early 2009. See Chapter 11 for more information on survey products.


SURVEY DEVELOPMENT

The survey was based on a widely-used international survey instrument, developed by the World Health Organization (WHO) for use by participants in the World Mental Health Survey Initiative. The Initiative is a global study aimed at monitoring mental and addictive disorders. It aims to collect accurate information about the prevalence of mental, substance use, and behavioural disorders. It measures the severity of these disorders and helps to determine the burden on families, carers and the community. It also assesses who is treated, who remains untreated and the barriers to treatment. The survey has been run in 32 countries, including Canada, South Africa, Germany, Japan and New Zealand.

Most of the survey was based on the international survey modules, however, some modules, such as Health Service Utilisation, were tailored to fit the Australian context. The adapted modules were designed in consultation with subject matter experts from academic institutions, government departments and consumer groups. Where possible, adapted modules used existing ABS standard questions.


MENTAL HEALTH

Mental health is a state of emotional and social wellbeing. It influences how an individual copes with the normal stresses of life and whether he or she can achieve his or her potential. Mental health describes the capacity of individuals and groups to interact, inclusively and equitably with one another and with their environment, in ways that promote subjective wellbeing and optimise opportunities for development and use of mental abilities (Australian Health Ministers, 2003).

Mental health is one of Australia's National Health Priority Areas and funding for this survey was provided by the Australian Government Department of Health and Ageing. The National Health Priority Areas (NHPA) initiative is a collaborative effort involving Commonwealth, State and Territory governments. It seeks to focus public attention and health policy on areas that:
  • contribute significantly to the burden of illness and injury, and
  • have the potential for health gains and reduction in the burden of disease.

The measurement of mental health is complex and is not simply the absence of mental illness. A mental illness is a clinically diagnosable disorder that significantly interferes with an individual's cognitive, emotional or social abilities (Australian Health Ministers, 2003). Mental illness encompasses short and longer term conditions, including Anxiety disorders (eg Agoraphobia), Affective or mood disorders (eg Depression) and Substance Use disorders (eg Alcohol Dependence). Depending on the disorder and its' severity, people may require specialist management, treatment with medication and/or intermittent use of health care services.

The survey data will contribute to research in the field of mental health. Mental health data is used to assist in the formulation of government policies and legislation and to provide information on the impact of mental disorders on individuals, families and the community. It can also assist in identifying needs for change to mental health services and in assessing risk factors for the development of mental disorders.


GOVERNMENT POLICIES ON MENTAL HEALTH

Commonwealth, State and Territory governments are committed to improving the mental health of the Australian population through two ongoing initiatives, the National Mental Health Strategy and the Council of Australian Governments (CoAG) National Action Plan on Mental Health. These initiatives are briefly described below.

1. National Mental Health Strategy

This Strategy provides a framework for reform and the basis for a coordinated government approach to mental health in Australia. It consists of the National Mental Health Policy and the National Mental Health Plan, and is underpinned by the Mental Health Statement of Rights and Responsibilities. The broad aims of the Strategy are to:
  • promote the mental health of the Australian community and, where possible, prevent the development of mental disorders;
  • reduce the impact of mental disorders on individuals, families and the community; and
  • assure the rights of people with mental disorders.

2. CoAG National Action Plan on Mental Health

The Plan involves a joint package of measures and new investment by all governments over a specified period (the current Plan covers 2006-2011). The Plan aims to promote better mental health and provide additional support to people with mental illness, their families and their carers. In particular, it aims to achieve four outcomes:
  • reducing the prevalence and severity of mental illness in Australia;
  • reducing the prevalence of risk factors that contribute to the onset of mental illness and prevent longer-term recovery;
  • increasing the proportion of people with an emerging or established mental illness who are able to access the right health care and other relevant community services at the right time, with a particular focus on early intervention; and
  • increasing the ability of people with a mental illness to participate in the community, employment, education and training, including through an increase in access to stable accommodation (AIHW, 2008).


MEASURING MENTAL HEALTH

Measuring mental health in the community through household surveys is a complex task as mental disorders are usually determined through detailed clinical assessment. To estimate the prevalence of specific mental disorders, this survey used the World Mental Health Survey Initiative version of the World Health Organization's Composite International Diagnostic Interview, version 3.0 (WMH-CIDI 3.0). More information on the WMH-CIDI 3.0 is provided in Chapter 2.


SURVEY RESPONSE

All sample surveys may be subject to error, which can be broadly categorised as either sampling error or non-sampling error. Sampling error occurs because only a small proportion of the total population is used to produce estimates that represent the whole population. Sampling error can be reliably measured as it is calculated based on the scientific methods used to design surveys. Non-sampling error may occur in any data collection, whether it is based on a sample or a full count (eg Census). Non-sampling error may occur at any stage throughout the survey process. For example, persons selected for the survey may not respond (non-response); survey questions may not be clearly understood by the respondent; responses may be incorrectly recorded by interviewers; or there may be errors in coding or processing survey data.

For this survey, extensive non-response analyses were undertaken to assess the reliability of the survey estimates as the response rate was lower than expected (60%). This included comparing population characteristics in the 2007 SMHWB to other data sources and a purposive small sample Non-Response Follow-Up Study (NRFUS). As a result of the analyses, adjustments were made to the weighting strategy. For more information on 'Weighting, benchmarking and estimation' see Chapter 2. As non-response may impact on population characteristics, as well as across data items, users should exercise caution. For more information on the non-response analyses see Chapter 10.


COMPARISON WITH THE 1997 SURVEY

In 1997 the ABS conducted the first National Survey of Mental Health and Wellbeing of Adults. The survey provided information on the prevalence of selected 12-month mental disorders, the level of disability associated with those disorders, health services used, and perceived need for help with a mental health problem, for Australians aged 18 years and over. The survey was an initiative of, and was funded by, the then Commonwealth Department of Health and Family Services, as part of the National Mental Health Strategy. A key aim of the 1997 survey was to provide prevalence estimates for mental disorders in a 12-month time frame. Therefore, diagnostic criteria were assessed solely on respondents' experiences in the 12 months prior to the survey interview.

In comparison, the 2007 National Survey of Mental Health and Wellbeing was designed to provide lifetime prevalence estimates for mental disorders. Respondents were asked about experiences throughout their lifetime. In the 2007 survey, 12-month prevalence was based on lifetime diagnosis and the presence of symptoms of that disorder in the 12 months prior to the survey interview. Therefore, the full diagnostic criteria were not assessed within the 12-month time frame.

Due to the differences outlined above and throughout this publication, caution should be exercised when comparing data from the two surveys. A summary of the broad differences between the two surveys is provided in Chapter 10. More detailed information on comparability is also provided in each chapter of this publication.