4363.0.55.001 - Australian Health Survey: Users' Guide, 2011-13  
ARCHIVED ISSUE Released at 11:30 AM (CANBERRA TIME) 07/06/2013   
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Contents >> Health conditions >> Mental health and well-being



Mental health and well-being relates to emotions, thoughts and behaviours. A person with good mental health is generally able to handle day-to-day events and obstacles, work towards important goals, and function effectively in society. However, even minor mental health problems may affect everyday activities to the extent that individuals cannot function as they would wish, or are expected to, within their family and community. Consultation with a health professional may lead to the diagnosis of a mental disorder.

In the 2011-12 NHS, information was collected on mental health and well-being via:

  • the Kessler Psychological Distress Scale-10 (K10) questions
  • self-reported long-term mental and behavioural problems.

Information collected later in the survey in the Family Stressors module (located in the Health Risk Chapter of this Users' Guide) also included items related to mental health.


There were 3 components in the NHS for measuring mental health and well-being:
  • information on long-term mental health conditions for all persons
  • information relating to the 'Mental Health and Wellbeing' module (the K10 levels of psychological distress) was collected for persons aged 18 years and over
  • information relating to the 'Family Stressors' module was collected from persons aged 15 years and over.

Kessler Psychological Distress Scale-10

The Kessler Psychological Distress Scale-10 (K10) is a scale of non-specific psychological distress. It was developed by Professors Ron Kessler and Dan Mroczek, as a short dimensional measure of non-specific psychological distress in the anxiety-depression spectrum, for use in the US National Health Interview Survey.

The 10 item questionnaire yields a measure of psychological distress based on questions about negative emotional states (with different degrees of severity) experienced in the 4 weeks prior to interview. For each question, there is a five-level response scale based on the amount of time that a respondent experienced those particular feelings. The response options are:
  • none of the time
  • a little of the time
  • some of the time
  • most of the time
  • all of the time.

Each of the items are scored from 1 for 'none' to 5 for 'all of the time'. Scores for the ten items are summed, yielding a minimum possible score of 10 and a maximum possible score of 50, with low scores indicating low levels of psychological distress and high scores indicating high levels of psychological distress.

K10 results are commonly grouped for output. Results from the 2011-12 NHS are grouped into the following four levels of psychological distress:
  • low (scores of 10-15, indicating little or no psychological distress)
  • moderate (scores of 16-21)
  • high (scores of 22-29)
  • very high (scores of 30-50).

Based on research from other population studies, a very high level of psychological distress shown by the K10 may indicate a need for professional help.

In Australia, national level information on psychological distress using the K10 was first collected in the Survey of Mental Health and Wellbeing (SMHWB) conducted by the ABS in 1997 and later in 2007. The SMHWB was an initiative of, and funded by, the (then) Commonwealth Department of Health and Family Services as part of the National Mental Health Strategy. The K10 was included in the 2001, 2004-05, 2007-08 and 2011-12 NHS as it proved to be a better predictor of depression and anxiety disorders than the other short, general measures used in the 1997 SMHWB. For further information about ABS use of the instrument, refer to Use of the Kessler Psychological Distress Scale in ABS surveys (cat. no. 4817.0.55.001).

K10 results for respondents who were represented by a proxy (and the respondent was not present for the interview) were recorded in the 'not asked' category.

Long-term mental and behavioural problems

Information on long-term conditions (conditions that had lasted or were expected to last for six months or more) was collected in the 2011-12 NHS for people of all ages. Mental health and behavioural problems were identified through self-reported information on long-term conditions. When respondents reported a long-term mental or behavioural problem, the conditions were treated in a similar manner to other long-term conditions such as diabetes and asthma. Up to six long-term mental and behavioural problems could be recorded.

Some possible conditions were:
  • behavioural or emotional disorders
  • dependence on drugs or alcohol
  • feeling anxious or nervous
  • depression
  • feeling depressed.

Other mental health conditions were collected when respondents were asked to identify any other long-term conditions they had. These conditions were identified by a mental health conditions coding list in the instrument.

Respondents who identified having specific mental health conditions were asked an additional set of questions for each condition up to a limit of 6 conditions. These questions included:
  • whether their mental health condition had been diagnosed by a doctor or nurse
  • at what age they were first told they had the mental health condition.

Irrespective of being diagnosed or not, respondents were then asked whether they had taken any of the following medications in the last two weeks for any of their conditions:
  • sleeping tablets or capsules
  • tablets or capsules for anxiety or nerves
  • tranquillisers
  • antidepressants
  • mood stabilisers
  • other medications for mental health.

How long they had been taking each type of medication for:
  • less than 1 month
  • 1 month to less than 3 months
  • 3 months to less than 6 months
  • 6 months or more.

The frequency they took each type of medication:
  • every day and/or night
  • more than 3 days and/or nights in a week
  • 1 to 3 days and/or nights a week
  • less than once a week
  • varies/as required.

Respondents with a diagnosed mental health condition were then sequenced to the Actions module where they were asked questions about the number of times they had seen a GP, specialist etc. for their mental health condition.

Respondents were asked in a later module about all other medications and health supplements that they were taking, but not in relation to any specific condition. This differs from the 2007-08 survey where questions about all other medications were asked within the mental health and well-being component of the "Long-term conditions" module.


Points to be considered in interpreting data for this topic include the following:
  • It is possible that there may be under-reporting of mental health conditions by proxies or when other household members are present due to the personal or sensitive nature of these conditions.
  • Those respondents incapable of being present for the interview due to illness or disability, and who were represented by a proxy, were recorded as being 'Not asked' for the Kessler Psychological Distress Scale-10 questions. In 2011-12, 0.4% of respondents aged 18 years and over were not asked these questions.

Data items

The data items and related output categories for this topic are available in Excel spreadsheet format from the Downloads page of this product.

Comparability with 2007-08

Changes in community perceptions of mental health, together with changes in the identification and treatment (e.g. institutional versus community care), may have affected the degree to which certain conditions were identified in the survey.

The K10 was included in the 2001, 2004-05, 2007-08 and 2011-12 NHS, and the data are considered directly comparable. Users should note that the version of K10 used in the NHS is slightly different to that used in the Survey of Mental Health and Wellbeing (see information paper Kessler Psychological Distress Scale, in Other Scales and Measures, National Survey of Mental Health and Wellbeing: Users' Guide, 2007 (cat. no. 4327.0)).

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