First insights from the National Study of Mental Health and Wellbeing, 2020-21

Comprehensive national estimates for 2020-21, including lifetime and 12-month prevalence of mental health disorders, are scheduled for release in June 2022. The sample of approximately 5,500 fully responding households is not sufficient to enable detailed analysis of state and territory estimates.

The June 2022 release will include:

• data cubes (spreadsheets) containing national level estimates and associated measures of error, and a data item list
• an expanded Methodology
• detailed microdata may also be available on DataLab for users to undertake complex analysis of microdata in the secure ABS environment.

Customised data extracts will be available from June 2022 onwards.  

A comprehensive release from the second (2021-22) cohort of the NSMHW is expected to be published in July 2023.

The National Study of Mental Health and Wellbeing (NSMHW) is a component of the wider Intergenerational Health and Mental Health Study (IHMHS) funded by the Australian Government Department of Health.

The 2020-21 cohort is the first of two in the NSMHW. Data for the NSMHW was collected in the Survey of Health and Wellbeing which was conducted by the Australian Bureau of Statistics (ABS). The first cohort was conducted between December 2020 and July 2021. The second cohort will be conducted from December 2021 to July 2022.

Scope

The scope of the study includes:

• all usual residents in Australia aged 16-85 years living in private dwellings
• both urban and rural areas in all states and territories, except for very remote parts of Australia and discrete Aboriginal and Torres Strait Islander communities.

The study excluded the following people:

• visitors to private dwellings
• overseas visitors who have not been working or studying in Australia for 12 months or more, or do not intend to do so
• members of non-Australian defence forces stationed in Australia and their dependants
• non-Australian diplomats, diplomatic staff and members of their households 
• people who usually live in non-private dwellings, such as hotels, motels, hostels, hospitals, nursing homes and short-stay caravan park (people in long-stay caravan parks, manufactured home estates and marinas are in scope)
• people in Very Remote areas
• discrete Aboriginal and Torres Strait Islander communities.

The exclusion of persons living in Very Remote areas and discrete Aboriginal and Torres Strait Islander communities is unlikely to impact on national estimates, and will only have a minor impact on any aggregate estimates that are produced for individual states and territories, except the Northern Territory where the excluded population accounts for around 21% of persons.

Sample design

Households were randomly selected to participate in the study. One person aged 16-85 years or over was randomly selected in each household to complete the study questionnaire. If the randomly selected person was aged 16-17 years, parental consent was sought for the interview to proceed.

The sample was designed to target persons aged 16-24 years to improve estimates for this age group. People in this age group had a higher probability of being selected in the sample.

Response rates

There were 5,554 fully responding households in the study, a response rate of 57.1%. These were completed face-to-face with an ABS interviewer.

Some respondents were unable or unwilling to provide a response to certain data items. The records for these people were retained in the sample and the missing values were recorded as 'Not stated' or 'Don't know'. No imputation was undertaken for these missing values.

Collection method

The study was collected over an 8-month period from 6th December 2020 to 31st July 2021. Households completed the study via a face-to-face interview. Interviews were conducted during periods when circumstances in individual jurisdictions permitted face-to-face interviewing according to relevant jurisdictional public health orders and restrictions.

All households selected in the sample initially received a letter in the post with instructions to arrange an appointment with an Interviewer to complete the study. Two reminder letters were sent to households.

Information collected in the study includes:

• Household Information, which can be completed by any responsible adult in the household who is aged 18 years or over. The Household Information component of the study collects basic demographic information about all usual residents of the household, including those aged under 15 years, as well as information about the dwelling and household income.
• Individual Questionnaire, which is completed by one randomly selected person in the household aged 16-85 years. The random selection is automatically performed upon completion of the Household Form.

Estimation methods

As only a sample of people in Australia were surveyed, their results needed to be converted into estimates for the whole population. This was done through a process called weighting.

• each person or household is given a number (known as a weight) to reflect how many people or households they represent in the whole population
• a person or household’s initial weight is based on their probability of being selected in the sample. For example, if the probability of being selected was one in 45, then the person would have an initial weight of 45 (that is, they would represent 45 people).

The person and household level weights are then calibrated to align with independent estimates of the in scope population, referred to as ‘benchmarks’. The benchmarks use additional information about the population to ensure that:

• people or households in the sample represent people or households that are similar to them
• the study estimates reflect the distribution of the whole population, not the sample.

The initial weights were calibrated to the estimated resident population (ERP) at March 2021. The Australian population at March 2021 aged 16-85 years was 19,644,025 (after exclusion of people living in non-private dwellings, very remote areas of Australia and discrete Aboriginal and Torres Strait Islander communities).

Analysis showed that the standard weighting approach did not adequately compensate for undercoverage in the 2020-21 sample for variables such as educational attainment, household composition, and labour force status, when compared to other ABS surveys. Therefore, additional benchmarks were incorporated into the weighting strategy.

Additional benchmarks were obtained from the ABS monthly Labour Force Survey (December 2020 to July 2021) for labour force status, educational attainment and household composition. These benchmarks were aligned to the estimated resident population aged 16-85 years, who were living in private dwellings in each state and territory, excluding very remote areas of Australia, at 31 March 2021.

The Census and Statistics Act 1905 authorises the ABS to collect statistical information and requires that information is not published in a way that could identify a particular person or organisation. The ABS must make sure that information about individual respondents cannot be derived from published data.

The ABS would like to thank all participants for their involvement in the National Study of Mental Health and Wellbeing. The information collected is critical to mental health policy, program development and evaluation in Australia.

Consultations with health professionals for mental health

Respondents were asked about consultations with health professionals for mental health in the 12 months prior to interview. These included:

• general practitioner
• psychiatrist
• psychologist
• mental health nurse
• other mental health professional – e.g. social worker, counsellor, occupational therapist
• specialist doctor or surgeon – e.g. cardiologist, gynaecologist or urologist
• other health professional – e.g. dietician, physiotherapist, pharmacist (advice only).

Financial stress

One person in the household was asked to report on behalf of the entire household whether they experienced one or more of the following due to a shortage of money in the 12 months prior to interview: 

• pawned or sold something because of a shortage of money 
• went without meals 
• went without dental treatment when needed
• were unable to heat or cool your home 
• sought financial assistance from friends or family 
• sought assistance from welfare or community organisations
• could not pay electricity, gas or telephone bills on time 
• could not pay mortgage or rent payments on time 
• could not pay for car registration or insurance on time 
• could not pay home and/or contents insurance on time
• could not make minimum payment on credit card.

Household

One or more persons usually resident in the same private dwelling.

Loneliness

Respondents were asked whether they felt lonely in the last 4 weeks prior to interview. This question was asked as part of a selected group of questions from the Living in the Community Questionnaire - Summary (LCQ-S). The LCQ-S was developed by the Australian Mental Health Outcomes and Classification Network (AMHOCN) to assess social support and societal participation of Australians. 

Other services for mental health accessed using digital technologies

In addition to consultations with health professionals for mental health, respondents were asked whether they had accessed other services for their mental health using digital technologies, including the phone or internet in the 12 months prior to interview. Types of services included:

• crisis support or counselling services
• treatment programs, training, assessment or other tools to improve mental health
• mental health support groups, forums or chat rooms.

Psychological distress

The study collected information on psychological distress using the Kessler Psychological Distress Scale (K10). The Kessler Psychological Distress Scale (K10) is a widely used indicator, which gives a simple measure of psychological distress.

Respondents were asked how often in the last four weeks they had felt:

• tired out for no good reason
• nervous
• so nervous that nothing could calm you down
• hopeless
• restless or fidgety
• so restless you could not sit still
• depressed
• everything was an effort
• so sad that nothing could cheer you up
• worthless.

Using these questions, a five-level response scale that corresponded to scores from 1 for ‘none of the time’ to 5 for ‘all the time’ were summed, with low scores indicating low levels of psychological distress and high scores indicating high levels of psychological distress. 

Results are grouped according to the following categories:

• 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).

Self-management strategies for mental health

Respondents were asked about self-management strategies they used for their mental health in the last 12 months. These included:

• taken non-prescription medicines, vitamins, supplements or herbal remedies
• changed your diet
• practised meditation, mindfulness, yoga or other relaxation techniques
• better organised home, life and other things
• practised thinking positively and setting achievable goals
• increased your level of exercise or physical activity
• done more of the things you enjoy
• seek support from family or friends
• used alcohol or drugs
• cut out alcohol or drugs
• other.