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).
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 2007 National Survey of Mental Health and Wellbeing collected information on three major groups of mental disorders: Anxiety disorders; Affective disorders; and Substance Use disorders. This publication presents findings from the survey, with an emphasis on persons with a 12-month mental disorder, that is, persons with a lifetime mental disorder who experienced symptoms in the 12 months prior to the survey interview. The survey also collected information on the use of health services and medication for mental health problems, physical conditions, functioning and disability, social networks and caregiving, and a range of demographic and socio-economic characteristics.
Funding for the 2007 National Survey of Mental Health and Wellbeing (SMHWB) was provided by the Australian Government Department of Health and Ageing (DoHA). 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, representing all regions of the world.
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 government and the research community. Where possible, adapted modules used existing ABS questions.
A Survey Reference Group, comprising experts and key stakeholders in the field of mental health, provided the ABS with advice on survey content, including the most appropriate topics for collection, and associated concepts and definitions. They also provided advice on issues that arose during field tests and the most suitable survey outputs. Group members included representatives from government departments, universities, health research organisations, carers organisations and consumer groups.
The National Survey of Mental Health and Wellbeing (SMHWB) was conducted from August to December 2007 with a representative sample of people aged 16-85 years who lived in private dwellings across Australia. Broadly, it collected information about:
- lifetime and 12-month prevalence of selected mental disorders;
- level of impairment for these disorders;
- physical conditions;
- health services used for mental health problems, such as consultations with health practitioners or visits to hospital;
- social networks and caregiving; and
- demographic and socio-economic characteristics.
A summary of the findings from the survey are presented in this publication through text, diagrams and tables. As this publication is a Summary of Results, not all of the information collected in the survey can be presented. For people who wish to undertake more detailed analysis of the survey data, special tabulations are available on request. Two confidentialised unit record files (CURFs) are planned for release in early 2009. See Products and Services in the Explanatory Notes
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, the 2007 National Survey of Mental Health and Wellbeing 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). The WMH-CIDI 3.0 was chosen because it:
- provides a fully structured diagnostic interview;
- can be administered by lay interviewers;
- is widely used in epidemiological surveys;
- is supported by the World Health Organization (WHO); and
- provides comparability with similar surveys conducted worldwide.
The WMH-CIDI 3.0 provides an assessment of mental disorders based on the definitions and criteria of two classification systems: the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV)
; and the WHO International Classification of Diseases, Tenth Revision (ICD-10)
. Each classification system lists sets of criteria that are necessary for diagnosis. The criteria specify the nature and number of symptoms required; the level of distress or impairment required; and the exclusion of cases where symptoms can be directly attributed to general medical conditions, such as a physical injury, or to substances, such as alcohol. Data in this publication are presented using the ICD-10
classification system. More information on the WMH-CIDI 3.0 diagnostic assessment criteria according to the ICD-10
is provided in Appendix 1
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 aged 16-85 years were asked about experiences throughout their lifetime. In the 2007 survey 12-month diagnoses were based on lifetime diagnosis and the presence of symptoms of that disorder in the 12 months prior to the survey interview. The full diagnostic criteria were not assessed within the 12 month time-frame. Users should exercise caution when comparing data from the two surveys. More information on comparability is provided in the Explanatory Notes
. A list of the broad differences between the two surveys is also provided in Appendix 2
and further information will be available in the National Survey of Mental Health and Wellbeing: Users' Guide (cat. no. 4327.0)
, planned for release on the ABS website
<www.abs.gov.au> in late 2008.