State-based differences in the prevalence and characteristics of untreated persons with serious psychological distress

Centers for Disease Control and Prevention, 4770 Buford Highway N.E., Atlanta, GA 30341, USA.
International Journal of Public Health (Impact Factor: 1.97). 05/2009; 54 Suppl 1(S1):9-15. DOI: 10.1007/s00038-009-0001-6
Source: PubMed

ABSTRACT To examine the state-based prevalence of serious psychological distress (SPD) and its treatment using the Kessler-6 scale.
SPD and treatment data were obtained from 202,114 respondents in the 2007 Behavioral Risk Factor Surveillance System Mental Illness and Stigma Module in 35 states, the District of Columbia, and Puerto Rico.
Approximately 4.0 % of persons in the 35 states, the District of Columbia, and Puerto Rico had SPD. The prevalence estimates ranged from 2.3 % in Iowa to 6.6 % in Mississippi. Among persons with SPD, 53.4 % were currently untreated, ranging from 33.3 % in Alaska to 67.0 % in Hawaii.
Mental health parity and a multidimensional approach to healthcare with extensive referrals between mental and physical healthcare is warranted.

Download full-text


Available from: Tara Strine, Jun 23, 2015
1 Follower
  • [Show abstract] [Hide abstract]
    ABSTRACT: While there are state and national estimates of serious psychological distress (SPD), these are not useful for targeting local mental health interventions or for addressing the needs of sub-populations at increased risk for SPD. This cross-sectional study uses data from the population-based 2010 Health of Houston Survey (n = 5,116) to examine (1) the prevalence of SPD and its determinants in Houston area and (2) predictors of the utilization of mental health services among people with SPD. The prevalence of SPD among the Houston area adult population was 7 %, more than twice the national average. Correlates of SPD included: being female, under 65, lacking emotional support, smoking, having poor health status and financial distress. The odds of utilizing health services by those with SPD were affected by financial distress, insurance, employment and perceived need for services, among other factors. Interventions should be tailored to mitigate risk factors for SPD and to improve access to mental health services in the SPD sub-population.
    Community Mental Health Journal 12/2014; DOI:10.1007/s10597-014-9790-z · 1.03 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective: To examine the association between serious psychological distress (SPD) and the Physical and Mental Health components of Quality of Life (QOL) while controlling for depression in a national sample of adults with diabetes. Methods: SPD was assessed in 1,659 adults with diabetes who participated in the 2007 Medical Care Expenditure Survey (MEPS). SPD was measured by the 6-item Kessler scale. Depression was assessed with the PHQ-2 screen. Quality of life was measured with the physical (PCS) and mental (MCS) components of the SF-12. We used multiple linear regression to assess the relationship between SPD and quality of life while controlling for relevant covariates and depression screen results to assess the independent effect of SPD on QOL above and beyond the effect of depression. Results: Among US adults with diabetes, 9% had SPD and 15.4% screened positive for depression. Among those with SPD, 85.8% had depression and among those with depression, 50.5% had SPD. In the adjusted model for socio-demographic factors and comorbidities, SPD was significantly associated with lower PCS scores (-5.51 95% CI -7.55; -3.45) and MCS scores (-18.99 95% CI -20.81; -17.18). In the adjusted model that also controlled for depression, SPD was still significantly associated with lower PCS scores (-3.03 95% CI -5.63; -0.43) and MCS scores (-9.46 95% CI -11.67; -7.24). Conclusions: Among U.S. adults, SPD is associated with significantly diminished QOL above and beyond the effects of depression. Targeted interventions to mitigate the adverse effects of SPD are needed, independent of programs to address depression.
    The International Journal of Psychiatry in Medicine 01/2014; 48(2):135-46. DOI:10.2190/PM.48.2.f · 0.81 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The Kessler six-item scale has been shown to be a valid and reliable measure of serious psychological distress (SPD) in community samples. We examined the effect of SPD on health service expenditures and utilization for seven categories in a national probability sample of community dwelling adults in the United States. We used the two-step sample selection model to examine the association between SPD and total, office-based, outpatient, emergency department (ED), inpatient, dental, home health and prescription expenditures and utilization in 18,330 US adults who participated in the 2007 Medical Expenditure Panel Survey (MEPS). SPD was significantly associated with $1735 ( 95% CI: $702-2769) higher total expenditures, $285 higher office expenditures ( 95% CI: $30-539), $183 higher ED expenditures (95% CI: $64-303), $282 (95% CI: $62-503) higher home health expenditures, $614 (95% CI: $403-825) higher prescription expenditures and $41 (95% CI: -$103 to $22) lower dental expenditures. SPD was associated with 3.09 (95% CI: 2.09-4.08) more office visits, 0.27 (95% CI: 0.17-0.36) more ED visits, 0.84 (95% CI: 0.36-1.32) more inpatient visits, 2.93 (95% CI: 0.13-5.70) more home health visits, 8.13 (95% CI: 6.08-10.18) more prescriptions and 0.18 (95% CI: -0.30 to -0.07) less dental visits. Among US adults, SPD is associated with significant increases in total expenditures and most other categories of expenditure and utilization. Targeted interventions to mitigate the adverse effects of SPD are needed.
    General hospital psychiatry 07/2011; 33(4):311-7. DOI:10.1016/j.genhosppsych.2011.03.014 · 2.90 Impact Factor