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: 2.7). 05/2009; 54 Suppl 1(S1):9-15. DOI: 10.1007/s00038-009-0001-6
Source: PubMed


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
  • Source
    • "support is consistent with the literature showing an association between lack of social support and psychological distress (and mental health problems more generally) (Andrews et al. 1978; Cohen et al. 2000). While other results in our study (e.g., increased SPD prevalence among ages 18–64, women, those having poor health status and smokers) are consistent with previous national studies (Kessler et al. 2010; Reeves et al. 2011; Strine et al. 2009a), some of the indicators that have previously been associated with SPD were not relevant in our final model. For instance, race/ethnicity, frequently reported as important, did not seem to play a role in the prevalence of SPD, given the ethnic and racial diversity of the urban setting in our study. "
    [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.
    Full-text · Article · Dec 2014 · Community Mental Health Journal
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: There is growing evidence linking the pathophysiology of lung disease to an imbalance state of reduction-oxidation (redox) equilibrium. The therapeutic potential of glutathione, an ubiquitous sulfhydryl thiol, and its immunopharmacological properties in the airway epithelium bears clinical consequences for the paediatric treatment of respiratory distress (RD). Dynamic variation in alveolar pO(2) and its effect on redox state may impose a direct role in modulating the pattern of gene expression in lung tissues and, accordingly, could be pivotal in determining cellular fate under these conditions. Hypoxia-inducible factor-1alpha (HIF-1alpha) and nuclear factor-kappaB (NF-kappaB) are redox-sensitive transcription factors of particular importance because their differential activation by reducing and oxidizing signals, respectively, regulate the expression/suppression of O(2)-responsive genes. The regulation of these transcription factors, therefore, which is redox sensitive, is consistent with their roles in coordinating adaptive homeostatic responses to oxidative stress. Functionally, the relationship between O(2), glutathione biosynthesis and transcription factor activity bears typical implications for the pattern of cellular survivorship and alveolarization on exposure to O(2)-linked stresses. In this review, I discuss (1) the HIF-1alpha/NF-kappaB responsiveness to dynamic changes in pO(2) characteristic of the transition period from placental to pulmonary-based respiration, (2) the capacity of the alveolar epithelium to engage in glutathione biosynthesis and redox shuttling, effectively forming a feedback mechanism governing gene expression, (3) the restitution of antioxidant/prooxidant equilibrium following oxidative challenge and its dependency on the adaptive coordination of responses between redox-associated signalling pathways controlling apoptosis and genetic regulatory factors and (4) a likely association between oxidative stress and the evolution of an inflammatory signal through the pleiotropic O(2)-sensitive cytokines.
    Full-text · Article · Nov 2002 · Cellular Signalling
  • [Show abstract] [Hide abstract]
    ABSTRACT: Although recognition and treatment of mental health disorders have become integrated into routine medical care, inequities remain regarding limits on mental health outpatient visits and higher copayments and deductibles required for mental health services when accessed. Two federal laws were passed by Congress in 2008: The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act and the Medicare Improvements for Patients and Providers Act. Both laws became effective on January 1, 2010. The purpose of this article is to discuss provisions of each act and provide clinical examples describing how patients are affected by lack of parity and may potentially benefit from implementation of these new laws. Using available evidence, we examine the potential strengths and limitations of mental health parity legislation from the health policy perspectives of health care access, cost, and quality and identify the important role of nurses as patient and mental health parity advocates.
    No preview · Article · Sep 2010 · Journal of Psychosocial Nursing and Mental Health Services
Show more