Panic Anxiety Education
Management Services

Australian Bureau of Statistics

1997 National Survey of Mental Health
and Wellbeing of Adults

ABS Media Release -- March 12 1998

26/98

YOUNG ADULTS MOST AT RISK OF MENTAL DISORDER -- ABS SURVEY Almost one in five (18 per cent) Australian adults had a mental disorder at some time during the 12 month period from mid 1996 to mid 1997. Young adults aged 18-24 years had the highest prevalence of mental disorder (27 per cent), declining steadily to 6 per cent of those aged 65 years and over, according to an Australian Bureau of Statistics report launched today by the Federal Minister for Health and Family Services, Dr Michael Wooldridge.
The report presents selected data from the 1997 National Survey of Mental Health and Wellbeing of Adults, a project funded by the Commonwealth Department of Health and Family Services as part of the National Mental Health Strategy. It provides the first comprehensive picture of the mental well-being of Australian adults aged 18 years or more.

Some highlights include:

Women were more likely than men to have experienced anxiety disorders (12 per cent compared with 7 per cent). The highest rate of anxiety disorders (16 per cent) was observed among women aged 45-54 years. For men, the prevalence of anxiety disorders varied little with age.

Young women were particularly prone to affective (mood) disorders with 11 per cent of those aged 18-24 being affected. This was more than three times the rate for men of this age. For women, the prevalence of affective disorders generally declined with age. For men, rates increased in the middle years before declining after age 55.Men were more than twice as likely as women to have substance use disorders (11 per cent compared with 4 per cent). Young men were particularly prone to substance use disorders, with 22 per cent of those aged 18-24 being affected. Alcohol use disorders were about three times as common as drug use disorders When considering prevalence rates among people in different circumstances, such as living arrangements or employment characteristics, rates have been adjusted for age.

Those who were separated or divorced had a high rate of anxiety disorders (18 per cent) and affective disorders (12 per cent). Those who had never been married had the highest rate of substance use disorders (14 per cent). Unemployed people had a high rate of substance use disorders (19 per cent of men and 11 per cent of women). Unemployed women also had a high rate of anxiety disorders (20 per cent).
Details are in Mental Health and Wellbeing: Profile of Adults, Australia 1997 (Cat No. 4326.0), available from ABS bookshops. Main features are available from this site.

FURTHER INFORMATION:

Media requests, interviews, comment

Carolyn Verey (02) 6252 6139; 0418 202 580 Statistical clarification

Gary Sutton (02) 6252 7318

Mental Health and Wellbeing: Profile of Adults, Australia 1997 ABS Catalogue No. 4326.0

INTRODUCTION

The designation of mental health by Commonwealth and State Governments as one of the five National Health Priority Areas is recognition of its social and public health importance. In addition to the pain and disability which may be suffered by individuals, mental illness may also burden their families considerably (Human Rights and Equal Opportunities Commission, 1993).
Mental health relates to emotions, thoughts and behaviors. 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.
Diagnoses of mental disorders presented in this publication are based on the International Classification of Diseases - 10th revision (ICD-10), Classification of Mental and Behavioral Disorders. According to the ICD-10, a mental disorder implies 'the existence of a clinically recognizable set of symptoms or behavior associated in most cases with distress and with interference with personal functions' (WHO, 1992, p. 5).

Background

The economic and personal costs of mental illness are major social and public health issues. In 1992 the Commonwealth, State and Territory governments of Australia endorsed the National Mental Health Strategy (NMHS). These governments have made a commitment through the NMHS to improve the lives of people with mental illness and of the people who care for them. The strategy aims to:

• promote the mental health of the Australian community where possible, prevent the development of mental health problems and mental disorders reduce the impact of mental disorders on individuals, families and the community assure the rights of people with mental disorders.

The reforms being pursued through the strategy are aimed to assist people with a mental illness have access to improved services and support.
In developing the strategy it was recognized that there was a lack of adequate mental health research and data on the prevalence of mental disorders and the welfare of mentally ill people in the community. In December 1994 a workshop commissioned by the Commonwealth Department of Health and Family Services (HFS) recommended the conduct of a national survey of mental health and well-being to meet this need. The survey was to comprise three components: an adult study; a child and adolescent study; and a study of low prevalence (psychotic) disorders, such as schizophrenia.
Subsequently HFS commissioned the Australian Bureau of Statistics (ABS) to conduct the adult component of the survey. Results will assist monitoring initiatives of the NMHS and provide an Australian baseline against which future activity can be compared and evaluated.

Features of adult survey

The 1997 National Survey of Mental Health and Well-being of Adults (SMHWB) was conducted from May to August 1997 from a representative sample of persons living in private dwellings in all States and Territories of Australia. Approximately 13,600 private dwellings were initially selected in the survey sample. One person aged 18 years or over from each dwelling was subsequently invited to participate. Approximately 10,600 people aged 18 years or over participated in the survey, representing a response rate of 78%. The SMHWB was conducted under the Census and Statistics Act 1905 on a voluntary basis.
The SMHWB was designed to provide information on the prevalence of a range of major mental disorders for Australian adults. The range of mental disorders included in this survey was determined by a Technical Advisory Committee, taking into consideration: disorders that were expected to affect more than one per cent of the population; the capacity of the Composite International Diagnostic Interview (CIDI) to diagnose selected mental disorders; and the limitations of a household survey identifying relevant population groups.

Other survey topics included:

a range of demographic and socioeconomic characteristics physical conditions disability associated with mental disorders health service use for a mental health problem perceived need for health services for a mental health problem.

Measuring mental health

Measuring mental health in the community through household surveys is a complex task as mental disorder is usually determined through clinical diagnoses. For the SMHWB the diagnostic component of the interview was administered through a modified version of the CIDI. This is a comprehensive interview for adults which can be used to assess current and lifetime prevalence of mental disorders through the measurement of symptoms and their impact on day-to-day activities. The World Health Organization (WHO) Training and Reference Centre for CIDI (The WHO Centre) in Australia, contracted by HFS, developed a computerized version of the CIDI for the SMHWB.
To enable the diagnosis of a particular mental disorder, as reported in this publication, the CIDI translates the criteria of the ICD-10 into sets of questions that can be readily answered by the general adult population. The CIDI identifies potential symptoms of mental health problems and probes these symptoms to identify the level of severity (or clinical significance) and eliminates those which are always caused by physical intervention such as drugs, medicines, alcohol, illness or injury. Specific combinations of appropriate symptoms may lead to the diagnosis of a specific mental disorder (e.g. depression). Further details on criteria for mental disorder diagnosis will be contained in the forthcoming survey user guide.

Selected mental disorders

As noted earlier the survey collected information on a range of major mental disorders, but did not attempt to cover all disorders. Prevalence rates for the following mental disorders are presented in this publication:

Anxiety disorders
Panic disorder Agoraphobia Social phobia Generalized anxiety disorder (GAD) Obsessive-compulsive disorder (OCD) Post-traumatic stress disorder (PTSD)

Affective disorders
Depression Dysthymia Mania Hypomania Bipolar affective disorder

Alcohol use disorders
Harmful use Dependence

Drug use disorders
Harmful use Dependence

Data interpretation

The survey instrument also incorporates additional CIDI modules which provide a set of screening questions for other mental disorders such as personality disorders. These modules provide an indication of whether a disorder may be present. However, they do not collect sufficient information to determine whether the criteria for a diagnosis of a mental disorder by the CIDI are met. As a diagnosis for these mental disorders is not made, the overall prevalence rates of mental disorder presented in this publication may underestimate the extent of mental disorder in Australia.
The CIDI is a structured interview for diagnosis of mental disorder for research purposes. The CIDI can inform a clinician's diagnosis but not replace it. Estimates of mental disorders presented in this publication are not clinical diagnoses and are therefore dependent on the accuracy of diagnosis based on survey data.
The questions used in this survey to collect data on labor force status and educational qualifications differ from those used in other ABS surveys. As such, these data items provide an indication of an individual's status and, though not directly comparable with other ABS surveys, they are sufficient to associate with mental health status.

Further information

This publication contains only a selection of the information from this survey. A user guide and confidentialised unit record file will be available. Special tabulations can be produced by the ABS on request.

ABS Website: http://www.abs.gov.au

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