MENTAL HEALTH AND WELL-BEING

Definition

Mental health and well-being relates to emotions, thoughts and behaviours. 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.

In the 2012-13 National Aboriginal and Torres Strait Islander Health Survey (NATSIHS), information was collected on mental health and well-being via:

• the Kessler Psychological Distress Scale (K5) questions
• the Multidimensional Scale of Perceived Social Support questions
• other positive well-being questions.

Information collected later in the survey in the Family Stressors module also included items related to mental health.

Population

Information relating to the 'Social and Emotional Well-being' module was collected for persons aged 18 years and over present at the interview. Non-remote respondents were asked some additional questions based on an adaption of the Pearlin Mastery Scale.

Methodology

The following data were collected in the 'Social and Emotional Well-being' module. Additional information about mental health and well-being data can be found in the Family Stressors section of this publication.

All questions below, except for use of mental health services, were able to have a 'don't know' or 'refusal' response.

Kessler Psychological Distress Scale (Kessler-5)

The Kessler-5 (K5) measure of psychological distress is a subset of five questions from the Kessler Psychological Distress Scale-10 (K10). The K10 is a non-specific psychological distress scale consisting of 10 questions designed to measure levels of negative emotional states experienced by people in the four weeks prior to interview.

The 2012-13 NATSIHS included questions from the K5 to provide a broad measure of people's social and emotional well-being. Respondents were asked about how often in the four weeks prior to interview they felt:

• nervous
• without hope
• restless or jumpy
• everything was an effort
• so sad that nothing could cheer them up.

For each K5 question, an answer was provided using a five-level response scale, based on the amount of time a person reported experiencing the problem. The response scale was as follows:

• all of the time
• most of the time
• some of the time
• a little of the time
• none of the time.

If a person answered none of the time or a mixture of none of the time, don't know or refusal to all K5 questions, were not asked any further K5 questions and were sequenced to the Positive well-being questions.

People who answered the K5 questions with responses ranging from 'a little of the time' to 'all of the time' were asked to think about the K5 responses and whether their feelings in the four weeks prior to interview happened:

• more often than usual
• about the same as usual
• less often than usual.

Respondents were then asked whether there were any days in the four weeks prior to interview when they were totally unable to work or carry out normal activities because of their feelings. If so, they were then asked how many days were like that. A response from 1 to 28 was possible.

Respondents were asked if they had seen a doctor or other health professional about these feelings in the last 4 weeks. If so, they were asked how many times. A response from 1 to 28 was possible.

Respondents were then asked how often physical health problems had been the main cause of these feelings using the same response scale as the K5 questions.

K5 score

Responses to the K5 questions were put together, resulting in a minimum possible score of 5 and a maximum possible score of 25. Low scores indicate low levels of psychological distress and high scores indicate high levels of psychological distress. Scores were grouped and output as follows:

• low/moderate 5-11
• high/very high 12-25
• not stated.

K5 results for respondents who were represented by a proxy (and the respondent was not present for the interview) were recorded in the 'not asked' category.

Positive well-being

Respondents were asked how often in the four weeks prior to interview they:

• felt calm and peaceful
• had been a happy person
• felt full of life
• had a lot of energy.

For each positive well-being question, an answer was provided using a five-level response scale, based on the amount of time a person reported experiencing the feeling. The response scale was as follows:

• all of the time
• most of the time
• some of the time
• a little of the time
• none of the time.

Pearlin Mastery Scale

Non-remote respondents were asked an additional adaptation of the Pearlin Mastery Scale. The Pearlin Mastery Scale is a 7-item self reported scale that measures the extent to which an individual feels control over life outcomes. The scale was utilised to further identify the emotional stability and personal mastery of persons in scope of the survey.

Each question was introduced by the statement 'how well does this statement apply to you':

• I have little control over the things that happen to me
• there is really no way I can solve some of the problems I have
• there is little I can do to change many of the important things in my life
• I often feel helpless in dealing with the problems of life
• sometimes I feel that I'm being pushed around in life
• what happens to me in the future mostly depends on me
• I can do just about anything I really set my mind to do.

Respondents were able to answer yes, sometimes or no, to each of these questions and only the one response was allowed for each.

Use of mental health services

All respondents were asked if they had accessed or used health services for a mental health condition. This was followed by asking whether they had received any counselling for their own health in the last 12 months. If no, respondents were asked whether they needed to see a counsellor in the previous 12 months but didn't. If yes, this was followed by a question regarding the reason they didn't go, from the below responses:

• Cost
• Discrimination
• Service not culturally appropriate
• Language problems
• Transport/distance
• Does not trust the counsellor
• Waiting time too long or not available at time required
• Not available in area
• Too busy (including work, personal, family responsibilities)
• Dislikes service/professional, afraid, embarrassed
• Felt it would be inadequate
• Decided not to seek care
• Other

More than one response was allowed. Remote respondents were not asked any further questions.

Multidimensional Scale of Perceived Social Support (MSPSS)

The MSPSS is a 12-item, uni-dimensional tool used to measure how a person perceives their support system, including sources of social support from family, friends and significant other(s). A sub-set of questions from the MSPSS were asked of respondents aged 18 years and over in non-remote areas.

Each statement was prefaced by the question 'How well does this statement apply to you?':

• My family really tries to help me
• I get the emotional support and help I need from my family
• I can talk about my problems with my family
• My family is willing to help me make decisions
• I can count on my friends when things go wrong
• I can talk about my problems with my friends

Self-esteem

The Western Australian Aboriginal Child Health Survey (WAACHS) included a 7-item tool designed to measure the self-esteem of young people aged 12-17 years. The items were specifically designed for use in the WAACHS. A sub-set of these items were asked of respondents aged 18 years and over in non-remote areas.

Each statement was prefaced by the question 'How well does this statement apply to you?':

• I find it easy to make friends
• I like most things about myself
• I feel proud of who I am
• I can usually sort out my own problems
• When I try, I can make good things happen for me
• No matter how bad I feel, I know that I will feel better eventually

Respondents were able to answer yes, sometimes or no, to each of these questions and only one response was allowed for each statement.

Interpretation

Points to be considered in interpreting data for this topic include the following:

• It is possible that there may be under-reporting of psychological distress when other household members are present due to the personal or sensitive nature of this topic.
• Possible under-reporting may also occur in remote areas due to the level of access to particular health services, or respondents may be less inclined to report such matters due to cultural or language issues.
• Those respondents incapable of being present for the interview due to illness or disability, and who were represented by a proxy, were recorded as being 'Not asked' for the Social and Emotional Well-being data items.

Data items

The data items and related output categories for this topic are available in Excel spreadsheet format from the Downloads page of this product.

Comparability with 2004-05 National Aboriginal and Torres Strait Islander (NATSIHS)

Results from the 2012-13 NATSIHS for the Kessler 5 psychological distress scale and positive well-being questions are considered comparable to the 2004-05 survey, other data were not collected.

Comparability with 2008 National Aboriginal and Torres Strait Islander Social Survey (NATSISS)

Results from the 2012-13 NATSIHS for the Kessler 5 psychological distress scale and positive well-being questions are considered comparable to data collected in the 2008 NATSISS, other data were not collected.

Comparability with 2011-12 National Health Survey (NHS)

Results from 2012-13 NATSIHS for the Kessler-5 psychological distress scale is considered comparable to the 2011-12 NHS, other data were not collected.

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