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	ADULT HEALTH: PSYCHOLOGICAL DISTRESS
	This article is part of a comprehensive series released as The Health and Welfare of Australia's Aboriginal and Torres Strait Islander Peoples

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KEY MESSAGES In 2008, nearly one-third (32%) of Aboriginal and Torres Strait Islander people aged 18 years and over had experienced high/very high levels of psychological distress, which was more than twice the rate for non-Indigenous people.

Health is more than simply the presence or absence of physical conditions or illnesses; it also incorporates mental health and social and emotional wellbeing. In 2003, anxiety/depression was estimated to be one of the largest specific causes of the burden of disease in Australia overall, while mental health conditions contributed to 16% of the total disease burden experienced by Aboriginal and Torres Strait Islander people (Endnotes 1 and 2).

This topic presents results from the 2008 National Aboriginal and Torres Strait Islander Social Survey (NATSISS) which provides the most recent data for psychological distress among Aboriginal and Torres Strait Islander people. The 2008 NATSISS collected information on psychological distress among those aged 15 years and over using selected questions from the Kessler Psychological Distress Scale (Endnote 3).

Responses to these questions showed that 31% of Aboriginal and Torres Strait Islander people aged 15 years and over reported high/very high levels of psychological distress during the four weeks prior to interview. Rates were higher among women (34%) than men (27%), particularly in younger age groups (graph 2.1). There was no significant difference in rates of distress between people living in remote and non-remote areas (29% compared with 31%).


Among those who had experienced high/very high levels psychological distress, 38% were unable to to work or carry out their normal activities due to their feelings, while 27% had been to see a health professional about their distress in the previous four weeks. Around one-quarter (24%) reported that their physical health was the main cause of these feelings all or most of the time.

Those with high/very high levels of distress were more likely than those with low/moderate levels of distress to report that they or their close family/friends had experienced at least one stressor in the last 12 months (88% compared with 73%). The most common types of stressors experienced by those with high distress were bad illness/accident (52%), death of a family member or close friend (51%) and alcohol and drug related problems (39%). People with high/very high levels of distress were twice as likely as those with low/moderate levels of distress to report abuse and violent crime, witness to violence and severe disability as stressors (table 2.2).

		Low/		High/
		moderate		very high		Rate ratio(c)
Bad illness/accident	%	39.4		51.6		1.3
Death of family member or close friend	%	49.9		51.1		1.0
Alcohol/drug-related problems	%	23.8		38.9		1.6
Not able to get a job	%	23.9		36.1		1.5
Mental illness	%	17.5		27.1		1.5
Trouble with the police	%	14.9		23.9		1.6
Overcrowding at home	%	12.7		21.2		1.7
Witness to violence	%	7.6		17.3		2.3
Abuse or violent crime	%	6.5		14.0		2.1
Bad disability	%	6.3		12.9		2.1
Total experienced a stressor in last 12 months(d)	no.	161 364		87 856		..

(a) In last four weeks.
(b) By self or close family/friends in last 12 months.
(c) High/very high distress proportion divided by low/moderate distress proportion.
(d) Multiple response item - proportions do not add to total.
Source: 2008 National Aboriginal and Torres Strait Islander Social Survey. These estimates are also available for download in the Adult Health datacube.


Psychological distress was also associated with poorer health outcomes. Those with high/very high levels of distress were more likely than those with low/moderate levels of distress to report fair/poor health (37% compared with 15%) and were less likely to report excellent or very good health (29% compared with 50%). They were also more likely to be be current daily smokers (54% compared with 41%), to drink at chronic risky/high risk levels (21% compared with 16%) and to have used illicit substances in the last 12 months (27% compared with 18%). People with high/very high levels of distress were twice as likely to have been a victim of physical or threatened violence (35% compared with 18%).

The most recent information on psychological distress for non-Indigenous adults is available from the 2007–08 National Health Survey. After adjusting for differences in age structure between the two populations, Aboriginal and Torres Strait Islander people aged 18 years and over were two and a half times as likely as non-Indigenous people to have experienced high/very high levels of psychological distress. This gap was evident in all broad age groups (graph 2.3).

ENDNOTES

1. Begg, S., Vos, T., Barker, B., Stevenson, T., Stanley, L. and Lopez, A. 2007, 'The Burden of Disease and Injury in Australia, 2003', cat. no. PHE 82, AIHW, Canberra, <www.aihw.gov.au>.

2. Vos, T., Barker, B., Stanley, L. and Lopez, A. 2007, 'The Burden of Disease and Injury in Aboriginal and Torres Strait Islander Peoples, 2003', School of Population Health, Brisbane, <www.uq.edu.au>.

3. The Kessler Psychological Distress Scale (K10) is a scale of non-specific psychological distress. It comprises 10 questions about negative emotional states experienced in the four weeks prior to interview. For the 2008 NATSISS, the K10 was reduced to five questions (some slightly modified) to provide the best set of questions to exhibit psychological distress within the Aboriginal and Torres Strait Islander population. For more information, see the Glossary or the Australian Institute of Health and Welfare report Measuring the social and emotional wellbeing of Aboriginal and Torres Strait Islander peoples.

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