June 26, 2008

Serious Psychological Distress among Adults Aged 50 or Older: 2005 and 2006

In Brief
  • Combined data from 2005 and 2006 indicate that an annual average of 7.0 percent of persons aged 50 or older experienced serious psychological distress (SPD) in the past year, with 8.8 percent of those aged 50 to 64 and 4.5 percent of those aged 65 or older having experienced past year SPD
  • Among persons aged 50 or older with past year SPD, 53.7 percent received mental health treatment in the past year, 6.2 percent did not receive treatment although they felt they needed it, and 40.1 percent did not receive treatment and did not perceive a need for it
  • Persons aged 50 to 64 with SPD, compared with their counterparts aged 65 or older, were more likely to have received mental health treatment (57.8 vs. 41.8 percent), more likely not to have received treatment although they recognized a need for it (7.9 vs. 1.3 percent), and less likely not to have received mental health treatment and not to have recognized a need for it (34.2 vs. 56.8 percent)

In 2006, an estimated 24.9 million adults aged 18 or older in the United States experienced serious psychological distress (SPD) in the past year, representing 11.3 percent of all adults in this country.1 There is evidence that older adults with certain mental health disorders are more likely than their younger counterparts to have higher levels of cognitive and functional impairment and lower rates of use of acute mental health services.2

The National Survey on Drug Use and Health (NSDUH) includes questions to assess SPD, an overall indicator of nonspecific psychological distress. NSDUH measures past year SPD using the K6 distress questions.3 The K6 questions measure symptoms of psychological distress during the 1 month in the past 12 months when respondents were at their worst emotionally.

NSDUH also asks respondents to report on their experiences with mental health treatment, which is defined as treatment or counseling for any problem with emotions, nerves, or mental health in the past 12 months in any inpatient or outpatient setting, or the use of prescription medication for treatment of a mental health problem.1 In addition, adults are asked if there was any time during the past 12 months when they needed treatment or counseling for mental health problems but did not receive it. For the purposes of this report, individuals who had not received treatment for a mental health problem in the past 12 months but who thought they needed it are referred to as having a perceived unmet need for mental health treatment.4,5

This issue of The NSDUH Report examines demographic and other variations in the rate of past year SPD among noninstitutionalized adults aged 50 or older, receipt of mental health treatment, and perceived unmet need for mental health treatment among those with SPD.6 All findings presented in this report are annual averages based on combined 2005 and 2006 NSDUH data.


Past Year SPD among Persons Aged 50 or Older

Combined data from 2005 and 2006 indicate that an annual average of 7.0 percent of adults aged 50 or older (an estimated 6.1 million persons) experienced SPD in the past year (Table 1). The prevalence of past year SPD varied by demographic characteristics. Among persons aged 50 or older, past year SPD was more likely among females than males (8.7 vs. 5.2 percent), and it was more likely among those with less than a high school education than those with higher levels of education. Adults aged 50 or older living in households with an annual family income of less than $20,000 were more likely than those living in households with higher family incomes to have experienced SPD in the past year. There was little difference in the rate of past year SPD between persons aged 50 or older who were retired and those who were employed. Adults aged 50 or older with no health insurance were nearly twice as likely as their counterparts with health insurance to have experienced past year SPD (12.3 vs. 6.7 percent).

Table 1. Percentages of Persons Aged 50 or Older with Past Year Serious Psychological Distress (SPD), by Age Group and Demographic Characteristics: 2005 and 2006
Demographic Characteristic Total Aged 50 or Older Aged 50 to 64 Aged 65 or Older
Total    7.0%    8.8% 4.5%
Gender      
Male    5.2%    6.4% 3.1%
Female    8.7%  11.1% 5.6%
Education      
< High School  10.2%  13.9% 7.5%
High School Graduate    6.4%    8.1% 4.4%
Some College    7.6% 10.0% 3.3%
College Graduate    5.2%    6.6% 1.9%
Family Income      
< $20,000  11.7% 18.3% 7.0%
$20,000-$49,999    6.9% 10.2% 3.7%
$50,000-$74,999    6.1%   7.4% 3.5%
≥ $75,000    4.4%   4.9% 2.8%
Current Employment      
Employed (Full or Part Time)    5.9%    6.6% 2.3%
Retired    4.9%    6.6% 4.5%
Health Insurance      
Any Health Insurance    6.7%    8.5% 4.4%
No Health Insurance  12.3%  11.9% *
Source: SAMHSA, 2005 and 2006 NSDUHs.


Mental Health Treatment and Unmet Treatment Need among Persons Aged 50 or Older with SPD

Among adults aged 50 or older with past year SPD, 53.7 percent received mental health treatment in the past year, 6.2 percent did not receive treatment although they felt they needed it, and 40.1 percent did not receive treatment and did not perceive a need for it (hereafter referred to as an "unmet, unperceived treatment need") (Table 2). Rates of receiving mental health treatment in the past year and having an unmet need for mental health treatment were similar for males and females and across family income levels.7 Among adults aged 50 or older with past year SPD, those with less than a high school education were less likely than those with higher levels of education to have received mental health treatment in the past year. Persons aged 50 or older with past year SPD and less than a high school education were generally more likely than those with higher levels of education to have an unmet, unperceived treatment need. Retired persons aged 50 or older with past year SPD were more likely than their employed counterparts to have an unmet, unperceived treatment need.

Table 2. Percentages of Persons Aged 50 or Older with Past Year Serious Psychological Distress (SPD) Who Reported Past Year Mental Health Treatment and Perceived Need for Treatment, by Demographic Characteristics: 2005 and 2006
Demographic Characteristic Received Mental Health Treatment** Did Not Receive Mental Health Treatment
Perceived Need for Treatment Did Not Perceive Need for Treatment
Total 53.7% 6.2% 40.1%
Gender      
Male 48.7% 6.7% 44.6%
Female 56.2% 6.0% 37.9%
Education      
< High School 40.7% 5.3% 54.0%
High School Graduate 51.4% 4.7% 43.9%
Some College 58.8% 9.1% 32.1%
College Graduate 67.8% 6.2% 25.9%
Family Income      
< $20,000 51.0% 4.6% 44.4%
$20,000-$49,999 53.4% 5.7% 41.0%
$50,000-$74,999 52.7% 9.7% 37.6%
≥ $75,000 60.1% 7.2% 32.6%
Current Employment      
Employed (Full or Part Time) 49.5% 8.8% 41.7%
Retired 45.4% 2.8% 51.8%
Source: SAMHSA, 2005 and 2006 NSDUHs.


Past Year SPD and Mental Health Treatment Need among Persons Aged 50 to 64 and Those Aged 65 or Older

Rates of past year SPD varied by detailed age group within the older adult population (Table 1). Combined data from 2005 and 2006 indicate that 8.8 percent of adults aged 50 to 64 experienced past year SPD compared with 4.5 percent of adults aged 65 or older. Within both age groups, females were more likely than males to have had past year SPD, and the rate of past year SPD generally decreased as income increased (Table 1). The rate of past year SPD generally decreased as the level of education increased among persons aged 65 or older. Among persons aged 50 to 64, the rate of past year SPD was higher among those who did not complete high school than among those with more education. Retired persons aged 65 or older were more likely than their employed counterparts to have had past year SPD, but there was no difference by employment status among persons aged 50 to 64.

Mental health treatment and unmet treatment need among adults with past year SPD also varied by detailed age groups within the population aged 50 or older. Persons aged 50 to 64 with SPD, compared with their counterparts aged 65 or older, were more likely to have received mental health treatment (57.8 vs. 41.8 percent), more likely not to have received treatment although they recognized a need for it (7.9 vs. 1.3 percent) and less likely not to have received mental health treatment and not to have recognized a need for it (34.2 vs. 56.8 percent) (Figure 1).

Figure 1. Percentages of Persons Aged 50 or Older with Past Year Serious Psychological Distress (SPD) Who Reported Past Year Mental Health Treatment and Perceived Need for Treatment, by Age Group: 2005 and 2006
This figure is a vertical stack bar graph comparing percentages of persons aged 50 or older with past year serious psychological distress (SPD) who reported past year mental health treatment and perceived need for treatment, by age group: 2005 and 2006. Accessible table located below this figure.

Figure 1 Table. Percentages of Persons Aged 50 or Older with Past Year Serious Psychological Distress (SPD) Who Reported Past Year Mental Health Treatment and Perceived Need for Treatment, by Age Group: 2005 and 2006
Past Year Mental Health Treatment and Perceived Need for Treatment Aged 50 to 64 Aged 65 or Older
Received Mental Health Treatment 57.8% 41.8%
Did Not Receive Mental Health Treatment and Did Not Perceive Need for It 34.2% 56.8%
Did Not Receive Mental Health Treatment Although Perceived Need for It    7.9%    1.3%
Source: SAMHSA, 2005 and 2006 NSDUHs.


End Notes
1 Office of Applied Studies. (2007). Results from the 2006 National Survey on Drug Use and Health: National findings (DHHS Publication No. SMA 07-4293, NSDUH Series H-32). Rockville, MD: Substance Abuse and Mental Health Services Administration.
2 Depp, C. A., Lindamer, L. A., Folsom, D. P., Gilmer, T., Hough, R. L., Garcia, P., & Jeste, D. V. (2005). Differences in clinical features and mental health service use in bipolar disorder across the lifespan. American Journal of Geriatric Psychiatry, 13, 290-298.
3 Kessler, R. C., Barker, P. R., Colpe, L. J., Epstein, J. F., Gfroerer, J. C., Hiripi, E., Howes, M. J., Normand, S. L., Manderscheid, R. W., Walters, E. E., & Zaslavsky, A. M. (2003). Screening for serious mental illness in the general population. Archives of General Psychiatry, 60, 184-189.
4 Individuals who had received mental health treatment in the past year but who felt they needed additional treatment are categorized as having received treatment.
5 This analysis excluded adults aged 50 or older with past year SPD for whom data on either past year receipt of mental health treatment or counseling or past year perceived unmet need for mental health treatment were unknown or missing.
6 NSDUH covers the civilian noninstitutional population and does not sample persons residing in institutional group quarters such as nursing homes and other long-term care facilities. Those in their own residences, including retirement communities, are included.
7 Estimates between males and females are not significantly different from each other; this may be due to low precision of the estimates.


Table Notes
* Estimate not shown due to low precision.
** See End Note 4.


Suggested Citation
Substance Abuse and Mental Health Services Administration, Office of Applied Studies. (June 26, 2008). The NSDUH Report - -  Serious Psychological Distress among Adults Aged 50 or Older: 2005 and 2006. Rockville, MD.

The National Survey on Drug Use and Health (NSDUH) is an annual survey sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA).   The 2005 and 2006 data used in this report are based on information obtained from 13,207 adults aged 50 or older who reported valid information on past year receipt of mental health treatment and perception of need for mental health treatment in the past year. The survey collects data by administering questionnaires to a representative sample of the population through face-to-face interviews at their place of residence.

The NSDUH Report  is prepared by the Office of Applied Studies (OAS), SAMHSA, and by RTI International in Research Triangle Park, North Carolina. (RTI International is a trade name of Research Triangle Institute.)

Information on the most recent NSDUH is available in the following publication:

Office of Applied Studies. (2007). Results from the 2006 National Survey on Drug Use and Health: National findings (DHHS Publication No. SMA 07-4293, NSDUH Series H-32). Rockville, MD: Substance Abuse and Mental Health Services Administration.

Information for earlier NSDUHs is available in the following publication:

2005 NSDUH: (DHHS Publication No. SMA 06-4194, NSDUH Series H-30)

Also available online: http://oas.samhsa.gov.

Because of improvements and modifications to the 2002 NSDUH, estimates from the 2002 through 2006 surveys should not be compared with estimates from the 2001 or earlier versions of the survey to examine changes over time.

The NSDUH Report is published periodically by the Office of Applied Studies, Substance Abuse and Mental Health Services Administration (SAMHSA).All material appearing in this report is in the public domain and may be reproduced or copied without permission from SAMHSA. Additional copies of this report or other reports from the Office of Applied Studies are available online: http://oas.samhsa.gov. Citation of the source is appreciated. For questions about this report, please e-mail: shortreports@samhsa.hhs.gov.

NSDUH_110


This page was last updated on December 30, 2008.