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Americans are experiencing serious psychological distress in higher numbers than ever before. More than 8 million adults in the US between the ages 18 and 64 have mental health issues – that’s 3.4 per cent of the nation’s population.

The US Centers for Disease Control and Prevention (CDC) has conducted an annual national health survey for the past 60 years. Respondents are asked how often over the past month they felt certain feelings, such as being so sad nothing could cheer them up, or that everything they did was an effort or worthless. The frequency of such feelings gives an indication of whether someone is in serious psychological distress (SPD).

An SPD score is highly correlated with mental health issues, such as depression and anxiety. It’s also linked to chronic disease, lower socio-economic status, smoking, drinking and a reduced life span.


Judith Weissman, an epidemiologist at the NYU Langone Medical Center, studied the survey data from 200,000 respondents between 2006 to 2014. She found that SPD was more prevalent in women than in men, in middle-aged adults versus younger adults, and in Hispanic and black people versus white people.

Weissman also found that while SPD rates were going up, access to mental health care was declining.

Recession effects

The recession from 2007 to mid-2009 may have contributed to the uptick in mental illness, says Weissman, and the financial consequences would have been tougher for those most in need of healthcare.

Between 2006 and 2014, access to mental health services increased for people who didn’t score highly for psychological distress. But over the same period, access got worse for people with SPD. There was also a marked decrease in the proportion of people who could afford to buy medications after 2008.

“People who had mental illness just could not recover. Maybe they were holding it together, they had a job, they had some resources, and then they got wiped out with this recession and they couldn’t get back on their feet,” she says.

By 2014, the number of people who could afford medications had increased, but those without mental illness rebounded faster and at a higher rate. “People with mental illness were left behind,” Weissman says.

“There is this generation of middle aged adults that are really suffering right now and if policies change, if we increase access to mental health care and we increase coverage for mental health care, we can save the next generation,” she says.

Weissman also noted that these findings could help explain why the US suicide rate is at a 30-year high.

Journal reference: Psychiatric Services, DOI: 10.1176/appi.ps.201600260

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