Explore Indicators
Psychological distress
What is the indicator?
This indicator measures prevalence of different levels of psychological distress in a community. Psychological distress is a negative emotional state in which a person is experiencing significant negative emotions that cause suffering; these symptoms include things like anxiety, depression, and feeling worthless, amongst others. Experiencing high levels of psychological distress is a sign that a person is not able to cope with the pressures, challenges or circumstances they are living in at that point in time. Psychological distress is an important indicator of a person’s mental health status, and an early warning sign of risk of mental health disorders. Persistent high symptoms of distress are often a sign that a person is likely to have a diagnosable mental health disorder.
What can this tell us about wellbeing?
While high wellbeing and high psychological distress can co-exist, having high distress makes it harder to have high wellbeing. A person who is feeling stressed, anxious and overwhelmed (experiencing distress) can still have high wellbeing if they are managing to overall cope with the challenges triggering distress, and to still maintain positive aspects of wellbeing such as strong relationships, purpose and satisfaction with their life. However, high distress is often associated with low wellbeing. While it should not be assumed that every individual person with high distress has low wellbeing, across a whole population, high rates of distress indicate the presence of significant stressors that are placing pressure on wellbeing.
Read more:
The ‘perfect storm’ causing Australians psychological distress (Melbourne Institute)
Psychological distress in young people in Australia (Mission Australia & Black Dog Institute)
Advantages and disadvantages of this indicator
Advantages: Psychological distress is a well established indicator of mental health, risk of diagnosable mental health disorder, and several well validated survey instruments are available that can be used to provide robust measures of distress levels.
Disadvantages: There is sometimes debate about which measure of psychological distress is best, or most appropriate. Like many survey measures, people from some cultural backgrounds may answer questions measuring distress differently due to having differing understandings of terms like feeling ‘nervous’ or ‘anxious’. It is critical to use measures of distress that have been tested in the type of population you will be measuring distress in, and to ensure they are collected using the same survey ‘mode’ over time, as people consistently report higher levels of psychological distress when completing a survey online or on a paper form, and lower distress when reporting their symptoms to another person by phone or in a face to face setting (see Klein et al. 2020 for more).
Find out more:
What measures should I use for this indicator?
While many validated measures of psychological distress have been developed, the measure most widely used in Australian surveys is the Kessler psychological distress scale, in either its six-item version (K6) or ten item version (K10). Almost all national surveys examining psychological distress use the K6 or K10, with examples including:
- NSW Mental Health Commission Psychological Distress indicator
- Australian Institute of Health and Welfare High psychological distress
- ABS National Study of Mental Health and Wellbeing 2020-21
- ABS General Social Survey
- Household, Income and Labour Dynamics in Australia (HILDA) survey
However, these surveys do not typically provide data at the scale of local government areas, particularly for rural areas. Currently the primary source of data on rates of psychological distress in smaller rural communities is the University of Canberra’s Regional Wellbeing Survey.
If you measure psychological distress in your own survey, ensure you use either the K6, K10, or another validated measure of psychological distress. You can find information on measuring the K6 and K10, and how to interpret their scores, on the following links:
Measures
Psychological distress is measured using the 6-item version of the Kessler Psychological Distress Scale (the K6).
These are published annually in data tables and the Regional Wellbeing Dashboard. Data are published for Australia, states and territories, regional Australia, and a range of geographic regions. The smallest scale at which data are available is the local government area (LGA), although sample sizes are too small to report data for some smaller population LGAs in rural Australia. Where this is the case, findings are published for a larger region that includes that LGA.
The K6 item has been validated for most Australian populations. However, some case is needed when using data from this measure for people for whom English is a second language. For those from some cultural backgrounds, answers to the English language version of the K6 used in the Regional Wellbeing Survey may reflect differing cultural understandings of some of the terms asked about such as feeling nervous or worthless. Additionally, it is important to identify how data were collected, as there is a known ‘survey mode’ effect for data on psychological distress: people asked questions about distress directly by another person in a phone or face to face interview typically report lower distress, while those who answer questions without talking to another person (for example in an online survey or paper form) typically report higher distress (see Klein et al. 2020 for more). This mode effect means you need to ensure any comparison of data on distress in your community with national averages needs to be done only with surveys that collected data using the same ‘mode’ (i.e. online, paper, phone or face to face).
The Regional Wellbeing Survey collects data using online and paper survey modes, and publishes K6 mean scores, as well as the proportion of people experiencing low, moderate and high distress using score cut-offs recommended by the Australian Bureau of Statistics (see the Information paper: Use of the Kessler Psychological Distress Scale in ABS Health Surveys for more information).
You can use measures of confidence in the local economy from the Regional Wellbeing Survey in a number of ways:
- Directly source data about your community or region from the results published each year in data tables and the Regional Wellbeing Dashboard
- Include the same questions in your own survey, and draw on Regional Wellbeing Survey data to provide comparison data that enables you to assess how your community is going compared to others of similar size, or to the average for regional areas in your state/territory, or across regional Australia, urban Australia, or Australia as a whole.
An increase in distress levels is an indicator that there are pressures likely to be having a negative effect on wellbeing, and vice versa.
The primary data source available for this indicator is the Regional Wellbeing Survey. Data are updated annually, and available in two formats: data tables that publish findings for small regions, including individual local government areas where sample size permits, and the Regional Wellbeing Dashboard.
This measure can be included in your own survey. However, it is critical to ask questions in exactly the same way they have been set out in the K6 survey instrument to ensure you collect data that can be compared to findings of other surveys.