National trends in mental health disability, 1997-2009

Objectives. I assessed recent trends in mental health disability in the US nonelderly adult population in the context of trends in physical disabilities and psychological distress. Methods. Using data for 312364 adults aged 18 to 64 years from the US National Health Interview Survey, 1997 to 2009, I examined time trends in selfreported disability attributed to mental health conditions, disability attributed to other chronic problems, and significant psychological distress (measured by using the K6 instrument). Results. The prevalence of self-reported mental health disability increased from 2.0% of the nonelderly adult population in the first 3 years (1997 to 1999) to 2.7% in the last 3 years (2007 to 2009), corresponding to an increase of almost 2 million disabled adults. Disability attributed to other chronic conditions decreased and significant psychological distress did not change appreciably. Change in self-reported mental health disability was more pronounced in adults who also reported disability attributed to other chronic conditions or significant psychological distress but who had no mental health contacts in the past year. Conclusions. These findings highlight the need for improved access to mental health services in the community and for better integration of these services with primary care.