Frequent Mental Distress - Age 65+ in United States

United States

A healthy mental state is essential to overall positive health and well-being. Frequent mental distress aims to capture the population experiencing persistent and likely severe mental health issues, defined by 14 or more days of self-reported poor mental health in the past month. Frequent mental distress is associated with health conditions and risk factors for further poor health, including diabetes, hypertension, smoking, obesity, physical inactivity and insufficient sleep. Sometimes, poor mental health may lead to suicide. Older adults are more likely to struggle with poor physical health and lack of access to quality health care, putting them at greater risk for mental health issues.

In 2013, direct medical spending associated with mental health disorders including dementia in the United States reached $201 billion, surpassing costs for heart disease ($147 billion) and traumatic injury ($143 billion).

According to America’s Health Rankings analysis, the prevalence of frequent mental distress is higher among:

• American Indian/Alaska Native older adults compared with Asian older adults. Multiracial, Hispanic and Black older adults also have a high prevalence. 
• Older adults with less than a high school education compared with those with higher levels of education; college graduates have the lowest prevalence. 
• Older adults with an annual household income less than $25,000 compared with those with higher levels of income.
• Older adults who have difficulty with cognition compared with those without a disability. The prevalence is also high among older adults who have difficulty with self-care.

Other studies have found that older adults with activity limitations due to chronic conditions, physical disabilities or mental or emotional problems are nearly three times as likely to suffer from frequent mental distress compared with those without limiting disabilities. Additionally, those who report being unable to see a doctor because of cost at least once in the past year have double the odds of frequent mental distress compared with those without severe cost barriers.

Although some poor mental health days or occasional short periods of mental distress may be unavoidable, more prolonged and severe episodes may be treatable and preventable through time-efficient screening procedures, early interventions and quality care. The National Institutes of Health provides resources for older adults who have depression or who may suffer from other mental health issues. The American Psychological Association recognizes the unique needs of older adults and offers several resources available through its Committee on Aging, including information on geropsychology. The 988 Suicide & Crisis Lifeline provides free, confidential support for people in distress 24/7 anywhere in the United States.

Healthy People 2030 has objectives to increase the proportion of adults with depression and adults with serious mental illness who receive treatment.

Dwyer-Lindgren, Laura, Johan P. Mackenbach, Frank J. van Lenthe, and Ali H. Mokdad. “Self-Reported General Health, Physical Distress, Mental Distress, and Activity Limitation by US County, 1995-2012.” Population Health Metrics 15, no. 1 (April 26, 2017): 16. https://doi.org/10.1186/s12963-017-0133-5.

Leggett, Amanda, and Steven H. Zarit. “Prevention of Mental Disorder in Older Adults: Recent Innovations and Future Directions.” Generations 8, no. 3 (2014): 45–52. https://pubmed.ncbi.nlm.nih.gov/26290620/.

Liu, Yong, Janet B. Croft, Anne G. Wheaton, Geraldine S. Perry, Daniel P. Chapman, Tara W. Strine, Lela R. McKnight-Eily, and Letitia Presley-Cantrell. “Association between Perceived Insufficient Sleep, Frequent Mental Distress, Obesity and Chronic Diseases among US Adults, 2009 Behavioral Risk Factor Surveillance System.” BMC Public Health 13, no. 1 (January 29, 2013): 84. https://doi.org/10.1186/1471-2458-13-84.

Roehrig, Charles. “Mental Disorders Top The List Of The Most Costly Conditions In The United States: $201 Billion.” Health Affairs 35, no. 6 (June 2016): 1130–35. https://doi.org/10.1377/hlthaff.2015.1659.

Segev, Zuzana, Ahmed A. Arif, and James E. Rohrer. “Activity Limitations and Healthcare Access as Correlates of Frequent Mental Distress in Adults 65 Years and Older: A Behavioral Risk Factor Surveillance Study—2008.” Journal of Primary Care and Community Health 3, no. 1 (January 1, 2012): 17–22. https://doi.org/10.1177/2150131911412380.