Frequent Mental Distress - Women in Pennsylvania

Pennsylvania

A healthy mental state is essential to positive health and well-being. Frequent mental distress, defined by 14 or more days of poor mental health a month, aims to capture the population experiencing persistent and likely severe mental health issues. There is a strong link between the 14-day period and clinically diagnosed mental disorders, such as depression and anxiety.

Populations suffering from severe mental illness and frequent mental distress have a higher prevalence of risky health behaviors, including smoking, alcohol use, unhealthy diet and lack of physical activity. These health behaviors increase the likelihood of developing chronic diseases like diabetes, cancer and cardiovascular disease. Chronic stressors such as housing insecurity, food insecurity and insufficient sleep are also related to frequent mental distress. In severe cases, poor mental health can lead to suicide, one of the leading causes of death in the United States. 

Poor mental health can impact financial health with costly treatments and missed economic opportunities. In 2019, the direct costs for treatment of mental health disorders among women in the U.S. totaled $61.5 billion. Among pregnant women and their children, untreated perinatal mood and anxiety disorders cost the U.S. roughly $14 billion.

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

• Women ages 18-24 compared with women ages 25-44.
• Multiracial and American Indian/Alaska Native women compared with Hispanic and Asian women.
• Women with less education compared with college graduates. 
• Women with annual household incomes below $25,000, who have a prevalence almost double that of women with incomes of $75,000 or more. 
• Women living in non-metropolitan areas compared with women in metropolitan areas.
• Women with independent living difficulty, who have a prevalence more than four times that of women without a disability. 
• LGBQ+ women, who have a prevalence more than twice that of straight women.

Although occasional short periods of mental distress and a few bad mental health days may be unavoidable, more prolonged and severe episodes are treatable and potentially preventable through early intervention. Parity laws that expand and protect insurance coverage for mental health care are associated with lower out-of-pocket costs, lower suicide rates and increased use of health care services. Collaborative care models, which connect primary care providers and mental health specialists, are also effective in managing depressive disorders. 

Surveillance systems for mental health issues — including frequent mental distress — help prioritize and tailor mental health promotion, mental illness prevention and treatment programs. The Centers for Disease Control and Prevention has a resources page for mental health, including a mental health services locator.

Healthy People 2030 has several objectives related to mental health, including: 

• Increasing the proportion of primary care visits where adolescents and adults are screened for depression.
• Increasing the proportion of adults with depression who get treatment.
• Increasing the proportion of adults with serious mental illness who get treatment.
• Increasing the proportion of homeless adults with mental health problems who get mental health services.

Arango, Celso, Covadonga M. Díaz-Caneja, Patrick D. McGorry, Judith Rapoport, Iris E. Sommer, Jacob A. Vorstman, David McDaid, et al. “Preventive Strategies for Mental Health.” The Lancet Psychiatry 5, no. 7 (July 2018): 591–604. https://doi.org/10.1016/S2215-0366(18)30057-9.

Caceres, Billy A., Abraham A. Brody, Perry N. Halkitis, Caroline Dorsen, Gary Yu, and Deborah A. Chyun. “Cardiovascular Disease Risk in Sexual Minority Women (18-59 Years Old): Findings from the National Health and Nutrition Examination Survey (2001-2012).” Women’s Health Issues 28, no. 4 (July 1, 2018): 333–41. https://doi.org/10.1016/j.whi.2018.03.004.

Hydes, Theresa J., Robyn Burton, Hazel Inskip, Mark A. Bellis, and Nick Sheron. “A Comparison of Gender-Linked Population Cancer Risks between Alcohol and Tobacco: How Many Cigarettes Are There in a Bottle of Wine?” BMC Public Health 19, no. 316 (March 28, 2019). https://doi.org/10.1186/s12889-019-6576-9.

Liu, Yong, Rashid Njai, and Kurt J. Greenlund. “Relationships Between Housing and Food Insecurity, Frequent Mental Distress, and Insufficient Sleep Among Adults in 12 US States, 2009.” Preventing Chronic Disease 11 (March 13, 2014). https://doi.org/10.5888/pcd11.130334.

Luca, Dara Lee, Caroline Margiotta, Colleen Staatz, Eleanor Garlow, Anna Christensen, and Kara Zivin. “Financial Toll of Untreated Perinatal Mood and Anxiety Disorders Among 2017 Births in the United States.” American Journal of Public Health 110, no. 6 (June 1, 2020): 888–96. https://doi.org/10.2105/AJPH.2020.305619.

Massetti, Greta M., Cheryll C. Thomas, Jessica King, Kathleen Ragan, and Natasha Buchanan Lunsford. “Mental Health Problems and Cancer Risk Factors Among Young Adults.” American Journal of Preventive Medicine 53, no. 3 Suppl 1 (September 1, 2017): S30–39. https://doi.org/10.1016/j.amepre.2017.04.023.

Rashid, Mamunur, M. Mazharul Islam, Aiping Li, and Naima Shifa. “Frequent Mental Distress among Adults in the United States and Its Association with Socio-Demographic Characteristics, Lifestyle, and Chronic Health Condition.” Journal of Public Health and Development 20, no. 1 (January 30, 2022): 146–62. https://doi.org/10.55131/jphd/2022/200112.

Reeves, William C., Tara W. Strine, Laura A. Pratt, William Thompson, Indu Ahluwalia, Satvinder S. Dhingra, Lela R. McKnight-Eily, et al. “Mental Illness Surveillance Among Adults in the United States.” MMWR Supplements 60 (September 2, 2011). https://www.cdc.gov/mmwr/preview/mmwrhtml/su6003a1.htm.

Slabaugh, S. Lane, Mona Shah, Matthew Zack, Laura Happe, Tristan Cordier, Eric Havens, Evan Davidson, Michael Miao, Todd Prewitt, and Haomiao Jia. “Leveraging Health-Related Quality of Life in Population Health Management: The Case for Healthy Days.” Population Health Management 20, no. 1 (2017): 13–22. https://doi.org/10.1089/pop.2015.0162.

Soni, Anita. “Healthcare Expenditures for Treatment of Mental Disorders: Estimates for Adults Ages 18 and Older, U.S. Civilian Noninstitutionalized Population, 2019.” Agency for Healthcare Research and Quality, February 2022. https://meps.ahrq.gov/data_files/publications/st539/stat539.pdf.