title: Mental disorders and distress: Associations with demographics, remoteness and socioeconomic deprivation of area of residence across Australia.
abstract: OBJECTIVE
  Australian policy-making needs better information on socio-geographical associations with needs for mental health care. We explored two national surveys for information on disparities in rates of mental disorders and psychological distress.
  
  
  METHODS
  Secondary data analysis using the 2011/2012 National Health Survey and 2007 National Survey of Mental Health and Wellbeing. Key data were the Kessler 10 scores in adults in the National Health Survey (n = 12,332) and the National Survey of Mental Health and Wellbeing (n = 6558) and interview-assessed disorder rates in the National Survey of Mental Health and Wellbeing. Estimation of prevalence of distress and disorders for sub-populations defined by geographic and socioeconomic status of area was followed by investigation of area effects adjusting for age and gender.
  
  
  RESULTS
  Overall, approximately one person in 10 reported recent psychological distress at high/very-high level, this finding varying more than twofold depending on socioeconomic status of area with 16.1%, 13.3%, 12.0%, 8.4% and 6.9% affected in the most to least disadvantaged quintiles, respectively, across Australia in 2011/2012. In the most disadvantaged quintile, the percentage (24.4%) with mental disorders was 50% higher than that in the least disadvantaged quintile (16.9%) in 2007, so this trend was less strong than for Kessler10 distress.
  
  
  CONCLUSIONS
  These results suggest that disparities in mental health status in Australia based on socioeconomic characteristics of area are substantial and persisting. Whether considering 1-year mental disorders or 30-day psychological distress, these occur more commonly in areas with socioeconomic disadvantage. The association is stronger for Kessler10 scores suggesting that Kessler10 scores behaved more like a complex composite indicator of the presence of mental and subthreshold disorders, inadequate treatment and other responses to stressors linked to socioeconomic disadvantage. To reduce the observed disparities, what might be characterised as a 'Whole of Government' approach is needed, addressing elements of socioeconomic disadvantage and the demonstrable and significant inequities in treatment provision.
authors.affiliation: Southern Synergy, Department of Psychiatry and School of Primary Health Care, Monash University, Melbourne, VIC, Australia.
authors.forename: Joanne C
authors.initials: JC
authors.lastname: Enticott
authors.affiliation: Monash Health, Melbourne, VIC, Australia graham.meadows@monash.edu.|School of Population Health, University of Melbourne, Melbourne, VIC, Australia.|Southern Synergy, Department of Psychiatry, Monash University, Melbourne, VIC, Australia.
authors.forename: Graham N
authors.initials: GN
authors.lastname: Meadows
authors.affiliation: Southern Synergy, Department of Psychiatry, Monash University, Melbourne, VIC, Australia.
authors.forename: Frances
authors.initials: F
authors.lastname: Shawyer
authors.affiliation: Department of Econometrics and Business Statistics, Faculty of Business and Economics, Monash University, Melbourne, VIC, Australia.
authors.forename: Brett
authors.initials: B
authors.lastname: Inder
authors.affiliation: Departments of Community Health Sciences and Psychiatry, University of Calgary, Calgary, AB, Canada.
authors.forename: Scott
authors.initials: S
authors.lastname: Patten
mesh_terms: D000293:Adolescent; D000328:Adult; D001315:Australia / Q000453:epidemiology; D005260:Female; D054624:Health Status Disparities; D006306:Health Surveys; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D012923:Social Class; D013315:Stress, Psychological / Q000453:epidemiology*; D035862:Vulnerable Populations / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Distress; equity; mental disorder; mental health; psychological distress