New study finds the number of Americans in &quotextreme&quot mental distress has doubled since 1993

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A new study has found that the proportion of American adults experiencing “extreme stress” — that is, those who reported having had serious emotional problems and mental stress in all 30 of the past 30 days — has increased has almost doubled since 1993. That year, the percentage reporting extreme mental stress was 3.6%. By 2019, the percentage had risen to 6.4%.

The study, published by David G. Blanchflower of Dartmouth College and Andrew J. Oswald of the University of Warwick, was published in the American Journal of Public Health.

To conduct their study, the two researchers used data from the Behavioral Risk Factor Surveillance System (BRFSS). Established in 1984, the BRFSS is a monthly survey of hundreds of thousands of Americans in all 50 states. It uses a standardized questionnaire and takes place over the phone. The survey is conducted by the Centers for Disease Control and Prevention.

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The data the survey collects includes respondents’ health-related risk behaviors, health status, and use of various services. The current annual number of respondents is about 450,000 (up from about 100,000 in 1993). This study is based on data from 8.1 million respondents from 1993 to 2019.

Measuring Mental Distress

Study authors Blanchflower and Oswald focused on a specific question in of the survey: “Now thinking about your mental health, which includes stress, depression, and emotional problems, on how many days in the last 30 days was your mental health poor?”

You classified the respondents who gave the highest possible answer (i.e. 30 days out of 30) as being in extreme need.

In 2019, the overall proportion of respondents who fell into this category was 6.4%. As recently as 1993, it was only 3.5%.

In 1993, non-whites were more likely (4.9%) than whites (3.9%) to report being in extreme distress. But by 2019, that relationship had reversed. This year, 5.5% of all non-white respondents reported extreme distress, versus 6.8% of white respondents.

Extreme emotional distress and demographics

Middle-aged for white respondents and less educated, the trend is even more worrying. In 2019, the final year of the study, the proportion of middle-aged white US citizens without a college degree reporting extreme hardship was 11%. In contrast, that figure was less than 5% in 1993.

“Something fundamental seems to have happened among middle-aged, low-educated white citizens,” the authors write.

About all Over the years studied, women and people with a lower level of education reported extreme stress more frequently. But the strongest growth has been among middle-aged and low-educated white men and women.

Economic insecurity as a cause of psychological distress

The authors suggest that changing employment conditions are the main reason for these changes. For example, the strongest statistical predictor of extreme stress was a positive response to the statement “I am unable to work”.

Additionally, the authors found that a 10% decrease in the proportion of manufacturing employees was associated with an approximately 0.5% increase in extreme mental health stress in the state. “These results appear to be consistent with other evidence of the psychological harm produced by economic insecurity,” the authors write.

The researchers say this is the first study to use this unique data point (i.e., the proportion of people reporting poor mental health in the BRFSS survey for each of the last 30 days) to measure the nation’s overall level of mental and emotional distress. As they put it, this metric is a proxy for the percentage of the population “that actually says, ‘every day of my life is a bad day.'”

“The upward trend in exceptional stress shows no signs of the slowdown,” the authors write. “Politicians must recognize the crisis facing an ever-growing group of US citizens in extreme distress.”

Research: “Trends in Extreme Distress in the United States, 1993-2019”Authors: David G. Blanchflower and Andrew J. OswaldPublished in: American Journal of Public HealthPublished date: October 2020DOI : 10.2105/AJPH.2020.305811Photo: by Nathan Cowley of Pexels

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