Notes on the data: Psychological distress

Estimated male, female or total population, aged 18 years and over, with high or very high psychological distress based on the Kessler 10 Scale (K10), 2017-18


Policy context:  Mental health is fundamental to the wellbeing of individuals, their families and the population as a whole. One indication of the mental health and wellbeing of a population is provided by measuring levels of psychological distress using the Kessler Psychological Distress Scale-10 items (K10). The K10 questionnaire was developed to yield a global measure of psychological distress, based on ten questions about people's level of nervousness, agitation, psychological fatigue and depression in the four weeks prior to interview, asked of respondents 18 years and over [1]. Based on previous research, a very high K10 score may indicate a need for professional help [2].

In 2017-18, 13.0% of Australians reported experiencing 'high' or 'very high' levels of psychological distress, compared with 11.7% in 2014-15, 10.8% in 2011-12, 12.0% in 2007-08 and 12.6% in 2001. Proportionally more females than males experienced 'high' or 'very high' psychological distress in 2017-18 (14.5% and 11.3% respectively) [3].


  1. Coombs T. Australian Mental Health Outcomes and Classification Network: Kessler-10 Training Manual. Sydney: NSW Institute of Psychiatry; 2005.
  2. Australian Bureau of Statistics (ABS). National health survey: users' guide - electronic publication, 2007-08. (ABS Cat. no. 4364.0). Canberra: ABS; 2009.
  3. Australian Bureau of Statistics (ABS) Psychological distress. National Health Survey: First results, 2017-18 — Australia. Canberra: ABS; 2018. Available from:; last accessed 15 October 2019


Differences from data published by the Australian Bureau of Statistics (ABS):

Data by quintile of socioeconomic disadvantage and Remoteness will differ to the extent that data extracted from Survey TableBuilder have been randomised, whereas those published by the ABS are not. In addition, rates published by the ABS for modelled estimates are generally crude rates; rates published by PHIDU are age-standardised.

Modelled Estimates:

In the absence of data from administrative data sets, estimates are provided at the Population Health Area (PHA) level for selected health risk factors from the 2017–18 National Health Survey (NHS), conducted by the Australian Bureau of Statistics (ABS). The estimates at the Population Health Area (PHA) are modelled estimates produced by the ABS (estimates at the Local Government Area (LGA) and Primary Health Network (PHN) level were derived from the PHA estimates).

Details of the method used and accuracy of results are available from the ABS paper Explanatory Notes: Modelled estimates for small areas based on the 2017-18 National Health Survey, available here.

For the Primary Health Network (PHN) data, differences between the PHN totals and the sum of LGAs within PHNs result from the use of different geographic correspondence files.

Estimates for quintile of socioeconomic disadvantage of area and Remoteness Area are direct estimates, extracted using the ABS Survey TableBuilder.

Users of these modelled estimates should note that they do not represent data collected in administrative or other data sets. As such, they should be used with caution, and treated as indicative of the likely social dimensions present in an area with these demographic and socioeconomic characteristics.

The numbers are estimates for an area, not measured events as are, for example, death statistics. As such, they should be viewed as a tool that, when used in conjunction with local area knowledge and taking into consideration the prediction reliability, can provide useful information that can assist with decision making for small geographic regions. Of particular note is that the true value of the published estimates is also likely to vary within a range of values as shown by the upper and lower limits published in the data (xlsx) and viewable in the column chart in the single map atlases.

What the modelled estimates do achieve, however, is to summarise the various demographic, socioeconomic and administrative information available for an area in a way that indicates the expected level of each health indicator for an area with those characteristics. In the absence of accurate, localised information about the health indicator, such predictions can usefully contribute to policy and program development, service planning and other decision-making processes that require an indication of the geographic distribution of the health indicator.

The relatively high survey response rate in the NHS provides a high level of coverage across the population; however, the response rate among some groups is lower than among other groups, e.g., those living in the most disadvantaged areas have a lower response rate than those living in less disadvantaged areas. Although the sample includes the majority of people living in households in private dwellings, it excludes those living in the very remote areas of Australia and discrete Aboriginal and Torres Strait Islander communities; whereas these areas comprise less than 3% of the total population, Aboriginal people comprise up to one third of the population. The survey does not include persons usually resident in non-private dwellings (hospitals, gaols, nursing homes - and also excludes members of the armed forces).

This and other limitations of the method mean that estimates have not been published for PHAs with populations under 1,000.

The ABS used a number of methods to measure the quality of the estimates, one of which is the relative root mean squared error (RRMSE) of the modelled estimates. The RRMSEs are included with the data. Users are advised that:

  • estimates with RRMSEs less than 25% are considered reliable for most purposes;
  • estimates with RRMSEs from 0.25 and to 0.50 have been marked (~) to indicate that they should be used with caution; and
  • those greater than 0.50 but less than 1 are marked (~~) to indicate that the estimate is considered too unreliable for general use.

Indicator detail

Information was collected from respondents aged 18 years and over using the Kessler Psychological Distress Scale-10 (K10). This ten-item questionnaire yields a measure of psychological distress based on questions about negative emotional states (with different degrees of severity) experienced in the four weeks prior to interview. For each question, there is a five-level response scale based on the amount of time that a respondent experienced those particular feelings. The response options are 'none of the time'; 'a little of the time'; 'some of the time'; 'most of the time'; or 'all of the time'. Each of the items are scored from 1 for 'none' to 5 for 'all of the time'. Scores for the ten items are summed, yielding a minimum possible score of 10 and a maximum possible score of 50, with low scores indicating low levels of psychological distress and high scores indicating high levels of psychological distress.

K10 results are commonly grouped for output. Results from the 2017-18 NHS are grouped into the following four levels of psychological distress: 'low' (scores of 10-15, indicating little or no psychological distress); 'moderate' (scores of 16-21); 'high' (scores of 22-29); and 'very high' (scores of 30-50). Based on research from other population studies, a 'very high' level of psychological distress shown by the K10 may indicate a need for professional help. For the indicator in this atlas, data are for respondents aged 18 years and over who scored in the 'high' and 'very high' levels of psychological distress.


Geography: Data available by Population Health Area, Local Government Area, Primary Health Network, Quintile of socioeconomic disadvantage of area and Remoteness Area


Numerator:  Male, female or total population aged 18 years and over assessed as having a high or very high level of psychological stress under the K10


Denominator:  Population aged 18 years and over


Detail of analysis:  Indirectly age-standardised rate per 100 population (aged 18 years and over); and/or indirectly age-standardised ratio, based on the Australian standard



PHA, LGA & PHN: Age-standardised rates are based on Australian Bureau of Statistics data, produced as a consultancy for PHIDU, from the 2017—18 National Health Survey.

Quintiles & Remoteness: Compiled by PHIDU based on direct estimates from the 2017–18 National Health Survey, ABS Survey TableBuilder.


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