A single-item measure of self-rated mental health and psychological distress. In what situations can a single-item measure be useful?

Abstract

To examine the association between self-rated mental health (SRMH) and psychological distress (PD) at multiple periods and subsequently assess the potential of SRMH as a screening tool. Staff working at a designated COVID-19 hospital in Sydney, Australia during March to May 2020 completed the SRMH and Kessler Psychological Distress Scale (K10) within a larger survey examining the pandemic's impact on health and well-being. SRMH was assessed before the pandemic (baseline), during its first peak in 2020 (time 2) and several months later (time 3). K10 was assessed for time 2 and time 3. All assessments took place at time 3. At time 2, 80% of respondents with high PD and 25% with low PD reported poor SRMH (χ2 = 21.3, p < .0001). At time 3, 90% with low PD reported good SRMH. Risk of high PD was greater for respondents with persistently poor SRMH (time 2: OR = 18.2, 95% CI = 7.7-42.8; time 3: OR = 14.4, 95% CI = 6.9-29.9) and, to a lesser extent, for those whose SRMH declined (time 2: OR = 11.6, 95% CI = 6.6-20.4; time 3: OR = 13.8, 95% CI = 2.9-66.9), compared to those with persistently good SRMH. During a crisis SRMH can identify the majority of those most likely to benefit from additional assessment and support. Persistently poor SRMH indicates highest risk, detectable from routine screening.