Mental Health in Regularly Collected Nationally Representative U.S. Surveys: What's Measured and What's Missing?

Abstract

To document the availability and quality of mental health measures in regularly collected national surveys in the United States. We conducted a review of the mental health measures included in eight publicly available health-focused recurring surveys capable of producing nationally-representative estimates. For each measure, we documented the constructs measured, number of items in the measure, the populations for whom the measure is collected, and the years in which the measure was collected. We examined peer-reviewed literature for psychometric properties of the measures. U.S. national surveys vary substantially in their measurement of mental health constructs in terms of the number of constructs (3-15), measure complexity (1 item - 233 items), populations covered, years administered, and the proportion of constructs that have validated measures (0%-100%). The Medical Expenditure Panel Survey offered the best mix of mental health measures (9; 56% validated), years covered (1996-Present), and related health information; however, each of the surveys offered distinct advantages in terms of the geographic information available (e.g., national, state, census tract), populations covered (e.g., children, teens, and/or adults) and measured mental health constructs (conditions, the impact of those conditions, and mental health service use). Mental health is measured in various ways across the nationally-representative surveys, with each survey offering distinct advantages and disadvantages. Mental health researchers should consider these differences when using national survey data. Future research should attempt to validate the mental health measures used in these surveys and efforts should be made to address existing gaps in measurement.