Assessing the association between mental health and disability indicators among adults living in the United States

Background: Over 40 million people in the U.S. experience mental illness and/or disabilities. However, there has been limited characterization of the relationship between mental health and disability in national surveys. Objective: To examine associations between current indicators for psychological distress, serious mental illness, and disability in the National Health Interview Survey (NHIS). Methods: Secondary analysis (univariate and multivariate log-binomial estimation of relative risk) of non-specific psychological distress, duration of serious mental illness, disability types, and demographic factors in adults from the NHIS. Results: Strong associations between psychological distress, serious mental illness, and disability types were found. After demographic stratifications and adjustment, associations were strongest for cognitive disabilities, compared to other disability types. Adults reporting serious psychological distress or more than 10 years of serious mental illness were 19.7 (17.8, 21.7) and 11.0 (10.2, 12.0) times more likely to report cognitive disabilities, compared to adults reporting no psychological distress or serious mental illness. After sex and race/ethnicity adjustment, individuals ages 35–54 years reporting serious psychological distress or more than 10 years of serious mental illness were 8.6 (6.9, 10.6) and 3.7 (3.3, 4.2) times more likely to report cognitive disabilities, compared to individuals ages 35–54 years reporting no psychological distress or serious mental illness. Conclusions: There is a robust association between mental health and cognitive disabilities among adults. Our results suggest health agencies and public policy consider addressing the concurrent nature of mental illness and cognitive disabilities in services and programs for adults with disabilities