Frequent Mental Distress Is...What?

A reader posed the following about my earlier post:

"Is "distress" being used as a politically correct version of "illness" perhaps. -something to make results more accessible to patients while reducing stigma?"

I don't think it's illness per se. They are trying to measure something that appears to be far broader than diagnosed mental illness. I cannot find one of the FMD questionaires yet, but so far I can find this bit from the CDC:

"Since January 1993, the interviews have included four health-related quality-of-life (HRQOL) questions (4), including the following general mental health question: "Now thinking about your mental health, which includes stress, depression and problems with emotions, for how many days during the past 30 days was your mental health not good?" Persons who reported that their mental health was not good for greater than or equal to 14 of the preceding 30 days were defined as having FMD. This 14-day minimum period was selected because a similar period is often used by clinicians and clinical researchers as a marker for clinical depression and anxiety disorders, and a longer duration of reported symptoms is associated with a higher level of activity limitation."

Stress, depression and problems with emotions don't equal mental illness, so this FMD thing is little more than a proxy question. Also, what is "not good?" What's the measure of good mental health for one person versus another? The FMD numbers that are being floated around come as the result of a subjective question and are self-reported by respondents. So there's a heck of a lot of flux there.

One thing that is interesting to me is that if I can take the 14 percent number in NYC and the 9 percent number in Seattle/King County at face value, then I wonder what that means for the prevlance of mental illness numbers often floated by advocates that 25 percent of Americans have a diagnosable mental illness. Or does it mean anything at all? Either way, the two data sets certainly don't line up perfectly.