Running head: MENTAL HEALTH 1

Jamie M. Deuel
Assignment: Mental Health
2020F_SOC621_VA_Advanced Sociological Research
Fort Hays State University
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Mental Health

Introduction
Mental health among the population is either flourishing or languishing. When mental
health is flourishing, it is developing rapidly and successfully; mental health is thriving. When
mental health is languishing, it is failing to make progress. Many people in the population
struggle with their mental health due to many different factors. Age, gender, race, ethnicity,
education, marital status, and income all play a role in mental health.
This paper will discuss research looking at whether females more likely to have more
days of poor mental health days than males, whether black individuals more likely to find it very
difficult to get the mental health care they seek than white individuals, and whether married
people less likely to receive treatment for a mental health problem than divorced people. It is
important to understand why mental health impacts different subsets of the population and it tells
us where and when we can benefit from gaining flourishing mental health.
Society gains benefit from understanding where mental health is lacking. The population
gains insight to the troublesome areas in our society and can benefit from understanding what
impacts one’s mental health. Mental health should be important to every person in society, as it
dependent on how we perceive feeling well versus feeling bad.
Mental health is important to me because I suffer from a mental illness. Gaining insight
to where and why mental health is impacted is importance because it tells what what areas or
aspects we need to work on to gain a flourishing mental health. Everyone can benefit from
understanding mental health and where it impacts our lives. We glean importance and
understanding by doing research in mental health and the overall health of society.
Understanding why one is languishing or flourishing in mental health is an important part of our
overall mental health status.

Literature Review
According to Keyes (2007), the United States is among three nations worldwide that now
spends over 10% of its gross domestic product on health care, and health care consumes the
largest percentage of the U.S. gross domestic product, more than housing, food, or defense
spending. In the United States, in terms of combined direct and indirect costs, mental illness is
among the three most costly conditions at approximately $160 billion in 1999 (Keyes, 2007).
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Keyes’ (2007) research suggests that the evidence indicates that the absence of mental illness
does not imply the presence of mental health, and the absence of mental health does not imply
the presence of mental illness. In terms of the studies’ measures, completely mentally healthy
adults with moderate mental health, who in turn functioned better than adults who were
languishing (Keyes, 2007).
Keyes (2007) survey was a random-digit-dialing sample of noninstitutionalized English-
speaking adults between the ages of 25 and 74 living in the 48 contiguous states conducted in
1995. The MIDUS used diagnostic criteria to diagnose four mental disorders, which were
operationalized by the Composite International Diagnostic Interview Short Form scales (Keyes,
2007). Three scales served as indicators of mental health: the summed scale of emotional well-
being, and the summed scale of social well-being; where four summary measures served as
indicators of mental illness as operationalized as the number of symptoms of major depressive
episode (MDE), generalized anxiety disorder, panic disorder, and alcohol dependence (Keyes,
2007).
Measures of mental illness and measures of mental health form two distinct continua in
the U.S. population and measures of disability, chronic physical illness, psychosocial
functioning, and health care utilization reveal that anything less than flourishing is associated
with increased impairment and burden to self and society (Keyes, 2007). Mental health as well as
mental illness lack specific diagnostic tests and remain identifiable only as collections of
symptoms and outwards signs of the underlying state or condition (Keyes, 2007). According to
Keyes (2007), flourishing individuals function markedly better than all others, but barely one
fifth of the U.S. adult population is flourishing. Although mental illness prevention efforts have
shown good efficacy, all prevention efforts are aimed at reducing cases of mental illness and
have yet to turn any attention to investigating whether those interventions do service of
promoting flourishing as well as preventing mental illness (Keyes, 2007).
In Piazza, Mogle, Sliwinski, & Almedia (2013) research about the wear and tear of daily
stressors on mental health, the researchers suggest that daily stressors cause wear and tear on
emotional well-being and are consistent with cognitive theories of depression: How people
experience daily negative affect and respond to the negative events in their lives is important to
future well-being. Piazza and colleagues (2013) used a large national community spanning a
wide age range for their study. They examined how levels of daily negative and affective
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reactivity in response to daily stressors predicted general affective distress and self-reported
anxiety and depressive disorders 10 years after they were first assessed. Piazza and colleagues
(2013) findings suggest that the average levels of negative affect that people experience and how
they respond to seemingly minor events in their daily lives have long-term implications for their
mental health.
They investigated whether both higher levels of negative affect on nonstressor days and
affective reactivity in response to daily stressors predicted mental health outcomes 10 years after
they were first assessed (Piazza et al., 2013). The 10-year period provided a long temporal
window in which to examine these relationships (Piazza et al., 2013). Participants included 711
subjects of varying age, gender, race, and education level. Measures were assessed using the
Midlife Development in the United States (MIDUS) survey and the National Study of Daily
Experiences (NSDE) between 1995 and 1996 and 10 years later completed the MIDUS II
questionnaire.
Keyes, Dhingra, & Simoes’s (2010) findings revealed that moderate mental health is
nearly as good a predictor, and languishing is a stronger, predictor of future mental illness. Gains
in mental health decreased the odds, and losses of mental health increased the odds, of the
incidence of mental illness (Keyes et al, 2010). Therefore, according to Keyes and colleagues
(2010) promotion and protection of mental health can reduce mental illness in the population.
Keyes and colleagues (2010) analyzed data from the national random-digit-dialing
portion of the Midlife in the United States (MIDUS) National Study of Health and Well-Being.
They studied respondents in 1995 that were invited to participate in a telephone interview, after
which they were mailed self-administered questionnaires where they were again asked to
participate in the study 10 years later, in 2005. Keyes and colleagues (2010) measured mental
illness using the MIDUS, mental health using the MIDUS, and other variables such as
race/ethnicity, employment status, marital status, age, gender, and level of education attainment.
All analyses were used by weighted data and SPSS version 16.0 (Keyes et al., 2010).
Results showed that the prevalence of mental illness was about the same in 1995 (18.5%)
as it was in 2005 (17.5%) (Keyes et al., 2010). Keyes and colleagues (2010) findings suggest the
need for investing in mental health promotion and protection to complement the de facto
approach of treatment and risk reduction for improving national mental health. Keyes and
colleagues (2010) suggest that the measures and diagnostic criteria of mental health may be
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useful as surveillance and clinical screening tools. These tools could be further evaluated for
monitoring progress toward improvement of population-level mental health and mental illness,
and for determining and individual’s likelihood of developing mental illness.
In Mersky, Topitzes, and Reynolds’s (2013) study, they show that adverse childhood
experiences (ACEs) increase the risk of poor health-related outcomes in later life. They
investigated the impacts of differential exposure to ACEs on an urban, minority sample of young
adults (Mersky et al., 2013). They examined health and mental health outcomes as well as
depressive symptoms, anxiety, tobacco use, alcohol use, and marijuana use. Data for the study
originate from the Chicago Longitudinal Study (CLS) of racial and ethnic minority children who
were underprivileged, urban dwelling families in 1979 or 1980 (Mersky et al., 2013). The present
study included CLS participants who responded to an adult survey between ages 22 and 24
(2002-2004) (Mersky et al., 2013).
Mersky and colleagues’ (2013) study confirmed that increased exposure to ACEs was
associated with an increased likelihood of poor health, mental health, and substance use
outcomes in early adulthood. Their results show that many compromising physical health
conditions manifested later in the life course, whereas the onset of mood, anxiety, and substance
use problems often occurs during late adolescence and early adulthood (Mersky et al., 2013).
The research results indicated that adverse outcomes in adulthood can be linked to adverse
experiences in childhood (Mersky et al., 2013). Mersky and colleagues (2013) suggest that
“given that the consequences of ACEs in early adulthood may lead to later morbidity and
mortality, increased investment in programs and policies that prevent ACEs and ameliorate their
impacts is warranted” (pp. 1).
Fledderus, Bohlmeijer, Smit, and Westerhof (2010) assessed whether an intervention
based on acceptance and commitment therapy (ACT) and mindfulness was successful in
promoting positive mental health by enhancing psychological flexibility. Participants completed
measures before and after the intervention as well as three months later at follow-up to assess
mental health in terms of emotional, psychological, and social well-being as well as
psychological flexibility (Fledderus et al., 2010). The study included adults aged 18 years and
older with mild or moderate psychological distress from the Netherlands (Fledderus et al., 2010).
Participants were randomly assigned to the ACT and mindfulness intervention or to a waiting
list. Participants completed measures on three occasions: at baseline, posttreatment at two
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months, and follow-up at five months after baseline (Fledderus et al., 2010). The participants
varied in level of education, marital status, and employment status. Study participants assigned to
the waiting list did not receive the ACT and mindfulness intervention (Fledderus et al., 2010).
Measures were the Acceptance and Action Questionnaire-II (AAQ-II) and the Mental
Health Continuum-Short Form (MHC-SF) and were measured with the SPSS version 17
(Fledderus et al., 2010). The study showed that the ACT and mindfulness group had significantly
more improvement in mental health at posttreatment and at follow-up than did the waiting list
group (Fledderus et al., 2010). The intervention group reported greater emotional and
psychological well-being at posttreatment and follow-up than did the control group, but not
greater social well-being and the ACT and mindfulness group showed greater improvement in
psychological flexibility only at follow-up compared with the waiting list group (Fledderus et al.,
2010). Fledderus and colleagues’ (2010) findings support the effectiveness of an ACT and
mindfulness intervention in promoting emotional and psychological well-being by targeting the
competence of psychological flexibility.
Andrade, Alonso, Mneimneh, Wells, Al-Hamzawi, Borges…Kessler’s (2013) findings
confirm that patients’ lack of perceived need plays a major role in not receiving care worldwide.
Twenty-fie World Health Organization (WHO) World Mental Health (WMH) surveys were
carried out in 24 countries (Andrade et al., 2013). Seventeen surveys were based on nationally
representative household samples (Andrade et al., 2013). Twelve-month treatment was assessed
for problems associated with emotions, nerves, mental health, or use of alcohol or drugs for
variables of participants that included age, sex, completed years of education, income, and
marital status (Andrade et al., 2013).
Among respondents with serious disorders, low perceived need was the most commonly
reported barriers to treatment in 15 of the 25 surveys and attitudinal barriers in the other 10
surveys (Andrade et al., 2013). Low perceived need for treatment was more common at older
ages, among men and among milder cases (Andrade et al., 2013). Andrade and colleagues’
(2013) results showed that low perceived need for treatment is an extremely important barrier for
seeking treatment worldwide. According to Andrade and colleagues (2013), they found that
being female, being younger or middle-aged and having severe/moderate disorders are associated
with perceived need for treatment, and with reporting more structural barriers to treatment
seeking. Young and middle-aged adults were more likely than older adults to perceive need for
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treatment, and to report structural barriers to treatment-seeking after they perceived a need
(Andrade et al., 2013). Besides self-stigma and negative attitudes toward help-seeking, Andrade
and colleagues’ (2013) results show that younger respondents may experience financial problems
and time barriers to seeking treatment.

Methodology
Data for this research study was collected through the GSS website. SDA (Survey
Documentation and Analysis) is a set of programs for the documentation and Web-based
analysis of survey data. SDA was developed, distributed, and supported by the Computer-
assisted Survey Methods Program (CSM) at the University of California, Berkeley until the end
of 2014 and includes several datasets, including the General Social Survey (GSS) (Survey
Documentation and Analysis, n.d.). GSS is a cumulative datafile from 1972 to 2018 that
generates multiple variables that society deals with daily. GSS allows you to create variables to
test theories in multiple aspects of the population.
The data collected through the GSS datafile were selected based on a topic of choice.
After choosing the topic, independent and dependent variables were generated based on the area
of interest, which was mental health. The independent variables included SEX – Respondent’s
sex, MARITAL – Marital status, and RACE – Race of R. The dependent variables included
MNTLHLTH – Days of poor mental health past 30 days, MHTRTSLF - Have ever personally
received treatment for mental health problem, and MNTLDIF – How difficult to get mental
health care. After the independent and dependent variables were generated, a list of questions
was developed based on the variables. Once the questions were established, theories and
hypotheses were constructed based on the questions. After the theories and hypotheses were
established, independent and dependent variables were generated through the GSS datafile. The
GSS datafile generated the data and graphs based on each question’s independent and dependent
variables.
Crosstabulation was placed in rows for the independent variable and columns for the
dependent variable to determine the measure of association, Rao-Scott-P Significance. The Rao-
Scott P Significance tells us the likelihood that the relationship exists in the population. Below,
the data analysis describes each question with a theory, hypothesis, and crosstabulations of the
independent and dependent variables.

Data Analysis
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Topic: Poor Mental Health

Research Question: Are females more likely to have more days of poor mental health days than
males?
Theory: Women tend to take care of more of the family’s needs along with the children than
men. Women also experience menses which impacts their emotions. Women will tend to have
more poor mental health days than men.
Hypothesis: Females are more likely to have more days of poor mental health days than males.
Independent Variable (Columns): SEX: Respondents sex.
Dependent Variable (Rows): MNTLHLTH: Days of poor mental health in the past 30 days by
respondents’ sex.

Rao-Scott-P Significance = 0.00

The red sections, which represent the percent of respondents who have had zero poor days of
mental health in the past 30-days for each category of sex, is larger for males, indicating that
males are more likely to have zero poor days of mental health. Similarly, the turquoise sections,
representing the percent of respondents who have had 20 or more poor days of mental health in
the past 30-days, is larger for females, indicating that females are more likely to have 20 or more
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poor days of mental health. This analysis indicates that females have more poor mental health
days than males. The Rao-Scott-P significance of 0.00 means we can reject the null hypothesis
and be 99% confident this relationship exists in the population. Thus, the data support the
research hypothesis and offer support for the theory that being a female causes you to have more
days of poor mental health.
Topic: Mental Health Treatment
Research Question: Are married people less likely to receive treatment for a mental health
problem than divorced people?
Theory: Married people have a more stable relationship than divorced people and divorced
people experience more traumatic experience from getting a divorce than married people, where
married people will tend to receive less treatment for a mental health problem than divorced
people.
Hypothesis: Married people are less likely to receive treatment for a mental health problem than
divorced people.
Independent Variable (Columns): MARITAL: Marital status
Dependent Variable (Rows): MHTRTSLF: R ever personally received treatment for mental
health problem

Rao-Scott-P Significance = 0.00

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The red area, which represents the percent of respondents’ marital status who have received
treatment for a mental health problem, is larger for divorced, indicating that divorced people are
most likely to have received treatment for a mental health problem. Similarly, the blue area,
representing the percent of respondents’ marital status who have not received treatment for a
mental health problem, is larger for married than divorced. The Roa-Scott-P significance of 0.00
means we can reject the null hypothesis and be 99% confident this relationship exists in the
population. Thus, the data support the research hypothesis that being married requires less
treatment than being divorced.
Topic: Mental Health Care by Race
Research Question: Are black individuals more likely to find it very difficult to get the mental
health care they seek than white individuals?
Theory: Black individuals are still stereotyped and not able to get into an appointment like white
individuals can. Black individuals are disproportionately more apt to be short changed, under
diagnosed, or denied mental health assistance, where black individuals are more likely to find it
difficult to get the mental health care they seek than their white counterparts.
Hypothesis: Black individuals are more likely to find it very difficult to get the mental health
care they seek than white individuals.
Independent Variable (Columns): Race of respondent
Dependent Variable (Rows): Difficulty to obtain mental health care

Rao-Scott-P Significance = 0.00

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The red area, which represents the percent of white’s, black’s, and other races who have found it
very difficult to get the mental health care they sought, is larger for blacks than for whites,
indicating blacks are more likely to find it very difficult to get mental health care they sought.
Similarly, the green area, representing the percent of white’s, black’, and other races who have
not found it difficult to get mental health care they sought, is larger for whites, indicating whites
are more likely to not find it difficult to get mental health care they sought than blacks. The blue
and red areas, representing the percent of white’s, black’s, and other races who found it
somewhat or very difficult to get mental health care they sought, is larger for blacks, indicating
blacks are more likely to find it somewhat or very difficult to get the mental health care they
sought. The Rao-Scott-P significance of 0.00 means we can reject the null hypothesis and be
99% confident this relationship exists in the population. Thus, the data support the research
hypothesis that black individuals tend to find it more difficult to obtain care than white
individuals.

Conclusion
Findings from the crosstabulations from the Roa-Scott P Significance suggests that
females have more poor mental health days than males. Thus, the data support the research
hypothesis and offer support for the theory that being a female causes you to have more days of
poor mental health. The data also supports the research hypothesis that being married requires
less treatment than being divorced and supports the research hypothesis that black individuals
tend to find it more difficult to obtain care than white individuals.
Based on the findings this research provided and the findings supported in the literature
review, we can conclude that gender, race, and marital status all play a role in flourishing or
languishing mental health. Findings also suggest that long-term stressors can create poor mental
health as well as substance abuse and physical health
The results imply that being female, being divorced, and being black tends to support
poor or languishing mental health. Whereas being male, being married, and being white tends to
support positive or flourishing mental health. Although one cannot control their gender or race,
one can control the strength of their marital status. The results also suggest that languishing
mental health is prevalent in these areas and one should be more conscientious on how to help
their mental health to become flourishing.
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Further research on the analysis and conclusion suggests that a researcher should
investigate why being female causes you to have more days of poor mental health, why being
married requires less treatment than being divorced, and why black individuals tend to find it
more difficult to obtain care than white individuals. Determining the strength of the independent
and dependent variables and analyzing other variables that can cause poor mental health will
glean insight to the troubling causes of languishing mental health.
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References
Andrade, L. H., Alonso, J., Mneimneh, Z., Wells, J. E., Al-Hamzawi, A., Borges, G., . . .
Kessler, R. C. (2013). Barriers to mental health treatment: Results from the WHO World
Mental Health surveys. Psychological Medicine, 44(6), 1303-1317.
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Charles, S. T., Piazza, J. R., Mogle, J., Sliwinski, M. J., & Almeida, D. M. (2013). The wear and
tear of daily stressors on mental health. Psychological Science, 24(5), 733-741.
doi:10.1177/0956797612462222
Fledderus, M., Bohlmeijer, E. T., Smit, F., & Westerhof, G. J. (2010). Mental health promotion
as a new goal in public mental health care: A randomized controlled trial of an intervention
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Keyes, C. L. (2007). Promoting and protecting mental health as flourishing: A complementary
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Keyes, C. L., Dhingra, S. S., & Simoes, E. J. (2010). Change in level of positive mental health as
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Mersky, J., Topitzes, J., & Reynolds, A. (2013). Impacts of adverse childhood experiences on
health, mental health, and substance use in early adulthood: A cohort study of an urban,
minority sample in the U.S. Child Abuse & Neglect, 37(11), 917-925.
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Survey Documentation and Analysis. (n.d.). Retrieved from https://sda.berkeley.edu/