Mental disorders, like physical disorders, can result in limitations in any major domain of a person's life, and people with mental disorders often experience an array of impairments in a number of domains. Characteristically, mental disorders are associated with limitations in the areas of work, social relationships, and self-care (Kennedy, Carlson, Üstün, et al., 1997). Unfortunately, the major national surveys tend not to measure limitations in social relationships, a domain that may be disproportionately impacted by mental disorders, compared to other disorders.
The most recent Mental Health Supplement to the National Health Interview Survey (NHIS-MH) conducted in 1989, illuminates the impact of serious mental illness on different areas of non-work-related functioning, and shows some gender differences. Among people between the ages of 25 and 64 who reported a serious mental illness, a large majority also reported disability (in the form of limitations in non-work-related activities). A higher percentage of men (87%) than women (71.3%) reported any non-work-related limitations. The most frequently reported limitation due to severe mental illness was a reduced ability to cope with daily stress (79.1% of men; 65.9% of women). More men (60%) than women (41.9%) reported that their mental illness interfered with their social functioning. Similarly, 59.2% of men with severe mental illness reported limitations in their ability to concentrate on tasks, compared to 41.4% of women. Finally more than a third (34.7%) of men, compared to only 16.9% of women reported limitations in their ability to perform instrumental activities of daily living (IADLs), such as shopping and managing money.
A number of factors may be responsible for the lower rates of reported disability among women with severe mental illness. As noted previously, women and men have different prevalence rates for different psychiatric disorders, with women reporting more depressive and anxiety disorders and men reporting more substance abuse. These different disorders may differently impact daily functioning. As described earlier, women are also more likely than men to seek and receive treatment for mental illness, which may result in less disabling mental illness for women.
Data Table for Figure 24
Source: National Center for Health Statistics (1996).
Surveys: National Health Interview Survey, Mental Health Supplement (NHIS-MH), 1989