Hall Jean P, Thomas Kathleen C, McCormick Bryan P, Kurth Noelle K
Institute for Health and Disability Policy Studies, University of Kansas, Lawrence, KS, United States.
Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
Front Psychiatry. 2025 Jun 25;16:1606154. doi: 10.3389/fpsyt.2025.1606154. eCollection 2025.
Accurately counting Americans with mental health conditions is essential to support program development and appropriate resource allocations, which are often based on prevalence data. Multiple federal surveys use the Washington Group Short Set (WG-SS) questions to identify people with disabilities, including those with mental health conditions. However, the WG-SS questions miss many people with mental illnesses, under-representing this population in US federal survey data. Hence, we sought to explore the degree to which people with serious mental illness are missed.
We used data from the 2020 National Survey on Health and Disability to assess the rates that respondents with self-reported serious mental illness (SMI) conditions, i.e., major depression, bipolar disorder, schizophrenia, and schizoaffective disorder (n=263), were missed as disabled by the WG-SS questions.
Using the three WG-SS questions suggested by the Washington Group to capture people with mental illnesses, 66.2%, 88.6%, and 96.6% of respondents with SMI were characterized as non-disabled; 58.2% were characterized as non-disabled across the three questions combined.
Previous research demonstrated that the WG-SS questions missed almost 60% of respondents with any mental illness. However, the Washington Group states that its question set better captures people with more severe disabilities, so this study focused only on respondents with serious mental illnesses and only on questions that the Washington Group suggests capture people with psychosocial disabilities.
Results indicate that the WG-SS questions miss large percentages of even those with the most severe mental illnesses, who therefore may be substantially undercounted in US federal surveys using these questions. In turn, public mental health programs may be substantially underfunded.
准确统计患有精神疾病的美国人对于支持项目开发和合理分配资源至关重要，而这些通常基于患病率数据。多项联邦调查使用华盛顿小组简表（WG-SS）问题来识别残疾人，包括患有精神疾病的人。然而，WG-SS问题遗漏了许多患有精神疾病的人，在美国联邦调查数据中对这一人群的代表性不足。因此，我们试图探究严重精神疾病患者被遗漏的程度。
我们使用了2020年全国健康与残疾调查的数据，以评估自我报告患有严重精神疾病（SMI），即重度抑郁症、双相情感障碍、精神分裂症和分裂情感性障碍（n = 263）的受访者被WG-SS问题遗漏为残疾人的比例。
使用华盛顿小组建议的三个WG-SS问题来识别患有精神疾病的人，66.2%、88.6%和96.6%的SMI受访者被判定为无残疾；综合这三个问题，58.2%的受访者被判定为无残疾。
先前的研究表明，WG-SS问题遗漏了近60%患有任何精神疾病的受访者。然而，华盛顿小组表示其问题集能更好地识别残疾程度更严重的人，因此本研究仅关注患有严重精神疾病的受访者，且仅关注华盛顿小组建议用于识别心理社会残疾者的问题。
结果表明，即使是患有最严重精神疾病的人，WG-SS问题也会遗漏很大比例，因此在使用这些问题的美国联邦调查中，这部分人群可能被大幅少计。相应地，公共心理健康项目可能资金严重不足。
