Dr Andrew Whelan: "The DASS-21 (Depression, Anxiety and Stress Scale): psychometric assessment and the scalable subject before predictive mental health analytics"

The DASS-21 (DASS) is a self-report questionnaire, measuring depression, anxiety and stress across three 7-point scales. The respondent assesses the extent to which 21 statements applied to them in the previous week, on a 4-point Likert scale. The first statement is ‘I found it hard to wind down’. The last is ‘I felt that life was meaningless’. The form includes the instruction: ‘Do not spend too much time on any statement’, as though to assure immediate and authentic access to emotional interiority. 

 

Originally developed in Australia and released in 1995, the DASS has been translated into 56 languages and is used all over the world. It is held to be a valid diagnostic tool. Activation of the DASS does not require clinical training. The form was intended as a supplement to clinical interviewing. In practice, it is applied in a wide range of contexts (such as youth work and antenatal care), usually as a screening or triage tool rather than as a precursor to clinical interviewing.

 

Approached here in terms derived from institutional ethnography, the DASS mediates psychic and organizational life, operating as a nexus between care work and administration. It inserts a standardized sequence into the care encounter, configuring case pathways and workflows across discrepant sites. It preformats and encodes the client as universally commensurable numerical values, enabling comparative rank by ‘severity’. Aggregated DASS data afford mapping of spatial and demographic distributions of ‘negative emotional states’, rendering these amenable to view. 

 

With major depression expected to become the most disabling disease by 2030, the use of instruments like the DASS-21 is likely to increase. The DASS, however, also sits on a border: between paper-based and computational datafication, a precursor technology at the dawn of commercial algorithmic psychometrics. Arising from a specific logic of evaluation, the DASS casts light back on the aspirations and values of quantification in public health administration, and forward on the prospects of predictive analytics in privatized mental health surveillance.