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The field of public mental health has seen many advances in policy and discovery, yet there is much more to be done. We must move beyond a narrow focus on clinical interventions to now embrace the impact of community and population dynamics in promoting mental health, preventing mental illnesses, and fostering recovery. We must take advantage of emerging technologies, tools and strategies to expand discovery of the causes of mental illness that will inform new prevention and treatment strategies. Emerging tools can also guide the best implementation of individual and systems-level changes. Finally, we must continue to monitor the frequency of illness and related outcomes among individuals and populations to gauge our progress and highlight areas for continued improvement.

Studies of older caregivers of persons with dementia, Parkinson’s disease or cancer in clinical samples indicate that caregivers have poorer subjective and objective sleep than non-caregiver controls. Less is known of older caregivers from population-based studies. We identified 948 community-dwelling participants who reported providing care for a spouse/partner, sibling, parent or other older relative, and 3,760 non-caregiver participants living in the community from the 2011 National Health and Aging Trends Study. Our sleep outcome measures were self-reported prior-month frequency of trouble falling asleep (i.e., sleep latency >30min), trouble returning to sleep when waking earlier than desired, and sleep medication use. Responses were on a 5-point scale (1 = every night, 5 = never). We selected responses of “some,” “most,” or “every night” to indicate a sleep problem; “rarely” or “never” indicated its absence. The prevalence of each sleep problem was similar in caregivers and non-caregivers. In a model adjusted for age, gender, marital status, education, self-reported health, depressive and anxiety symptoms, and heart attack or heart disease in the past year, we found that being female, having poor self-reported health, and greater levels of depressive and anxiety symptoms were associated with a greater odds of prolonged sleep latency, trouble falling asleep, and greater sleep medication use (adjusted odds ratios ranged from 1.06 to 1.69, all p