Kessler Psychological Distress Scale (K-10)
Ten-item measure of non-specific psychological distress, and the standard outcome measure for Better Access.
Last reviewed: May 2026
The K-10 was developed by Ronald Kessler and colleagues (2002) as a brief measure of non-specific psychological distress. Its ten items ask how often a person has experienced symptoms of anxiety and depression over the past four weeks, such as feeling nervous, hopeless, restless or worthless.
Scoring & Interpretation
Each of the ten items is rated 1 (none of the time) to 5 (all of the time) over the past four weeks. ClientForms sums the ten responses to a total of 10 to 50, the 1-to-5 convention used in Australian primary care and the National Survey of Mental Health and Wellbeing. A score of 20 or above is the standard cut-off suggesting a likely mental disorder. Some services score the same items 0 to 4 for a 0-to-40 total, so always confirm which scale a reported number is on. The total is mapped to the four severity bands below.
| Score Range | Severity | Clinical Action |
|---|---|---|
| 10-19 | Likely well | Likely to be well: low psychological distress |
| 20-24 | Mild disorder | At or above the cut-off of 20: likely a mild mental disorder |
| 25-29 | Moderate disorder | Likely a moderate mental disorder: review supports and care |
| 30-50 | Severe disorder | Likely a severe mental disorder: prioritise assessment and review risk |
Australian general-population standard deviation is 9.4 on the 10-to-50 scale (Slade, Grove and Burgess, 2011; National Survey of Mental Health and Wellbeing, N=8,841). Test-retest reliability is high in an Australian treatment-seeking sample (ICC = 0.89; Merson et al., 2021). A cut-off of 20 or above indicates a likely mental disorder, with the 20-24, 25-29 and 30-50 bands corresponding to mild, moderate and severe distress (Andrews and Slade, 2001).
When to Use This vs Alternatives
Use DASS-21 when…
You want to see depression, anxiety and stress as three separate subscales rather than one global distress score. The DASS-21 breaks distress into its components; the K-10 gives a single index well suited to repeating at each review.
View DASS-21 →Use CORE-10 when…
You are doing session-by-session outcome monitoring and want a brief distress measure that includes an explicit risk item and is designed for repeated use. The K-10 is the distress measure psychologists submit for Better Access reporting in Australia; the CORE-10 is built for frequent check-ins between reviews.
View CORE-10 →Use CORE-OM when…
You want a fuller, four-domain baseline (wellbeing, problems, functioning and risk) rather than a single distress index. The CORE-OM gives a structured whole-picture read at assessment and review; the K-10 gives one brief overall index well suited to repeating at each appointment.
View CORE-OM →See It in Action
- 1Total distress score on the 10-to-50 scale with its severity band
- 2Score plotted against the four bands and the cut-off of 20
- 3Hopeless and worthless items flagged for review beside the total
- 4One-click PDF export and email delivery for the patient record
What It Measures
The K-10 was developed by Ronald Kessler and colleagues (2002) as a brief measure of non-specific psychological distress. Its ten items ask how often a person has experienced symptoms of anxiety and depression over the past four weeks, such as feeling nervous, hopeless, restless or worthless. It does not map onto a single diagnosis: it indexes the general level of distress that cuts across the common mental disorders. In Australia it is the standard distress measure in primary care and the National Survey of Mental Health and Wellbeing.
When to Use the K-10
Use the K-10 to gauge the overall level of psychological distress at intake and to track it over a course of care. It is brief enough to repeat at each review, which makes it well suited to outcome monitoring and to the Better Access reporting that psychologists submit. It is a measure of distress, not a diagnostic instrument: a high score indicates distress that warrants further assessment, while the formulation and any diagnosis remain the psychologist's judgement. Pair it with a symptom-specific scale where a particular disorder is suspected.
Who It's For
Adults aged 18 and over, validated in community, primary-care and clinical samples across Australia and internationally. Self-report: the patient completes it themselves. The K-5 is a five-item variant developed for use with Aboriginal and Torres Strait Islander populations, and the K-6 is a widely used six-item short form. Two items ask about feeling hopeless and worthless, so a high response on either is worth reviewing for risk alongside the total.
Frequently Asked Questions
What does the K-10 measure?
The K-10 is a ten-item self-report measure of non-specific psychological distress over the past four weeks, sampling symptoms of anxiety and depression. It gives a single overall index of distress rather than a diagnosis.
How is the K-10 scored, and what are the cut-offs?
Each item is rated 1 to 5 and the ten responses are summed to a total of 10 to 50. A score of 20 or above is the standard cut-off suggesting a likely mental disorder; some services use a 0-to-40 variant, so confirm which scale a number is on.
What do the K-10 severity bands mean?
On the 10-to-50 scale, 10 to 19 indicates a person is likely well, 20 to 24 suggests a likely mild disorder, 25 to 29 a moderate disorder, and 30 to 50 a severe disorder (Andrews and Slade, 2001). The bands suggest a level of distress; the clinical interpretation remains the psychologist's.
Is the K-10 free to reproduce?
Yes. The K-10 is free to use and reproduce with attribution (Kessler et al., 2002) and is distributed freely by Australian health services. It is widely used in primary care and Better Access reporting.
How is the K-10 used for Better Access and Medicare reporting?
The K-10 is the distress measure psychologists commonly submit under Medicare Better Access, administered at the start of treatment and again at review to document change. ClientForms scores it the moment the patient submits and produces a report you can attach to the treatment record.
What is the difference between the K-10, K-5 and K10+?
The K-5 is a five-item variant developed for Aboriginal and Torres Strait Islander populations, while the K10+ adds supplementary questions about days unable to work or function and contact with health professionals. All share the same core distress items as the K-10.
Use the K-10 in your practice
Available on the Free plan. No credit card required. Patients complete it on their phone or computer. Scored the moment they hit submit.