RESIDENCY PRESENTATION

My Degree: Ph.D.

Program Emphasis: Industrial Organizational Psychology

Ten Strategic Points

Comments or Feedback

Broad Topic Area

Factor Responsible for Poor Utilization of Mental Health Services in Texas

Lit Review

(Theoretical Framework (Theory)

Gaps

Themes

All Citations

Gaps

A. Basu, Rehkopf, Siddiqi, Glymour, & Kawachi (2016). According to the authors, the changes being experienced in social policies in recent years has created a gap among women with low income in the South Texas. Accordingly, the authors used the determination of the differences in income to understand the relationships between health outcomes and welfare reforms as it impacts the less privileged women in comparison to the most affected women.

B. Ly, A. (2019). This study focused on the factors that influence the utilization of mental health among Vietnamese Americans and the barriers to seeking help in Texas. The study had 12 participants including providers and community leaders who were familiar with the target population. The findings of the study indicated the need to culturally specify mental health intervention to improve mental health utilization. However, the study was limited by the small sample size hence the findings cannot be generalized. Further studies should include more cultural groups to validate the findings of this research.

C. Kwan, P. P., Soniega-Sherwood, J., Esmundo, S., Watts, J., Pike, J., Sabado-Liwag, M., & Palmer, P. H. (2020). The authors of this study aimed to evaluate the facilitators and barriers to mental health utilization among Pacific Islanders. Semi structure interviews were used to collect information from 12 pacific islanders. Trained community leaders recruited eligible candidates for the study. The study was limited by the small sample size. Five themes arose from the study. Cost of healthcare, mental health stigma and language and culture barriers were themes that emerged concerning barriers affecting the utilization of mental health services. The researchers indicated the need for future studies to include a larger sample size to enable generalization of the findings.

D. Volkert, J., Andreas, S., Härter, M., Dehoust, M. C., Sehner, S., Suling, A., . . . Schulz, H. (2018). The aim of this study was to evaluate various aspects of the utilization of mental health services among the elderly. The study had 3,142 participants aged between 65-84 years. Logic regression approach was used to analyze predisposing, enabling, and need factors among the participants. Similarly, the study found that most elderly people failed to utilize mental health services because they felt they could deal with their situations. The study indicated that more research is needed to validate the results of this study.

Theoretical Foundation

Albert Bandura’s Social Cognitive Theory will be used as the theoretical model for this research gap (Morin & Cherry, 2019). The authors, Morin & Cherry, (2019), describe the Social Cognitive Theory as an applicable theory that is appropriate in the context of mental health promotion and prevention. The theory helps in describing how motivations in health and human behavior is influenced by the interaction of people's beliefs, environment, and behaviors (Morin & Cherry, 2019).

Components of the theory is concerned with individual behavior change such as:

•Self-efficacy: which is the belief and self-confidence, which states a person can control and execute a behavior successfully. This is uniquely influenced by a person’s capabilities and environmental factors. (Bandura, 1994).

•Behavioral capability: which entails the understanding and acquisition of behavioral skills and ability to execute the behavior.

Literature Review

A. Empathic Approach: The problems of underutilization of mental health services and non-institutionalization of adults has been emphasized as behavioral risk factors. According to Kohn et al. (2018) there is a gap in utilization of mental health services in the United States among the individuals that require treatment and those that actually receive the treatment. Therefore, there is the need to establish and understand what the social determinants of mental disorders are, and align them with the sustainable development goals, and to establish the potential mechanisms and targets for interventions (Kohn et al., 2018). Lund et al., (2018) also expressed the same gap in mental health utilization in Southern Texas, stating that there is need to conduct further research on why individuals utilize or chose to reject mental health services. The authors assert that the number of mental health patients seeking treatment and medication are fewer than those that are actually suffering from the illness (Lund et al., 2018).

Professional Development:

Job Satisfaction:

With some recent issues in the country that have been linked to mental health issues, there is an emergence focus on mental health as a critical area of interest. Problems of mental health has been sidelined for many years, but now, there is the realization to understand the reasons why people utilize or reject treatment. While this is being extensively studied, more attention should be focused been to the patients. According to De Luca et.al. (2016), most chronic health conditions and terminal illnesses tend to result in mental disorders in patients. For various reasons, mental health is now among the priorities of medical practice (De Luca et al., 2016).

Kohn, et al. (2018), examined recent prevalence of mental health disorders including lack of utilization of its services. The outcome was that about 43% of children and adolescents in the country suffer from mental illness, the treatment gap in the group was 64%. Utilizing or rejecting the services is dependent on collaboration of participating in treatment, while both patients and providers work together to make the therapy valuable.

(Kohn, et al., 2016).

Problem Statement

It is not known how mental health providers describe the factors responsible for utilization or reject mental health services in Texas.

Research Questions

· RQ1: What do mental health providers identify as factors contributing to patient’s utilization of mental health services?

· RQ 2: What strategies do mental health providers use to encourage patients to use mental health services?

· RQ3: What do mental health providers identify as factors contributing to patient’s rejection of mental health services?

· RQ 4: What strategies do mental health providers use to address patient’s rejection of mental health services?

Population

Target Population

Sample

· Location – Harris County, Texas. USA

· Participants will include people who are members of Mental Health Organizations including:

· Mental Health America (MHA)

· National Institute of Mental Health (NIMH)

· National Alliance on Mental Health (NAMI)

· Target Population:

· Mental Health Providers

· Caregivers

· Psychiatrists

· Therapists

Sample: 20 samples that will comprise of interviews with 10 Mental Health Providers and 10 Caregivers.

Describe Phenomena (qualitative) or Define Variables/Hypotheses (quantitative)

To understand factors responsible for poor utilization of mental health services by individuals living in Harris County, Texas.

· Lack of mental health utilization in Harris County, Texas.

· High rate of mental health conditions is reported in Southern Texas

· Harris County, Texas is reported as poorly utilizing its allocated budget funding of mental health care

Methodology & Design

Qualitative Descriptive Study

Rationale for Methodology

Qualitative methodology is justified for my research because it is effective at providing rich data and is neither restrained nor bound by limitations. In addition, it is most appropriate because it is going to provide real life evidences based on interviews with participants who will be healthcare providers and caregivers that have difference experiences at giving primary data (Colorafi & Evans, 2016).

Furthermore, Ondersma, et al., (2017)’s comments on kim et al. (2017)’s topic “Staying Focused on Non‐Treatment Seekers,” described qualitative methodology as appropriate because data can be obtained in order to determine the health seeking behaviors (Ondersma, et al., 2017). This is applicable to my study as I try to determine individuals’ behavioral patterns and why they choose to either utilize or reject mental health treatment.

Qualitative methodology appropriately addressed the problem statement that tries to understand how mental health providers and caregivers describe the contributing factors to individual’s decision to utilize or reject mental health treatment because the methodology will be flexible and effective when collecting data and gathering information from the participants (healthcare providers and caregivers) based on their experiences.

Purpose Statement

The purpose of this qualitative descriptive case study is to understand what mental health providers describe as the factors responsible for the utilization of mental health services in Harris County, Texas

Data Collection Approach

· Informed & signed consent by participants

· Visits to mental health providers and mental health facilities

· Interview with mental health providers & caregivers recorded on tape

· Interviews will involve 20 respondents from within Texas.

· Focus group with subset of 6.

· Sampling Method: Purposeful Sampling

· Sources: Interviews, Questionnaires & Focus Group Discussion

Data Analysis Approach

· Data to be collected

· Data will be analyzed for the study.

· Data will be entered into MaxQDA for analysis.

· Peer Debriefer meetings after analysis complete

· Descriptive statistics will be used to summarize collected data.

· Coding will be adopted to answer all questions.

· Will develop a narrative summary.

· Summaries of each participants codes will be emailed to participants for members’ checking. (Code, Definition, Quote for each code)