Graduation Date

Fall 12-17-2021

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Programs

Health Services Research, Administration, and Policy

First Advisor

Hyo Jung Tak

Second Advisor

Li-Wu Chen

Abstract

Mental health has emerged as a major public health concern in recent times with several disparities and barriers related to adequate health service utilization. Different age groups experience diverse symptoms and face distinct barriers in accessing and utilizing healthcare. Policies like Mental Health Parity and Addiction Equity Act and the Patient Protection and Affordable Care Act were launched to improve insurance coverage and delivery of mental health services. However, a large gap of unmet needs exists for adequate mental health service utilization in the country. This dissertation aims to describe the financial and non-financial barriers to mental health service utilization and academic outcomes among the pediatric age group, disparities in mental health service utilization among the geriatric population, and the ecology of mental health and its impact on overall health outcomes among adolescents.

The goal of this dissertation is to provide the most recent and updated results to fill the information gap and thereby guide physicians, healthcare systems, and policymakers to initiate and implement changes to improve access and utilization of mental health services. Data from the National Survey of Children’s Health, 2016-2018, and the National Health and Nutrition Examination Survey, 2015-2018, were used for this dissertation with respective study populations identified based on age groups and a diagnosis of mental health condition. The data were weighted to produce individual-level nationally representative results. We used Anderson’s Health Care Utilization Model and Social-Ecological Model to derive the conceptual framework of this dissertation.

The dissertation underlines that spreading awareness and reducing stigma could potentially impact behavioral patterns towards seeking mental healthcare. Training healthcare providers to offer culturally sensitive patient-centered care and services will help mitigate disparities among distinct population groups. Mental health support should be incorporated in transition plans to adult health care to ensure appropriate healthcare delivery. Home environment and social structure play a vital role in shaping physical and mental health outcomes among adolescents. More holistic strategies and policies are needed to improve mental health service utilization and outcomes.

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