Factors Influencing Utilization of Mental Health Services in South Texas

Submitted by

Kehinde Alli

A Dissertation Presented in Partial Fulfillment

of the Requirements for the Degree

Doctor of Education

(or) Doctor of Philosophy

(or) Doctor of Business Administration

Grand Canyon University

Table of Contents Ten Strategic Points vi Chapter 1: Introduction to the Study 1 Introduction 1 Background of the Study 8 Definition of Terms 15 Anticipated Limitations 16 Summary and Organization of the Remainder of the Study 17 Chapter 2: Literature Review 20 Introduction to the Chapter and Background to the Problem 20 Identification of the Problem Space 22 Theoretical Foundations 24 Review of the Literature 26 Problem Statement 56 Summary 57 Chapter 3: Methodology 59 Qualitative Methodology 59 Introduction 59 Purpose of the Study 62 Research Questions 63 Rationale for a Qualitative Methodology 64 Rationale for Research Design 66 Population and Sample Selection 69 Qualitative Sample Size 70 Recruiting and Sampling Strategy 72 Sources of Data 73 Research Data 74 Additional Data 76 Trustworthiness 76 Credibility 77 Dependability 78 Transferability 78 Confirmability 79 Data Collection and Management 79 Data Analysis Procedures 81 Ethical Considerations 85 Assumptions, and Delimitations 87 Assumptions 87 Delimitations 88 Summary 88 References 91 Appendix A. 123 Appendix B. Site Authorization 123 Appendix C. IRB Approval Letter 125 Appendix D. 126 Appendix F. 129 Appendix G. Focus Groups Questions 131

The study of mental health in Texas forms its basis on the argument that lack of social connections affects the mental health status of people. This paper shall be based on mental health improvement in Texas which is a critical consideration in the current health environment. There have been prevalent social issues that have caused worsening and development of mental health conditions. The most common issues that lead to mental disorders are finances, systemic racism, traumatic events, adverse upbringing, physical or sexual abuse, substance abuse, and lack of emotional support during changes in external environment (Einstein et al., 2017). These factors often result in the affected persons lacking proper wellbeing that would ensure they transform the situations for the better. It is evident that environmental factors form the root of the majority of mental health conditions. This proposal shall identify issues that are linked to rejection and inaccessibility of mental health improvement initiatives.

Einstein et al. (2017) explained that mental illnesses are linked to environmental issues especially when the affected person is constantly exposed to situations that cause anxiety and depression. This paper’s study of mental illnesses in Texas and factors influencing use of mental health improvement initiatives is critical since the state as constantly gotten exposed to changes in its social structure and environmental issues. For instance, the recent pandemic has resulted in the majority of college students developing mental illnesses due to the government measures of social distancing (Taboada, 2020). This is a clear indication that people in Texas suffer mental health issues as they are unable to access required medical improvement initiatives. After discovering the presence of mental health issues, the affected persons often reject mental health improvement measures.

The study of mental health in Texas is influenced further by the fact that accessibility of mental health improvement measures is limited in the state (Leonard, 2017). A study of mental health in Texas reveals that “1 in 5 Texans” are exposed to adverse mental health illness every year. The issue of mental health in Texas continues even as the National Alliance on Mental Illness discovered that 110,000 persons in Montgomery County were exposed to mental illnesses (Leonard, 2017). The author further states that schizophrenia or bipolar disorder affect around 23000 persons in Montgomery county only (Leonard, 2017). This indicates that mental health issues are adverse in the state and require study to ensure the creation of solutions that would ensure proper wellbeing of all persons. The statistics for all persons in Texas was approximately more than 500,000 persons in Texas who were living with adverse and recurrent mental health issues.

The main types of mental disorders, according to the World Health Organization (WHO) are “depression, bipolar disorder, schizophrenia and other psychoses, dementia, and developmental disorders” (WHO, 2019). These disorders affect many persons in Texas and become worse when they lack access to healthcare. The most important solution of mental health issues to offer suitable social support and to provide treatment measures that are proven to create effective outcomes. The process of identification of the cause of mental health disorders is connected to patients’ cognitive capability (Magaard et al., 2017). This forms a basis of treatment of mental health conditions since the affected persons can identify their need to receive treatment. This would influence their desire to visit mental health providers in order to identify the type of issue and to receive treatment. Issues in mental healthcare develop internal barriers to mental health access that cause them to have worse conditions.

Mental health disorders develop further due to overreliance of positive factors in the environment that do not provide full positive wellbeing for accepted persons. In this era, social media has caused in increase in mental health issues since many people get affected by adverse conditions that lead to inability to realize real stressors that cause them to get mental health issues (Wongkoblap et al., 2017). This paper shall study how intrapersonal issues affect the capability of people to recover from mental health issues. The use of social media forms an intrapersonal barrier to mental healthcare access especially when the affected persons form a different reality while using the vast choices of social media platforms (Keles et al., 2019; McLafferty, et al., 2017; McKenzie, et al., 2021). This is an adverse barrier of improvement of healthcare since it becomes difficult to offer improvements based on the prevailing conditions.

The factors influencing mental health improvement are also connected to substance abuse which is an adverse issue that changes cognitive capability of affected person (Kim et al., 2020; Middleton et al., 2018; Mehta & Edwards, 2018). Any type of mental health issue affects people’s normal capacity to identify that they need help. In the case of South Texas, it is imperative to study how mental health conditions have affected local residents and the different government initiatives developed to ensure improvement in all areas. Any type of mental disorder can get considered as a negative issue that can form full incapacitation for affected persons. The fact that environmental issues often develop results in the need to study how mental health improvement can get performed without affecting the possibility of fully treating the condition.

Treatment of mental health disorders is possible by creating a conducive environment, identifying root cause of issues, and selecting a treatment plan that suits the type of patient (Mayo Clinic, 2019). This paper shall create an argument that is linked to mental health improvement requirements to ensure the capability of offering support to persons affected with mental illnesses. Any type of mental health issues has an impact on the affected persons daily operations. The issues worsen as the people lack connection with family members or friends that would enable them to cope with their adverse conditions. This results in the need to create more social awareness for affected persons to ensure they would be able to engage with the proper solutions and professionals that can offer solutions.

Chang et al. (2019) identified that psychological issues often develop as people get exposed to adverse social conditions. The process of detection is critical since it ensures identification of issues that would lead to the proper solution depending on patient conditions. The issue of mental health is strongly connected to any professional environment since it is required to ensure identification of limiting factors that can cause a person to gain profitable outcomes. The development of personality traits affects the possibility of mental health improvement since it is connected to the issue of accessibility by affected persons. The transition between personal factors and mental health improvement requires consideration since it affects normal functioning that has a capability of generating required outcomes for patients.

After studying factors that may lead to development of mental health issues, it is imperative to analyze how people’s desire to access care gets performed. There are certain barriers for mental health improvement that often occur due to limited capability to generate profitable treatments. The most common barriers are financial constraints, inability to reach required destination, age, stigma, social influence, limited literacy about mental health, lack of insurers, inadequate government interventions, and lack of access with professionally trained persons (Smith et al., 2019; Shukla et al., 2020; Shi et al., 2020; Shalaby & Agyapong, 2020). For instance, adolescents find it hard to receive mental health treatment since they are influenced by their peers (Cuddy & Currie, 2020). This is also connected to the social influence that is common in all areas of a person’s daily life. Limited desire to mental health improvement often occurs in this way and thus creates more constraints for mental health departments.

There is a discrepancy between mental health improvement initiatives and the desire of targeted persons to engage with the improvement measures (Nyblade et al., 2019). This is dangerous for the health departments and affected persons since it affects their desire to access care. The procedure of identification of a type of mental health issue requires collaboration with the affected person and professionally trained person. Whenever the affected persons lack full confidence in their health provider’s capabilities, it becomes difficult to improve quality of care and to offer the best outcome (Brondani et al., 2017). There are a variety of interventions like emotional support, therapy, and medicine to help affected persons to cope with their issues. Depending on the type of issue mental healthcare providers are involved with the improvement measures that have a high likelihood of producing required outcomes.

There is availability of mental healthcare procedures in th