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Community Social Vulnerability and Youth Mental Healthcare: Exploring Disparities in Geographic Availability and Service Utilization for Children and Adolescents in the State of New York
Community Social Vulnerability and Youth Mental Healthcare: Exploring Disparities in Geographic Availability and Service Utilization for Children and Adolescents in the State of New York
상세정보
- 자료유형
- 학위논문 서양
- 최종처리일시
- 20260202103158
- ISBN
- 9798291564608
- DDC
- 157
- 서명/저자
- Community Social Vulnerability and Youth Mental Healthcare: Exploring Disparities in Geographic Availability and Service Utilization for Children and Adolescents in the State of New York
- 발행사항
- [Sl] : New York University, 2025
- 발행사항
- Ann Arbor : ProQuest Dissertations & Theses, 2025
- 형태사항
- 192 p
- 주기사항
- Source: Dissertations Abstracts International, Volume: 87-02, Section: B.
- 주기사항
- Advisor: Chacko, Anil.
- 학위논문주기
- Thesis (Ph.D.)--New York University, 2025.
- 초록/해제
- 요약Access to care continues to be a concern in the delivery of mental health services, particularly for children. Grounded in a population health framework and informed by Levesque et al.'s (2013) patient-centered access to health care framework and ecological systems theory, this dissertation examines how community-level social vulnerability factors shape access to New York state-licensed children's mental health services across two dimensions of access: geographic availability and service utilization.Study 1 evaluated how overall social vulnerability and specific themes of vulnerability due to socioeconomic status, household characteristics, racial and ethnic minority status, and housing type/transportation relate to the geographic distribution of children's mental health programs at the county and census tract levels. Using Geographic Information Systems (GIS) and negative binomial regression analyses, findings showed that at the county level, higher overall social vulnerability and higher racial and ethnic minority status vulnerability were associated with lower geographic availability. However, at the census tract level, higher vulnerability was often associated with greater geographic availability, suggesting targeted placement in high-need neighborhoods, particularly around housing and socioeconomic disadvantage. These findings emphasize that greater geographic availability does not necessarily translate to equitable access.Study 2 shifted focus from availability to service utilization, examining the relationship between social vulnerability themes and rates of children's mental health service use across New York counties. Higher overall social vulnerability and greater racial and ethnic minority vulnerability were associated with lower service utilization rates, especially among non-Medicaid populations. Vulnerability due to household characteristics, such as limited English proficiency, also emerged as a significant factor related to lower service use. In contrast, socioeconomic status and housing type/transportation vulnerabilities were not consistently associated with service utilization, suggesting that financial or infrastructural barriers alone do not fully explain differences in service utilization.Taken together, findings from both studies illustrate that access to mental health care is not a linear issue. Access to children's mental health services involves not only the presence of services but must also account for families' ability to perceive services as necessary, seek them out, and engage with them. Availability does not guarantee use. These results underscore the importance of considering multiple, interacting factors when addressing mental health care access for children. This dissertation highlights the need for policies and interventions that not only increase the number of available programs, but also enhance the cultural appropriateness, linguistic accessibility, and acceptability of mental health services to better meet the needs of vulnerable communities.
- 일반주제명
- Clinical psychology
- 일반주제명
- Counseling psychology
- 일반주제명
- Public health
- 일반주제명
- Mental health
- 기타저자
- New York University Applied Psychology
- 기본자료저록
- Dissertations Abstracts International. 87-02B.
- 전자적 위치 및 접속
- 로그인 후 원문을 볼 수 있습니다.
MARC
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■040 ▼aMiAaPQ▼cMiAaPQ
■0820 ▼a157
■1001 ▼aMatthews, Brittany L.
■24510▼aCommunity Social Vulnerability and Youth Mental Healthcare: Exploring Disparities in Geographic Availability and Service Utilization for Children and Adolescents in the State of New York
■260 ▼a[Sl]▼bNew York University▼c2025
■260 1▼aAnn Arbor▼bProQuest Dissertations & Theses▼c2025
■300 ▼a192 p
■500 ▼aSource: Dissertations Abstracts International, Volume: 87-02, Section: B.
■500 ▼aAdvisor: Chacko, Anil.
■5021 ▼aThesis (Ph.D.)--New York University, 2025.
■520 ▼aAccess to care continues to be a concern in the delivery of mental health services, particularly for children. Grounded in a population health framework and informed by Levesque et al.'s (2013) patient-centered access to health care framework and ecological systems theory, this dissertation examines how community-level social vulnerability factors shape access to New York state-licensed children's mental health services across two dimensions of access: geographic availability and service utilization.Study 1 evaluated how overall social vulnerability and specific themes of vulnerability due to socioeconomic status, household characteristics, racial and ethnic minority status, and housing type/transportation relate to the geographic distribution of children's mental health programs at the county and census tract levels. Using Geographic Information Systems (GIS) and negative binomial regression analyses, findings showed that at the county level, higher overall social vulnerability and higher racial and ethnic minority status vulnerability were associated with lower geographic availability. However, at the census tract level, higher vulnerability was often associated with greater geographic availability, suggesting targeted placement in high-need neighborhoods, particularly around housing and socioeconomic disadvantage. These findings emphasize that greater geographic availability does not necessarily translate to equitable access.Study 2 shifted focus from availability to service utilization, examining the relationship between social vulnerability themes and rates of children's mental health service use across New York counties. Higher overall social vulnerability and greater racial and ethnic minority vulnerability were associated with lower service utilization rates, especially among non-Medicaid populations. Vulnerability due to household characteristics, such as limited English proficiency, also emerged as a significant factor related to lower service use. In contrast, socioeconomic status and housing type/transportation vulnerabilities were not consistently associated with service utilization, suggesting that financial or infrastructural barriers alone do not fully explain differences in service utilization.Taken together, findings from both studies illustrate that access to mental health care is not a linear issue. Access to children's mental health services involves not only the presence of services but must also account for families' ability to perceive services as necessary, seek them out, and engage with them. Availability does not guarantee use. These results underscore the importance of considering multiple, interacting factors when addressing mental health care access for children. This dissertation highlights the need for policies and interventions that not only increase the number of available programs, but also enhance the cultural appropriateness, linguistic accessibility, and acceptability of mental health services to better meet the needs of vulnerable communities.
■590 ▼aSchool code: 0146.
■650 4▼aClinical psychology
■650 4▼aCounseling psychology
■650 4▼aPublic health
■650 4▼aMental health
■653 ▼aSocial vulnerability
■653 ▼aYouth mental healthcare
■653 ▼aGeographic availability
■653 ▼aService utilization
■653 ▼aChildren and adolescents
■690 ▼a0622
■690 ▼a0603
■690 ▼a0347
■690 ▼a0769
■690 ▼a0573
■71020▼aNew York University▼bApplied Psychology.
■7730 ▼tDissertations Abstracts International▼g87-02B.
■790 ▼a0146
■791 ▼aPh.D.
■792 ▼a2025
■793 ▼aEnglish
■85640▼uhttp://www.riss.kr/pdu/ddodLink.do?id=T17357268▼nKERIS▼z이 자료의 원문은 한국교육학술정보원에서 제공합니다.


