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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 Geogr...
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
저자명  
Matthews, Brittany L.
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
키워드  
Social vulnerability
키워드  
Youth mental healthcare
키워드  
Geographic availability
키워드  
Service utilization
키워드  
Children and adolescents
기타저자  
New York University Applied Psychology
기본자료저록  
Dissertations Abstracts International. 87-02B.
전자적 위치 및 접속  
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MARC

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■040    ▼aMiAaPQ▼cMiAaPQ
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■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.

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