Thesis, PlanB (M.S.)--University of Wisconsin--Stout, 2005. / Includes bibliographical references.

Thesis (Psy. D.)--Wheaton College Graduate School, Wheaton, IL, 2002. / Abstract. Includes bibliographical references (leaves 88-94).

Thesis (Ph. D.)--University of Texas at Austin, 2006. / Vita. Includes bibliographical references.

Thesis (Ph. D.)--University of Texas at Austin, 2007. / Vita. Includes bibliographical references.

Thesis (PH.D.) -- Syracuse University, 2006 / "Publication number AAT 3251786."

Thesis (PH.D.) -- Syracuse University, 2006 / "Publication number AAT 3242501."

<p> This dissertation investigates the mental health needs of the growing Somali population in Minneapolis and St. Paul, Minnesota by examining clinicians&rsquo; views of the challenges they experience conducting mental health assessments for Somali clients. The research describes the development of a multicultural competence model and recent attempts to improve multicultural competence in assessment and treatment strategies. Specific emphasis is placed on the foundation of current theories supporting diagnoses and treatment issues through a review of current literature on cultural aspects of Somali mental health conceptualization. The researcher conducted semi-structured interviews with eight mental health providers who have worked with Somalis, seeking information for how clinicians handle culturally-specific challenges during the assessment process. Results suggest best practice for assessing Somali clients ought to involve the use of trained full-time interpreters. It is also beneficial for clinicians to be aware of the differences in mental health and illness conceptualization between Somali and Western cultures. Findings show strong support for establishing a trusting triadic relationship with the clinician, client, and interpreter. Using slow-engagement practice, indirect open-ended questions, predicated on previous relationship, will improve rapport and obtain desired information. Results from this study have informed the development of a culturally sensitive diagnostic protocol, providing guidance on how to collect information in a manner that helps ease the Somali client into the assessment process. The culturally sensitive form, described in Appendix F, must be used in conjunction with the education of all parties. This research has implications for those seeking to conduct culturally sensitive assessment and treatment by reducing incongruent cultural practices and promoting culturally competent service for Somalis.</p>

<p> The primary purpose of this study was to explore ways migration experiences and cultural factors influence how sub-Saharan African-born immigrants diagnosed with HIV access medical and psychological health services in the United States. The study was conducted with African-born immigrants diagnosed with HIV. The participants were all members of a support group. The data was obtained through two focus group interviews. Qualitative methodology with thematic analysis was used. The findings of the study yielded six salient themes: (a) factors contributing to healthcare disparities; (b) emotional distress and psychosocial adjustment; (c) positive emotional wellness and support; (d) education as criteria to eliminate disparities; (e) stigmatization by interpreters; and (f) belief in God. Based on these findings, the following recommendations for reducing healthcare disparities among sub-Saharan African-born immigrants diagnosed with HIV were suggested: (a) provide culturally sensitive services that meet the needs of the population; (2) include clients in selecting their interpreters; and (3) provide in-depth education to clients and patients about their mental health with consideration for cultural meaning. Mental health providers are encouraged to seek some level of understanding about their patients&rsquo; perceptions of mental health symptoms and use culturally sensitive resources as an aid in providing services. The use of a collaborative and multidisciplinary team approach to care is likely to improve health seeking behaviors. Suggestions for mental health clinicians and implication for future research are discussed in the last section. </p><p> Key Words: healthcare disparities, stigma, HIV/AIDS, African-born immigrants, mental health, support, interpreters, refugees.</p>

<p> Depression is a leading cause of disability and mortality worldwide, especially for women. No nutrition recommendations exist for depression. Oral contraceptives (OCs) have become the leading form of pregnancy prevention in the United States. Studies have associated OC use with impaired nutrient status, specifically folate, vitamin B₁₂, and vitamin B₆, which also affect brain functions. Dietary folate, vitamin B12, and vitamin B6 self-reported intakes were used to determine the relationship between depression in women who used OCs (<i>n</i> = 34) in a selected cohort (<i> n</i> = 409) from the National Health and Nutrition Examination Survey, 2003&ndash;2008. OC users were more depressed than non-OC users; depression was associated with various quartile levels of vitamin intake (<i>p</i> &lt;.001). No benefit was observed with intakes which exceeded RDAs for non-OC users; OC users were less depressed when intakes exceeded RDAs for folate, vitamin B₁₂, and vitamin B6 by 13%, 75%, and 7%, respectively. </p>

<p> With one in five youth in the United States (US) having a diagnosable mental illness in a given year and fewer than seven percent receiving needed treatment, a tremendous burden has been placed on the US economy and society. Given the lack of connection between mental health service need, resource availability, and factors influencing receipt of treatment, this study aims to lay the groundwork, elucidating the complexity of mental health for youth using Anderson&rsquo;s Behavioral Model of Service Use. Before further system modifications are made or policy revisions, there needs to be a full understanding of the problem. Utilizing the 2015 National Survey on Drug Use and Health, factors that potentially influence reported mental health concerns and service utilization, such as age, gender, SES, geographic location, race/ethnicity, religion, and insurance status, were explored. The results showed that youth with the highest prevalence of MDE in 2015 were White, high SES, females, living in urban settings, with private insurance. However, higher prevalence of MDE did not equate with increased utilization of mental health services, even though MDE was the most significant predictor of mental health utilization in the final logistic regression model. Given the barely adequate fit of the model, important variables are missing in determining access to mental health care in youth. Therefore, it is recommended that a more robust national mental health survey be developed to provide greater understanding of the associated factors to receipt of mental health treatment, in addition to more research to further understand the impact of insurance status and geographic location.</p><p>