Thesis (Ph. D.)--University of Texas at Austin, 2001. / Vita. Includes bibliographical references (leaves 288-301). Available also in a digital version from Dissertation Abstracts.

Thesis (M.P.A.)--Kutztown University of Pennsylvania, 1997. / Source: Masters Abstracts International, Volume: 45-06, page: 2943. Abstract precedes thesis as 1 preliminary leaf. Typescript. Includes bibliographical references (leaves 66-67).

Historically, African Americans consistently underutilize mental health services. This trend is also seen in the African American college population, despite easier access to mental health resources. This report examines the central barriers experienced by African Americans in seeking out mental health services, which are most often seen in the literature. Barriers explored include stigma, the foundations of counseling, cultural mistrust, and attitudes and beliefs about mental health services. The barriers are then used as a framework to discuss preventive, developmental, and community interventions. Further suggestions are made as to how to best utilize interventions to reduce the barriers experienced by African American students in seeking mental health services. / text

Background and Objectives The prevalence of child and adolescents mental health problems has been increasing in Hong Kong and is comparable to that of the world. It is estimated that the mental health problems of the future generations would account for 15% to 30% of their disability-adjusted life years (DALYs) and become a healthcare burden on societies in the near future. Therefore, it is necessary to address their mental healthcare needs now. The objective of the project is to review how the mental health services for children and adolescents have been changing in Hong Kong throughout the past few decades and to assess whether the local services have improved. While the service advancement in adult and old age (for example dementia) psychiatry has been significant, the children and adolescent mental health services would be reviewed by using the Donabedian framework. Based on some local and western models, the project will also address what the local healthcare providers can do for the children and adolescents with the capacity of developing multi-disciplinary and community-based integrated care as well as primary care and prevention. Service gap and areas of improvement on addressing the healthcare needs would be identified for the consideration of policymakers. Methods This project is a literature review. Archives of the Hong Kong College of Psychiatrists and Paediatricians, PubMed, PsycInfo, World Psychiatry, Lancet, etc have been searched with keywords including “children”, “adolescents”, “mental health services”, “child psychiatry” and “Hong Kong”. Journals from 1991 to 2011 have been retrieved. Publications and official sites of Hospital Authority and government organizations have also been searched. 52 journals, articles and online sources have been searched. 38 papers are identified and 19 are providing relevant materials. Studies with aggregated population level data rather than clinical studies which focus on symptoms and treatment of individuals are much more useful and providing more relevant information to this project. Results Secondary and tertiary care, in terms of screening, detection, in-patient and out-patient setting and rehabilitation services have been developed in Hong Kong since the 1980s whilst there are rooms for further development on primary care and prevention. An integrated approach, which emphasizes early identification and treatment by specialists-led multi-disciplinary professionals, has been more prominent. The stigmatization, which would result in reluctance of treatment, should also be addressed by enhancing the public understanding and awareness on the mental healthcare needs of children and teenagers. Conclusions It is necessary to work on the improvement of child and adolescent mental health in the primary, secondary and tertiary care in Hong Kong at present. Policymakers shall consider strengthening the support for child and adolescent psychiatry services in addition to the adults’. / published_or_final_version / Public Health / Master / Master of Public Health

The Chinese population in New Zealand has grown rapidly in recent years, and it has become an important component in New Zealand society. In reality, these Chinese people are likely to be under stress in their new lives, and therefore, at high risk of mental health problems. Moreover, evidence shows that Chinese people are the under-users of mental health services, and that mental health issues among the Chinese population tend to be under-recognised, under-reported and untreated. Therefore, the method of descriptive qualitative study was chosen and semi-structured interviews were carried out to describe how health providers perceive and support mental health needs of Chinese patients in Christchurch. Purposive sampling was used to identify potential participants, namely the health providers, who have experience of working with Chinese people‘s mental health issues. They were recruited from a wide range of health services, including general practice, psychiatry, social work, counselling, project leadership, health promotion, different management roles, nutrition, nursing, and Chinese medicine. Data analysis was assisted by the computer software Nvivo 8, with thematic analysis used to identify themes and sub-themes which emerged from the information of the interviews. From the health providers‘ point of view, migration-related stressors and physical problems all pose risks to Chinese people‘s mental health. Although Chinese clients with mental health problems are not commonly seen in the clinical settings, they do potentially have mental health problems and suffer from these issues, but rarely seek mental health support from mainstream services. The health providers pointed out that although good mental health services and information are offered to local people, the existing health care model and health system do not meet Chinese people‘s mental health needs, due to barriers of language and culture. Under these circumstances, the providers indicated that establishing cultural and linguistic mental health services, and offering education to Chinese people and health providers might be helpful in overcoming cultural barriers, improving low access issues and meeting Chinese people‘s mental health needs. This study also identified a range of mental health problems and some groups among the Chinese population with a high risk of mental health issues, both of which need further investigation.

Given the high prevalence of client unilateral termination from psychotherapeutic services, elucidating client reasons for ending therapy is an important activity for researchers. Three studies were designed to shed light on reasons for both premature and appropriate termination from the perspective of adult clients and therapists: 1) In Study 1, I examined data from the Canadian Community Health Survey, Cycle 1.2, to establish base rates of client reasons for psychotherapy termination in Canada, along with their demographic and clinical correlates, 2) In Study 2, I used training clinic data to examine client and therapist perspectives of reasons for termination, working alliance, and barriers to treatment participation in mutual versus unilateral terminators, and 3) In Study 3, I collected data from Canadian clinical psychologists to examine their perspectives of client reasons for early versus later termination, and their use of engagement strategies to reduce client-initiated unilateral termination. In Study 1, 43.1 percent of respondents reported terminating therapy for reasons other than feeling better or completing treatment. In general, individuals with low income and diagnosable mental disorders had significantly increased odds of premature termination. Study 2 revealed that when clients made unilateral decisions to end therapy, therapists were only partially aware of either the extent of clients’ perceptions of their success in therapy or with their dissatisfaction with therapy. Although working alliance and barriers to treatment participation were rated as lower in the context of unilateral termination by both clients and therapists than in the context of mutual decisions to terminate therapy, all clients, in general, rated the early alliance and barriers to treatment as higher than did their therapists. In Study 3 psychologists assigned differential importance to reasons for termination depending on whether termination was before versus after the third session. Theoretical orientation (CBT versus other) did not influence views of reasons for termination, but influenced use of some engagement strategies. Results are discussed in terms of research and clinical implications.

Thesis (D. Min.)--Southwestern Baptist Theological Seminary, 1989. / Includes bibliographical references (leaves 217-225).

Thesis (Psy. D.)--Wheaton College Graduate School, 2005. / Abstract. Includes bibliographical references (leaves 77-82).

Thesis (Ph.D.)--University of Melbourne, School of Post Graduate Nursing, Faculty of Medicine, Dentistry and Health Sciences, 2002. / Typescript (photocopy). Includes bibliographical references (leaves 311-322).

Thesis (Ph.D.) - University of Glasgow, 2007. / Ph.D. thesis submitted to the Faculty of Medicine, Public Health and Community-Based Sciences, 2007. Includes bibliographical references. Print version also available.