Matching Items (2)
Description
The Arizona healthcare system is changing and although its effects can be seen in almost every realm of the medical field, psychiatry is a specialty that is still experiencing hardship. There are scarce resources available for the ever-growing and struggling patient pool, especially in rural areas and minority populations. A comorbid cycle of untreated psychiatric illness contributes to the burden on emergency department and primary care medicine, as well as homelessness, crime, and suicide within the state. Arizona currently has a dismal spot in the rankings for American states with appropriate access to psychiatric resources, leaving many who need treatment without it. Compared to states with similar populations who are at the top of these rankings, Arizona spends more government money for behavioral health services, indicating a disparity in productivity and questioning monetary waste. Demographic statistics and other relevant scientific literature reveals that Arizona's psychiatric system lacks appropriate structure, and is failing the mental health care system both in monetary and societal constructs. These issues highlight the need for remedies and identify areas for future reform. Recommendations on such reform include permanent change in legislation and department models to improve crisis ward work, communication and networking during transition of care, integration of and access to continuum of care, and community education. They also include creating incentive and certification programs within the state in order to increase the number of available providers, especially in rural areas. These recommendations are directed to specifically reduce the burden of mental illness on emergency medical services, increase productivity, and decrease chronic untreated mental disease and monetary waste.
ContributorsHarding, Calen LeMay (Author) / Perez, Marisol (Thesis director) / Neal, Tess (Committee member) / Department of Psychology (Contributor) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05
Description
A high percentage of Native Hawaiian and other Pacific Islander (NHPI) adults (37.4%) aged 18 and older did not see a doctor in the past year. This is the highest percentage among all racial groups. Furthermore, approximately one in eight NHPI adults (12%) are uninsured, a rate that is markedly higher than Whites. Federal reports historically struggle to capture data that could explain these phenomena. Hence, NHPI are insufficiently and incompletely represented in health statistics, access health services at lower rates, and are insured at lower rates than other racial and ethnic minority groups. This has implications for perpetuating adverse mental health conditions and mental health disparities that are prevalent in this community (e.g., depression, anxiety, alcohol use disorder, and tobacco use), particularly following the global COVID-19 pandemic. The overarching goal of this research is to improve and broaden understanding of novel multi-level health determinants causing low mental health care service utilization rates of NHPIs, a presently understudied health disparity for Native Hawaiians and other Pacific Islanders in the U.S. Design: A closed access, cross-sectional Internet survey was used to collect data. Participants were recruited with announcements distributed nationwide via email to NHPI organizations, associations, and networks across the United States and social media. The sample included 395 NHPI adults aged 18 and older. Analysis: Latent profile analysis (LPA) were conducted using Mplus 8 statistical software to examine whether different conceptually meaningful profiles of NHPI Islanders emerge based on hypothesized health determinants measuring Symptom Distress (Perceived Health Status, Depression/Anxiety, and Perceived Stress), Protective Factors (Pacific Cultural Efficacy, Religious Centrality and Embeddedness, Pacific Connectedness and Belonging, and Perceived Societal Wellbeing) and Health Attitudes (Medical Mistrust and Service Provider Preferences [i.e., Traditional/Native Healer vs Medical Doctor/Nurse]) while accounting for demographic covariates (e.g., education, income, and insurance status). Results supported a four-profile model solution, where four distinct groups (named “Very Low Symptomatic,” “Low Symptomatic,” “Moderate Symptomatic,” and “High Symptomatic”) of participants demonstrated varying levels of symptom distress, endorsement of protective factors, and health attitudes. Furthermore, planned mental health care utilization was analyzed as an outcome variable, demonstrating varying levels of planned mental health service utilization across the four profiles. Significance: Findings may inform public policy and healthcare professionals about how to meaningfully engage NHPI communities in culturally competent mental health care services.
ContributorsMarsiglia, Steven Sasa (Author) / Dillon, Frank R (Thesis advisor) / Yellow Horse, Aggie J (Committee member) / Truong, Nancy N (Committee member) / Arizona State University (Publisher)
Created2024