Low SES and Access to Therapy

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A number of studies reported that mental health care becomes one of the most demanded services since the rates of depression and mood disorders tend to increase (Assari, 2017; Delgadillo, 2015). The literature extensively studies the associations between patients’ socioeconomic status (SES) and their access to mental health care. The barriers that impede their utilization of psychotherapy are not yet clear, and many scholars called for research to address the perceived need to receive mental care services in terms of SES. In particular, in the study by Villatoro et al. (2018), the intersection of ethnicity, age, gender, and SES was analyzed. In turn, Manstead (2018) examined the impact of patients’ feelings and thoughts in terms of the psychology of social class theory.

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The problem to be addressed by this study is a lack of understanding of how ethnicity and age affect psychological therapy access in minority communities with low SES. According to Jang et al. (2015), the identified problem impacts the individuals who have mental health concerns but remain uncovered by the necessary services. Also, postponed care leads to additional health care costs, setting an additional burden on the personnel and system as a whole. If the identified problem remains unresolved, the level of mental disorders is likely to increase (Assari, 2017; Delgadillo, 2015; Finegan et al., 2018). The adverse consequences of not addressing this problem would include the increase in mental disorders among the vulnerable populations that face low SES-related challenges, such as low income, unemployment, inequality, et cetera (Becker et al., 2017). More to the point, a lack of further research and subsequent interventions is likely to deteriorate their SES and cause chronic diseases. To study the given problem, it is expected to employ the social class theory to focus on the perceived self of the target population and better understand their barriers to accessing mental therapy.

The purpose of this qualitative descriptive study is to study the role of SES in perceptions of the need for care among older adults of ethnic minorities. The rationale for the proposed study is to become aware of their perceived problems and adjust care practices to approach such patients to provide timely and effective care (Wuthrich & Frei, J2015). Creedon and Cook (2016) stated that language and communication issues could be one of the main challenges. Kenning et al. (2017) pointed to the importance of cultural habitus and inadequacies to understand the problem to be studied. Accordingly, a lack of research regarding the role of SES (ethnicity and age) should be researched to contribute to both theory and practice of mental health care.

A questionnaire will be used as the method of data collection to focus on the ethnic minority population of different ages, who will be contacted through three mental health care units in the US. By contacting the management of the selected hospitals, it is expected to enroll the study participants and provide them with the informed consent forms. The sampling frame will include patient data, demographic information, and a questionnaire based on direct element sampling. The total sample size will include 60 patients, who will be chosen as a result of purposeful sampling (Brenes et al., 2015; Villatoro et al., 2018). Ethnicity, age, the perceived need for care, and the level of actual access to mental health services will be identified as the variables.

Data will be collected by means of such methods as the review of patients’ medical data and interviews. Yin’s stage theory for qualitative analysis will be used to research the role of SES, including such phrases as compiling a database, disassembling data, reassembling data, interpreting findings, and concluding. NVivo software will be applied to organize and process the collected information. The study findings will inform the available theory by adding valuable insights regarding the role of age and ethnicity in accessing mental health care.

The formulation of research questions is associated with determining the criteria for the proposed study. According to Creswell and Poth (2016), they should not be excessively strict since it can limit the amount of information to be collected and analyzed. Patient characteristics, study design, the perceived need for care, and settings are the key categories that shape the core of the proposed study. Taking into account that the purpose is to understand the role of SES in perceptions of the need for care, the following questions are formulated:

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  • How do older adults of ethnic minority groups with low SES, having depression, anxiety, and other mental disorders, identify their need for mental health care?
  • What are the perceived barriers of ethnic minority groups with low SES regarding the use of psychotherapy?
  • How to make mental health care more accessible for older adults of ethnic minority groups with low SES, having depression, anxiety, and other mental disorders?

These research questions will allow for studying the identified problem by collecting information directly from the patients and assessing with regards to their medical data. The answers given by patients will be processed to address the above research questions and make relevant conclusions. Some recommendations for improving access to therapy for the given population will be provided.


Assari, S. (2017). Social determinants of depression: The intersections of race, gender, and socioeconomic status. Brain Sciences, 7(12), 156-168.

Becker, J. C., Kraus, M. W., & Rheinschmidt-Same, M. (2017). Cultural expressions of social class and their implications for group-related beliefs and behaviors. Journal of Social Issues, 73(1), 158-174.

Brenes, G. A., Danhauer, S. C., Lyles, M. F., Hogan, P. E., & Miller, M. E. (2015). Barriers to mental health treatment in rural older adults. The American Journal of Geriatric Psychiatry, 23(11), 1172-1178.

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Creedon, T. B., & Cook, B. L. (2016). Access to mental health care increased but not for substance use, while disparities remain. Health Affairs, 35(6), 1017-1021.

Creswell, J. W., & Poth, C. N. (2016). Qualitative inquiry and research design: Choosing among five approaches (4th ed.). Sage.

Delgadillo, J. (2015). Worlds apart: Social inequalities and psychological care. Counseling and Psychotherapy Research, 18(2), 111-113.

Finegan, M., Firth, N., Wojnarowski, C., & Delgadillo, J. (2018). Associations between socioeconomic status and psychological therapy outcomes: A systematic review and meta‐analysis. Depression and Anxiety, 35(6), 560-573.

Jang, Y., Yoon, H., Chiriboga, D. A., Molinari, V., & Powers, D. A. (2015). Bridging the gap between common mental disorders and service use: The role of self-rated mental health among African Americans. The American Journal of Geriatric Psychiatry, 23(7), 658-665.

Kenning, C., Daker-White, G., Blakemore, A., Panagioti, M., & Waheed, W. (2017). Barriers and facilitators in accessing dementia care by ethnic minority groups: A meta-synthesis of qualitative studies. BMC Psychiatry, 17(1), 316-329.

Manstead, A. (2018). The psychology of social class: How socioeconomic status impacts thought, feelings, and behavior. The British Journal of Social Psychology, 57(2), 267-291.

Villatoro, A. P., Mays, V. M., Ponce, N. A., & Aneshensel, C. S. (2018). Perceived need for mental health care: The intersection of race, ethnicity, gender, and socioeconomic status. Society and Mental Health, 8(1), 1-24.

Wuthrich, V. M., & Frei, J. (2015). Barriers to treatment for older adults seeking psychological therapy. International Psychogeriatrics, 27(7), 1227-1236.

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PsychologyWriting. "Low SES and Access to Therapy." February 1, 2022. https://psychologywriting.com/low-ses-and-access-to-therapy/.