Mental health is an essential element of a person’s well-being and ability to function in society. Mental health illness hinders one’s ability to work, socialize, and complete typical daily activities necessary for survival. However, psychology and psychiatry development ensured that these problems could be addressed either through medication or by using different types of therapy. While this partially resolves the problem of mental health illnesses because it allows individuals to get help, not everyone can receive these services. One predeterminant of whether an individual will address their mental health concerns is the socioeconomic factors (SES), which include income, social class, financial security, and perceptions of one’s social status. This research aims to determine the SES factors that impact a member of a minority community’s decision to seek professional mental health help.
The broader context of access to the services for mental health care is the increasing prevalence of mental health illnesses in the United States and people’s lack of awareness that they have a mental health problem, which has to be addressed. Richter et al. (2018) state that globally, there is a moderate increase in the prevalence of these disorders. This trend has been present for years, and if the increase continues, the global community will have to deal with a large number of patients who require mental health help. In this light, some researchers examined the ability of different social groups to access mental health services, with an attempt to determine whether if the existing demand for these services is satisfied.
Several studies point out the fact that the needs for mental health care of different communities are satisfied disproportionately. For example, Assari (2017) states that income and ethnicity influence whether a person will get mental health help. The African Americans report is having less access to these services when compared to others. Additionally, Narendorf and Palmer (2016) state that a person’s perception of the necessity to address their mental health condition is an important aspect contributing to the prospects of obtaining care services. As a result, there is evidence suggesting that the mental health support needs of some individuals are not satisfied, and it may be connected to their socioeconomic characteristics. However, the gap in the existing studies is the decision that led to an individual choosing to access mental health care remains unclear. Therefore, the research indicates the disproportionate access to mental health care services within different communities and by researching the factors that led to the decision of people from those communities to get mental health care one can design policies and strategies for increasing the number of adults with mental illnesses who receive professional help.
The examination of this side of the problem will help understand how, in certain communities, the need to access mental health care can be promoted, which can help reduce the number of severe mental illnesses or adverse effects associated with mental illnesses that remain untreated for extensive periods. Hence, empirically, the exploration of this topic for a Ph.D. study can help determine the actual relationship between ethnicity, age, and decision to obtain mental health care. From a practical perspective, this study will help develop programs that target increasing the awareness about mental health problems.
Statement of the Problem
The problem to be addressed by this study is the underutilization of mental health services by low SES individuals due to unequal access.Gonzalez et al. (2016) and Silva et al. (2016) reported that socioeconomic status has a strong impact on mental health and basic psychological needs. According to Delgadillo et al. (2016), the “prevalence of mental healthproblems is greater in poorer areas,” and “these areas have lower average recovery rates” (p. 429). People from more vulnerable social groups experience moremental health problems and have less access to mental health services (Creedon et al., 2016; Derr et al., 2016; Memon et al., 2016).Low income, ethnic and racial disparities, age, and area of living may constitute barriers in this regard (Finegan et al.,2018; Hodgkinson et al., 2017; Platell et al., 2017).Mental disorders can exacerbate the living situation of people from vulnerable groups, thus exacerbating social and economic circumstances.
These social groups have their own perception of barriers and need for mental healthcare, which is an additional significant factor of its underutilization (Packness et al., 2019; Stepanikova et al., 2017; Villatoro et al., 2018). People from vulnerable communities are not willing to trust and use professional assistance because of perceived discrimination and healthcare disparities (Holley et al., 2016; Maura et al., 2017).According to Wilson et al. (2018), misconceptions and stigma in this regard prevalent among discriminated and vulnerable groups affect their underutilization of mental health services and need to be investigated. This research is intended to explore what SES are associated with perceived barriers and low perceived need for mental health services. The self-determination theory can be used to investigate this issues (Gonzalez et al., 2016). Lack of research data in this area may lead to mental health and socioeconomic deterioration of vulnerable groups.
Significance of the Study
The selected research problem deserves the attention of practitioners and scholars alike due to several reasons. Firstly, the issue of unequal access to mental health care requires serious consideration at different levels, including local, state, and governmental. Without addressing the question properly, healthcare practitioners will not be able to help all those in need, which will inevitably lead to the deterioration of the problem. Research findings indicate that mental health of individuals is gradually declining, which necessitates finding effective solutions (Richter et al., 2019). However, without providing all population groups with equal opportunities, society will not be able to cope with the emerging adverse trends in the mental health sphere. Meanwhile, according to Assari (2017), there exists a disproportional division of high-quality mental health care, depending on people’s socioeconomic and ethnic features. Since the present study aims at finding answers to the question of which socioeconomic factors have the greatest effect on people’s access to care, it is of high relevance and significance to practitioners.
Another reason why research will be of great use is that it will provide ample material for further studies. Specifically, the ways older adults with low socioeconomic factors identify their mental health care needs will be singled out in the study. Having this information available, further research can focus on the methods of mitigating barriers to care access. Additionally, scholars will be able to find links between socioeconomic factors (SES) and people’s likelihood to address specialists for help or remain silent about their issues. Furthermore, researchers will be able to compare health indicators of older adults with low high SES, older adults with other age groups, and, finally, people from different ethnic communities. Each of these studies will contribute to the enhancement of the nation’s mental health since by locating differences between population groups, it will be possible to search solutions to the problems each of them might be having.
One more issue of the study’s relevance is the possibility to come up with effective but inexpensive ways of coping with mental disorders, as well as preventing them. The findings that are expected to be obtained will contain information about the onset of mental illness or anxiety, major comorbid factors, and negative impacts of the environment that can contribute to the problem. Hence, further scholarly endeavors may be aimed at creating and testing mobile applications or other interventions that could help older adults to overcome their mental health issues with minimal risk.
The study also bears importance for practitioners since they will be able to utilize findings in their everyday work with patients. Nurses will assess older adults’ conditions based on research findings. Even if a person is hospitalized due to some physical health reasons, healthcare professionals will be able to identify psychiatric problems and address them promptly. Also, since the study will single out perceived barriers of ethnic minority groups to the use of psychotherapy, doctors and nurses will be able to predict and overcome them.
The study is promising in terms of providing practitioners and communities with valuable information on low-SES older adults’ mental health care needs. Both scholars and hospital employees will find relevant information, which can be used in their practice or further research. It is expected that dissertation findings will not only find solutions to existing social drawbacks in access to care but also offer ways of preventing the most typical problems, thereby minimizing the risks of developing mental issues in older adults from minority groups.
Purpose of the Study
The purpose of this quantitative cross-sectional study is to analyze the relationship between one’s socioeconomic status and access to therapy. The research will help clarify how significant SES differences are in determining one’s ability to receive help for their mental issues. If it finds a substantial disparity in the access to care of different populations, especially if this inequality results in critical needs not being addressed, the scholarly and medical communities will consider the issue deeper and develop solutions. To that end, the study will consist of a survey to determine one’s SES and their perceived access to psychological care. The data will then be processed and analyzed to obtain a picture of the relationship between the variables. The results will be published in the finished manuscript and used to explore the situation further.
Two independent variables form the basis of socioeconomic status: income and education. Additional independent variables that are not as critical but will also be considered are the respondent’s race, ethnicity, and age. They will be discussed in relation to the dependent variables, which will be the perceived need for mental health assistance and access to such, using statistical software. The sample should consist of at least 300 people from different socioeconomic classes and communities, preferably evenly distributed. To that end, the author will employ cluster sampling, surveying groups in several socioeconomically homogeneous communities. These locations will be located within the same town or city to ensure that the respondents are discussing the same facilities. As such, the differences in access that can be rationalized as disparities in the general quality of the local healthcare system should be minimized.
Theoretical and Conceptual Frameworks
This research will apply the social class theory to analyze the relationship between socioeconomic status and access to care. In accordance with the framework, the differences in access between individuals and, consequently, their health outcomes should mostly be determined by their SES characteristics (Detels et al., 2017). Those with the income required to afford quality care will receive it regularly, and, as a result, their mental health issues will generally not develop into significant problems. On the other hand, the people without the resources or education required to access quality care will be underserved unless there are social safeguards in place. They will likely not receive treatments for their problems in the early stages, only recognizing them once they progress and become dangerous. Moreover, this health disparity will create a further divide in the two groups’ ability to earn money, exacerbating the health difference further, and perpetuating the process.
The primary factors that determine one’s socioeconomic status are their income and education, which govern one’s ability to recognize their problems and access care when necessary. However, other factors can also contribute to one’s ability to address their issues via the healthcare system. One’s ethnicity can affect the effectiveness of the care they receive upon accessing ethnic and racial communities being served to different extents through the medical system. Lastly, the prevalence of issues increases with age, increasing the need for access while impeding one’s ability to earn an income through work. As such, these three causes can affect one’s health through the differences in ways healthcare facilities treat them or their willingness to seek care. However, their effects are likely to be less significant than those based on cultural factors. Race can also be a factor in care access, with various of SES because of efforts undertaken to serve these particular population segments.
This belief is reflected in the conceptual framework, which considers the relationship between SES, care access, and health outcomes. It is similar to the one proposed by Barr (2019), where one’s socioeconomic conditions directly influence their health outcomes, with access contributing to this relationship as a mediating variable through being affected by the former and being correlated with the latter. With that said, the study will also consider health a determinant of perceived access to reflect the effects of an increased need to access care and the associated costs lowering access. As the study focuses on the relationship between SES and access, it will not consider the indirect effects of access on health, as such a consideration would be out of the scope of the research.
The author believes the three additional independent variables to act as moderators, influencing the relationship between SES and access to care. As such, people with the same socioeconomic conditions but differences in these variables may exhibit different access levels. However, the author expects a majority of the differences to be relegated to the primary variables, which leads to the belief that people with low SES may be underserved in terms of access. The possibility warrants investigation, and, therefore, the author has decided to make it central to this study and obtain information that confirms or denies the idea. Quantitative research would help gain a preliminary picture of the situation, which can then be explored with a supplementary qualitative study if necessary. The research questions and hypotheses were formulated to clarify the matter, investigate different aspects of the relationship.
Research Questions and Hypotheses
The first three questions explore the relationship between SES and access to care, as well as health outcomes. They are the most important topics of inquiry for this study, though they are not necessarily the only ones.
- RQ1. What effect does one’s socioeconomic status have on their perceived access to care, particularly psychological help?
- RQ2. What effect does one’s socioeconomic status have on their mental health?
- RQ3. How does one’s mental health affect their perception of access to mental healthcare?
The second pair of questions concerns the moderating factors of the other three variables explored in this study. It is essential to consider these aspects when discussing disparities in access to care and the possible reasons for their existence.
- RQ3. What effect do one’s race, ethnicity, and age have on the relationship between one’s SES and perceived access to care, particularly psychological help?
- RQ4. What effect do one’s race, ethnicity, and age have on the relationship between one’s SES and their mental health?
The hypotheses establish the types of relationships that the author expects to find between the variables in the study. They are consistent with the theoretical and conceptual frameworks and outline the potential disparities, or lacks thereof, that may be found as a result of the data collection and analysis.
- H10. There is no relationship between a person’s income and their perceived access to mental healthcare.
- H1a. People with a lower income will have worse perceived access to mental healthcare than those with a higher income.
- H20. There is no relationship between a person’s education level and their perceived access to mental healthcare.
- H2a. People with a lower education level will have worse perceived access to mental healthcare than those with a higher level.
- H30. There is no relationship between a person’s income and long-term mental health outcomes.
- H3a. People with a lower income will have worse long-term mental health outcomes than those with a higher income.
- H40. There is no relationship between a person’s education level and their long-term mental health outcomes.
- H4a. People with a lower education level will have worse long-term mental health outcomes than those with a higher level.
- H50. People with current mental health concerns do not perceive their access to mental healthcare differently from people in similar circumstances who do not have any.
- H5a. People with current mental health concerns possess a more negative perception of their access to mental healthcare than people in similar circumstances who do not have any.
- H60. People of different races in comparable socioeconomic circumstances have a similar perception of their access to mental healthcare.
- H6a. People of different races in comparable socioeconomic circumstances have a different perception of their access to mental healthcare.
- H60. People of different ethnicities in comparable socioeconomic circumstances have a similar perception of their access to mental healthcare.
- H6a. People of different ethnicities in comparable socioeconomic circumstances have a different perception of their access to mental healthcare.
- H70. People of different ages in comparable socioeconomic circumstances have a similar perception of their access to mental healthcare.
- H7a. People of older ages see their access to mental healthcare as worse than that of younger people in similar socioeconomic circumstances.
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