Doctor of Philosophy, The Ohio State University, 2022, Educational Studies

Suicide is the second leading cause of death for students in higher education, accounting or over 1,100 student losses each year (Appelbaum, 2006; National Mental Health Association & The Jed Foundation, 2002; Rodriguez, 2013; Silverman et al., 1997; Suicide prevention Resource Center, 2004; Wilcox et al., 2010). Moreover, recent data suggests that suicidal behaviors and prevalence of anxiety and mood disorders among the university student population is trending upward (Center of Collegiate Mental Health, 2020), highlighting suicide prevention and mental health (SP/MH) support and promotion as crucial considerations for student support at institutions of higher education. Data suggests that graduate students are at an elevated risk for suicide compared to undergraduate students (Silverman et al., 1997), however graduate students are underrepresented in literature exploring SP/MH in higher education (Bruns & Letcher, 2018; Evans et al., 2018; Garcia-Williams et al., 2014; Hyun et al., 2006; Moffit et al., 2014). Best practice for evidence-based prevention science advocates for a high fidelity between prevention programming and the target population (Castro et al., 2004; Chen et al., 2013). Therefore, it crucial that graduate students receive more focused attention in university SP/MH support and promotion research in order to inform guidelines and evidence-based practice for graduate student congruent SP/MH support and promotion in the campus setting. This study utilized a comparative case study methodology (Bartlett & Vavrus, 2016) to explore SP/MH support and promotion in graduate education. Four research questions guided this study: (1) What is the nature of the graduate academic programs' participation in mental health support and suicide prevention initiatives for graduate students? “Nature” is defined as the current and historical creation, maintenance, and sustainment of a network of relationships with campus mental health resources and suicide prevention (open full item for complete abstract)

Psy. D., Antioch University, 2018, Antioch Seattle: Clinical Psychology

Mental health issues among school-aged children are a growing concern and subject of intervention and prevention studies nationwide. While several implementation and service delivery models exist for school-based mental health services (SBMHS) they are often localized, population or program specific, and do not adequately address the issues related to stigma. Building on Cook and Kilmer's 2012 article integrating community psychology principles and systems of care values, a review of the literature is conducted to identify issues and barriers from stigma in current school-based and mental health service delivery. Key guidelines and specific considerations are presented to address identified limitations and augment the current implementation models for collaborative SBMHS through the practical application of community psychology principles. The creation and function of a coalition in the spirit of collaboration uniquely provided by partnering systems of care & community psychology principles is a central component. While the main focus and application of these objectives is at the micro and exosystem levels for change, the local community and school, school district and state, they can also be integrated at the macrosystem level for initiatives, legislation, and policy changes.

PHD, Kent State University, 2023, College of Arts and Sciences / Department of Sociology and Criminology

This dissertation extends Fundamental Cause Theory (FCT) to the study of holistic mental health. Using multiple quantitative methods and data from wave three of the Midlife in the United States (MIDUS) study, I explore if socio-economic status (SES) can be considered a "fundamental cause" of holistic mental health. To do so, I advance four hypotheses that address each step necessary to demonstrate a fundamental cause. Results show promising evidence that FCT can be extended to predict mental illness and positive mental health outcomes and that SES can be considered a fundamental cause of holistic mental health. High SES is associated with greater holistic mental health outcomes, and there are also significant mediation effects between SES and holistic mental health through exposure to risk and protective factors. Additionally, there is mixed evidence that mediation is an emergent mechanism between high SES and greater holistic mental health and that the deployment of health resources improves holistic mental health. This represents an advancement of sociological mental health theory, serves as an exemplary study of how sociologists can investigate positive mental health inequalities, and has critical policy implications for how to best improve community mental health.

PHD, Kent State University, 2021, College of Education, Health and Human Services / School of Lifespan Development and Educational Sciences

This qualitative inquiry explored the experiences of group participants in a partial hospitalization program. The methodology used was Interpretative Phenomenological Analysis (IPA; Smith et al., 2013). The research question was: What are participants' experiences of group therapy in a partial hospitalization program? Two interviews were conducted over the course of a 13-week long program. Thirteen participants were interviewed once, and nine returned to be interviewed a second time at the end of their participation in the program. Three willing participants never returned to be interviewed. The focus of the first interview was on identifying the initial experiences of the group experience, whereas the second interview incorporated themes from the first interview to guide and personalize the second interview schedule. Data analysis was completed using IPA guidelines (Smith et al., 2013) while incorporating coding defined by Saldana (2013). Four superordinate themes emerged from this process and each theme had supportive subordinate themes. Participants experienced the following when participating in group therapy in a partial hospitalization program: (1) feeling safe in group; (2) becoming vulnerable and taking emotional risks; (3) developing connections through experience; and (4) change as an outcome of group experience.

Psy. D., Antioch University, 2014, Antioch New England: Clinical Psychology

In 2009, Gawande published an article in The New Yorker that put the unknown mid-sized South Texas city of McAllen on the map. The article stated that McAllen was one of the most expensive health care markets in the country; it caused such media-frenzy that in a few days President Barack Obama (2009) began citing McAllen in his speeches for health care reform. Gawande concluded that overspending in the area was due to overutilization of medical services. The present study examined whether mental health services are overutilized based on archival data on McAllen's mental health services collected from Medicaid, Tropical Texas Behavioral Health (a McAllen area community mental health center [CMHC]), and The Behavioral Center at Doctors Hospital at Renaissance (a McAllen area private hospital). Findings yielded that diagnostic-related groups significantly impacted the average length of stay, as well as total costs for psychiatric inpatient treatment in McAllen, TX. Schizophrenia spectrum disorders required more days of treatment within the hospital than Bipolar disorders and further more days than Depressive disorders. Correspondingly, inpatient treatment of Schizophrenia spectrum disorders cost an additional $5,554.80 when compared to Bipolar disorders and $9,095.16 more than for Depressive disorders. Additionally, the readmission rate at Doctors Hospital was 26.72%, with nearly 1/4 of patients being readmitted at least once, and nearly 7% had 4 or more psychiatric hospitalizations within a one-year period. This readmission rate was higher than the national average perhaps because of inadequate after-care outpatient treatment in McAllen. Medicaid data showed that Texas consistently failed to contribute any state moneys to mental health spending; and that Massachusetts saw a considerably smaller increase in mental health expenditures over a 10-year period for both inpatient and outpatient services when compared to the United States as a whole (i.e., 26% vs. 260% for (open full item for complete abstract)

MA, University of Cincinnati, 2012, Arts and Sciences: Psychology

The estimated annual economic burden of serious mental illness is $317 billion, excluding costs associated with comorbid conditions, incarceration, homelessness, and early mortality. This sum is equivalent to about $1,000/year for every man, woman, and child in the United States (Kessler et al., 2008). A critical need exists for a thorough examination of public mental health care spending. This information is important so that policy makers, foundations, and community agencies can make informed and rational planning decisions regarding the optimal mix of services to provide. It is commonly believed that the decrease in public funding for mental health has had the effect of focusing money on chronic illnesses to the exclusion of funding for prevention, early intervention, or treatment of acute disorders. The purpose of this descriptive study was to document how public dollars have been spent on mental health by examining what problems and populations are being addressed and by whom. In addition, the study documented the distribution of county spending by source, identified the top service providers, and ascertained spending priorities amongst the provider agencies. Finally, this research addressed the implications of those spending patterns, likely future outcomes, and offered policy recommendations. It was necessary to review data from the individual agencies which received and distributed public funds. The data were gathered in Hamilton County, OH, based on the largest providers given the difficulty of state or multi-county analysis. The initial step was obtaining budgets from the Hamilton County Mental Health Recovery and Services Board for fiscal year 2010 (FY 2010) and creating a report which tracked the flow of funds from their sources to the agencies that delivered services. Then, funder expenditures and agency services were integrated and findings were discussed by local mental health experts via individual interviews. Results showed that ten agencies were (open full item for complete abstract)

Doctor of Musical Arts (DMA), Bowling Green State University, 2024, Contemporary Music

This paper explores the intersection of U.S. graduate music student experiences and mental health. A literature review discussing nineteenth-century mechanist piano pedagogy practices, Carl Seashore's Measures of Musical Talent, the impact of neoliberal capitalism on students, and an overview of current U.S. studies on university music student mental health underscore the need for further inquiry into the student experience. I held eight semi-structured interviews with current or former U.S. graduate music students focused on their experiences as a music major. Through poetic inquiry and qualitative content-coding, the interview transcripts were analyzed and organized into poetic portraits representing the collective essence of the lived experiences of the interviewees. The set of eight poems, “Portraits of a Wonderful Musician,” explores uncovered codes including: identity, self-perception, pressure, expectations, urgency, anxiety, the pursuit of perfection, guilt, depression, criticism, comparison, and burnout. Grounded in phenomenology, this paper foregrounds the subjective lived experiences of those interviewed and demonstrates how these rich understandings can inform current music education trends and practices. Poetic inquiry and coding revealed a correlation between traditionalist pedagogical practices and students exhibiting fixed mindset traits, which are associated with the negative lived student experiences. Influenced by the historical, social, and cultural constraints of music pedagogies, teachers and students can benefit from student-centered learning approaches, deliberate practice strategies, and modeling growth mindsets to proactively challenge detrimental traditions.

Ph.D., Antioch University, 2023, Leadership and Change

This study explored the experiences of African American mental health clinicians' during the intersecting crises of the Black mental health crisis, the highly publicized racial tension tied to extrajudicial violence and over-policing of Black Americans, and the COVID-19 pandemic. The pandemic started a global crisis that affected millions of people's physical and mental health and overall well-being. Shared trauma explores the duality of mental health clinicians' personal and professional experiences. Grounded in critical race theory and models of trauma, this study explores Black mental health clinicians' lived experiences and lessons. This is an interpretive phenomenological study with narrative interviews of 10 mental health clinicians who provided services to at least 50% Black clientele before the advent of COVID-19. The study explored how Black mental health clinicians providing mental health care fared, personally and professionally, during COVID-19 and with racial upheaval: How did they adapt their lives and practices? What did they learn personally and professionally during these crises? Data were collected in individual qualitative interviews and analyzed using Saldana's first-cycle and second-cycle thematic coding model. Themes that emerged were (a) anxiety and fear regarding the unknown of COVID-19; (b) anger towards the continued racism and over-policing and killing of the Black community; (c) the importance physical activity and therapy as a clinician as means of self-care (d) connection to others to help with emotional support and the isolation of COVID-19; (e) transitioning to telehealth from in-office clinical services; (f) increase in demand of services, and (g) increase in demand for the expertise of Black clinicians, specifically. Understanding the lived experiences of Black mental health clinicians during these crises informs future practices of clinicians by teaching how to optimize health and well-being for self-care and not (open full item for complete abstract)

PHD, Kent State University, 2023, College of Education, Health and Human Services / School of Lifespan Development and Educational Sciences

The purpose of conducting this qualitative research was to investigate Middle Eastern international students' perceptions of individual mental health counseling services at their colleges/universities in the U.S. An Interpretative Phenomenological Approach (IPA) developed by Smith et al. (2009) was used to analyze the data. Six participants (three females and three males) participated in two individual interviews. Both interviews were conducted during the Coronavirus pandemic (COVID-19). Therefore, interviews were conducted via Microsoft Teams rather than in a face-to-face format to keep participants and the researcher safe. Two superordinate themes and five subthemes emerged from analyzing the data. The first superordinate theme was Mental Health Counseling Services are Unsafe to a Point. The three subthemes that emerged within the first superordinate theme were influence of cultural stigma, misinformation surrounding mental health counseling services, and mistrust related to English as a second language. The second superordinate theme was College Mental Health Counseling is Progressively Effective and Supportive. The subthemes that developed within the second superordinate theme were shifting generational perceptions of mental health counseling services and personal experiences with professional counselors.

Master of Science, The Ohio State University, 2022, Agricultural and Extension Education

This descriptive study explored the perceptions of Ohio agriscience education teachers on mental health wellness in their schools. This study will specifically focus on agricultural education teachers' perceptions, roles, and impacts of their program on student mental health wellness. The purpose of this study of this study is to explore School Based Agricultural Education teacher's perceptions of mental health among their agricultural education students. Participant data were collected from Ohio School Based Agricultural Education teachers who are currently teaching in the pathway AO Agribusiness and Production Systems. The results indicated that schools do not go beyond supporting the student within school, including their family and community, and that most teachers believe in supporting student mental health wellness. The results also indicated that teachers perceive students' mental wellness improving because of their agricultural education program. However, conflicting views were found in agricultural education teachers identifying and supporting mental wellness. Future research should seek to explore data related to mental health wellness in other pathways in agricultural education, explore how teacher education programs prepare preservice teachers to manage mental health wellness in their classrooms, explore if years of teaching experience correlates with comfort level of managing student mental health wellness in classroom, and what additional resources schools need to promote mental health wellness. The results of this study should be used in teacher preparation programs and professional development events with school district and agricultural education associations.

Specialist in Education, Miami University, 2021, Educational Psychology

Over the last decade, mental health recognition and diagnoses for children, adolescents, and adults has increased. The need for mental health related services in schools is high, however there are many identified barriers to students receiving these services. Common barriers identified in literature included both structural (e.g. insurance, communication) and perceptual (e.g. stigma, discrimination) barriers. The current study was a local mixed methods evaluation of secondary school professionals' perceptions of barriers to mental health related services in schools. School referral process and pre-collected barrier data was also examined. Both structural (e.g., insurance, caregivers) and perceptual (e.g., stigma, language/culture) barriers were indicated in the results in addition to suggestions to overcome barriers. Study limitations and implications for practice will be discussed.

Doctor of Healthcare Administration (D.H.A.), Franklin University, 2020, Health Programs

Mental illness is a growing concern among families in the United States, as one in five children between the ages of 13 and 18 suffer from a severe mental illness (National Alliance on Mental Illness, 2013). That means that 20% of children in the country are suffering from an illness whose treatment is difficult to access. Unfortunately, one-fourth of families report problems finding and initiating services for their children, with wait lists that typically start at three months (American Academy of Child and Adolescent Psychiatry, 2013). Even more troubling is the fact that 80% of children with mental illness do not receive any treatment at all (American Academy of Child and Adolescent Psychiatry, 2013). However, to improve access to treatment, organizations need to feel confident that they can open safe, financially sustainable mental health units. The Children's Hospital of Orange County (CHOC) in California recently opened an 18-bed inpatient psychiatric unit that services children ages 3-17 (Perkes, 2016). Many months of thoughtful consideration occurred to develop this elite and cutting-edge model of care. This researcher developed a specific model to approach pediatric mental healthcare through a different lens, called The Core Value Driven Care Model. The model of care is centered around three pillars of focus firmly built on the groundwork of core values. The pillars are representative of People, Place, and Practice, and are anchored in a foundation of empathy, compassion, trust, integrity, dignity, respect, sincerity, unity, honesty, and open-mindedness, as well as trauma-informed thinking. Implementing the Core Value Driven Care Model in a pediatric mental health unit directly impacts the perception of safety and quality of care being provided. The purpose of this study will be to assess the impact the 11 foundational core values have on employee perception of employee safety, patient safety, and quality of care.

Ph.D., Antioch University, 2020, Leadership and Change

Across the United States, each state has a public mental health system that is designed to support children and youth with emotional and behavioral challenges. This is critically important as recent estimates show that one in six children in the United States has a diagnosed mental health condition (Whitney & Peterson, 2019). The design and structure of these systems vary by state, but consistent across them is the presence of a state-designated leader who is faced with an array of constraining factors that influence their behavior and shape the resulting system. This study describes the experience of leaders in children's mental health administration and how they define, interpret, and perceive their current environments; the constraining factors that impact them, such as decline, instability, risk, politics, policy, and random events; and the strategies they engage in to achieve their goals. Using narrative inquiry, this study captures the experiences of ten leaders engaged in state-level children's mental health system reform. These stories paint a rich picture of the complexity of leading change in public sector environments where there is dynamic interplay across people, politics, and policy and offer new insights into effecting change in complex systems. This dissertation is available in open access at AURA: Antioch University Repository and Archive, http://aura.antioch.edu/ and OhioLINK ETD Center, https://etd.ohiolink.edu/.

Doctor of Ministry , Ashland University, 2020, Doctor of Ministry Program

The project purpose was to discover the knowledge, attitudes and actions of parishioners about ministering to the mentally ill in the Cleveland District of the AME church. A survey questionnaire, with 3 sections of 16 questions each plus an evaluation section; was distributed to AME members and clergy in the District; with 33 Black AME church members responding. The results of the project revealed that respondents know mental wellness is a vital part of overall health, mental health services are available; plus church members are willing to engage in ministries that provide mental health resources and work in support ministries.

Doctor of Philosophy, The Ohio State University, 2020, EDU Physical Activity and Educational Services

The purpose of this study is to examine the effectiveness of an educational video shown to patients during their visit with a hospital resident. The main research question examined whether a video providing education about mental health counseling, shown to patients during a medical visit, was positively correlated with patients reporting having a conversation with their doctor about mental health counseling during the medical visit. There were 147 patients in this study and 93 did not watch a video about counseling and received the standard level of care while 54 patients watched the video about mental health counseling. The study used a series of regression analysis to examine the main research questions and found a significant difference between patients who watched the video and those who did not in their reported conversations about mental health counseling with their doctor. The study also found that patients who viewed the video were more likely to have more positive attitudes towards seeking help (ATSPPH-SF). Finally, the study examined whether there were differences in outcomes for those patients who reported having a conversation with doctor and those who did not have a conversation and found those who reported having a conversation with their doctor were more likely to have lower knowledge about counseling.

MS, Kent State University, 2018, College of Arts and Sciences / Department of Computer Science

Posting on the internet, including weblogs or social media, is one of the ways individuals seek for an outlet to express themselves or mental health concerns. For many mental health issues such as psychosis, the timing of detection and treatment is critical; short and long-term outcomes are better when individuals begin treatment close to the onset of psychosis. While the internet offers a positive medium for short term therapy, it is not a face to face therapy session, wherein a trained professional is better able to deduce the root of the problem. Many clinicians are adopting electronic communication to strengthen their therapeutic alliance with their patients. The drawback of psychiatry is that it lacks objectified tests for mental illnesses that would otherwise be present in medicine. Current neuroscience has yet not found genetic markers that can characterize individual mental illnesses. A thought disorder (ThD) which is a widely found symptom in people suffering from schizophrenia, is diagnosed from the level of coherence when the flow of ideas is muddled without word associations. A system that can explore the use of speech analysis for aiding in psychiatric diagnosis is highly desirable and would help early detection and effective treatment results. This thesis introduces a framework – Prediction Onset Prediction System (POPS) - to predict the onset of psychosis based on written language habits. A scrape of a multitude of individual comments is analyzed using a trained psychosis prediction module that is able to predict if an individual is psychotic (based on the semantics) using natural language processing, machine learning techniques and a customized corpus with terms consist with psychotic language tendencies created using speech analysis techniques. The effectiveness of the corpus and its implication in psychosis detection is explored.

Doctor of Philosophy, University of Akron, 2018, Public Administration

Over the past decade, the topic of mental health on college campuses across America has gained increasing attention and invoked interest as to what institutions of higher education should do to offset what appears to be a changing shift in mental health conditions presented by students to college counseling centers. This exploratory study examines the challenges of providing mental health services to students on campuses across the United States and how it has evolved over the years. It looks to identify the type of providers utilized at counseling centers, the processes utilized at the centers for primary intake and the decision-making processes used as students enter the system. Participants in this study were requested to respond to a questionnaire that included both closed and open-ended questions and designed to obtain pertinent information to determine how counseling centers were handling the shift in mental health services. After several university counselors were consulted, a questionnaire was delivered to 213 current counseling directors across the country with 80 usable responses. Herbert Simon's decision theoretical model was used to determine how the counseling process takes place at college counseling centers. Participants in this study responded to an eight-question questionnaire, made up of four parts. The first part was to determine if the school was public or private. The second part was designed to determine the intake process and wait time at centers today. The third part was eliciting information on the use of a community provider, the level of complexity of students presenting at counseling centers today versus 10 to 15 years ago, and what barriers students are facing to receive mental health services. The fourth part of the questionnaire requested information on challenges facing counselors today and how they are working to overcome them to accommodate students as needed. Recommendations for alternative methods of improvement include: e (open full item for complete abstract)

Psy. D., Antioch University, 2015, Antioch Seattle: Clinical Psychology

The Children's Institute on Mercer Island (CHILD) is a private therapeutic day school in the Seattle area serving students in elementary and secondary education. Their stated mission is to "provide innovative school programs and therapies that promote social, emotional and academic development for children with special needs." In the fall of 2012 they engaged in a program evaluation that in many respects resembles a needs assessment in order to explore and improve aspects of their functioning. Through preliminary evaluation processes, including dialogue with CHILD's Leadership Team and a survey of internal stakeholders, an area of interest in student mental health was uncovered and an initial evaluation question emerged: "How does CHILD claim expertise, particularly in the area of mental health?" Historically, evidence of CHILD's impact in this regard has been largely anecdotal. Aside from a limited collection of behavioral data pertaining largely to IEP goals and objectives, CHILD does not track mental health, or long-term student outcomes. As a program interested in its own claims to "expertise," members of the Leadership Team and other stakeholders have called for improved data collection in this regard. This program evaluation is an attempt to understand the types of data that would be most useful to CHILD's interest in expertise and then design a program for tracking this data. Bronfenbrenner's (1994) ecological model was used as a framework for guiding data collection, the results of which are synthesized and integrated into a series of recommendations constituting the final results of the project. This dissertation is available in open access at AURA, http://aura.antioch.edu/ and Ohio Link ETD Center, https://etd.ohiolink.edu/etd

EdD, University of Cincinnati, 2014, Education, Criminal Justice, and Human Services: Counselor Education

This dissertation evaluated the impact of a professional training opportunity on childhood anxiety on knowledge and confidence for educators of elementary school-age children. Previous research has shown that training sessions improve teacher preparation for coping with and assisting children with mental health care needs in the classroom. One of the most common behavioral and emotional concerns among children in schools is anxiety. Educators report a lack of knowledge on childhood anxiety and a lack in confidence on strategies to intervene. The purpose of the current project was to present a training session on management of child anxiety in the classroom and evaluate teacher perceptions of change in knowledge of and confidence for assisting children with anxiety. Twenty-five educators in a North College Hill elementary school, serving primarily children who are African American and residing in low-income families participated in a professional development training session. They rated change in knowledge and confidence for working with children as well as their satisfaction with the training session. Findings indicated an increase in knowledge and confidence post-training as well as high satisfaction with the training. Educators reported new knowledge and implementation of strategies into the classroom environment. Educators reported a desire for continued psycho-educational workshops focusing on childhood mental health concerns. Future research should examine utilizing workshops or trainings with larger sample sizes in multiple school districts and assess for possible change in teacher behaviors in the classroom.

Master of Social Work, The Ohio State University, 2008, Social Work

To help children achieve academic success and healthy youth development, new models of school improvement must include effective methods to address mental health needs. To improve the implementation of school mental health approaches, this thesis had two main goals: (1) To determine any relationships between educator stress, professional support, teaching self-efficacy, and perceptions of student mental health needs and educators' readiness to adopt school mental health approaches; and, (2) To determine if educator stress is moderated by professional support, teaching self-efficacy, or perceptions of student mental health needs to predict educators' readiness to adopt school mental health approaches. This study used hierarchical regression to analyze primary data from 122 educators. Results indicated that educator stress was the greatest predictor of educator readiness to adopt school mental health approaches. Teaching self-efficacy and perceptions of student mental health needs also were related to readiness to adopt school mental health approaches.