14Dissertation ProspectusFactors Influencing.docx

14
Dissertation Prospectus
Factors Influencing Individuals' Decision to not Utilize Mental
Health in Fort-Bend County, Texas. Comment by
Reviewer: James, Usually, we do not include the actual name of
the county or state. Just say mental health services in one
county located in a southern state. You need to make sure you
establish that this problem exists outside of this one county in
Texas. You need to include the sample in the problem, purpose
and RQs. Cite the theory you are using from the seminal source,
which would be Bandura or Vygotsky. I provided a problem,
purpose and RQ. You need at least 2 questions. See comments.
Submitted by
James Dada
November 20, 2019
The Prospectus Overview and Instructions
Prospectus Instructions:
1. Read the entire Prospectus Template to understand the
requirements for writing your prospectus. Each section contains
a narrative overview of what should be included in the section
and a table with required criteria for each section. WRITE TO

THE CRITERIA, as they will be used to assess the prospectus
for overall quality and feasibility of your proposed research
study.
2. As you draft each section, delete the narrative instructions
and insert your work related to that section. Use the criterion
table for each section to ensure that you address the
requirements for that particular section. Do not delete/remove
the criterion table as this is used by you and your committee to
evaluate your prospectus.
3. Prior to submitting your prospectus for review by your chair
or methodologist, use the criteria table for each section to
complete a realistic self-evaluation, inserting what you believe
is your score for each listed criterion into the Learner Self-
Evaluation column. This is an exercise in self-evaluation and
critical reflection, and to ensure that you completed all sections,
addressing all required criteria for that section.
4. The scoring for the criteria ranges from a 0-3 as defined
below. Complete a realistic and thoughtful evaluation of your
work. Your chair and methodologist will also use the criterion
tables to evaluate your work.
5. Your Prospectus should be no longer than 6-10 pages when
the tables are deleted.
Score
Assessment
0
Item Not Present
1
Item is Present. Does Not Meet Expectations. Revisions are
Required: Not all components are present. Large gaps are
present in the components that leave the reader with significant
questions. All items scored at 1 must be addressed by learner
per reviewer comments.
2
Item is Acceptable. Meets Expectations.Some Revisions May Be
Required Now or in the Future. Component is present and

adequate. Small gaps are present that leave the reader with
questions. Any item scored at 2 must be addressed by the
learner per the reviewer comments.
3
Item Exceeds Expectations. No Revisions Required. Component
is addressed clearly and comprehensively. No gaps are present
that leave the reader with questions. No changes required.
Dissertation Prospectus
Introduction
According to the Substance Abuse and Mental Health Services
Administration (SAMHSA), the Centers for Disease Control and
Prevention (CDC) and the U.S. Department of Justice, every
year in the United States, millions of people suffer from mental
illness. The numbers are significantly high that it requires
raising public awareness and start campaigning for a much
better health care system. In 2018, 47.6 million people in the
U.S. experienced mental illness. This means 1 in every 5 adults.
11.4 million adults between ages 25 and 35 had an episode of
serious mental illness. In 2016, 7.7 million youths aged 6-17
experienced some sort of mental health disorder, while 9.2
million people were reported to have experienced substance use
disorder (National Alliance on Mental Illness, 2019).
Comment by Reviewer: Left justify your work.
Comment by Reviewer: Read and revise Comment by
Reviewer: Fragment.
The health sector in Texas has been applauded for the good
work in health allocations and expenditures. Fort Bend county,

which is located within Texas, has also been on the map for
having the best medical services in the country. Despite all the
expenditures and better services offered to the people living in
the county, Mental health sector still faces challenges. Research
has shown that many Asian and African American people living
in Fort Bend has little to no access and utilization of mental
health services within the region (Texas 2017). This has been
attributed to a number of factors which hinder most people from
accessing mental health services. The poor access to this
medical help has led to many people dying and committing
suicide as a result of poor utilization of mental illness health
services. Comment by Reviewer: This is good information, but
we also need to establish that the need for this study exists
outside of this county and outside of Texas. Can you do that
here? Comment by Reviewer: Is this a peer-reviewed
research source? Please be sure and include results of at least 3-
5 studies in this section to establish that a problem exists.
Comment by Reviewer: Ok, this is contradictory. You just
said that Fort Bend has the best services in the country?
Fort Bend County in Texas has been recognized as one of the
counties where the utilization of mental health facilities is
below the expected standards. Although the Fort Bend County is
one of the areas with the highest and the best health facilities
within Texas, the county still faces a lot of challenges on the
number of children with mental health challenges. The study
will be conducted on the affected people who the African
Americans, Asian Americans and the Caucasian citizens of Fort
Bend County, Texas. Comment by Reviewer: Ok, based on
the results of what studies on the topic?
The high mental health cases in Fort Bend County in Texas is
blamed on various factors. One of the factors is the lack of
enough and well-trained mental health professionals within the
county. Such has resulted to lack of utilization of the mental
health facilities hence the rising number of mentally challenges
children. Poverty levels in the county have also been blamed for
the increased number of mentally challenges children. Most of

the people in the Fort Bend County have low income and cannot
afford insurance hence lacking the access to mental healthcare.
Care givers in the mental healthcare clinics in Fort Bend, agreed
that many people in the county laced knowledge about the
mental healthcare because of their low social status within the
Fort Bend County. Also, they acknowledged that they lacked
enough knowledge about the importance of mental healthcare.
This paper is aimed at discussing the factors influencing
individuals' decision not to utilize mental health services in
Fort-Bend County, Texas. The study is important in
understanding the major reasons which limit utilization of
mental health services in the county and recommending ways
through which the issues can be resolved. Comment by
Reviewer: This is a research study.
Criteria
Learner Self-Evaluation Score
(0-3)
Chair Evaluation Score
(0-3)
Reviewer Score
(0-3)
Introduction
This section briefly overviews the research focus or problem,
why this study is worth conducting, and how this study will be
completed.
The recommended length for this section is two to three
paragraphs.
1. Dissertation topic is introduced along with why the study is
needed.
2. Provides a summary of results from the prior empirical
research on the topic. Comment by Reviewer: We have no
results of studies on the topic; therefore, we have no gap. You

need to show that this problem exists across the United States,
not just in this one county in Texas.
3. Using results, societal needs, recommendations for further
study, or needs identified in three to five research studies
(primarily from the last three years), the learner identifies the
stated need, called a gap. Comment by Reviewer: missing
4. Section is written in a way that is well structured, has a
logical flow, uses correct paragraph structure, uses correct
sentence structure, uses correct punctuation, and uses correct
APA format.
NOTE: This Introduction section elaborates on the Topic from
the 10 Strategic Points. This Introduction section provides the
foundation for the Introduction section in Chapter 1 of the
Proposal.
Reviewer Comments:
Background of the Problem
Previous research works have explored the field of health
accessibility not only in Texas but throughout the country.
When narrowing downne to Fort bend in Texas, research has
shown a gap alignment of medical services and needs of the
people living in the county. Children at Risk (2013) deliberates
on various increasing children with mental disorders’ needs in
the society. Most of these develop mental illness from birth.
Though Fort Bend has been applauded for having the best health

services, the area still faces a number of challenges which are a
threat to the child-health. Access to mental health is a gap yet
to be filled in Fort bend (Beatty, Wilson, Ciecior, & Stringer,
2015). This has been fueled by few mental health professionals
in Texas which has led to poor infrastructure in the mental
health sector. The sectors greatly affected are the juvenile
systems and emergency facilities. Many people in the region are
uninsured and also have lower income which makes it had for
them to get mental health services. In addition, poor parenting
was a great contributor of health illness. This calls for further
research into the field to understand more factors which affect
the utilization of mental-health services in the areas not only in
children but all people of Fort bend in Texas. Comment by
Reviewer: this is six years old.
Goldman Robin & Chester (2018) argues that mental health
accessibility is an issue of concern among the healthcare
industry in Texas. The article carried a research to evaluate the
factors which affect medical accessibility with specification of
Hispanic and black Americans living in Texas. The results of
the research indicated that lack of education in mental health
was a major factor that affected the utilization of Mental health
within the region. This has increased the deaths resulting from
mental cases in the region. 56% of all the population received
mental health treatment. Out of the total percentage women
formed the highest number with those who had been sexually
abused at their young age forming many of the women.
However, due to poor education on mental health programs the
treatment was under-utilized, and target groups were not
sufficiently reached in the community. Comment by
Reviewer: Ok, this is a research study. However, be clear that
this was done with American Indian men and women. The
company that sponsored this study was: Laboratory of
Neurogenetics, National Institute on Alcohol Abuse and
Alcoholism, Rockville, MD, USA.

So you are saying that this study was done in Texas? This was a
quantitative study: This study investigated the effects of gender,
number of lifetime psychiatric diagnoses, and childhood
victimization on utilization of mental health and substance
abuse treatment services in a Southwestern American Indian
tribe.
Correctly attribute your work. Comment by Reviewer: What
region? I can’t access the full text of this study. Comment by
Reviewer: Read your work carefully.
Similarly, in their 2015 research analysis, Augsberger, Yeung,
Dougher, & Hahm (2015), analyzed the hidden barriers to
accessing care and utilization of mental health for Asian
American Women in the Fort-Bend County of Texas. It showed
that 299 women representing 43% of the survey participants
have suffered from symptoms of depression or have had suicidal
attempts. It examined the mismatch between available services
and cultural needs, contribution of Asian society to mental
health and contribution of Asian family to the stigma of mental
health. Comment by Reviewer: This study is not in your
reference list. Comment by Reviewer: What was the purpose of
the survey?
Hamilton, Desai, Hoot, Gearing, Jeong, Meyer, & Begley
(2016), did research on the factors that affect mental healthcare
access among African Americans. They identified one of the
reasons to be low income and lack of awareness about the
existing institutions that offer mental healthcare. Augsberger,
Yeung, Dougher, & Hahm (2015), identified further issues that
affect the accessibility of mental healthcare among Asian
American women in Fort Bend County. Accordingly, the authors
concluded in their research that the Asian American women are
suffering from depression and often were faced with the
thoughts of suicide. According to the authors, Asian American
women were stigmatized because of the mental health issues,
and most of them do not want to come out and seek treatment.
Misra, S. M., Guffey, D., Roth, I., & Giardino, A. P. (2017) in

their article “Complementary and Alternative Medicine use in
Uninsured Children in Texas”, the authors describe the concept
relating to the use of complementary and alternative medicine
(CAM) for mental health treatment among children in Southern
Texas. According to the authors, CAM use among US children
stands at 12%. According to the 2012 National Health Interview
Study. The research suggests that there are a number of
uninsured population due to their limited access to care, which
resulted in higher CAM use. A survey of 250 uninsured patients
at various pediatric facilities in a free mobile clinic program
showed a very high use by Hispanic population, their rate of
CAM use in the last 12 months was close to 50% among
children and 60% among parents. Southern Texas has placed a
lot of effort into improving the health care treatment of
children; according to that 2012 research report conducted a
study National Health Interview Study. Research study suggests
that facilities that the services offered are inversely
proportional to the allocation provided. Misra and the rest have
concluded that this issue has raised a lot of concern since the
mental health of the people remain to be very low despite the
efforts implanted. Research showed that some institutions have
released a lot of funds to run this sector. This research also
showed that Sothern Texas receive the second largest allocation
for mental health.
The gap identified for research in this paper is the factors that
affect the utilization of Mental health facilities within Fort
Bend County. Various people within the mental healthcare
profession have done research on some factors that may deter
people from receiving mental healthcare. The literature on the
mental health gap in Fort Bend, Texas, has revealed major
reasons as to why the gap exists. Stigmatization and low income
are some reasons as to why the gap exists in Fort bend County,
Texas. Comment by Reviewer: Ok, you need to better
explain the factors... these studies do not necessarily do that ..
build an argument for the need for the study.

Criteria
(0-3)
Chair or Score
(0-3)
Reviewer Score
(0-3)
Background of the Problem
This section uses the literature to provide the reader with a
definition and statement of the research gap and problem the
study will address. This section further presents a brief
historical perspective of when the problem started and how it
has evolved over time.
The recommended length for this section is two-three
paragraphs.
1. Includes a brief discussion demonstrating how literature has
established the gap and a clear statement informing the reader
of the gap.
1
2. Discusses how the “need” or “defined gap” has evolved
historically into the current problem or opportunity to be
addressed by the proposed study (citing seminal and/or current
research).
1
3. ALIGNMENT: The problem statement for the dissertation
will be developed from and justified by the “need” or “defined
gap” that is described in this section and supported by the
empirical research literature published within the past 3-5 years.
2

APA format.
2
NOTE: This Background of the Problem section uses
information from the Literature Review in the 10 Strategic
Points. This Background of the Problem section becomes the
Background of the Study in Note, this section develops the
foundation for Chapter 1 in the Proposal. It is then expanded to
develop the comprehensive Background to the Problem section
and Identification of the GAP sections in Chapter 2 (Literature
Review) in the Proposal.
Reviewer Comments:
Theoretical Foundations/Conceptual Framework and Review of
the Literature/Themes
Theoretical literature
There is the need to understand the consequences of not
utilizing mental health as it evolved historically. Mental health
services in Texas has faced several challenges. Texas (2017)
asserts that people suffering from mental illness still faces
problems despite the huge costs that are directed towards the
healthcare. Schwartz, (2017) in support of Texas argue that the
increased growth-rate of populations in Fort Bend has impacted
the health sector at large. The high population together with
economic constrains has led to few medical insurances which
limits access to health. The access and utilization to mental
medical care for the populations living in Fort Bend has created
a gap within the county (Children at Risk, 2013).
Review of the Literature
Empathic Approach: Emphasized the issues of underutilized

mental health resources and non-institutionalized adults as
behavioral risk factors in Southern Texas. Comment by
Reviewer: Not following you here. What approach?
(Augsberger, Yeung, Dougher, & Hahm, 2015; Basu, Rehkopf,
Siddiqi, Glymour, & Kawachi, 2016; De Luca, Blosnich,
Hentschel, King, & Amen, 2016; Hamilton, Desai, Hoot,
Gearing, Jeong, Meyer, & Begley, (2016).
Augsberger, Yeung, Dougher, & Hahm (2015) identified various
issues such as the history of suicide thoughts and depression
among the Asian American women, different cultural needs in
Fort Bend County, Texas.
It was identified that there are certain factors that influence the
underutilization of mental health services among Asian
American women with a history of depression and suicide in
Fort-Bend County. There is also a mismatch between available
services and cultural needs, contribution of Asian society to
mental health and contribution of families to the stigma of
mental health. It concluded and recommended that mental health
utilization should not be low among all the cultures, but rather
extremely encouraged especially among women in the county
(Augsberger, Yeung, Dougher, & Hahm, 2015).
Boyer, C., Greenberg, L., Chutuape, K., Walker, B., Monte, D.,
Kirk, J., & Ellen, J. (2017). Exchange of sex for drugs or money
in adolescents and young adults: An examination of
sociodemographic factors, HIV-related risk, and community
context. Journal of Community Health, 42(1), 90-100.
doi:10.1007/s10900-016-0234-2
The purpose of this article is to carry out an assessment on
maternal health and the wellbeing of the child and how it
contributes to long term mental health. It mainly focuses on the
anal stage especially when the child is born. It lays an emphasis
on ensuring an understanding of basic but critical pediatric care.
It resulted that the hospital was able to ensure that it provides
the pediatric care to the critical patients for 24 hours before and
after birth. This is to make sure that young and divorced
mothers know how to navigate and ensure the provision of

proper mental care. Recommendations includes providing
classes and courses that to the main practitioners on how to
handle new parents and how to guide them into providing the
required help to the children who are ill.
Goldman D., Robin R. W. & Chester B. (2018), Factors
Influencing Utilization of Mental Health and Substance Abuse
Services by American Health Institutions
The purpose of this article is to study the impact that gender,
the number of childhood victimization and psychiatric
diagnoses has on the utilization of mental health patients in the
Southwestern American Indian community. In its outcome and
recommendations, the article declares these factors as the main
contributors in the utilization of the substance abuse and mental
health when one is coming up with proper treatment
interventions.
Schwartz, A. (2017). A report on the demographic changes and
changing needs of fort bend county University of Texas at
Austin. doi:10.15781/T2MC8RZ1M
Ariel and Peter give an analysis how population growth has
affected the health status of people living in Fort Bend, Texas.
There have been different studies conducted to indicate the
mental status of individuals living within the country. In the
outcome of the research, this article laid emphasis on the fact
that many people in the population are uninsured, and that the
economic challenges that the large population is experiencing is
responsible in part for what is influencing individuals' decisions
to not utilize Mental Health and the extent to which the
community healthcare extends its services to every member.
Recommendations include training and mentioning healthcare
providers and caregivers on improvements that need to be done
continually to ensure that the different needs of the growing
population are met.
Literature Themes
Review of the literature review identified the following themes:
· Lack of proper mental health education and infrastructure has
been the major factor affecting the utilization of mental health.

Goldman Robin & Chester (2018) in his research found out that
women who had been exposed to sexual abuse and drug abuse
formed the high numbers of people who utilized mental health
services among the Hispanic and non-white people in Texas.
Augsberger, Yeung, Dougher, & Hahm, (2015) in support of
this research argued that mental health services had been
underutilized by Asian women living in fort-bend as a result of
both cultural needs and mismatch of the services offered in the
health facilities in Texas.
· Lack of medical insurance. Research has shown that many
people due to poor economic status has left many people
without health insurance as they cannot afford. This limits many
average and lower-class families from accessing mental illness
services (Children at Risk, 2013).
· Poor perception among the community members. Researchers
reveals that many people who live in Fort Bend perceive child
mental illness as a mere sign of hunger besides poor diets. This
has left many people neglecting utilization of mental-healthcare
in the community (Children at Risk, 2013).
The theoretical model for the research gap is the Social
Development Theory. The Social Development theory is a
theory done by De Luca et. al. Within the theory, the authors
propose that unfavorable social conditions and chronic health
issues have a role that they play in promoting mental health
issues within a certain category of people. The authors made a
comparison between the utilization of the mental health
conditions between the African Americans, Asian Americans
and the Caucasians in the Fort Bend County, Texas.
Comment by Reviewer: Hmmm. Why don’t you try
Vygotsky.... use the seminal source. I could not find these
authors. Plus, you have no date here, so it is hard to tell if this
is a seminal source. Comment by Reviewer:
Criteria
(0-3)
Chair or Score

(0-3)
Reviewer Score
(0-3)
Theoretical Foundations and/or Conceptual Framework
This section identifies the theory(s) or model(s) that provide the
foundation for the research. This section should present the
theory(s) or models(s) and explain how the problem under
investigation relates to the theory or model. The theory(s) or
models(s) guide the research questions and justify what is being
measured (variables) as well as how those variables are related
(quantitative) or the phenomena being investigated (qualitative).
Review of the Literature/Themes
This section provides a broad, balanced overview of the existing
literature related to the proposed
research topic. It describes the literature in related topic areas
and its relevance to the proposed research topic findings,
providing a short 3-4 sentence description of each theme and
identifies its relevance to the research problem supporting it
with at least two citations from the empirical literature from the
past 3-5 years.
The recommended length for this section is 1 paragraph for
Theoretical Foundations and a bulleted list for Literature
Themes section.
1. Theoretical Foundationssection identifies the theory(s),
model(s) relevant to the variables (quantitative study) or
phenomenon (qualitative study). This section should explain
how the study topic or problem coming out of the “need” or
“defined gap” in the as described in the Background to the
Problem section relates to the theory(s) or model(s) presented in
this section. (One paragraph)
1
2. Review of the Literature Themes section: This section is a

bulleted list of the major themes or topics related to the
research topic. Each theme or topic should have a one-two
sentence summary.
1.5
3. ALIGNMENT: The Theoretical Foundations models and
theories need to be related to and support the problem statement
or study topic. The sections in the Review of the Literature are
topical areas needed to understand the various aspects of the
phenomenon (qualitative) or variables/groups (quantitative)
being studied; to select the design needed to address the
Problem Statement; to select surveys or instruments to collect
information on variables/groups; to define the population and
sample for the study; to describe components or factors that
comprise the phenomenon; to describe key topics related to the
study topic, etc.
1.5
APA format.
1
NOTE: The two parts of this section use information about the
Literature Review and Theoretical Foundations/Conceptual
Framework from the 10 Strategic Points.
This Theoretical Foundations section is expanded upon to
become the Theoretical Foundations section in Chapter 2
(Literature Review). The Theoretical Foundations and the
Literature Review sections are also used to help create the
Advancing Scientific Knowledge/Review of the Literature
section in Chapter 2 (Literature Review).

Reviewer Comments:
Problem Statement
It is not known what is influencing individuals' decision to not
utilize mental health in Fort Bend County, Texas. It is not
known how mental health providers describe the factors
influencing individuals’ decision to not utilize mental health in
one county located in a southern state. The research topics seek
to identify the key issues that prevent the people of Fort Bend
County, Texas from utilizing the mental health services and
facilities yet, although, there are increasing mental health cases
among the children in Fort Bend County, Texas. Comment by
Reviewer: Ok, you mentioned earlier that you were looking at a
specific set of individuals. First, you need to show that they are
not using health services in Texas.
This problem will target, address and serve as a model of
investigating factors that affect utilization of mental health in
the County ofThe population of interest is...
Fort Bend, Texas. The study plans to use qualitative-
descriptive-research design in carrying out the study.
Criteria
(0-3)
Chair or Score
(0-3)
Reviewer Score
(0-3)
Problem Statement
This section includes the problem statement, the population
affected, and how the study will contribute to solving the
problem.
The recommended length for this section is one paragraph.
1. States the specific problem proposed for research with a clear
declarative statement.
1

Describes the population of interest affected by the problem.
The general population refers to all individuals that could be
affected by the study problem. Comment by Reviewer:
missing
1
Describes the unit of analysis. Comment by Reviewer:
missing
For qualitative studies this describes how the phenomenon will
be studied. This can be individuals, group, or organization
under study.
For quantitative studies, the unit of analysis needs to be defined
in terms of the variable structure (conceptual, operational, and
measurement).
1
Discusses the importance, scope, or opportunity for the problem
and the importance of addressing the problem.
1
The problem statement is developed based on the need or gap
defined in the Background to the Study section.
2
Section is written in a way that is well structured, has a logical
flow, uses correct paragraph structure, uses correct sentence
structure, uses correct punctuation, and uses correct APA
format.
1

NOTE: This section elaborates on the Problem Statement from
the 10 Strategic Points. This section becomes the foundation for
the Problem Statement section in Chapter 1 and other Chapters
where appropriate in the Proposal.
Reviewer Comments:
Purpose of the Study
The purpose of this qualitative, descriptive study is to
explore how mental health providers describe the factors
influencing individuals’ decision to not utilize mental health in
one county located in a southern state. The purpose of the study
is to come with the factors that deter the people of Fort Bend
County from accessing the much-needed mental healthcare. The
study will employ a qualitative study that will target the
specific people within Fort Bend County who have mental
challenges and yet cannot utilize the mental facilities available
at Fort Bend County.
Qualitative descriptive study aims at finding out the factors that
affect mental health utilization in Fort bend, Texas. The study
will go ahead to come up with recommendation on how to
improve the mental health accessibility in the county.
Criteria
(0-3)
Chair or Score
(0-3)
Reviewer Score
(0-3)
PURPOSE OF THE STUDY
This section reflects what the study is about, connecting the
problem statement, methodology & research design, target
population, variables/phenomena, and geographic location.
1. Begins with one sentence that identifies the research

methodology and design, target population, variables
(quantitative) or phenomena (qualitative) to be studied and
geographic location.
1
Quantitative Studies: Defines the variables and relationship of
variables.
Qualitative Studies: Describes the nature of the phenomena to
be explored. Comment by Reviewer: missing
1
format.
1
NOTE: This section elaborates on information in the Purpose
Statement from the 10 Strategic Points. This section becomes
the foundation for the Purpose of the Study section in Chapter 1
and other Chapters where appropriate in the Proposal.
Reviewer Comments:
Research Questions and/or Hypotheses
The study is going to be a qualitative descriptive study that will
involve psychiatrists, therapists, caregivers and service
providers' descriptions of what and why they feel people are not
accessing mental health services and what must be done to
change their behavior towards accessing the services. It entails
utilizing interviews to collect data and to understand how
successful it will be if professionals are learning more about the
Fort Bend communities, and how they can contribute to
improved learning outcomes.

Research questions
How do mental health providers describe factors influencing
individuals’ decision to not utilize mental health in one county
located in a southern state?
· RQ1. How much higher is the cost for mental health care in
the county compared to the rest of Southern Texas?
Comment by Reviewer: these are not research questions.
These are more items that you might cover in your literature
review.
· RQ2. What is the average expenditure per adult enrollee in the
area for mental health care?
· RQ3. Do the facilities offer state-of-the-art treatments using
research and discoveries in the field of mental health?
· RQ4. What is the average number of mental health admissions
and lengths of stay at behavioral hospitals?
· RQ5. Is there a statistically significant difference in the level
of utilization of mental health among the different cultures?
· RQ6. Is there a statistically significant difference in the
number of isolations of behavioral hospitals
Criteria
(0-3)
Chair Score
(0-3)
Reviewer Score
(0-3)
Research Question(s) and/or Hypotheses
· The recommendation is a minimum of two research questions
along with related hypotheses and variables is required for a
quantitative study.
· Also recommended is a minimum of two research questions
along with the phenomenon description is required for a
qualitative study.
· Put the Research Questions in the appropriate Table in
Appendix B based on whether the study is qualitative or
quantitative.

The recommended length for this section is a list of research
questions and associated hypotheses (quantitative)
1. Qualitative Studies: States the research question(s) the study
will answer and describes the phenomenon to be studied.
Quantitative Studies: States the research questions the study
will answer, identifies and describes the variables, and states
the hypotheses (predictive statements) using the format
appropriate for the specific design and statistical analysis.
2
Alignment: The research questions are based on both the
Problem Statement and Theoretical Foundation model(s) or
theory(s). There should be no research questions that are not
clearly aligned to the Problem Statement.
2
format.
2
NOTE: This section elaborates on the information about
Research Questions) & Hypothesis/variables or Phenomena
from the 10 Strategic Points. This section becomes the
foundation for the Research Question(s) and/or Hypotheses
section in Chapter 1 in the Proposal.
Reviewer Comments:
Advancing Scientific Knowledge and Significance of the Study
The major objective of any health sector is to improve
healthcare for the citizens regardless of the sickness. Fort Bend
has devoted a large share of its finances towards healthcare

which has seen it shine on the national map. Despite this effort,
statistics show that mental health accessibility in the county is
still very low. This has been evidenced by numerous research
findings. Lack of Insurance, professionals, infrastructure and
education has been theorized as major sources of the problem.
This project through qualitative descriptive research aims at
finding the factors that affect utilization of mental healthcare
and recommend better ways through which mental health
utilization can be improved in the county. Comment by
Reviewer: How will the results add to the results of other
studies?
how will the results be of value to practitioners and society?
How will results add to the knowledge of social learning
theory?
Criteria
(0-3)
Chair Score
(0-3)
Reviewer Score
(0-3)
ADVANCING SCIENTIFIC KNOWLEDGE and
SIGNIFICANCE OF THE STUDY
This section reiterates the gap or need in the literature and
states how the study will address the gap or need and how the
research will contribute to the literature, practical implications
to the community of interest, and alignment with the program of
study.
The recommended length for this section is one to two
paragraphs, providing a brief synopsis of each criteria listed
below which will be expanded in the proposal.
1. Clearly identifies the “gap” or “need” in the literature that
was used to define the problem statement and develop the
research questions. (citations required)
2

Describes how the study will address the “gap” or “identified
need” defined in the literature and contribute to /advance the
body of literature. (citations required)
2
Describes the potential practical applications from the research.
(citations required)
2
Identifies and connects the theory(ies) or model(s) that provide
the theoretical foundations or conceptual frameworks for the
study. (citations required)
2
format.
2
NOTE: This section builds on information about the Literature
review and Theoretical Foundations sections in the 10 Strategic
Points. This section becomes the foundation for the Theoretical
Foundations section in Chapter 2
Reviewer Comments:
Rationale for Methodology
The most appropriate methodology that will be used in
answering the research questions, and which will also address

the problem statement is a qualitative descriptive methodology
(Colorafi, & Evans, 2016). The qualitative approach is very
effective when a phenomenon that is being queried is properly
and effectively defined, and this study has distinctly defined the
phenomena of factors influencing individuals' decision to not
utilize Mental Health in Fort-Bend County, Texas. The
methodology is preferred as it is flexible when researching on
health science topic to support various medical theories. This
will support the research in finding and filling the gap in the
study. Comment by Reviewer: No, it does not. See the
classroom assessment technique I posted in class. I gave you all
a list of criteria or attributes to use here.
Criteria
(0-3)
Chair or Score
(0-3)
Reviewer Score
(0-3)
Rationale for Methodology
The Rationale for Methodology section clearly justifies the
methodology the researcher plans to use for conducting the
study. It argues how the methodological choice (quantitative or
qualitative) is the best approach to answer the research
questions and address the problem statement. Finally, it
contains citations from textbooks and articles on research
methodology and/or articles on related studies to provide
evidence to support the argument for the selected methodology.
1. Identifies the specific research methodology for the study.
2
Justifies the methodology to be used for the study by discussing

why it is an appropriate approach for answering the research
question(s) and addressing the problem statement.
Quantitative Studies: Justify in terms of problem statement and
the variables for which data will be collected.
Qualitative Studies: Justify in terms of problem statement and
phenomenon.
2
Uses citations from seminal (authoritative) sources (textbooks
and/or empirical research literature) to justify the selected
methodology. Note:Introductory or survey research textbooks
(such as Creswell) are not considered seminal sources.
2
format.
2
NOTE: This section elaborates on the Methodology and Design
in the 10 Strategic Points.This section becomes the foundation
for the Research Methodology in Chapter 1 of the Proposal and
the basis for developing Chapter 3, Research Methodology.
Reviewer Comments:
Nature of the Research Design for the Study
The design for this piece of research work will be a qualitative
descriptive study that is aimed at identifying the specific issues
that are deterring utilization of mental healthcare facilities in
Fort Bend County, Texas. This method applies the description
of the factors in play and how they affect the outcome. This
technique is best suited for the research as it will provide a
description of factors limiting utilization of mental healthcare

in Fort Bend. Comment by Reviewer: Missing the attributes of
descriptive design and how they align with the problem.
The target population for this research will be 70
respondents, while the respondents will be chosen from Fort
Bend, which will include caregivers, psychiatrists, therapists,
and service providers' that will form the sample population.
Study area for the research will be schools, hospitals, doctors’
offices and counseling facilities within Fort Bend. The data
collection will be collected in a period of three weeks with each
respondent given 30 minutes for the interview and filing the
questionnaire. After the exercise, the questionnaires and all
research materials will be coded. The phenomenon under testing
is factors influencing individuals' decision to not utilize Mental
Health in Fort-Bend County, Texas. Comment by
Reviewer: How did you determine this? Ok, if you are using
caregivers as a sample, then that needs to be in your problem
and purpose. Comment by Reviewer: Semistructured
interviews must be the primary source of data in a GCU
qualitative study.
Criterion Score
(0-3)
Chair or Score
(0-3)
Reviewer Score
(0-3)
Nature of the Research Design for the Study
This section describes the specific research design to answer the
research questions and why this approach was selected. Here,
the learner discusses why the selected design is the best design
to address the problem statement and research questions as
compared to other designs. This section contains a description
of the research sample being studied, as well as, the process that
will be used to collect the data on the sample.

The recommended length for this section is two to three
paragraphs and must address each criterion.
1. Identifies and describes the selected design for the study.
Comment by Reviewer: Describe the design and tell how
specific attributes align with the design.
2
Justifies why the selected design addresses the problem
statement and research questions.
Quantitative Studies: Justifies the selected design based on the
appropriateness of the design to address the research questions
and data for each variable.
Qualitative Studies: Justifies the selected design based on
appropriateness of design to address research questions and
study the phenomenon.
1
Briefly describes the target population and sample for the study.
Comment by Reviewer: missing
2
Identifies the sources and instruments that will be used to
collect data needed to answer the research questions.
1
Briefly describes data collection procedures to collect data on
the sample.
2

format.
2
NOTE: This section also elaborates on the Design portion of the
Methodology and Design section in the 10 Strategic Points. This
section provides the foundation for Nature of the Research
Design for the Study in Chapter 1.
Reviewer Comments:
Research Materials, Instrumentation, OR Sources of Data
The study will utilize both unstructured and structured
questionnaires in addition to face-face interviews for the
research. Tools will be used in collecting primary data, while
the selected group will be composed of schools besides
hospitals. Furthermore, the research will take note of the factors
that interviewees think can improve the mental health
accessibility in the country. Comment by Reviewer:
interviews.. and one questionnaire. What is the name of that
questionnaire and what RQ will it address?
Criterion Score
(0-3)
Chair or Score
(0-3)
Reviewer Score
(0-3)
RESEARCH MATERIALS, INSTRUMENTATION, OR
SOURCES OF DATA
This section identifies and describes the types of data that will
be collected, as well as the specific research materials,
instruments, and sources used to collect those data (tests,
surveys, validated instruments, questionnaires, interview
protocols, databases, media, etc.).

paragraphs. Note: this section can be set up as a bulleted list.
Quantitative- Instruments/Research Materials:
Provides a bulleted list of the instrumentation and/or materials
for data collection.
Describes the survey instruments or equipment/materials used
(experimental research), and specifies the type and level of data
collected with each instrument.
Includes citations from original publications by instrument
developers (and subsequent users as appropriate) or related
studies.
1
Qualitative - Sources of Data:
Describes the structure of each data collection instrument and
data sources (tests, questionnaires, interview protocols,
observations databases, media, etc.).
1
format.
1
NOTE: This section elaborates on the Data Collection from the
10 Strategic Points.
This information is summarized high level in Chapter 1 in the
Proposal in the Nature of the Research Design for the Study
section. This section provides the foundation for Research
Materials,Instrumentation (quantitative) or Sources of Data
(qualitative) section in Chapter 3.
Reviewer Comments:Data Collection
Approval from the University will be sought before starting the
process of data collection. The dissertation will collect

information from a selected group of patients to provide
primary data. Data collection will only start after the candidates
must have acknowledged and signed the consent form. It will be
collected systematically in a way that begins with schools,
interview with caregivers and service providers', interview with
psychiatrists and therapists and hospitals. The process will be as
follows: Comment by Reviewer: Site authorization? Informed
consent? Field test of interview? How will you schedule the
interviews? How will they get the questionnaire?
· Five respondents from 10 schools, hospitals, hospitals will be
given questionnaires to fill be three researchers.
· Interviews will involve five respondents from every hospital
and school within the county.
· Respondents will respond to both interviews and both types of
questionnaires.
· Manual coding will be done to all collected data.
· Data will be checked for any errors by both parties before
further processing.
· Data will be entered into SciLab for analysis.
Criteria
(0-3)
Chair or Score
(0-3)
Reviewer Score
(0-3)
DATA COLLECTION AND MANAGEMENT
This section details the data collection process and procedures
so that another researcher could conduct or replicate the study.
It includes authorizations and detailed steps.
The recommended length for this section is a bullet or numbered
list of data collection steps that should not exceed one page.
Quantitative Studies: Lists steps for the actual data collection
that would allow replication of the study by another researcher,

including how each instrument or data source was used, how
and where data were collected, and recorded. Includes a linear
sequence of actions or step-by-step of procedures used to carry
out all the major steps for data collection. Includes a workflow
and corresponding timeline, presenting a logical, sequential,
and transparent protocol for data collection that would allow
another researcher to replicate the study.
Data from different sources may have to be collected in parallel
(e.g., paper-and-pen surveys for teachers, corresponding
students, and their parents AND retrieval of archival data from
the school district). A flow chart is ok—"linear" may not apply
to all situations
Qualitative Studies: Provides detailed description of data
collection process, including all sources of data and methods
used, such as interviews, member checking, observations,
surveys, field tests, and expert panel review. Note: The
collected data must be sufficient in breadth and depth to answer
the research question(s) and interpreted and presented correctly,
by theme, research question, and/or source of data.
2
Describes the procedures for obtaining participant informed
consent and for protecting the rights and well-being of the study
sample participants. Comment by Reviewer: missing
2
format.
2
NOTE:This section elaborates on the Sample and Location and

Data Collection in the 10 Strategic Points. This section provides
the foundation for the Data Collection Procedures section in
Chapter 3 in the Proposal. And it is summarized high level in
Chapter 1 in Nature of the Research Design for the Study in the
Proposal.
Reviewer Comments:
Data Analysis Procedures
Data analysis will use descriptive analysis, and the data
collected will first be manually coded in relation to the themes
of the study. The coded themes will then be analyzed, and
explanations given. The overall aim of the analysis will be to
find factors influencing individuals' decision to not utilize
Mental Health in Fort-Bend County, Texas. At the initial
starting stage, individual interviews will be conducted, recorded
and transcribed verbatim. This will be followed by the
researcher repeatedly reading and listening to the content in
order to get familiarized with it. As such, the researcher will be
able to gain deeper and better familiarization with the contents;
he or she will also identify the answers to those questions asked
as well as identify the themes. The researcher will use the two
theories selected to see if the themes from the interviews align
with the theoretical framework. Comment by Reviewer: you
need a research-based process. See Braun and Clarke.. again,
see the discussion forum in class.. where I posted this
procedure.
· Data will be collected and analyzed for the study.
· Descriptive statistics will be used in summarizing acquired
data.
· Coding will be used to address the questions posed.
· A narrative summary will be developed.
The researcher may adopt the process notes and MAXDQA in
organizing and visualizing data. Similarly, he or she can also
adopt the Braun and Clarke’s (2006) six-step thematic analysis

process in identifying the relevant patterns in the data
· Stage 1: Get familiarized with the data. At this stage, the
researcher is expected to already get familiarized with the
contents of the research and have a better understanding of it.
This is because the researcher is the individual that will collect
the data.
· Stage 2: At the second stage, the researcher is going to
generate first codes regarding the significant ideas discovered
in the data.
· Stage 3: This stage allows the researcher to start the search for
themes through analysis and a review of the codes and to
understand those that can be developed into acceptable themes.
· Stage 4: This provides the researcher the opportunity of
reviewing and refining the themes and then determine whether
there is any of them that needs to be removed, combined, or if
they can be broken down into additional themes.
· Stage 5: The researcher is expected to define and name the
themes after refining them.
· Phase 6: At this stage, the final report should be generated by
the researcher.
Criteria
(0-3)
Chair or Score
(0-3)
Reviewer Score
(0-3)
DATA ANALYSIS PROCEDURES
This section provides detailed steps for the analytic procedures
to be used to conduct data analysis.
paragraphs, can also be presented in bulleted format.
Describes in detail the relevant data collected for each stated
research question and/or each variable within each hypothesis

(if applicable).
Quantitative Studies: "In detail" means scales (and subscales) of
specified instruments AND type of data for each variable of
interest. IMPORTANT: For (quasi) experimental studies,
provide detailed description of all treatment materials per
treatment condition, as part of the description of the
independent variable corresponding to the experimental
manipulation.
2
What: Describes, in detail, statistical and non-statistical
analysis to be used and procedures used to conduct the data
analysis.
Quantitative Studies: (1) describe data file preparation
(descriptive statistics used to check completeness and accuracy;
for files from different sources, possibly aggregating data to
obtain a common unit of analysis in all files, necessarily
merging files (using the key variable defining the unit of
analysis); (2) computation of statistics for the sample profile;
(3) computation of (subscales and) scales; (4) reliability
analysis for all scales and subscales; (5) computation of
descriptive statistics for all variables of interest in the study
(except those already presented in the sample profile); (6) state
and justify all statistical procedures ("tests") needed to generate
the information to answer all research questions; and (7) state
assumptions checks for all those statistical procedures
(including the tests and / or charts to be computed).
Qualitative Studies: This section begins by identifying and
discussing the specific analysis approach or strategy, followed
by a discussion of coding procedures to be used. Note: coding
procedures may be different for Thematic Analysis, Narrative
Analysis, Phenomenological Analysis, or Grounded Theory
Analysis.

2
Why: Provides the justification for each of the (statistical and
non-statistical) data analysis procedures used in the study.
2
Show Steps that Support Evidence
Quantitative Analysis - states the level of statistical
significance for each test as appropriate, and describes tests of
assumptions for each statistical test.
Qualitative Analysis - evidence of qualitative analysis
approach, such as coding and theming process, must be
completely described and included the analysis /interpretation
process. Clear evidence from how codes moved to themes must
be presented.
2
format.
2
NOTE: This section elaborates on the Data Analysis from the 10
Strategic Points.This section provides the foundation for Data
Analysis Procedures section in Chapter 3 in the Proposal.
Reviewer Comments:
Ethical Considerations

Before the commencement of the study, I will seek
authorization form all the relevant bodies including the IRB for
approval. The research will also seek authority from the
University board for conducting the research. All the data
collected will be purely used for research purposes and remain
confidential. The data will remain free to withdrawal by
respondents from the study. No personal name or organizational
names which may bring conflict of interest in the research will
be included. The research will remain in the custody of the
University will all rights reserved. Additionally, only relevant
data will be collected by the researcher and only for the sole
purpose of the study. He or she must stay clear of any
subjectivity in analyzing the data and must also be proactive at
preventing anything that will be harmful to the participants.
Criteria
(0-3)
Chair or Score
(0-3)
Reviewer Score
(0-3)
Ethical Considerations
This section discusses the potential ethical issues surrounding
the research, as well as how human subjects and data will be
protected. It identifies how any potential ethical issues will be
addressed.
1. Describes site authorization process, subject recruiting, and
informed consent processes.
2
2. Describes how the identities of the participants in the study
and data will be protected.

2
3. Discusses potential ethical concerns that might occur during
the data collection process.
2
4. ALIGNMENT: Ethical considerations are clearly aligned
with, and relate directly to the specific Data Collection
Procedures. This section also identifies ethical considerations
related to the target population being researched and
organization or location as described in the Purpose Statement
section.
2
format.
2
NOTE: This section does not include information from any of
the 10 Strategic Points.
This section provides the foundation for Ethical Considerations
section in Chapter 3 in the Proposal.
Reviewer Comments:
References
Beatty, K. E., Wilson, K. D., Ciecior, A., & Stringer, L. (2015).
Collaboration among Missouri nonprofit hospitals and local
health departments: Content analysis of community health needs

assessments. American Journal of Public Health, 105 Suppl
2(S2), S337-S344. doi:10.2105/AJPH.2014.3024
Children at Risk (2013), Fort Bend County Assessment, A
Report on the Needs of the Community’s Children, The
George Foundation and The Fort Bend Chamber of Commerce,
pp. 23.
Colorafi, K. J., & Evans, B. (2016). Qualitative descriptive
methods in health science research. HERD: Health
Environments Research & Design Journal, 9(4), 16-25.
Goldman D., Robin R. W. & Chester B. (2018), Factors
Influencing Utilization of Mental Health and Substance
Abuse Services by American Indian Men and Women, pp. 1.
Children at Risk: The Future of Fort-Bend’s Children 2012-
2014. Retrieved from
http://www.thegeorgefoundation.org/media/resources/future-of-
fort-bends-children-report-2014.pdf
Schwartz, A. (2017). A report on the demographic changes and
changing needs of fort bend county University
Texas 2017 mental health national outcome measures (NOMS):
SAMHSA uniform reporting system: Center for mental health
services uniform reporting system output tables;2018 ASI 4096-
13.50. (2018)
Appendix A
10 Strategic Points
My Degree: Ph.D.
Program Emphasis: Industrial & Organizational Psychology
Ten Strategic Points

Comments or Feedback
Broad Topic Area Final Topic
Factors Affecting Utilization of Mental Health in Southern
Texas
Factors Affecting Utilization of Mental Health in Fort-Bend
County, Texas
Lit Review
(Theoretical Framework (Theory)
Gaps
Themes
All Citations
Gaps
A. De Luca, Blosnich, Hentschel, King, & Amen (2016). The
authors indicate that mental health has emerged as one of the
critical areas of focus in recent times, and for a long time, it
had been sidelined. However, with the realization that most
health conditions are related in one way or another to a mental
disorder, this area is now been studied extensively, and more
attention has been given to patients.
B. Hamilton, Desai, Hoot, Gearing, Jeong, Meyer, & Begley
(2016). The authors reviewed and analyzed how the likelihood
of lower hospitalization was associated with the race of African
Americans while increasing age was a key predisposing factor
in increased likelihood of hospitalization in Fort-Bend county.
C. Augsberger, Yeung, Dougher, & Hahm (2015). The authors
of this research article analyzed the hidden barriers to accessing
care and utilization of mental health for Asian American
Women in the Fort-Bend County of Texas. It showed that 299
women representing 43% of the survey participants have

suffered from symptoms of depression or have had suicidal
attempts. It examined the mismatch between available services
and cultural needs, contribution of Asian society to mental
health and contribution of Asian family to the stigma of mental
health.
D. Basu, Rehkopf, Siddiqi, Glymour, & Kawachi (2016). The
authors of this scholarly research article explored how changes
in social policy in recent years have affected women who have
low income in the Southern Texas area. They used the approach
of difference in difference to estimate associations between
health outcomes and welfare reforms among less affected
women compared to the most affected women.
Theoretical Foundation
Social Development Theory: The theoretical framework for this
research study is comprised of the theory by De Luca et.al.
(2016) The authors proposed that most of the chronic conditions
and terminal illnesses lead to mental disorders in patients. It
compared the variances in the rates of utilization of Mental
Health among the African Americans, Caucasians and Hispanics
in Southern Texas.
Literature Review
A. Empathic Approach: Emphasized the issues of underutilized
mental health resources and non-institutionalized adults as
behavioral risk factors in Southern Texas. (Augsberger, Yeung,
Dougher, & Hahm, 2015; Basu, Rehkopf, Siddiqi, Glymour, &
Kawachi, 2016; De Luca, Blosnich, Hentschel, King, & Amen,
2016; Hamilton, Desai, Hoot, Gearing, Jeong, Meyer, & Begley,
2016). There are certain factors that influence the
underutilization of mental health services among Asian
American women with a history of depression and suicide in
Fort-Bend County. There is also a mismatch between available
services and cultural needs, contribution of Asian society to
mental health and contribution of families to the stigma of
mental health. It concluded that mental health utilization is
extremely low among all the cultures, especially among women

in the county. Augsberger, Yeung, Dougher, & Hahm (2015).
Professional Development:
Job Satisfaction: Mental health has recently emerged as a
critical area of interest as it had been sidelined for years. Due to
this realization, the illness is now been studied extensively, and
more attention has been given to patients. It has been suggested
that most of the chronic conditions and terminal illnesses lead
to mental disorders in patients. For many reasons, mental health
is now among the priorities of medical practice (De Luca et.al.
2016).
Problem Statement
It is not known what is affecting the utilization of mental health
in Fort Bend County, Texas.
Research Questions
RQ1- How much higher is the cost for mental health care in the
county compared to the rest of Southern Texas?
RQ2- What is the average expenditure per adult enrollee in the
area for mental health care?
RQ3- Do the facilities offer state-of-the-art treatments using
research and discoveries in the field of mental health?
RQ4- What is the average number of mental health admissions
and lengths of stay at behavioral hospitals?
RQ5- Is there a statistically significant difference in the level of
utilization of mental health among the different cultures?
RQ6- Is there a statistically significant difference in the number
of isolations of behavioral hospitals
Population
Target Population
Sample
· Location – Fort-Bend County, Texas. USA

· Target Population:
· Behavioral Hospitals
· Psychiatrists
· Therapists
· School Counselors
Sample: Will comprise of interviews with 10 hospitals, 10
schools and counselors, 10 Psychiatrists, and 10 Therapists in
the county.
Describe Phenomena (qualitative) or Define
Variables/Hypotheses (quantitative)
To understand why the people living in Fort-Bend County are
not effectively utilizing the mental health resources available to
them
· There is a high rate of mental health conditions in Southern
Texas
· The Fort-Bend County utilizes very low budget allocation on
funding of mental health care
· The utilization of mental health services in Southern Texas is
poor compared to cost.
Methodology & Design
Qualitative Descriptive Study
Purpose Statement
The purpose of this qualitative descriptive case study is to
understand what is affecting the utilization of mental health in
Fort Bend County, Texas
Data Collection Approach
· Informed & signed consent from participants
· Visits to hospital sites, schools and other mental health
facilities
· Interview with Physicians & Therapist recorded on tape
· Sampling Method: Purposeful Sampling
· Sources: Interviews, Surveys & Questionnaires

Data Analysis Approach
· Data will be collected and analyzed for the study.
· Descriptive statistics will be used in summarizing acquired
data.
· Coding will be used to address questions posed.
· A narrative summary will be developed.

References
Augsberger, A., Yeung, A., Dougher, M., & Hahm, H. C.
(2015). Factors influencing the underutilization of mental health
services among Asian American women with a history of
depression and suicide. BMC health services research, 15(1),
542.
https://bmchealthservres.biomedcentral.com/articles/10.1186/s1
2913-015-1191-7
Basu, S., Rehkopf, D. H., Siddiqi, A., Glymour, M. M., &
Kawachi, I. (2016). Health behaviors, mental health, and health
care utilization among single mothers after welfare reforms in
the 1990s. American journal of epidemiology, 183(6), 531-538.
https://academic.oup.com/aje/article/183/6/531/2195922
Blosnich, J. R., Marsiglio, M. C., Gao, S., Gordon, A. J.,
Shipherd, J. C., Kauth, M., ... & Fine, M. J. (2016). Mental
health of transgender veterans in US states with and without
discrimination and hate crime legal protection. American
journal of public health, 106(3), 534-540.
https://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2015.3
02981
De Luca, S. M., Blosnich, J. R., Hentschel, E. A., King, E., &
Amen, S. (2016). Mental health care utilization: how race,
ethnicity and veteran status are associated with seeking
help. Community mental health journal, 52(2), 174-179.
https://link.springer.com/article/10.1007/s10597-015-9964-3
Hamilton, J. E., Desai, P. V., Hoot, N. R., Gearing, R. E.,
Jeong, S., Meyer, T. D., ... & Begley, C. E. (2016). Factors
associated with the likelihood of hospitalization following
emergency department visits for behavioral health
conditions. Academic Emergency Medicine, 23(11), 1257-1266.
https://onlinelibrary.wiley.com/doi/full/10.1111/acem.13044

Prospectus Template v.8.2 05.09.19
Case Study: Desert Viejo (DV) Elementary School
Demographics
DV Elementary School is situated in a working class
neighborhood. It is a K-6 school and has student body of 1,200
children. The population of students is diverse in culture and
race.
Disposition
This morning as the children were preparing to go to lunch, a
distraught father entered the school yard. Earlier in the day, the
distraught father “Ben” had had another argument about custody
and visitation with his ex-wife. Ben’s daughter Sierra is an 8-
year-old 4th grader at DV Elementary School.
When Ben entered the school grounds, he was carrying an M-16
assault rifle. Ben is a retired veteran who likes to collect guns.
His M-16 was equipped with an extended clip, allowing him to
carry over 50 rounds of ammunition in the clip attached to the
gun. Ben eventually made his way into the school, then the front
administrative office and emptied all 50 rounds on the
occupants.
A group of students were passing by the front office as the

assault began. One child was injured, but not fatally. When
emergency services arrive and secure the locked down school,
they count 5 fatalities. One of the fatalities was Ben, who took
his own life with a hand gun after his killing spree.
The small group of children passing by the office at the time of
the assault was the only children who witnessed the horror. The
remainder of the student body and teachers report hearing
“pops,” crashing, and “breaking stuff” from their classrooms.
© 2014. Grand Canyon University. All Rights Reserved.
Case Study: Joshua
Name: Joshua
Demographics
Joshua is a 17-year-old Caucasian male. Joshua is a junior in
high school and his parents report he is an “average” student,
earning Bs & Cs a majority of the time. Joshua is the youngest
of four children, his two eldest siblings no longer live in the
family home. Joshua’s 19-year-old sister lives in the family
home while she attends the local college. Joshua is a medium
build
Treatment History
Joshua was hospitalized last year for a substance abuse
disorder. Joshua has been using drugs and alcohol since his 12th
year.

Current Treatment
Joshua reports he has no current therapist, “They just don’t
listen to me and even when they do they don’t understand my
issues.”
Current Disposition
Joshua has called the hotline reporting “I just don’t see any
reason to go on.” Joshua reports that his girlfriend recently
broke with him and he has been feeling hopeless about his
future. Joshua reports that he plans to “Play in traffic” soon.
© 2014. Grand Canyon University. All Rights Reserved.

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