Date of Award

5-1-2024

Language

English

Document Type

Master's Thesis

Degree Name

Master of Arts (MA)

College/School/Department

Department of Psychology

Dissertation/Thesis Chair

James F. Boswell

Committee Members

Mitch Earleywine

Subject Categories

Clinical Psychology

Abstract

Background: Social determinants of health (SDOH) are conditions in the environment in which people live and work that influence health risks and outcomes. These include a range of social, economic, psychosocial, and behavioral factors such as food insecurity, hazardous housing, and financial resource strain. Such factors account for variance in numerous health outcomes, including life expectancy and quality of life. Studies on university student populations also demonstrate that unmet SDOH needs are associated with poorer self-assessed general health as well as higher anxiety and depression symptom severity. However, little is known about SDOH in the context of routine outpatient psychotherapy in community mental health settings. The current study examined the association between unmet SDOH needs and other patient and clinical characteristics, including demographics and baseline symptom severity, at a community mental health clinic. Method: This study used routinely collected data from treatment seeking adults presenting at a county community mental health clinic (N = 247). Patients completed the Patient Health Questionnaire (PHQ-9) routinely throughout treatment. The Health Leads Social Needs Screening Toolkit was also administered to collect information about SDOH. Results: Around half (47.8%) of patients endorsed at least one unmet SDOH need. Having at least one unmet need was associated with higher symptom severity at the start of treatment. Additionally, patients with non-psychotic disorders reported unmet SDOH needs at a higher rate than patients with psychotic disorders. Finally, exploratory analyses revealed that non-conditional SDOH items together had acceptable internal consistency. Discussion: Implications for treatment planning and patient care informed by patients’ SDOH needs are discussed.

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