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Sociocultural influences on mental health functioning: implications for the design of community-based services

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Title	Sociocultural influences on mental health functioning: implications for the design of community-based services
Author	Dinh, Tam Quy Thi
Author email	tamdinh@usc.edu
Degree	Doctor of Philosophy
Document type	Dissertation
Degree program	Social Work
School	School of Social Work
Date defended/completed	2008-05-29
Date submitted	2008
Restricted until	Unrestricted
Date published	2008-07-31
Advisor (committee chair)	Yamada, Ann Marie
Advisor (committee member)	Brekke, John Dembo, Myron
Abstract	Despite the promising effects of psychosocial rehabilitation (PSR) interventions on outcomes for individuals with severe and persistent mental illness (SPMI), wide variation still exists in individual functional outcomes. This is particularly true for ethnic minorities as empirical evidence has documented persistent racial disparities in mental health outcomes. In this dissertation, the author examines sociocultural factors -- support systems and minority status -- that influence rehabilitative independent living and employment functional outcomes for individuals with SPMI, using secondary data from a longitudinal study conducted at four community-based psychosocial rehabilitation programs in Southern California.; Based on a psychosocial rehabilitation framework, available support systems include support from PSR service system, social support from family and friends, and personal intrapsychic support. Minority status will be treated as a proxy variable for cultural influences to determine its moderating influence on support and outcomes. The three specific aims are to (a) illustrate change patterns in treatment outcomes over twelve months; (b) identify the strongest support determinants (service support, social support, or intrapsychic support) for each functional outcome; and (c) explore whether minority status exerts a significant moderating effect on the relationship between the support variables and functional outcomes. Muthen and Muthen's (2007) Mplus Version 5 multivariate repeated model approach is used to run a series of latent growth curve models to study the functional outcome growth structure and the predictors.; The study findings suggest that the functional change mechanism is a complex issue. While independent living functioning exhibited continuous linear growth from baseline to twelve months, work productivity experienced a slight decrease after 6 months (Aim 1). Intrapsychic support explained most of the variance for both functional outcomes at baseline (Aim 2). However it is social support that has the most influence on the growth trajectory for both independent living and work productivity (Aim 2). Minority status was found to moderate some of the relationship between the available support systems and functional outcomes (Aim 3). It is hoped that this study will contribute to the knowledge base needed to facilitate the development of effective and culturally responsive psychosocial rehabilitative interventions for ethnic minorities experiencing SPMI.
Keyword	severe mental health; sociocultural factors; psychosocial rehabilitation; community-based services
Geographic subject (state)	California
Language	English
Part of collection	University of Southern California dissertations and theses
Publisher (of the original version)	University of Southern California
Place of publication (of the original version)	Los Angeles, California
Publisher (of the digital version)	University of Southern California. Libraries
Type	texts
Legacy record ID	usctheses-m1476
Contributing entity	University of Southern California
Rights	Dinh, Tam Quy Thi
Repository name	Libraries, University of Southern California
Repository address	Los Angeles, California
Repository email	http://www.usc.edu/isd/libraries/services/ask_a_librarian/email/
Filename	etd-Dinh-20080731
Archival file	uscthesesreloadpub_Volume44/etd-Dinh-20080731.pdf

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Title	Page 1
Contributing entity	University of Southern California
Full text	SOCIOCULTURAL INFLUENCES ON MENTAL HEALTH FUNCTIONING OVER TIME: IMPLICATIONS FOR THE DESIGN OF COMMUNITY-BASED SERVICES by Tam Quy Thi Dinh A Dissertation Presented to the FACULTY OF THE GRADUATE SCHOOL UNIVERSITY OF SOUTHERN CALIFORNIA In Partial Fulfillment of the Requirements for the Degree DOCTOR OF PHILOSOPHY (SOCIAL WORK) August 2008 Copyright 2008 Tam Quy Thi Dinh