1. 32
Dissertation Prospectus
Factors Influencing Individuals' Decision to Utilize Mental
Health in South Texas
Submitted by:
James Dada
April 5, 2020
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

2. 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

3. is addressed clearly and comprehensively. No gaps are present
that leave the reader with questions. No changes required.
Dissertation Prospectus
Introduction
This research study will examine the factors according to
mental health providers that influence an individuals' decision
to utilize mental health services in South Texas. This research
will help us understand why individuals choose to utilize or
reject mental health services in the state. Researchers (AUTH
YEAR) have expressed a need for further research on the
reasons why people decide to utilize or reject mental health
services. In South Texas this research is needed because
XXXXXXX. There is a high need as this region receives the

4. second-largest allocation for mental health in the country (Mista
et al. 2017). Interestingly, Misra et al. (2017) describe the use
of complementary and alternative medicine (CAM) for mental
health treatment among children in Southern Texas. Despite all
these efforts, there still exists a gap between the treatment of
mental health disorders in the US. This research on reasons why
people use or reject mental health treatment is needed because
mental health is such a prevalent problem. Indeed, mental
health service use is an international problem. Comment by
Dr. Seymour: This is the “gap” statement for further research
that we discussed.
Mental health is a major issue around the World. The United
Nations (UN, 2015) has identified the issue as one of its
Sustainable Development Goals. These are a collection of goals
designed globally that aim to achieve a sustainable future for
all. The UN expressed its uncertainty regarding the extent to
which major social determinants of mental disorders are being
addressed worldwide (WHO, 2015). Developing a conceptual
framework will address There is a need to identify the social
determinants of mental disorders, and align it with its
sustainable development goals, . This way it can systematically
review the pieces of evidence about the social deter minants and
identify potential mechanisms and targets for interventions
(Lund, et al. 2018). Part of this effort is to determine why
people choose to get mental health support or not. Comment by
Dr. Seymour: Provides a summary of results from the prior
empirical research on the topic.This is really not meeting this
item. Instead it is part of the reason why the study is needed
from the first rubric item.
Mental health is a national problem as well. 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, millions of people
suffer from mental illness in this country. The high numbers
necessitate raising public awareness and start campaigning for a
much better health care system (Hamilton.et al. 2016).

5. According to the National Alliance on Mental Health (2019),
47.6 million people in the U.S. experienced signs of a mental
illness in 2018. This amounts to one in every five adults.
Roughly 11.4 million Adults between the ages of 25 and 35 had
an episode of serious mental illness that same year. In 2016, 7.7
million young people between the ages of 6 and 17 experienced
some sort of mental health disorder, while 9.2 million people
were reported to have experienced a substance use disorder
(National Alliance on Mental Illness, 2019). The high numbers
necessitate raising public awareness and campaigning for a
better health care system (Hamilton.et al. 2016). Part of this
effort is identifying the reasons why people choose to utilize or
reject mental health support.
Results from previous studies on the topic of use of mental
health services indicate that there is a gap between the people
who need treatment and the people who get treatment.
According to Kohn, et al. (2018), there is an emphasis on the a
gap in mental health treatment in America when examined
through the prevalence of mental health disorders, the lack of
use of mental health services, and the global burden of disease.
Statistical data from community-based surveys of mental
disorders in the various countries in America including
Argentina, Brazil, Canada, Chile, and the United States, etc.
were utilized in formulating this conclusion. While 42.6% of
children and adolescents in the US suffered mental illness, the
treatment gap in this group was 64%. This issues of addressing
a lack of mental health services has not been given enough
attention, thus resulting in a wide gap in treatment(REF).
Comment by Dr. Seymour: Provides a summary of results
from the prior empirical research on the topic. Comment by Dr.
Seymour: How it is about America when the data is
international? Focus on US.
Other studies have found that there are programs that help
support the use of mental health services. According to
Bowdoin et al. (2018), a patient-centered medical home

6. (PCMH) model This designed to improve certain mental health
outcomes, while at the same time proving effective as cost-
containment. A total 6908 non-aging adults suffering from
mental illness participated in the 2007-2012 Medical
Expenditure Panel Survey. Utilization of healthcare services
was compared with expenditures on care consistent with the
PCMH, other participants include a non-PCMH, usual source of
care (USC), and participants without a USC. The outcome
showed differences in utilization and expenditures between
participants who were provided with care consistent with the
PCMH and those who had a non-PCMH. USC showed no
statistical importance for any healthcare services category.
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
Given these needs in the mental health around the world, in the
US and in South Texas this study will examine the gap: there is
a need to understand why people choose to utilize or reject
mental health services. This is recommended by researchers
including xxxx who stated “ xxxx” (p. 202).
Mental disorders in children can be corrected if detected early
enough. Unfortunately, most of the caregivers do not have the
skills to detect these disorders, which allows them to persist to
the point that it is dangerous (Kohn et al. 2018).
According to Bowdoin et al. (2018), a patient-centered medical
home (PCMH) model is designed to improve certain mental
health outcomes, while at the same time proving effective as
cost-containment.
This proposed study will examine the links between care
provided that is inconsistent with the PCMH and healthcare

7. services utilization as well as expenditures for non-aging
citizens who are suffering from mental illness in the United
States. Comment by Dr. Seymour: This seems too
complicated. You don’t want to do this for your study I don’t
think. You would need a pcmh system. Do you have one? You’d
have to compare it to non pcmh.
A total 6908 non-aging adults suffering from mental illness
participated in the 2007-2012 Medical Expenditure Panel
Survey. Utilization of healthcare services was compared with
expenditures on care consistent with the PCMH, other
participants include a non-PCMH, usual source of care (USC),
and participants without a USC. The outcome showed
differences in utilization and expenditures between participants
who were provided with care consistent with the PCMH and
those who had a non-PCMH. USC showed no statistical
importance for any healthcare services category. This research
study will examine the factors according to mental health
providers that influence an individuals' decision to utilize
mental health services in South Texas. This research will help
us understand why individuals choose to utilize or regject
mental health services in the state.
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

8. paragraphs.
1. Dissertation topic is introduced along with why the study is
needed.
1.5
2. Provides a summary of results from the prior empirical
research on the topic.
1
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
.5
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.
1.5
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
According to the Centers for Disease Control and Prevention
(2018), mental health has become a significant public health
issue in the United States that requires immediate attention.

9. There is a gap in the research regarding the reasons people
utilize or reject mental health treatment according to Authors
(years). The research has documented this gap. This includes
REFS REFS REFS. Comment by Dr. Seymour: Includes a brief
discussion demonstrating how literature has established the gap
and a clear statement informing the reader of the gap.
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).
Early research on use of mental health services found xxxxxx.
Later research on use of mental health services found xxxxxx.
Current research on use of mental health services found xxxxxx.
There is the need to understand the consequences of both
effective utilization and non-utilization of mental health as it
has evolved historically. Mental health services in this southern
state have faced several challenges. Texas (2017) asserts that
people suffering from mental illness still face problems despite
the huge costs that are directed towards healthcare. Schwartz
(2017), in support of the Southern State Region, argues that the
increased growth-rate of populations in one specific county
located in a southern state has impacted the health sector at
large. The high population together with economic constrains
has led to a decrease in the number of insurance policies
offering individuals access to health. The access to and
utilization of mental health care for the populations living in
this county has created a gap within the State (Children at Risk,
2013).

10. A mental disorder must be diagnosed at its early stages to avoid
the advance effects of it progressing into adolescence (Kohn et
al. 2018). According to Grayson (2018), there has been a
notable difference in how patients utilize mental health services
with patients that experience a high level of burden more likely
to utilize mental health services. Similarly, the caregivers that
experience serious signs of depression or anxiety in their child
or adolescent will tend to use the services more than the
caregivers who experience mild or no sign of depression or
anxiety. The mental health status of the caregiver is of no
significance and does not influence need and utilization
(Grayson, 2016). Comment by Dr. Seymour: This is research
on what people have already found on your research question. It
answers your research question instead of indicating that there
is a need for research on it. It might be useful in the literature
review.
Misra et al. (2017) in their article describe the concept relating
to the use of complementary and alternative medicine (CAM)
for mental health treatment among children in the Southern
State Region. According to the authors, CAM use among US
children stands at 12%. South Texas has begun to put forth a lot
of effort into improving the health care treatment of children.
The services offered are directly proportional to the allocation
provided. Research showed that some institutions have released
more funding to operate this sector and that this region receives
the second-largest allocation for mental health in the country
(Mista et al. 2017). Despite all these efforts, there still exists a
gap between the treatment of mental health disorders in the US.
Criteria
Learner Self-Evaluation Score
(0-3)
Chair or Score
(0-3)
Reviewer Score
(0-3)

11. 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.
2
.5
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).
2
0
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
????
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.
2
1

12. 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
The theoretical model for this research gap is Albert Bandura’s
Social Cognitive Theory. The Social Cognitive Theory can be
applied to the context of mental health promotion and
prevention. It helps to describe how motivations in health and
behaviors are influenced by the interaction of people's beliefs,
environment, and behaviors. It was advocated by famous
psychologist Albert Bandura (Morin, 2019). It is important to
determine the limiting factors behind individuals and families
not currently getting the mental health services that they need.
Major components of the theory concerning individual behavior
change include:
· Self-efficacy: The belief that an individual has control over
and can execute a behavior.
· Behavioral capability: Understanding and having the skill to
perform a behavior.
· Expectations: Determining the outcomes of behavior change.
· Expectancy: Assigning a value to the outcomes of behavior
change.
· Self-control: Regulating and monitoring individual behavior.
· Observational learning: Watching/observing outcomes of
others' performance or modeled behavior.
· Reinforcements: Promoting incentives and rewards that
encourage behavior change (Eslami et al. 2018).

13. Theoretical literature
There is the need to understand the consequences of both
effective utilization and non-utilization of mental health as it
has evolved historically. Mental health services in this southern
state have faced several challenges. Texas (2017) asserts that
people suffering from mental illness still face problems despite
the huge costs that are directed towards healthcare. Schwartz
(2017), in support of the Southern State Region, argues that the
increased growth-rate of populations in one specific county
located in a southern state has impacted the health sector at
large. The high population together with economic constrains
has led to a decrease in the number of insurance policies
offering individuals access to health. The access to and
utilization of mental health care for the populations living in
this county has created a gap within the State (Children at Risk,
2013).
Literature Themes
Review of the literature review identified the following themes:
Comment by Dr. Seymour: 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.
· Research documenting Mental Health Need
· Research Documenting the lack of use of mental health
services
· Reasons for Lack of Use of Mental Health Services
· Lack of proper mental health education and infrastructure has
been the major factor affecting the utilization of mental health
(REF) .
· Augsberger et al. (2015) in support of this research argued
that mental health services had been underutilized by Asian
women living in this county, as a result of both cultural needs
and mismatch of the services offered in the health facilities in
this Southern State.

14. · Lack of medical insurance.
· Research has shown that many people due to poor economic
status have left many people without health insurance as they
cannot afford it. This limits many average and lower-class
families from accessing mental illness services (Children at
Risk, 2013).
· The poor perception among the community members.
Researchers reveal that many people who live in this county
perceive child mental illness as a mere sign of hunger besides
poor diets. This has left many people neglecting the utilization
of mental healthcare in the community (Children at Risk, 2013).
· Reasons for Use of Mental Health Services
· Goldman et al. (2018) in their research found out that women
who had been exposed to sexual abuse and drug abuse formed
the high numbers of people who utilize mental health services
among the Hispanic and non-white people in the county.
Augsberger et al. (2015) in support of this research argued that
mental health services had been underutilized by Asian women
living in this county, as a result of both cultural needs and
mismatch of the services offered in the health facilities in this
Southern State. What happens to these women as a result of
these lack of services needs to be further extrapolated by further
research. This demonstrates a current gap in existing literature.
· This is another gap in existing literature. It is important to
ascertain the reality that living in poverty face and how a lack
of services prevents them from being able to be class mobile in
terms of future career opportunities.
· The theoretical model for this research gap is the Albert
Bandura, Social Cognitive Theory. The Social Cognitive
Theory: Examines the context of health promotion and disease
prevention. It helps to describe how motivations in health and
behaviors are influenced by the interaction of people's beliefs,
environment, and behaviors. It was advocated by famous
psychologists Albert Bandura (Morin, 2019). It is important to
determine the limiting factors behind individuals and families
not currently getting the mental health services that they need.

15. Many do no seek help due to social stigmatization, while others
simply lack any type of access in the first place. Due to a lack
of promotion in this area, many do not know where to turn and
this is causing the problem to be compounded in society from
one generation to the next.
Major components of the theory concerning individual behavior
change include:
· Self-efficacy: The belief that an individual has control over
and can execute a behavior.
· Behavioral capability: Understanding and having the skill to
perform a behavior.
· Expectations: Determining the outcomes of behavior change.
· Expectancy: Assigning a value to the outcomes of behavior
change.
· Self-control: Regulating and monitoring individual behavior.
· Observational learning: Watching/observing outcomes of
others' performance or modeled behavior.
· Reinforcements: Promoting incentives and rewards that
encourage behavior change (Eslami et al. 2018).
Criteria
Learner Self-Evaluation Score
(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).

16. 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)
1.5
2
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
1
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)

17. 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
????
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.
1.5
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
The problem is that individuals across South Texas are do not
make use of the mental health services that are offered to them.
It is not known how mental health providers describe the factors
influencing individual decisions to utilize mental health
services. Comment by Dr. Seymour: Need evidence of this .
references.

18. Describes the population of interest affected by the problem.
The general population refers to all individuals that could be
affected by the study problem
For qualitative studies this describes how the phenomenon will
be studied. This can be individuals, group, or organization
under study.
Discusses the importance, scope, or opportunity for the problem
and the importance of addressing the problem
There are increasing mental health cases among the children in
the country, indicating that much improvement in this area is
needed. This research seeks to identify the key issues that
prevent the people of this part of the state from utilizing its
mental health services and facilities. Comment by Dr.
Seymour: Are you going to focus on children?Is there a
recommendation in the literature for this?Is there a need in
South Texas for this in particular? Is there a reason to focus on
this and not look at it in general? Are you going to be able to
get enough pediatric mental health people to participate???
They are few and stressed.
Criteria
Learner Self-Evaluation Score
(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

19. problem.
The recommended length for this section is one paragraph.
1. States the specific problem proposed for research with a clear
declarative statement.
1.5
1.5
Describes the population of interest affected by the problem.
The general population refers to all individuals that could be
affected by the study problem.
1.5
0
Describes the unit of analysis.
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).
1.5
0
Discusses the importance, scope, or opportunity for the problem
and the importance of addressing the problem.
1.5
0
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

20. format.
1.5
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.
…
32
Dissertation Prospectus
Factors Influencing Individuals' Decision to Utilize Mental
Health in South Texas
Submitted by:
James Dada
April 5, 2020
The Prospectus Overview and Instructions
Prospectus Instructions:
1. Read the entire Prospectus Template to understand the

21. 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.

22. 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
Mental health is a major issue around the World. The United
Nations (UN, 2015) has identified the issue as one of its
Sustainable Development Goals. These are a collection of goals
designed globally that aim to achieve a sustainable future for
all. The UN expressed its uncertainty regarding the extent to
which major social determinants of mental disorders are being
addressed worldwide (WHO, 2015). Developing a conceptual
framework will address the social determinants and align it with

23. its sustainable development goals. This way it can
systematically review the pieces of evidence about the social
determinants and identify potential mechanisms and targets for
interventions (Lund, et al. 2018). 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, millions of people suffer from
mental illness in this country. The high numbers necessitate
raising public awareness and start campaigning for a much
better health care system (Hamilton.et al. 2016). According to
the National Alliance on Mental Health (2019), 47.6 million
people in the U.S. experienced signs of a mental illness in 2018.
This amounts to one in every five adults. Roughly 11.4 million
Adults between the ages of 25 and 35 had an episode of serious
mental illness that same year. In 2016, 7.7 million young people
between the ages of 6 and 17 experienced some sort of mental
health disorder, while 9.2 million people were reported to have
experienced a substance use disorder (National Alliance on
Mental Illness, 2019).
According to Kohn, et al. (2018), there is an emphasis on the
gap in mental health treatment in America when examined
through the prevalence of mental health disorders, the use of
mental health services, and the global burden of disease.
Statistical data from community-based surveys of mental
disorders in the various countries in America including
Argentina, Brazil, Canada, Chile, and the United States, etc.
were utilized in formulating this conclusion. While 42.6% of
children and adolescents in the US suffered mental illness, the
treatment gap in this group was 64%. This issues of addressing
a lack of mental health services has not been given enough
attention, thus resulting in a wide gap in treatment. Mental
disorders in children can be corrected if detected early enough.
Unfortunately, most of the caregivers do not have the skills to
detect these disorders, which allows them to persist to the point
that it is dangerous (Kohn et al. 2018).
According to Bowdoin et al. (2018), a patient-centered medical

24. home (PCMH) model is designed to improve certain mental
health outcomes, while at the same time proving effective as
cost-containment. This proposed study will examine the links
between care provided that is inconsistent with the PCMH and
healthcare services utilization as well as expenditures for non-
aging citizens who are suffering from mental illness in the
United States. A total 6908 non-aging adults suffering from
mental illness participated in the 2007-2012 Medical
Expenditure Panel Survey. Utilization of healthcare services
was compared with expenditures on care consistent with the
PCMH, other participants include a non-PCMH, usual source of
care (USC), and participants without a USC. The outcome
showed differences in utilization and expenditures between
participants who were provided with care consistent with the
PCMH and those who had a non-PCMH. USC showed no
statistical importance for any healthcare services category. This
research study will examine the factors according to mental
health providers that influence an individuals' decision to utilize
mental health services in South Texas. This research will help
us understand why individuals choose to utilize or regject
mental health services in the state.
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.

25. 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.
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
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
According to the Centers for Disease Control and Prevention
(2018), mental health has become a significant public health
issue in the United States that requires immediate attention. A
mental disorder must be diagnosed at its early stages to avoid

26. the advance effects of it progressing into adolescence (Kohn et
al. 2018). According to Grayson (2018), there has been a
notable difference in how patients utilize mental health services
with patients that experience a high level of burden more likely
to utilize mental health services. Similarly, the caregivers that
experience serious signs of depression or anxiety in their child
or adolescent will tend to use the services more than the
caregivers who experience mild or no sign of depression or
anxiety. The mental health status of the caregiver is of no
significance and does not influence need and utilization
(Grayson, 2016).
Misra et al. (2017) in their article describe the concept relating
to the use of complementary and alternative medicine (CAM)
for mental health treatment among children in the Southern
State Region. According to the authors, CAM use among US
children stands at 12%. South Texas has begun to put forth a lot
of effort into improving the health care treatment of children.
The services offered are directly proportional to the allocation
provided. Research showed that some institutions have released
more funding to operate this sector and that this region receives
the second-largest allocation for mental health in the country
(Mista et al. 2017). Despite all these efforts, there still exists a
gap between the treatment of mental health disorders in the US.
Criteria
Learner Self-Evaluation Score
(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

27. 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.
2
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).
2
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
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.
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

28. 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 both
effective utilization and non-utilization of mental health as it
has evolved historically. Mental health services in this southern
state have faced several challenges. Texas (2017) asserts that
people suffering from mental illness still face problems despite
the huge costs that are directed towards healthcare. Schwartz
(2017), in support of the Southern State Region, argues that the
increased growth-rate of populations in one specific county
located in a southern state has impacted the health sector at
large. The high population together with economic constrains
has led to a decrease in the number of insurance policies
offering individuals access to health. The access to and
utilization of mental health care for the populations living in
this county has created a gap within the State (Children at Risk,
2013).
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 et al. (2018) in their research found out that women
who had been exposed to sexual abuse and drug abuse formed
the high numbers of people who utilize mental health services
among the Hispanic and non-white people in the county.
Augsberger et al. (2015) in support of this research argued that
mental health services had been underutilized by Asian women
living in this county, as a result of both cultural needs and
mismatch of the services offered in the health facilities in this

29. Southern State. What happens to these women as a result of
these lack of services needs to be further extrapolated by further
research. This demonstrates a current gap in existing literature.
· Lack of medical insurance. Research has shown that many
people due to poor economic status have left many people
without health insurance as they cannot afford it. This limits
many average and lower-class families from accessing mental
illness services (Children at Risk, 2013). This is another gap in
existing literature. It is important to ascertain the reality that
living in poverty face and how a lack of services prevents them
from being able to be class mobile in terms of future career
opportunities.
· The poor perception among the community members.
Researchers reveal that many people who live in this county
perceive child mental illness as a mere sign of hunger besides
poor diets. This has left many people neglecting the utilization
of mental healthcare in the community (Children at Risk, 2013).
Again, further research must be conducted to determine how
these attitudes can shift so that socio-economically
disadvantaged families can get their children access to the
critical mental health services that they need.
The theoretical model for this research gap is the Albert
Bandura, Social Cognitive Theory. The Social Cognitive
Theory: Examines the context of health promotion and disease
prevention. It helps to describe how motivations in health and
behaviors are influenced by the interaction of people's beliefs,
environment, and behaviors. It was advocated by famous
psychologists Albert Bandura (Morin, 2019). It is important to
determine the limiting factors behind individuals and families
not currently getting the mental health services that they need.
Many do no seek help due to social stigmatization, while others
simply lack any type of access in the first place. Due to a lack
of promotion in this area, many do not know where to turn and
this is causing the problem to be compounded in society from
one generation to the next.
Major components of the theory concerning individual behavior

30. change include:
· Self-efficacy: The belief that an individual has control over
and can execute a behavior.
· Behavioral capability: Understanding and having the skill to
perform a behavior.
· Expectations: Determining the outcomes of behavior change.
· Expectancy: Assigning a value to the outcomes of behavior
change.
· Self-control: Regulating and monitoring individual behavior.
· Observational learning: Watching/observing outcomes of
others' performance or modeled behavior.
· Reinforcements: Promoting incentives and rewards that
encourage behavior change (Eslami et al. 2018).
Criteria
Learner Self-Evaluation Score
(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,

31. 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)
1.5
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.

32. 1.5
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.
1.5
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
The problem is that individuals across South Texas are not make
use of the mental health services that are offered to them. It is
not known how mental health providers describe the factors
influencing individual decisions to utilize mental health
services. There are increasing mental health cases among the
children in the country, indicating that much improvement in
this area is needed. This research seeks to identify the key
issues that prevent the people of this part of the state from
utilizing its mental health services and facilities.
Criteria
Learner Self-Evaluation Score

33. (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.
1.5
Describes the population of interest affected by the problem.
The general population refers to all individuals that could be
affected by the study problem.
1.5
Describes the unit of analysis.
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).
1.5
Discusses the importance, scope, or opportunity for the problem
and the importance of addressing the problem.
1.5

34. 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.
1.5
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 examine
how mental health providers describe the factors influencing
individuals' decision to utilize mental health services in South
Texas. The study aims to come with the factors that either
influence or deter the people in the State from accessing much-
needed mental healthcare. The study will employ a qualitative
study that will target mental health providers within the State
who are service providers that care for the mentally challenged
and compare factors impacting utilization and non-utilization of
mental services available in the State. This study will make a
recommendation on how to improve the mental health
accessibility in the State. It will identify multiple factors that
are associated with both the utilization and under-utilization of
specialty mental health services among the people living in
South Texas, such as delays in observing and recognizing the
symptoms and how to seek help, the absence of appropriate
mental health providers, and lack of health insurance.

35. Criteria
Learner Self-Evaluation Score
(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.
The recommended length for this section is one paragraph.
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.
1.5
Quantitative Studies: Defines the variables and relationship of
variables.
Qualitative Studies: Describes the nature of the phenomena to
be explored.
1.5
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.
1.5
NOTE: This section elaborates on information in the Purpose

36. 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
The following research questions will help to guide this
qualitative study:
· RQ1: How do mental health providers describe the influence
of self-efficacy on individuals' decisions to utilize mental health
services?
· H1: Self-efficacy influences individuals' decision to utilize
mental health services.
· RQ2: How do mental health providers describe the influence
of behavioral capacity on individuals' decision to utilize mental
health services?
· H2: Behavioral capacity influences individuals' decision to
utilize mental health services.
· RQ3: How do mental health providers describe the influence
of expectations on individuals' decisions to utilize mental health
services?
· H3: Expectations influence individuals' decisions to utilize
mental health services.
Criteria
Learner Self-Evaluation Score
(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.

37. · 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
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.
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

38. section in Chapter 1 in the Proposal.
Reviewer Comments:
Advancing Scientific Knowledge and Significance of the Study
The results of this research will add considerably to the
conclusions already reached by other studies, as it provides
means by which prevention and intervention efforts will help to
raise mental health awareness and the importance of utilizing
mental health services among Americans as well as offer
culturally sensitive services. The result would direct and focus
efforts on reducing the stigma that is associated with mental
health problems in the minds of most people (Morin and Cherry,
2019). In addition, the results will help and be of value to
practitioners in determining the necessary strategies to be used
to allow more individuals to receive the necessary health care
services that they require. It will also help in eliminating the
individualized beliefs that prevent people from getting the
public services they need and thus help them be more
responsive to the services that are available to them.
Similarly, the result will enhance knowledge of social learning
theory through observation and modeling as they both play
significant and primary roles in this process, which moves far
and beyond Albert Bandura's behavioral theory, which suggests
that all behaviors can or are learned through conditioning, and
cognitive theories. Bandura's social learning theory also
proposed that learning also exists or develops simply by
observing the actions of others (Morin and Cherry, 2019).
Therefore, a learning condition like this may be used in
explaining different behaviors, including those factors
influencing individuals' decision to either utilize or not utilize
mental health.
Criteria
Learner Self-Evaluation Score
(0-3)
Chair Score
(0-3)
Reviewer Score

39. (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
Section is written in a way that is well structured, has a logical
flow, uses correct paragraph structure, uses correct sentence

40. structure, uses correct punctuation, and uses correct APA
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
…