Draft Timeline and Outline Project Plan and ROL

Draft Timeline and Outline Project Plan and ROL

Topic: Mental Health Stigma and Its Effect on Mental Health Seeking Behaviors among Racial and Ethnic Minority Groups

Mental health is a major aspect of overall health and well-being. However, the impact of mental health is disproportionate across racial groups in the United States. Additionally, there are notable disparities in mental healthcare access and utilization among racial and ethnic minorities (Ramos & Chavira, 2022). There are various contributing factors to such disparities. However, emerging aspects of mental health that pose unique challenges and fuel the disparities in mental healthcare access and utilization among racial and ethnic minority groups are the stigma and misconceptions towards mental health among these groups. Mental health stigma is a pervasive and major challenge in mental healthcare, which creates the need for a rigorous and detailed approach to understanding stigma in mental health and developing targeted interventions (Ahad et al., 2023).

PICO(T) Question

In racial and ethnic minority groups (P), what is the impact of mental health stigmatization (I) compared to other barriers of mental healthcare (C) on mental health-seeking behaviors (O) among individuals from ethnic minority community backgrounds?

Literature Review

A majority of research exploring differences in mental health care across groups finds evidence of disparities in access and use. Cook et al. (2018), based on a review of research data on mental health disparities between 2011 and 2014, indicate that, indeed, racial and ethnic minorities in the United States have limited access to mental health services as compared to Whites. Ideally, these racial and ethnic minority groups are more likely to receive inadequate and low-quality mental care when treated. Additionally, individuals from racial and ethnic minority groups, such as Blacks and other racial minority groups, are more likely to delay or avoid seeking mental healthcare services (Fante-Coleman & Jackson-Best, 2020).

Research exploring the various barriers or factors contributing to the delays in access or lack of access and utilization of mental health services among individuals from racial and ethnic minority groups identifies both systemic and community- and individual-level barriers, including cultural barriers. From a systemic perspective, the mental disparities in healthcare settings are mostly attributed by discriminatory provider practices based on the race or appearance of the individual. For instance, a study by Edbrooke-Childs and Patalay (2019) found that systemic discrimination existed in the United Kingdom’s healthcare system, especially in the referral for care, noting that notable ethnic differences existed in the referral route to youth mental health services, with individuals from minority groups receiving referrals through routes that were less likely to be voluntary. Similar practitioner-related barriers to access, including racially biased discrimination from providers and poor institutional support, have also been identified in a scoping review by Fante-Coleman and Jackson-Best (2020). Additionally, Fante-Coleman and Jackson-Best (2020) note that minority racial groups such as Blacks face systemic challenges in access to mental healthcare, including having longer wait times, limited access to practitioners, and both geographical and financial barriers. According to Lu et al. (2021), ethnic mismatch between patient and practitioner and differences in the perceptions of the etiological factors and beliefs related to mental health affect the relationship between patients and care providers, which act as barriers to mental healthcare service utilization.

Recent research has also explored personal and community-related cultural views on mental health as a major barrier affecting access and use of mental healthcare services. For instance, Fante-Coleman and Jackson-Best (2020) and Lu et al. (2021) identify internalized stigma and stigma from the community as major barriers to access and use of mental health services among minority groups. Stigma, which is majorly characterized by societal prejudice and discrimination, significantly influences an individual’s or a community’s perceptions of mental health and negatively impacts psychiatric care due to the delayed recognition and treatment of mental health issues (Ahad et al., 2023). Evidence highlights the strong stigma attached to mental health conditions and its influence on barring individuals from seeking psychological help (Eylem et al., 2020). Ahad et al. (2023) note that mental health stigma is not a monolithic entity, but its aspects vary across cultures based on the uniqueness of societal norms, values, and beliefs. However, the consequences and influence of differences in mental health-related stigma across racial and ethnic groups are not well explored (Eylem et al., 2020). Alemu et al. (2023) further add that there lacks a comprehensive understanding of the prevalence of and factors associated with internalized stigma among minorities living with mental illness. Ahad et al. (2023) further argue that, although there have been multiple awareness campaigns, mental health practitioners still struggle to understand stigma in mental health across racial and ethnic groups and the barriers that stigma imposes on patient care, requiring further analysis of the issue.

In summary, mental health disparities affecting major racial and ethnic minority groups are a challenge in mental health care. However, it is only through the comprehensive understanding of mental health stigma in racial and ethnic minority groups and its influence on health-seeking behaviors that can help mental health practitioners to develop and implement effective and culturally sensitive interventions.

Implementation Plan

Objective of the PhD Project

1. To explore and understand the impact of mental health stigma compared to other barriers to mental healthcare access on the mental healthcare-seeking behaviors of racial and ethnic minority groups.
2. To implement EBP in mental healthcare settings to improve access to and utilization of healthcare resources to improve the mental health outcomes among patients from minority backgrounds.

Target Population

Racial and ethnic minority

Location of Implementation

• OSU Medical Center DODD Hall
• Columbus Spring East to deliver targeted

Project Timing

Estimate timeline: 30 months

Spring 2023

• March/April 2023
• Select the project topic and fine-tune the topic
• Develop a PICO(T) question
• Conduct a comprehensive literature review
• Identify and define literature analysis tools

Summer 2023

• June/July 2023:
• Development of the proposal for the DNP project.
• Review of the IRB requirements for the DNP project and
• Present project proposal
• Apply business and financial concepts to develop a budget for the DNP project.
• Complete Information Literacy modules.
• Appraise literature search and evidence analysis tools.
• Update project planning paper.
• Update timeline paper.
• Update the DNP project proposal with a refined PICO(T) question.
• Collaborate with facility staff to further identify the problem of concern and focus.

Summer to Fall 2024

• Conduct a comprehensive literature review to further identify gaps in current evidence
• Continue to collaborate with other practitioners at work in practices related to the DNP project
• Collect data
• Analyze data
• Refine methodologies for the DNP Project
• October/November 2023
• Attend relevant conferences and workshops to network and gather more insights.
• Continue drafting the initial chapters of the thesis.

Spring/Fall 2024

• Finalize data collection and analysis
• Review and analyze collected data
• Draw conclusions
• Present project to related Boards for further review
• Completion of the DNP project

Tools of Survey

• Internalized Stigma of Mental Illness (ISMI) scale by Dr. Joseph H. Hammer and Dr. Michael D. Toland
• The Perceived Devaluation-Discrimination Scale by Bruce G. Link

Proposed Outcomes

• Comprehensive understanding of mental health stigma and its significance in health-seeking behaviors among minority populations
• Reduced negative attitudes toward mental disorders among racial and ethnic minority groups
• Reduced mental health stigma
• Reduced racial discrimination in mental healthcare settings
• Provision of culturally sensitive mental healthcare
• Better treatment outcomes
• Policy and practice changes

Evaluation Plan

The evaluation plan focuses on the two overarching objectives of the DNP project—to explore and understand the impact of mental health stigma compared to other barriers to mental healthcare access on the mental healthcare-seeking behaviors of racial and ethnic minority groups and to implement EBP in mental healthcare settings to improve access and utilization of healthcare resources to improve the mental health outcomes among patients from minority backgrounds.

Preliminary Budget

Project Expenses
Salaries/Wages*		+30% Benefits
Individual Jane Doe Tom Smith Feliz White Juan Rodrigez       Total Salary Costs:	Monthly $5,000 $4,500 $4,500 $4,500	Total $6,500 $5,850 $5,850 $5,850       Total: $24,050
Start-Up Costs:
(Itemize costs here- copies, charts, display board, etc.)     Total Start-up Costs	Printing and copying materials Charts and graphs Display board	$7,00 $350 $150   Total: $1,200
Capital Costs
Hardware Equipment Other Total Capital Costs	Data collection Tech Laptop Others	$1,200 $2,000 $850 Total: $4,050
Operational Costs
Itemize operational costs in this section (electricity, heat, etc)	Electricity Internet and Data:	$150/Month $120/Month Total: $270/Month
Total Project Expenses for the First Month		Total: $29,570
Total costs for Second Month		Total: 24,320
Project Revenue**
Revenue Generation
Itemize potential revenue in this section           Total Project Revenue		$ $ $ $   Total
Program Benefit/Loss
Total Revenue		$
Less Expenses		$
Total Program Benefit/Loss		$

 References

Ahad, A. A., Sanchez-Gonzalez, M., & Junquera, P. (2023). Understanding and addressing mental health stigma across cultures for improving psychiatric care: A narrative review. Cureus, 15(5). https://doi.org/10.7759/CUREUS.39549

Alemu, W. G., Due, C., Muir-Cochrane, E., Mwanri, L., & Ziersch, A. (2023). Internalised stigma among people with mental illness in Africa, pooled effect estimates and subgroup analysis on each domain: systematic review and meta-analysis. BMC Psychiatry, 23(1), 1–19. https://doi.org/10.1186/S12888-023-04950-2

Cook, B. L., Hou, S. S. Y., Lee-Tauler, S. Y., Progovac, A. M., Samson, F., & Sanchez, M. J. (2018). A review of mental health and mental health care disparities research: 2011-2014. Medical Care Research and Review, 76(6), 683–710. https://doi.org/10.1177/1077558718780592

Edbrooke-Childs, J., & Patalay, P. (2019). Ethnic differences in referral routes to youth mental health services. Journal of the American Academy of Child & Adolescent Psychiatry, 58(3), 368-375.e1. https://doi.org/10.1016/J.JAAC.2018.07.906

Eylem, O., Eylem, O., De Wit, L., Van Straten, A., Steubl, L., Melissourgaki, Z., Danlşman, G. T., De Vries, R., Kerkhof, A. J. F. M., Bhui, K., & Cuijpers, P. (2020). Stigma for common mental disorders in racial minorities and majorities a systematic review and meta-analysis. BMC Public Health, 20(1). https://doi.org/10.1186/S12889-020-08964-3

Fante-Coleman, T., & Jackson-Best, F. (2020). Barriers and facilitators to accessing mental healthcare in Canada for black youth: A scoping review. Adolescent Research Review, 5(2), 115–136. https://doi.org/10.1007/S40894-020-00133-2

Lu, W., Todhunter-Reid, A., Mitsdarffer, M. L., Muñoz-Laboy, M., Yoon, A. S., & Xu, L. (2021). Barriers and facilitators for mental health service use among racial/ethnic minority adolescents: A systematic review of the literature. Frontiers in Public Health, 9, 641605. https://doi.org/10.3389/FPUBH.2021.641605

Ramos, G., & Chavira, D. A. (2022). Use of technology to provide mental health care for racial and ethnic minorities: Evidence, promise, and challenges. Cognitive and Behavioral Practice, 29(1), 15–40. https://doi.org/10.1016/

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The purpose of this assignment is to explain your ideas to ensure you are on the right track before starting on the Timeline and Outline.

Include your PICO(T) question. State the issue and explain why this issue is of interest. Include background information showing the need for this project.
Show at least some of your review of the literature (ROL) so we can get an idea of how you are synthesizing the information. The more you have the better. You should have some information from your matrix assignment in 816 that you can use here.

Next, briefly explain what your project is. Include where you plan to conduct your project, who you plan to collaborate with for your project (who the key participants will be to ensure the success of your project), and approximately how long your project will last. Also include sampling information, any intervention that you propose as well as the design you will be using.
Last, discuss what tools you plan to use for your project. If you will be using a survey to measure the results, you will need to include the name of the survey and identify the creator. If you plan on using an established teaching tool as your intervention, again you will need to identify the originator of that tool. Any established tools will need permission to be used before you initiate your intervention.
Begin to think about the budget that you will need to carry out this project.
These are not all the details- if you want more details- review the rubric for the document and see the template below.