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Dissertation
The impact of evidence-based and promising practices on the mental health of violently injured youth: a focus on racial/ethnic minorities & on lesbian, gay, bisexual, and transgender (LGBT) youth
Doctor of Philosophy (Ph.D.), Drexel University
Mar 2025
DOI:
https://doi.org/10.17918/00010955
Abstract
Community violence, with gun violence as its most devastating manifestation, is a pervasive public health problem across the US. Black, Latino, and LGBTQ youth disproportionally experience violence. The resulting mental health consequences, including PTSD and depression, often go untreated, especially among impoverished youth. Untreated mental health challenges related to violence can derail youths' healthy development, often resulting in poor outcomes across settings. Hospital-based violence intervention programs (HVIPs) were designed to prevent reinjury and retaliation among youth. However, only recently have HVIPs focused on victims' mental health needs, post-traumatic stress disorder (PTSD), and depression. This dissertation examined the effectiveness of evidence-based and promising trauma-specific practices in addressing the mental health needs of Black, Latino, and LGBTQ youth who experience community violence, inclusive of schools, as victims or witnesses, or who lost a loved one to gun violence. A mixed-methods approach was utilized, consisting of three studies: 1) A systematic literature review of studies in the HVIP field between 2008 and 2024 that focused on youth's mental health, 2) Pilot testing the integration of home and community-based Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) with peer services and case management for youth who experience violence, and 3) A qualitative study that explored the experiences of LGBTQ youth who experience violence. This dissertation contributes to the field of child trauma and violence prevention in the following ways: 1) it documents the gaps in HVIP's effectiveness in addressing the mental health needs of youth after violence; 2) it highlights the need to incorporate evidence-based, culturally sensitive mental health interventions in HVIPs settings; 3) it pilot tests a novel approach to providing trauma-focused mental health services for Black & Latino Youth and their caregivers showing significantly positive improvement in youth-reported posttraumatic stress disorder and depressive symptoms when incorporating peer support with TF-CBT; 4) it documents barriers faced by LGBTQ youth in accessing mental health services after experiencing violence, and 5) it advances recommendations for affirming and effective trauma-specific services for this population. Further research, implementation, and evaluation of mental health interventions in HVIP settings are needed to improve mental health outcomes for these vulnerable yet immensely resilient, minoritized communities. The meaningful inclusion of youth and caregiver voices in both research and practice is also critical to advancing culturally relevant mental health interventions.
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Details
- Title
- The impact of evidence-based and promising practices on the mental health of violently injured youth
- Creators
- Arturo Zinny
- Contributors
- Randall Sell (Advisor)
- Awarding Institution
- Drexel University
- Degree Awarded
- Doctor of Philosophy (Ph.D.)
- Publisher
- Drexel University; Philadelphia, Pennsylvania
- Number of pages
- xi, 129 pages
- Resource Type
- Dissertation
- Language
- English
- Academic Unit
- Dana and David Dornsife School of Public Health; Drexel University
- Other Identifier
- 991022054840104721