Assessing social determinants of mental health: Client experiences and counselor practices

Increasing socioeconomic challenges and their impacts on mental health support the importance of assessing clients' social determinants of mental health (SDMH) challenges. We examined counseling clients' (N = 390) experiences with SDMH assessment in counseling using the Client Perceptions of SDMH Assessment Scale (CP-SDMH). Confirmatory factor analysis confirmed a three-factor structure for the CP-SDMH. Results suggest potential biases in SDMH assessment practices. Clients reported that SDMH assessment most often occurred verbally and in relation to health and economic issues. Disparities emerged, indicating higher assessment frequency for Black/African American clients compared to White clients, and lower SDMH assessment rates for clients in specific settings, such as private practices. Furthermore, results indicate a significant positive correlation between assessment of SDMH challenges and client satisfaction. Implications for counseling and future research are discussed.