Author ORCID Identifier

https://orcid.org/0000-0003-3877-0038

Date of Award

8-31-2026

Document Type

Open Access Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Clinical Psychology

First Advisor

Sarah Hayes-Skelton

Second Advisor

Lizabeth Roemer

Third Advisor

Mukta Gundi

Abstract

Women living in contexts of urban poverty (IWLCUP) experience disproportionately high rates of psychological distress, yet their mental health needs remain largely underrecognized. Beyond individualized explanations, broader ecological perspectives situate these women’s distress within previously underemphasized macrolevel forces and acknowledge the role of inequity and related structural disparities (e.g., economic, sociocultural, political etc.) in their oppression and disempowerment, thereby contributing to increased psychological vulnerability. Such frameworks call for intervention efforts that reduce individual psychological risk by addressing structural determinants proximally and distally impacting the lives of IWLCUP. Specifically, targeting poverty and economic insecurity might drive positive downstream effects that ultimately promote significant and sustainable mental health improvements in this population. Although poverty alleviation or economic empowerment interventions in low- and middle-income countries have been associated with improved social and economic outcomes, far less is known about their effects on mental health or the mechanisms through which change may occur, especially among economically marginalized women.

As such, the present study examined the impact of a 16-week vocational training program (designed to promote economic empowerment) on common mental health disorders (CMDs) and wellbeing among IWLCUP in Hyderabad, India (N = 35). Further, potential underlying psychological processes and mechanisms, including social support self-efficacy and autonomy, that might be associated with CMD symptom change across women’s engagement in the intervention were explored. Study results provide preliminary evidence that vocational training may contribute to meaningful and sustained reductions in depressive and anxiety symptoms in this population. Further, increases in reported levels of social support across the training were associated with reductions in tension-related symptoms and improvements in quality of life. Overall, this study addresses a critical gap in the literature by providing preliminary empirical support for structural interventions targeting economic vulnerability as a pathway to improving mental health among socially and economically marginalized women. At the same time, mixed findings related to psychosocial mechanisms underscore both the promise and the limitations of vocational training as a standalone mental health intervention, highlighting the importance of integrated, multi-level approaches to addressing the complex mental health needs of IWLCUP.

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