Post on 04-Jan-2016
description
2011 National Hispanic Medical
Association Conference
Becoming Familiar with Hispanic Veterans Healthcare:Hispanic Veterans and the VA
Gabriel Pérez, CEO, Phoenix VA Health Care System
and President, Board of Directors, National Forum for Latino Healthcare Executives
La Familia
Hispanic Veterans increasing
Stress on military families
Clinician awareness
Special considerations
Phoenix Experience
Governor’s Commission 2010
Shift in emphasis to family members
National Task Force Recommendations
Hispanic Veterans
Exhibit higher risk of PTSD Might other postwar adjustment
problems and life stressors be more prevalent among Hispanics?
Did factors in the War Zone contribute to Hispanic Veterans’ higher rates
of PTSD? Puerto Rican Vietnam Veterans
PTSD Elevated prevalence rates Other possible explanations
War Zone stressors Differences in prewar vulnerability factors Ethno-cultural factors (experiencing distress) Powerful stressful events Experiences with racial/ethnic prejudices and
distress La familia relationships
Severity of Combat Related PTSD vs Non-Combat Related PTSD
Combat exposure Psychiatric disorders Social impairment
Rates of PTSD Comparison
Demographics and Diagnosis of OEF/OIF Veterans
Demographics: OEF/OIF Patients
12,480 triaged In Germany 10.1% to Psychiatry
More likely to be: Female under 31 years Black or Hispanic Enlisted or National Guard/Reserves
80% evacuated during first 6 months 17% evacuated during second 6 months
Demographics and Diagnosis of OEF/OIF Veterans
Diagnosis: Adjustment Disorders 37.6% Mood Disorders 22.1% Personality Disorders 15.7% Anxiety Disorders 15.4% No Psychiatric Diagnosis 9.2%
Only 5% returned to OEF/OIF duty
Veteran Suicides
Military Service – Traumatic Experience Devastation Killing Torture Life-threatening situations Unexpected
US Army suicide rates doubled since 1943.
Suicide Rates Keep Rising Increased risk
Lack of social support Traumatizing life events Deprived sense of control PTSD (Iraq – US Marines experience highest DX) General anxiety disorders Depression Failed relationships
Hispanics higher risk Marginalization conditions Lack of bilingual language management Discrimination
Partial Solution for Prevention
Screening at earliest interface
Culturally sensitive
Planned interaction
How to Serve Veterans Understand
Past military service Utilization of available services
Examples 1954 Segregation
Utilization of VA Services Black Veterans – 3.7 times more likely to use VA Hispanic Veterans – 5.3 times more likely Korean Veterans – More than WWII OEF/OIF – Phoenix: 44% market penetration
Department of Veterans Affairs Mission
Provide Primary care, Secondary Care, and Related Medical and Social Support Services to eligible Veterans.
Mitigation of disparities
Minority Veterans go to VA for treatment Why??
The VA – “The Best Health Care System in the World”
One Part: Mental Health Prevention PTSD and Suicide screening Coordinated care Housing Mental Health expansion MICHM Homelessness Hotline: 1-877-4AID-VET (877-424-3838) Tele-health Veterans Court National Suicide Hotline: 1-800-273-TALK (8255)
Your help is needed. How??
Conclusion
Future Veterans
Disparity attention
Access
Target Groups
Constant Needs Assessment
A Few References
J. Clin Psychiatry, 2010 Jul; 71(7): e16.J. Clin Psychiatry, 2010 Apr; 71(4): e08.J. Trauma Stress, 2002 Apr; 21(2): 133-41.J. Nerv Ment Dis, 2007 Aug; 195(8): 655-61Cultur Divers Ethnic Minor Psychol, 2000 Aug; 6(3): 235-51Am J of Psychiatry, 2000 Apr; 157(4): 615-9Gen Hosp Psychiatry, 2006 Jul-Aug; 28(4): 352-6Bol Assoc Med PR, 2009 Jul-Sep; 101(3): 33-41Mil Med, 2002 Jul; 167(7): 525-31Mil Med, 2002 Mar; 167(3): 235-41Med.Care, 2002 Jan; 40(1 Suppl): 117-28
Hispanic Veterans Health Care and the VA
Thank you!
Gabriel Pérez, CEO, Phoenix VA Health Care System
and President, Board of Directors, National Forum for Latino Healthcare Executives