ABSTRACT
Are veterans who have serious mental health problems seeking out and finding appropriate help? This seemingly straightforward question is at the heart of this chapter—and our data reflect the complexity of the answer.
The image often portrayed in the mass media is that Vietnam theater veterans, particularly those afflicted with PTSD or other forms of psychological readjustment problems, do not receive the care they need. However, the research literature has not always supported this popular notion. In terms of physical health care, for example, some studies have found no differences in the use of physical health care services between veteran and non-veteran populations of the same age. Further, these studies suggested that there may be little need for special planning or efforts to provide physical health care for Vietnam or other veterans because they were receiving care in about the same proportions as non-veterans.
In terms of mental health care, the story is different. It has been estimated that approximately 10 percent of all veterans use the VA health care system for mental health reasons and that as much as 25 percent of veterans’ mental health care is provided through the VA. However, there have been no solid data on how many veterans use non-VA mental health care and what proportion of veterans with mental health problems receive care.
Chapter IX brings new and more complete data to bear on these 201issues. Overall, the findings do not suggest that Vietnam theater veterans are less likely to use mental health services than non-veterans. The data suggest that male Vietnam theater veterans are as likely as non-theater veterans and civilians to have used mental health services at some point in their lives, as well as in the last six months to a year. The male theater veterans were more likely to have used a VA service for mental health problems than were non-theater veterans. For females, the pattern was slightly different. Female theater veterans tend to use VA and non-VA services more currently and VA services more on a lifetime basis than female era veterans, but not more than their civilian counterparts.
In examining those with PTSD, it was revealed that this group was more likely to report use of VA and non-VA services for mental health problems on both the current and lifetime basis than were theater veterans without PTSD. For example, 62 percent of the males and 73 percent of the females with PTSD reported post-military use of some VA or non-VA health care service for mental health problems. Among theater veterans without PTSD, only 25 percent of the males and 39 percent of the females reported any kind of mental health care use.
Though these figures suggest that a significant proportion of Vietnam theater veterans with PTSD have found their way at least to some mental health care resource, they do not justify complacency on the part of the health care delivery system. First, it should be kept in mind that these data only reflect those persons who have made at least one visit about a mental health problem to a health care provider. More than one half of those visits were made to general health care personnel and not to mental health specialists. Further, the data from the study analyzed to date reports no information on the amount, quality, or effectiveness of services received.
When the data were analyzed in terms of whether theater veterans with PTSD were receiving current help, the results were more discouraging. Some three quarters of the male and almost half of the female Vietnam theater veterans with current PTSD do not receive any mental health care. It is noted in this chapter that among some subgroups of theater veterans, particularly Hispanics, significantly larger proportions of those with PTSD are currently receiving no mental health care. Some 22 percent of the males and 55 percent of the females who currently have PTSD report receiving some mental health care in the last six 202months. Approximately one half of those receiving any care report having used a VA resource in the last year.
