Center on Enhancement of Community Integration for Homeless Veterans, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA.
Center on Enhancement of Community Integration for Homeless Veterans, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA.
J Psychiatr Res. 2024 Apr;172:102-107. doi: 10.1016/j.jpsychires.2024.02.037. Epub 2024 Feb 15.
The COVID-19 pandemic disproportionately impacted marginalized populations including Black Americans, people with serious mental illness, and individuals experiencing homelessness. Although the double disadvantage hypothesis would suggest that individuals with multiple minoritized statuses would experience worse psychosocial impacts from the pandemic, this may not be the case for vulnerable Black Veterans. The present study investigated the sustained mental health and functional responses to the pandemic in Black and White Veterans with psychosis or recent homelessness and in a control group of Veterans enrolled in the Department of Veterans Affairs healthcare services. Clinical interviews and questionnaires were administered remotely by telephone at five time points from May 2020 through July 2021, including a retrospective time point for March 2020 (i.e., before the pandemic started). Overall, there was a striking absence of systematic differences by race in the trajectories of psychiatric symptoms and functioning among Veterans during the study period. These findings are consistent with a report on initial responses to the pandemic that revealed only a few select differences by race among Veteran groups. The lack of racial disparities is inconsistent with the double disadvantage hypothesis. Although further investigation is needed, one possible interpretation is that the wrap-around services offered by the Veterans Health Administration may have mitigated expected differences by race among Veterans with psychosis or homelessness. Future research should continue to examine whether VA services mitigate disparities in mental health and psychosocial outcomes.
译文：
新冠疫情大流行不成比例地影响了边缘化人群，包括非裔美国人、患有严重精神疾病的人群和无家可归者。尽管双重劣势假设表明，具有多种少数群体地位的个体将从疫情中经历更严重的心理社会影响，但这对脆弱的黑人退伍军人来说可能并非如此。本研究调查了患有精神病或最近无家可归的黑人和白人民兵以及参加退伍军人事务部医疗保健服务的退伍军人对照组在疫情期间的持续心理健康和功能反应。从 2020 年 5 月到 2021 年 7 月，通过电话远程进行了五次临床访谈和问卷调查，包括 2020 年 3 月（即疫情开始前）的回顾性时间点。总体而言，在研究期间，退伍军人的精神症状和功能轨迹在种族方面没有明显的系统差异。这些发现与对疫情最初反应的报告一致，该报告仅揭示了退伍军人群体中种族之间存在少数几个选择差异。缺乏种族差异与双重劣势假设不一致。尽管需要进一步调查，但一种可能的解释是，退伍军人事务管理局提供的全方位服务可能减轻了精神病或无家可归退伍军人中种族差异。未来的研究应继续检查 VA 服务是否减轻了心理健康和心理社会结果的差异。
