Rosenheck R, Fontana A
Evaluation Division of the National Center for PTSD, Yale University, New Haven, Connecticut.
J Nerv Ment Dis. 1994 Dec;182(12):685-91. doi: 10.1097/00005053-199412000-00002.
This study sought to identify differences in utilization of mental health services among members of five minority groups who served in the military during the Vietnam era. Data on utilization of mental health services from five different types of provider (Veterans Affairs [VA] and non-VA mental health providers, nonpsychiatrist physicians, clergy, and self-help groups) were obtained from a national survey of Vietnam era veterans (the National Vietnam Veterans Readjustment Study) along with information on sociodemographic characteristics, health status, income, and health insurance coverage. Chi-square tests and multivariate logistic regression analyses were used to compare use of various services among whites, blacks, Puerto Rican Hispanics, Mexican Hispanics, and others. Black veterans and Mexican Hispanic veterans were significantly less likely than white veterans to have used non-VA mental health services or self-help groups, after adjusting for health status and other factors. There were no differences between ethnocultural groups in use of VA mental health services, or services provided by nonpsychiatrist physicians or clergy, even after adjustment was made for health and economic factors. Although military service during the Vietnam conflict may have alienated many minority veterans from the federal government, the reluctance of minorities to use non-VA mental health services does not extend to the VA system. Further studies are needed to clarify the reasons for less non-VA service use among some minority groups.
本研究旨在确定在越南战争时期服役的五个少数群体成员在心理健康服务利用方面的差异。从一项对越南战争时期退伍军人的全国性调查（《全国越南退伍军人重新适应研究》）中获取了来自五种不同类型提供者（退伍军人事务部[VA]和非VA心理健康提供者、非精神科医生、神职人员和自助团体）的心理健康服务利用数据，以及社会人口学特征、健康状况、收入和健康保险覆盖情况的信息。使用卡方检验和多变量逻辑回归分析来比较白人、黑人、波多黎各裔西班牙人、墨西哥裔西班牙人和其他群体在各种服务使用上的差异。在调整健康状况和其他因素后，黑人退伍军人和墨西哥裔西班牙退伍军人使用非VA心理健康服务或自助团体的可能性明显低于白人退伍军人。在调整健康和经济因素后，不同种族文化群体在使用VA心理健康服务、非精神科医生或神职人员提供的服务方面没有差异。尽管越南冲突期间的军事服役可能使许多少数群体退伍军人与联邦政府疏远，但少数群体不愿使用非VA心理健康服务的情况并不适用于VA系统。需要进一步研究以阐明一些少数群体较少使用非VA服务的原因。
