Magazine article Clinical Psychiatry News

For Vets, Social Supports Can Facilitate Treatment

Magazine article Clinical Psychiatry News

For Vets, Social Supports Can Facilitate Treatment

Article excerpt

BALTIMORE -- Veterans who receive treatment for posttraumatic stress disorder appear more likely to use social supports to get around barriers that block many from getting treatment.

But after veterans get into treatment, those who are older and have more severe symptoms may be more likely to complete it, preliminary research presented at the annual meeting of the International Society for Traumatic Stress Studies shows.

"Even after problem recognition, many people with psychiatric disorders do not seek professional help. Our work suggests that this pattern is seen in veterans who believe that they may have PTSD," said Nina A. Sayer, Ph.D., of the Center for Chronic Disease Outcomes Research at the Minneapolis VA Medical Center.

To understand why so few of those who appear to be seeking treatment are actually in treatment, Dr. Sayer and her associates selected 44 veterans out of those who were seeking disability status for PTSD in their region. There were 22 Operation Iraqi Freedom (OIF) and/or Operation Enduring Freedom (OEF), 19 Vietnam-era, and 3 other veterans from other service eras.

"By design," only 21 of these 44 veterans were in treatment at the time of their interview, Dr. Sayer said. A total of 14 women were in the sample, which had a mean age of 42 years and included three nonwhite participants.

In the preliminary results of the qualitative study, the investigators found that certain values, beliefs, and social norms acted as factors that might predispose veterans to not seek treatment, whereas other factors appeared to facilitate treatment, such as a social support network and the ease of accessing appropriate care within the VA health care system.

Dr. Sayer and her coinvestigators grouped the veterans according to gender, service era, or treatment-seeking status to find any significant differences of factors between veteran groups. Pride in self-reliance--widely held by people in and not in treatment across all groupings--interferes with getting help, Dr. Sayer said. OIF/OEF veterans tied this pride to their military training and their upbringings, whereas male Vietnam-era veterans associated self-reliant pride with their social role as providers and their cultural heritages. Individuals across all groupings also believed that any symptoms needed to be extreme to justify their entering treatment.

Veterans in and not in treatment cited the stigma of mental illness and the fear of being called or considering themselves "weak" or "crazy" as important reasons for not entering treatment. Some women were particularly concerned about being labeled "weak," because many sought parity with men to receive respect, Dr. Sayer said.

Vietnam-era veterans discussed the added layer of social stigma that accompanies the typical stereotype of a person who cannot hold down a job and has been divorced many times. …

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