Racial Disparities in Posttraumatic Stress Disorder Treatment

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Table of Contents

Introduction
Policy Solution
Policy Impact
Conclusion
Works Cited

Introduction

We all know that African Americans participated in every war in which the United States of America was involved. Their sufferings are not limited to their war struggle as they tend to suffer even when they return home. While African Americans make up for approximately 14% of the US population, they account for 17% of the overall number of US soldiers. The African American soldiers and veterans are exposed to numerous stressors that can be characterized by a rather high level of multi-layeredness and interconnection (Rosen et al. 355). Like numerous other American soldiers, African Americans may feel left and unsupported when they come back home from the battlefield. However, the issue is rather complex for Black veterans and soldiers because they experience stresses based on critical changes occurring in mental health and associated with institutional racism.

All these factors lead to the advent of a struggle regarding the inability to obtain necessary resources and gain support that is vital throughout the process of overcoming the pains of war (Kaczkurkin et al. 93). This is why clinicians have to understand that they have to deal with specific cultural experiences when treating African American veterans. This leads us to the hypothesis that the healthcare specialist has to be culturally competent to provide high-quality treatment to African American veterans. Within the framework of this submission, the author is going to discuss several components that may critically impact the complexity of psychological traumas received by African American soldiers and provide a conceptualized policy that will be expected to contribute to the changes in healthcare practices. This population necessitates essential clinical treatment, and specific assessment techniques have to be used (Mustillo and Kysar-Moon 330).

Moreover, the researcher realizes that there are quite a few ethnicity-specific reactions that may transpire during the veterans exposure to combat-related PTSD. This kind of ordeals may include the African American Psychic Trauma, for example. A thorough analysis of this topic will help the researcher to investigate the nature of African American vulnerabilities and come up with a brand new treatment plan that will also include a novel type of care delivery. Such evidence was presented by Tiet et al. who examined the status of minority veterans and then associated it with expectancies regarding the treatment of PTSD (317). This study was based on the information presented by the Department of Veteran Affairs (VA) and included several additional aspects such as components of the therapeutic alliance. The researchers asked veterans to complete surveys regarding the efficiency of PTSD residential treatment that they received (37% minority respondents, 63% white respondents) (Tiet et al. 319).

It was hypothesized by the researchers that minority status adversely impacted their therapeutic bond with the outpatient provider. At the same time, the authors of this research article stated that the expectancies for residential treatment also relied on the association with the former provider. Tiet et al. found out that higher expectancies could be positively associated with the concept of task agreement (instead of the previously mentioned therapeutic bond (319). The problem with their findings consisted in the fact that effect sizes were relatively small. To conclude, the researchers were not able to identify any critical differences in terms of VA PTSD residential treatment that would consider the ethnic minority status. According to the information obtained throughout the surveys, the investigators were able to point out the idea that other treatment settings should be involved in future research to investigate the issue of veterans with PTSD more comprehensively.

Another study on the topic of PTSD among African American veterans was conducted by Spoont et al. (419). They based their research project on the idea that PTSD can be associated with several physical and social deficiencies that are exclusively PTSD-related. Even though the VA does a lot to cover the expansion of mental health issues among African American veterans, they cannot provide sufficient care to the majority of those in need. Therefore, the clinical benefit cannot be achieved, and African American veterans keep on struggling (Spoont et al. 419). In addition to this inclusive hypothesis, the researchers decided to take into account the question of race differences when it came to premature mental health treatment. The investigators went even further and addressed the issue of differential access to healthcare services. To obtain the most accurate results, they took a sample of African American veterans who were recently diagnosed with PTSD (Spoont et al. 420).

The researchers waited for six months to complete a follow-up survey. The results of their investigation showed that minority veterans (Latino and African American) did not receive sufficient treatment throughout those six months (Spoont et al. 422). Nonetheless, African American veterans were also found to meet the effects of pharmacotherapy retention negatively. Race disparities related to treatment retention did not show any significant variation between White and African American veterans. Spoont et al. concluded by claiming that even in the VA, there are occasional disparities in terms of PTSD treatment. They advocated for a much more direct approach towards the patients treatment beliefs. Therefore, we have to conduct further research in the area to address the issue of treatment disparity properly and provide African American veterans with decent and fair PTSD treatment.

The issue with PTSD consists in the fact that more and more veterans are annually affected by this disorder. In perspective, treatment may be costing more than several billions of dollars because the country does not pay proper attention to the problem. Therefore, there is a need to advocate for critical changes in the current policy to help the VA get rid of race-associated disparities. Counseling Services of the organization also have to be improved the VA does not even try to outsource these services yet, and the burden of derisory treatment resources remains undefeated. It is safe to say that without an applicable intervention, veterans with PTSD will be subject to abusing alcohol and other substances.

The evidence shows that they numb their pain using displaying hazardous or felonious behaviors (Koo et al. 12). Currently, fixing the short-term issues may lead to the advent of several complex long-term issues that will affect the whole ecology, not a single individual. African American veterans are mostly affected by PTSD because they showcase their non-adaptive coping mechanisms. Consequently, we have to find a solution that would let African American veterans have access to the necessary services and resources. Lee and Gabriele also mention that African American veterans are much more inclined to being exposed to traumas, obesity, and sleep problems (3). The VA did not pay enough attention to the question of posttraumatic stress, but there is a robust body of evidence that shows that the current policy has to be revised to provide better treatment plans for the minority veterans.

Policy Solution

This policy solution will be divided into several important points. First of all, there is a need to take into account the cultural eco-map and ethnically relevant readings. This policy stresses the importance of facilitating the development of simpler eco-maps and military-adjusted narratives. In this case, the policy relies on the idea that African American veterans may identify themselves more with their armed services family. The proposed action plan revolves around the idea that many African American veterans may have unresolved conflicts that transpired from the death of their military partners. The evidence discussed in the literature review section hints at the fact that there is a strict necessity to build new narratives to approach African American veterans culturally.

This policy change is justified by the fact that the new processes of cognitive synthesis may help African American veterans to integrate their traumatic past into the current existence. At the same time, this approach will help healthcare practitioners to decrease the strength of PTSD symptoms (this will be discussed in the next subsection of this proposal). The rationale for reworking the framework of passing down information consists is the difference between the traditional African American methods (storytelling and narratives) and those that are currently used by practitioners. The evidence shows that such clinical treatment plans may have a positive impact on African American veterans. Therefore, the idea that is covered in this policy relates to the concept that collaborative partnership increases the chances to come up with an appropriate treatment plan for African American veterans with PTSD.

The second part of this proposal is intended to disclose several recommendations for the practitioners. First of all, there is a stringent necessity to help PTSD practitioners to gain more insight into the question of the cultural identity of African American veterans. The problem here consists of the fact that they may be still exposed to the adverse influence of racism and the history enslavement. According to this policy proposal, practitioners should not disregard the fact that African American individuals are oppressed and battle against inequalities even in the modern world. Second, it is recommended to identify the strengths present in African American veterans to help them to build positive relationships with their families. Here, practitioners will have to emphasize the importance of finding the solution collaboratively. The third recommendation hints at the fact that African American veterans should be perceived as partners on several levels.

It may be reasonable to learn more about the everyday life of regular African American individuals to find more points of contact. Expanding on this topic, the new policy also suggests that practitioners should interact with veterans throughout each of the treatment stages. These stages include diagnosis, medication intake, and the overall treatment process. Clinical interaction with African American veterans can be subject to transference issues, so it has to be guided carefully. Overcoming this barrier is vital, and the policy suggests that African American veterans have to work on their PTSD in collaboration with the practitioners to achieve positive results. We should also consider the fact that the psychological traumas of African American veterans may be reflected in other family members. This may happen because typical African American families are in a state of interdependence. The policy intends to address PTSD as a disorder that causes a lack of affection and makes African American veterans too preoccupied with their traumas. Therefore, the possibility of internal family disintegration also has to be addressed by the renewed policy.

The third part of the proposal relates to the implementation of specific family therapies as they can also be helpful. This idea also has to be supported by an additional initiative psychoeducation for the members of African American families with veterans. Nonetheless, this should not be the only improvement. It is also proposed to provide counseling services using the Army Community Services Program (ACS). The rationale behind this decision is an extensive number of services that can be adjusted to the needs of African American veterans with PTSD and their families. Also, this program can be implemented because it is available in several places and local communities fully support these initiatives. In perspective, the policy is willing to connect with the ACS because it provides relocation, deployment, and budgeting services for African American veterans.

Also, at this particular point, we may address the primary cultural issue associated with the African American population and soldiers/veterans in particular. There is a problem with the inability of the majority of clinicians to embrace a different archetype that outlines the African American community. The rationale for this particular decision consists of the idea that there are ways to conceptualize African American worldviews and develop an African-centered treatment framework that will be based on the strengths of this community. Within the framework of this policy, it is proposed to pay attention to the significance of family and collectivism, religion and spirituality, empathy, empowerment, and healing rituals. As it has been mentioned before, we have to focus on the African American culture and history to be able to develop a multi-dimensional treatment framework. To conclude, the author of this proposal believes that African American veterans with PTSD should be exposed to holistic treatment because of numerous spiritual aspects that are typical of this community.

The author of this proposal understands that religiosity and spirituality of African American veterans is one of the cornerstones of reforming the existing policy. Therefore, minority veterans with PTSD must be influenced by practitioners properly as there is no other method to cope with traumatic events. Without an in-depth understanding of the African-centered culture, there is no point in revising the current policy. All the PTSD practitioners dealing with African American veterans will have to possess knowledge in military culture. The author of this policy proposal is certain of the fact that clinicians have much better chances of building positive relationships with African American veterans if they are well-versed in the discipline of the armed services. This policy is compiled to promote the significance of military values that are highly appreciated by African American veterans. It may be safe to say that effective PTSD treatment can only take place into a culturally appropriate environment that respects the peculiarities of African American worldviews. To conclude, the development of a renewed policy can also be supported by the fact that African American veterans are less expected to approve PTSD treatment than their White counterparts. There is no way we can elaborate and implement a new policy without addressing the question of mental health stigma. This may be particularly beneficial when treating African American veterans with PTSD.

Policy Impact

It is expected that the epidemiological data reports will show a robust decline in the number of African American veterans with PTSD after the policy is implemented. Also, the researcher assumes that even the rates of PTSD prevalence will go even lower than expected. Nonetheless, there may still be some issues with providing appropriate treatment for veterans with severe functional impairment. One of the problems that may interfere with the successful implementation of the policy and spoil the positive impact of the latter is the willingness of quite a few veterans to exaggerate their symptoms for the sake of disability compensation. Regardless, the policy will deal with the cases where the reports on combat exposure change repeatedly and do not reflect the severity of PTSD correctly. The proposed policy will allow clinicians to perform a much more accurate clinical evaluation and provide services to the majority of African American veterans in need.

In perspective, this policy will exterminate the need to be watchful and validate veterans sincerity using additional check-ups and unnecessary interviews. One of the outcomes that are perceived as central is the ability to preserve effective and compassionate healthcare and maintain positive relationships with African American veterans. Statistically, African American veterans with PTSD do not commonly benefit from treatment if compared to other patients with this disorder. The researcher expects that the employment of the proposed policy will increase the overall number of African American veterans that are willing to complete psychotherapy and engage in posttreatment activities. It is also expected that the implementation of this policy within the VA framework will provide us with more evidence regarding clinical improvements in African American veterans with PTSD. This policy can be positively associated with a cognizant attempt to encourage African American veterans to participate in vocational rehabilitation.

The significance of this policy can be highlighted by the fact that currently, vocational rehabilitation is not available to the majority of African American VA associates with PTSD. This will help the researcher to replace the existing policy and implement only those evidence-based practices that are aligned with the rehabilitation principles mentioned in the previous subsection of the proposal. Most probably, African American veterans will be able to find a job after being exposed to the countertherapeutic practices of the past. The impact of the proposed policy will be perceived on working, social, and physical levels. More to say, the policy will strengthen the existing knowledge base regarding the African American community and the minority veterans with PTSD. The researcher expects to minimize the occurrence of cases where veterans with PTSD are merely seeking compensation and are not interested in being a part of clinical research or an evidence-based treatment plan. This recommendation was not taken into consideration before, but the author of this proposal believes that it makes no sense to ignore this population.

On a bigger scale, the implementation of the proposed policy will give clinicians the possibility to recruit applicants that are involved in the treatment process and not motivated solely by compensation. This will allow us to develop the existing PTSD interventions for African American veterans and help them overcome their combat trauma. It is also expected that they will closely collaborate with clinicians to investigate the under-researched aspects of PTSD. US veterans deserve to be treated appropriately, and this policy will change their status in the healthcare community. Moreover, appropriate rehabilitation services that are in line with the cultural specifics of African American veterans will positively impact their civilian life. The social expectations associated with this policy are rather high. In perspective, the proposed policy will eradicate the counterproductive practices from the radar of PTSD practitioners and provide the latter with more possibilities to save African American veterans from becoming psychiatrically disabled. Using this policy, the researcher expects to develop flexibility in the minority veterans, but they have to bear in mind that psychiatric problems may impact the process of recovery regardless of the chosen strategy. This is why resilience is pivotal, and the author of this policy proposal believes that the number of chronically ill African American veterans with PTSD will decrease significantly.

Therefore, the policy outlined within the framework of this submission will pave the way for a fundamental reform of healthcare that will flexibly address the issue of African American veterans with PTSD and increase the overall level of responsiveness of all actors involved in the circumstances. Using this extensive policy, the researcher is willing to increase the level of healthcare services and review the number of resources that are dedicated to helping African American veterans with PTSD. The prevalence of invalidism will not be nurtured, and the available resources will not be wasted. Despite quite a few changes that the author of the policy proposes to implement, the ultimate goal of this incentive is to integrate the existing principles into the proposed framework and adjust them so that they would be in line with the needs of African American veterans. Some of these crucial aspects include emphatic treatment and vocational rehabilitation. Using the proposed policy, we will be able to make sure that the interventions are recovery-focused and there are no principles that undermine or underestimate the value of the African American community and the minority veterans with PTSD.

This policy is expected to have a major impact on the development of rehabilitation strategies and facilitation of the treatment process. This will allow the current healthcare system to take care of the most relentlessly ill African American patients. The impact of this policy on healthcare can also be characterized by the fundamental changes that will occur in medicine and labor conditions. The existing technology allows us to conduct all-inclusive research projects and implement the most farfetched treatment practices. One of the most important concepts that will be addressed using this policy is the concern about symptom overstatement. All the defective check-up procedures will be replaced with culturally appropriate interventions that will be approved by African American veterans as well. The benefits of the proposed policy are also expected to include the reduction of impediments in terms of participation in different PTSD treatment practices. African American veterans deserve to come back from the battlefield and become productive members of society one more time. This is why the author of this proposal reconsidered the existing PTSD policy and realized that the implementation of certain practices would lead to improved patient outcomes.

The most important outcome of the implementation of this policy is the complete funding of the needs of African American veterans with PTSD. The researcher believes that this step will critically improve retention rates of healthcare personnel and improve the overall quality of services provided to the African American community. In perspective, the implementation of this policy will validate the existence of licensed mental health providers that practice PTSD specifically. The majority of faux disability claims will disappear due to an updated methodology of treating African American patients. Veterans will be treated appropriately, and the conditions of participating in a disability claim program will be revised. The author of this proposal expects that several programs that support African American veterans with PTSD will be deployed to provide the necessary assistance to this vulnerable population. The policy also suggests that the appointment scheduling procedures will also be impacted.

Additionally, the author of the proposal expects that the healthcare information system will also be revised and African American veterans with PTSD will receive continuous care. In terms of the military impact of the policy, it is expected to reduce mental health stigma and increase the involvement of military personnel in the process of elaborating veteran-related policies. Also, the policy presupposes that mental health awareness programs will become an essential part of military training and minimize the incidence of PTSD among African American soldiers in the future. The VA is expected to provide specific medications to its associates to ensure that more cognitive care practices are incorporated. Importantly, this policy is expected to trigger the advent of finance-based research on stigma and other types of military traumas. Therefore, the implementation of this policy will have an incredible impact on US healthcare and veteran policies in particular.

Conclusion

This policy proposal extensively dwelled on the existence of several issues that are commonly associated with African American veterans with PTSD. Taking into consideration numerous implications of this disorder and quite a few specific concepts that relate to the nature of African American soldiers and veterans, it is safe to say that any policy on PTSD has to be extensive enough to ensure that all the aspects of care are covered. The researcher accurately outlined the issue of racial disparities in PTSD treatment of veterans and then focused on the policy that would eliminate all those discrepancies. It was found out that the implementation of the policy will not be associated with major resource expenditures and the most important concept that has to be taken into account is the cultural exclusiveness of African American veterans.

In other words, this vulnerable population has to be treated differently, and the researcher conducted a serious literature review to identify the gaps and close them using the current proposal. It can be concluded that numerous issues have to be addressed. Nonetheless, the researcher believes that a decent relationship between the VA and policy-making institutions may ultimately lead to the creation of a practically flawless healthcare system where all veterans will be treated equally. The current state of affairs hints at the fact that a lot of hard work is necessary to revive the reimbursement system and get rid of unfairness inherent in the current treatment processes. While we cannot predict the future, we can make sure that the particular nature of the African American community is addressed properly. This will facilitate the process of providing care to any veteran, not only the minority representatives because practitioners will become way more knowledgeable and versatile.

PTSD is a serious disorder, and we cannot mitigate all of the discrepancies associated with African American veterans overnight. Nonetheless, the current policy proposal provides a rational framework for the upcoming incentives and makes the best effort to include all focal points into the healthcare equation. The impact of the proposed policy cannot be estimated yet, but it is going to affect the system of veteran care provision in the United States of America. Several essential resources have to be allocated properly and the author of this proposal critically addressed this issue. African American veterans with PTSD can be rightfully considered to be a vulnerable population that does not receive the recognition it deserves. This policy was elaborated to equalize the current state of affairs in healthcare and ensure that all the parties attain accurately calculated reimbursements that do not rely on veterans race and do not perceive the latter as one of the decisive factors when it comes to providing PTSD treatment. Most probably, even the attitude of African American veterans towards healthcare will be affected, and the researcher sees this as a positive outcome that cannot be replaced by any other benefits. A collaborative care environment will reduce the tension between veterans and care providers and the key idea behind the current policy proposal is that positive relationships between the parties may help them both. It may be concluded that this all-encompassing policy may be able to promote equality in healthcare and improve the majority of aspects that relate to the African American community and their veteran representatives who have PTSD.

Works Cited

Kaczkurkin, Antonia N., et al. Ethnic and Racial Differences in Clinically Relevant Symptoms in Active Duty Military Personnel with Posttraumatic Stress Disorder. Journal of Anxiety Disorders, vol. 43, 2016, pp. 9098., Web.

Koo, Kelly H., et al. PTSD Detection and Symptom Presentation: Racial/Ethnic Differences by Gender among Veterans with PTSD Returning from Iraq and Afghanistan. Journal of Affective Disorders, vol. 189, 2016, pp. 1016., Web.

Lee, Aaron A., and Jeanne M. Gabriele. Racial Differences in the Associations of Posttraumatic Stress and Insomnia with Body Mass Index among Trauma-Exposed Veterans. Behavioral Medicine, vol. 1, no. 1, 2017, pp. 18., Web.

Mustillo, Sarah A., and Ashleigh Kysar-Moon. Race, Gender, and Post-Traumatic Stress Disorder in the U.S. Military. Armed Forces & Society, vol. 43, no. 2, 2016, pp. 322345., Web.

Rosen, Marc I., et al. Racial Differences in Veterans Satisfaction with Examination of Disability from Posttraumatic Stress Disorder. Psychiatric Services, vol. 64, no. 4, 2013, pp. 354359., Web.

Spoont, Michele R., et al. Are There Racial/Ethnic Disparities in VA PTSD Treatment Retention? Depression and Anxiety, vol. 32, no. 6, 2014, pp. 415425., Web.

Tiet, Quyen, et al. Relationships between Racial/Ethnic Minority Status, Therapeutic Alliance, and Treatment Expectancies among Veterans with PTSD. Psychological Services, vol. 13, no. 3, 2016, pp. 317321., Web.

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