Culturally competent mental health services for American Indian and Alaska Native veterans

¶ … Culturally Competent Services to Native Peoples)

This article importantly addresses special needs that American Indian (AI) and Alaska Native (AN) peoples have following their deployment. Unfortunately, in many instances, the research shows, AI/AN veterans are not receiving the care they are entitled to. There are several reasons for this: a) about 40% of these veterans live in "geographically dispersed reservations and tribal lands," making it difficult to receive care (transportation is problematic in many cases); b) there is a distinct lack of diagnostic services and "specialty care" available to AI/AN veterans; c) the AI/AN veterans have "a higher incidence of mental health problems" then Caucasian veterans; and d) AI/AN veterans are "significantly" more likely to delay care because their homes are remote (Noe, et al., 2014). In fact the VA employees (doctors, nurses, psychologists and other trained staff) are often not aware that AI/AN veterans prefer to receive mental health services from tribal leaders and traditional healers in their cultures. Moreover, AI/AN veterans report "impersonal care" and very limited understanding of what the VA can do for them. Hence, much dissatisfaction is reported by these veterans who served their country.

The authors used the Organizational Readiness to Change Assessment (ORCA) to research services at 27 VA facilities in order to determine if AI/AN veterans were in fact receiving adequate care. Clearly the authors point to the need for a movement to provide more culturally appropriate services to Native Peoples. The answer to the existing problem could be forthcoming because the VA is focusing on the above-reviewed problems. The recent Memorandum of Understanding by the VA outlines the need for innovations, for a new sense of motivation for employees at VA, and for the VA to clarify its mission regarding services to AI/AN veterans. The authors collaborated with VA facilities in the Western Region, and in those facilities the authors recruited 135 employees in order to discover the level of understanding vis-a-vis patient-centered services for AI/AN veterans. The outcomes showed that the very fact of identifying VA facilities with positive organizational characteristics will be critical in implementing new and better services for AI/AN veterans. Those needed changes can take place if "senior leadership" provides "clear goals for improvement of patient care," according to Noe (S553). Just 42% of the 67 respondents from 27 VA facilities indicated they had projects aimed at launching better services for AI/AN veterans; only 30% of respondents reported their VA facilities had projects that ensured needed resources were available for AI/AN veterans; and only 15% of the 67 respondents from 27 VA facilities provided "traditional healing services for AI/AN veterans," notwithstanding "advocacy in the [official] literature" for providing traditional healing services for AI/AN veterans (Noe, S553).

TWO: Implications of the Research

The use of the ORCA formula could be used in other research involving VA hospitals and medical facilities. Especially, it seems, additional objective, science-based research is needed given the widespread scandal that broke in 2014 as to the long wait time that veterans were subjected to in VA facilities throughout the United States. The terrible injuries that military personnel suffer from land mines and other weapons in Afghanistan, Iraq and elsewhere should be cared for immediately. And moreover, the post traumatic stress disorder (PTSD) is very common among soldiers returning from the wars the U.S. has been involved in, and the VA has not demonstrated the ability to serve these returning veterans.