Veteran 's Access to Mental Health Services Based on Gender Research Paper

Excerpt from Research Paper :

Does Gender Affect the Utilization of Mental Health Care Services among Veterans?

The decision one makes when choosing a career poses a lifelong effect on his own life as well as of his family members. The deployment decision of a career that the person has to face sometimes harms his mental health and family both (Brooks & Chopik, 2020). For example, if the person belongs to the army, he might be deployed in a war zone, which later would have disastrous impacts on his mental health in the form of stress, depression, and excessive use of alcohol, etc. The intensity of trauma might increase if the diagnosis is not done on time and may lead to family problems like divorce, social dysfunction, substance abuse, difficulties in future employment, legal complications, and, most of all, physical health troubles.

Recently, women's inclusion in almost all areas of life has been largely increased, and the same stands true for the army. Generally, it is observed that women need special care for small illnesses and therefore require outpatient health care services more frequently as compared to men; the same stands true for reproductive and depression care as well. So, per person, the medical costs of women are higher than men in general.

If women are deployed in conflict areas of war while being in the army, the medical costs might be higher (high outpatient and pharmacy costs) due to resulting mental health problems despite lower overall costs incurred by women in comparison to army men. It is important to understand that V.A. (Veteran Affairs) mental health costs based on gender differ among veterans of the army. The thesis statement of the following literature review highlights that there is a gender difference in the utilization of health care services among veterans, specifically military women. Although women's presence is large, since they are either young or belong to minorities, but the benefits they get against men are unfair. In further sections, a literature review is presented to provide sufficient background on the selected topic.

Literature Review

A Definite Need for Mental Health Care for Military Veterans

Various studies have now emerged which prove that military veterans who have served in conflict seas like Iraq and Afghanistan need special mental health care. The reason for this being that they suffer from severe mental impacts of the war circumstances during their service years in the deployment field. It has been proved from these researches that there has been a constant growth in the number of veterans seeking mental health care.

Therefore, the costs incurred on the visits per veterans for receiving mental care have also risen (Harpaz-Rotem & Rosenheck, 2011). This includes new veterans as well since it is imperative to retain them so that their services could be used for future years of their deployment. This study holds significance with relevance to the selected topic here as it shows that military veterans need special V.A. mental health care, and there is no left ambiguity in this regard.

It is accurate to assert that the negative impacts of the warzone are observed equally on V.A. military men and women who either have or not have received mental health care. Depression is a part of their personality when they return and therefore need special attention. Rates of PTSD were detected to be three times greater in military veterans who have received mental health care as compared to those who have not (Vaughan et al., 2014).

A key reason for such failure can be because the V.A. mental health care service was not meeting the veterans' treatment requirement. This difference can be eliminated by providing high-quality mental health care so that enrollment in V.A. mental care could be increased in the future, as still, a large population of veterans exists, who are not receiving this facility as yet. This research is similar to the selected topic here since it suggests the effects of V.A. mental health care on those who are receiving it and on those who are not, regardless of gender.

Signs when Medical Intervention for V.A. Health Care is Needed

Post-deployment health care includes numerous factors that provide the basis for veteran mental health care intervention. In a current research study, it had been established that mainly military men, who were older and belonged to the White community, were in war zone deployments (Adams et al., 2019).

The visible signs of mental health disorders included suicidal thoughts, depression, post-traumatic stress disorder (PTSD), and over usage of alcohol. The prominent factor of this research was the veteran identity and the number of years he had served in the military. Moreover, it was noted that older veterans had less income but were more likely to use alcohol and qualified strongly for V.A. services. This study is similar to the selected topic here since it provides the factors which are paid attention to for studying the need for V.A. services for veterans.

More Military Inclusion of Women and More Service Utilization

Veterans in any field serve several years in that specific career and expect returns after they are deployed. It should not be limited to those only who serve in the military but also applies to various other veterans who are in other careers. Recently, there has been a growing number of women seeking V.A. medical health care concerning chronic cancer pain. A study directed that there was a gender difference in the prescription of younger veterans as compared to the older ones (Weimer et al., 2013). Women observed higher visits, but the prevalence of pain was higher in females as compared to males. The difference was observed on the basis that women used more V.A. health care services in comparison with men. The data would have varied if the women using health care services were outside V.A. service, but this may provide a substantial basis for our research here. This study is similar to the selected topic since it provides grounds for gender difference with relevance to V.A. mental health care for military men and women.

In a similar study where men and women receiving V.A. medical health care for chronic pain showed that women use higher rates of outpatient services with chronic pain in terms of V.A. utilization (Kaur et al., 2007). Several research studies have demonstrated that women are less tolerant of the pain stimuli and exhibit high levels of distress when in pain, be it tissue injury.

This clearly shows a difference in the utilization of V.A. services among women, and this was also because patients linked with higher rates of depression received more outpatient care services. The study is similar to the currently chosen topic of research since it indicates that patients' psychological stage of mind determines his or her level of V.A. health care reception. The difference, however, comes with the gender when coping with pain.

Women and men are different from each other, physically and mentally. They both would suffer pain in different extents. Here, gender plays an important part since it would be interesting to see which gender is more persistent in receiving and bearing with pain. A study conducted by Haskell et al. (2009) showed that there was a gender difference in the prevalence of overall pain. The levels of pain varied from slight to moderate pain among participants from V.A. outpatient clinic visits.

The results showed that during the first year of deployment, women were less prevalent to have moderate to severe pain despite women being slightly more likely to have moderate to severe pain. This shows that women might not be directly deployed to the war zone, but they were taking part in equal assisting roles in the same area and were exposed to the same circumstances in comparison to men. However, the rate of persistent pain was lesser in women than in men. This study is similar to the currently chosen topic here since…

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…their receiving of mental health care treatment. This study is similar to the currently chosen topic here as the gender disparity majorly depends on the women's own reluctance to receive it.

Various previous studies point out the reasons for not seeking mental health care treatment. The low rates of veterans seeking mental health care are due to the reasons like societal shame, the impression of being weak, fear that people might deem them less suitable for military inclusion or leadership, negative impacts on friends and future employment, self-disgrace and functional barriers including distance from the clinic and time restrictions (True, Rigg & Butler, 2015). Building upon this work, it was further found that displeasure with specific treatment procedures and lack of willingness also deterred them from seeking treatment.

When talking about women, particularly, a study predominantly included White female respondents in reporting their response regarding civilian and veteran perceptions of stigma about PTSD (Roscoe & Anderson, 2019). Most of the labels selected by the participants were "crazy, weird, unfit to raise kids, unreliable," etc. This means that women thought they had a responsibility towards their home and kids, and that would be on risk if they are stigmatized as depressed veterans; thus, they were reluctant to receive mental health care. Moreover, they thought their friends and families would humiliate them, which can also lead to divorce and further depression.

In the above discussion, it was mentioned that women are using more outpatient mental health care services as compared to men so that they could get back to their normal lives with a clear state of mind. This observation sets in contrast with what is said here; the source of conflict being the females themselves. Most of them who have sought medical help are found to be showing positive results, but they're still is a majority that does not believe in getting medical help. The greatest deterrent for such behaviors is a social stigma in their professions, in families, and the perception that their children would have if they come to know about their mental state. This needs further research and needs to be revised so that this inconsistency could be studied deeper to understand the women's psyche and how these hindrances could be eliminated.

While this inconsistency remains, a study was conducted in which female military veterans from Iraq and Afghanistan recommended strategies for boosting their mental health care (Koblinsky, Scroeder & Leslie, 2016). This is a powerful leap towards mending their mental health since it includes their thoughts and proposals in this specified area. The researchers of this study were well aware that many women were reluctant to receive mental health care. For that, these females suggested that military culture should be studied thoroughly for understanding best practices for women and then devising treatments for them. The focus group responses of these women pointed out three aspects: enhancement of therapeutic relationship, clinical settlements, and overall system of health care itself. The interpersonal relations between the female patients and the psychiatric doctor were critical since the females needed to be listened too; they needed to share their devastating experiences in the warzone and wanted to take out all of their grief, anger, and depression. For this purpose, active listening and empathetic treatments are the core requirement. They required respect and care, which formed the basis of their mental health treatment. The gender-sensitive care was imperative since clinicians should have military, cultural expertise, which would be greatly helpful in welcoming unwilling females of the military setting. This is an advancement in the study of women's reluctance to receive mental health care since this study provided some groundwork mentioning women's thoughts in this area.

The difference in Costs when Military Men and Women used V.A. Mental Health Care

As the increase in women inclusion is seen in the army, especially those who are female veterans linked to OEF and OIF, the V.A. services are used by them more frequently. It was observed in research…

Sources Used in Documents:

References

Adams, R.E., Urosevich, T.G., Hoffman, S.N., Kirchner, H.L., Figley, C.R., Withey, C.A., Boscarino, J.J., Dugan, R.J. & Boscarino, J.A. (2019). Social and psychological risk and protective factors for veteran well-being: The role of veteran identity and its implications for intervention. Military Behavioral Health, 7(3), 304-314. https://doi.org/10.1080/21635781.2019.1580642

Allore, H.G., Ning, Y., Brandt, C.A., & Goulet, J.L. (2013). Accounting for the hierarchical structure in veterans' health administration data: Differences in healthcare utilization between men and women veterans. International Journal of Statistics in Medical Research, 2(2), 94-103. DOI: 10.6000/1929-6029.2013.02.02.03

Brooks, C. & Chopik, W. (2010, June 17). Research finds deployment affects mental health of veterans differently. Michigan State University. https://msutoday.msu.edu/news/2020/research-finds-deployment-affects-mental-health-of-veterans-differently/

Desta, H., Berhe, T. & Hintsa, S. (2018). Assessment of patient's satisfaction and associated factors among outpatients received mental health services at public hospitals of Mekelle town, northern Ethiopia. Springer Link, 12(38). https://doi.org/10.1186/s13033-018-0217-z

Duggal, M., Goulet, J.L., Womack, J., Gordon, K., Mattocks, K., Haskell, S.G., Justice, A.C. & Brandt, C.A. (2010). Comparison of outpatient health care utilization among returning women and men veterans from Afghanistan and Iraq. BMS Health Services Research, 10 (175). https://doi.org/10.1186/1472-6963-10-175

Hansen, A.H. &Hoye, A. (2015). Gender differences in the use of psychiatric outpatient specialist services in Tromso, Norway, are dependent on age: A population-based cross-sectional survey. BMC Health Services Research, 15(477). DOI https://doi.org/10.1186/s12913-015-1146-z

Harpaz-Rotem, I. & Rosenheck, R.A. (2011). Serving those who served: Retention of newly returning veterans from Iraq and Afghanistan in mental health treatment. Psychiatric Services, 62(1), 22-27. DOI: 10.1176/ps.62.1.pss6201_0022.

Haskel, S.G., Brandt, C.A., Krebs, E.E., Skanderson, M., Kerns, R.D., & Goulet, J.L. (2009). Pain among veterans of operations enduring freedom and Iraqi freedom: Do women and men differ? Pain Medicine, 10(7), 1167-1173.  https://doi.org/10.1111/j.1526 4637.2009.00714.x

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