Impact of discrimination and coping on Veterans’ willingness to seek treatment for physical and mental health problems.

Abstract

Objective: This study aimed to provide insight into health disparities among Veterans by (a) documenting the prevalence of physical and mental health problems in a racially diverse sample of Veterans, (b) comparing Veterans' willingness to seek treatment for various physical and mental health conditions, and (c) examining the impact of discrimination and coping on willingness to seek treatment. Method: Veterans reported on current physical and mental health symptoms and the importance of treatment for various health conditions. Patterns were examined in the full sample (N = 334, 32% female) and the subsample who reported hazardous alcohol use in the past year (n = 116, 33% female). Linear regression was used to test alternative coping as a moderator of the association between experiences with discrimination and willingness to seek treatment among Veterans of color (n = 242, 37% female). Results: Participants reported greater willingness to seek treatment for physical than mental health conditions. Sleep problems (75%) and substance use (74%) were the most prevalent health behaviors, but they were rated lowest in treatment importance. Among Veterans of color, everyday experiences with discrimination were generally associated with less willingness to seek physical or mental health treatment, but often only among those who denied use of coping strategies. Conclusions: Veterans are least willing to seek treatment for the health conditions that are most prevalent in their communities. Coping strategies may mitigate the negative association between discriminatory experiences and willingness to seek treatment among Veterans of color. Public Health Significance StatementThis study indicates that Veterans are least willing to seek treatment for the health behaviors that are most prevalent within their communities (sleep problems, alcohol, and other drug use). Importantly, coping strategies may mitigate the negative associations between discriminatory experiences and willingness to seek treatment among Veterans of color.

Perpetuating and protective factors in insomnia across racial/ethnic groups of veterans

“…In contrast, White veterans demonstrated relatively low rates of insomnia (58%) and relatively high interest in treatment (80%). Complementing our findings that veterans as a group are least willing to seek treatment for the conditions that are most prevalent in their communities (Miller, Monk, et al, 2022), these data indicate that participants from racial/ethnic groups with the highest need for insomnia treatment are also among the least interested. Given these findings, providers are especially encouraged to screen for sleep problems and offer sleep treatment among veterans of colour, as these minoritised groups may not share sleep issues spontaneously or request sleep treatment unprompted.…”

“…Based on data in civilian samples (Chen et al, 2015; Grandner et al, 2010; Kaufmann et al, 2016), we hypothesised that Black, Hispanic/Latine and Asian veterans would demonstrate higher rates of insomnia than non‐Hispanic White veterans. Our previous research found that veterans (as a group) demonstrate the concerning combination of high rates of sleep problems with comparatively low interest in treatment (Miller, Monk, et al, 2022). To inform future research in this area, we examined this discrepancy (rates of sleep problems versus interest in treatment) across racial/ethnic groups.…”

Comparative feasibility and preliminary efficacy of CBT for insomnia among adults seeking and not seeking addiction treatment

“…In heavy‐drinking samples, interest in treatment for emotional problems is significantly greater than interest in treatment for alcohol‐related problems (Capron et al, 2018). Indeed, both heavy‐drinking adults and individuals with substance use disorders (SUD) are more willing and/or likely to seek care for co‐morbid conditions than for substance use (Edlund et al, 2012; Miller et al, 2022). One co‐morbid health condition that is prevalent among those who use alcohol/other drugs and tends to be less stigmatised than substance use is sleep disturbance.…”