PTSD and Mental Health Care

Three quarters of American Indian and Alaska Native Vietnam veterans have significant mental health problems (including PTSD, alcohol and substance abuse, depression, and panic disorder). The great majority have not received any mental health services. In the MVVP more than 5 in 6 (84%) had not received any mental health care in the past year.

Barriers to participation in mental health care noted in the MVVP included most of those that also prevented use of medical care:

• Hospital/clinic too far away
• Needed care not offered
• Too much red tape at the VA/IHS
• Quality of care poor at the VA/IHS
• Not eligible for VA health care services
• Encountered/feared racial prejudice

But many people reported additional fears and concerns about seeking mental health treatment.

"I was kind of afraid they would just confine me in some facility...they suggested the PTSD treatment center in California. And they said it [treatment] took three months. And I said to myself, you know three months, boy, that's a long time. I wondered is it like a dormitory or a barracks? I kind of pictured a barracks, with bunks lined up on each side of the wall and kind of run like the military...So l said, Oh, I wouldn't like it. But they assured me that it was a good setting. And when I came here to the VA Medical Center it wasn't like [my] picture. So when I got here. I knew I would get help."

Sometimes, veterans have had bad experiences with VA mental health services in the past. Some are now finding that services have changed for the better.

"I had an incident where I had went into the VA looking for information for a problem, and the person was trying to get me to see a doctor And I said, 'What don't you understand about what I'm asking you?' And they told me, 'Well, where do you come off having an attitude?' And so, it wasn't necessarily that they didn't want to help me. It's that we didn't understand each other.

...[But] now, when you go to the VA...they have an awareness and an understanding of it... They don't always have an answer; but they always have an open hand. They always have a fresh cup of coffee. And they always have an open area. And they'll let you sit there and talk. They'll support you. They'll do the best they can to explain what they heard from you. And if they can't, they'll find someone in that office that will."