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US veterans and their unique issues: enhancing health care professional awareness

0 2 years ago

Veterans experience mental health disorders, substance use disorders, post-traumatic stress, and traumatic brain injury at disproportionate rates compared to their civilian counterparts. Eighteen to 22 American veterans commit suicide daily and young veterans aged 18–44 are most at risk. Health care professionals must be aware of patients’ military history and be able to recognize suicide-risk factors, regardless of age. Advancement in medical technology has allowed servicemen to survive their injuries but, for many, at the cost of a traumatic limb amputation and associated mental scarring. Health care professionals must be able to address physical safety concerns, as well as, emotional health of veterans. Approximately 49,933 American veterans are homeless and face the same difficulties as non-veterans in addition to service-related matters. Separation from military service and issues related to complex multiple deployments are among specifically identified veteran issues. Successful veteran reintegration into civilian life rests upon providing veterans with training that builds on their military knowledge and skill, employment post-separation from service, homelessness prevention, and mental health programs that promote civilian transition. Preparing health care providers to meet the complex needs of a vast veteran population can be facilitated by implementing veteran content into curricula that includes veteran patient simulations and case studies, and utilizes veteran clinical faculty.

Introduction

United States veterans are multifaceted and may be considered a population, a culture, and a subculture. Military culture includes, but is not limited to, the values, customs, traditions, philosophical principles, ethos, standards of behavior, standards of discipline, teamwork, loyalty, selfless duty, rank, identity, hierarchy, ceremony and etiquette, cohesion, order and procedure, codes of conduct, implicit patterns of communication, and obedience to command (LD Purnell, University of Delaware and Florida International University, personal communication, January, 2015).1

The American veteran population is a unique population. Varying military service branches and varying military experiences among the veteran population is unique. Varying wartime eras and health-specific issues associated with those eras are unique among the veteran population. From a comparison of veterans from the Vietnam, Persian Gulf, and Iraq/Afghanistan (Operation Iraqi Freedom [OIF]/Operation Enduring Freedom [OEF]) war eras, Fontana and Rosenheck2 noted distinct differences. OIF/OEF veterans include fewer African-Americans, more Latinos, and more females than other eras. In addition, this group is younger, less likely to be married, less likely to have been incarcerated, and more likely to be gainfully employed.2 It was also observed that OIF/OEF veterans appear to be more socially integrated, less often diagnosed with substance abuse disorders, and required less Veterans Affairs (VA) disability compensation for post-traumatic stress disorders (PTSDs) when compared to their Persian Gulf and Vietnam veteran counterparts.2

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