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60. Utilization of VA Mental Health Services among Hispanic Veterans in New Mexico

Jose M Canive, Albuquerque VAMC and University of New Mexico; Joseph Westermeyer, Minneapolis VAMS and University of Minnesota

Objectives: 1. To identify sociodemographic characteristics and psychiatric diagnoses associated with VA mental health care (vs. care in other settings, vs. no care; 2. To identify perceived barriers to mental health care in VA settings associated with VA care (vs. care in other settings, vs. no care)

Methods: 1. Intensive focused non-probability community-based sample of 484 Hispanic veteran. 2. Sociodemographic characteristics. 3 Current and lifetime psychiatric diagnoses based on algorithmic computer-based symptom queries (Q-DIS). 4. Mental health care received in VA setting; since in last year, discharge form military, other care in medical and traditional settings. 5. Perceived barriers to mental health care in VA based (obtained in open-ended interviews).

Results: 1. Demography: 98% male; age 56.3, 84% high school grad or above, 28% full-time employed, 73% live c/family, 62% rural. 2. Lifetime dx: 56% any psychiatric dx,. Current dx: 43% any psychiatric dx; 19% any substance use disorder (w/ 15.2% alcohol abuse/dependence); 34% any anxiety disorder (w/ 23% PTSD); 34% any affective disorder; 33% more than one disorder. 3. VA service-use, any psychiatric disorder: 46% no care on VA ever; 37.3% since military duty but not last year; 17% in last year. 4. Self-reports of perceived barriers to care: response to open-ended query (currently being tabulated).

Conclusions: 1. Current psychiatric disorders among Hispanic veterans in NM was high. 2. Hispanic veterans had a high rate of comorbidity, suggesting no treatment, delayed and/or ineffective treatment. 3. About half of Hispanic veterans who had ever had a substance use disorder have not manifested substance use disorder in the last year. 4. Early barrier analyses suggest that Hispanic veterans ascribe barriers themselves, their families and communities, VA staff, and the "VA system." Common categories of VA barriers will be presented.

Impact: 1. A majority of Hispanic veterans with a current psychiatric disorder have received no care in the last year. 2. The rate or recovery form from substance use disorder is higher than observed in previous studies, with abut half recovered. 3. Recovery form affective disorder and PTSD is much lower than expected, with a high rate of comorbidity. 4. Tentative data regarding perceived obstacles to care provide opportunities for interventions to improve access.