Health Services Research & Development

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2007 HSR&D National Meeting Abstract

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National Meeting 2007

3094 — Ethnicity and VA Psychiatric and Substance Use Disorder Patients

Tiet QQ (VA Palo Alto HCS/Stanford U) , Schutte K (Palo Alto HCS/Stanford U)

Objectives:
Patients from different ethnic backgrounds seeking SUD and psychiatric treatment may have different pre-treatment characteristics and different perceptions of their treatment experience. Identifying such differences may help clinicians to tailor services that better fit the patients’ needs. This study examined the differences between Caucasian and minority patients on characteristics at treatment initiation, including psychiatric disorders, service needs, readiness for change, initial experience with service providers at intake, and satisfaction of treatment at 6-month follow-up.

Methods:
The current analyses utilized baseline (N=411) and 6-month follow-up (n=345) data on patients entering treatment at one of four specialty psychiatric or SUD clinics in California and Maryland. Participants completed the computerized Diagnostic Interview Schedule (C-DIS) and a self-report survey, including measures assessing patients’ service needs, readiness for change (modified SOCRATES), experiences with their treatment providers (modified Working Alliance Inventory), and their treatment satisfaction.

Results:
At treatment initiation, minority patients had higher rates of schizophrenia, any substance use related disorder, any drug related disorder, or cocaine related disorder, but lower rates of a major depressive disorder, amphetamine related disorder, and alcohol related disorder. However, minority patients were more likely to express needs for help for both alcohol and drug problems, and had greater readiness to address their substance use problems than did Caucasian patients. They also reported that their treatment providers liked them less and were less likely to have consensus on the therapeutic tasks with service providers than their Caucasian counterparts. Furthermore, follow-up data among patients who received psychiatric treatment in the past 6 months (n=260) revealed that Caucasian patients were more satisfied with their psychiatric treatment than minority patients.

Implications:
Minority patients may have more severe psychiatric disorders at treatment initiation, such as schizophrenia and cocaine dependence. On the other hand, minority patients, on average, are more ready for treatment and for change. Future studies should explore mediating factors between patients’ ethnic backgrounds and therapeutic alliance and treatment satisfaction.

Impacts:
This study underscores the need to further understand the experience and needs of patients seeking treatment from different ethnic groups.