NAMI | Veterans of Culturally Diverse Populations

The U.S. veteran population is comprised of 85.5% White (non-Hispanic), 9.7% Black (non-Hispanic), 4.3% Hispanic/Latino, 1.2% Asian American or Pacific Islander, and 0.7% American Indian or Alaska Native.[1]

Culture or ethnic group affiliation may affect how one reacts to Post Traumatic Stress Disorder (PTSD). African American and Latino individuals may be more likely than whites to develop PTSD.[2]

Hispanic Vietnam veterans, especially Puerto Rican Vietnam veterans, have a higher risk for PTSD and experience more severe PTSD symptoms than non-Hispanic white Vietnam veterans. A high level of symptoms among this population was not accompanied by substantial reduction in functioning, suggesting that the observed differences in symptom reporting may reflect features of expressive style rather than different levels of illness.[3]

A study comparing Hispanic veterans with schizophrenia to a similar group of White non-Hispanic veterans found that while primary symptoms of schizophrenia were very similar for both groups, Hispanic veterans reported a later age of onset, exhibited higher somatization, and spent less time in the hospital than their White counterparts.[4]

One study found that Native American veterans were more likely to have been treated for alcohol-related disorders than other veterans, but they were no more likely than other veterans to have been treated for drug or psychiatric problems.[5]

A 2002 national study assessing intensive PTSD treatment programs found that Black patients showed greater improvement than White patients on one measure of PTSD symptoms and Hispanic patients were more satisfied with their treatment than White patients although they showed smaller gains in employment income.[6]

After examining pharmacy records, one study found that the use of atypical antipsychotics among African-American and Hispanic veterans was less than that of white patients for the treatment of schizophrenia. For example, the prescription of clozapine-uniquely effective for patients with comorbid substance abuse- varied greatly by race.[7]

Northern Plains American Indian Veterans expressed a high degree of satisfaction and comfort with a weekly telepsychiatric treatment program for rural, isolated, American Indians with Post-Traumatic Stress Disorder.[8]

57% of all homeless veterans are African American or Hispanic; Approximately 40% of homeless veterans have some form of mental illness.[9]

Native Americans are overrepresented in the homeless veteran population[10], while Asian-American veterans appear to experience a lower risk of homelessness than veterans from other racial or ethnic groups.[11]

Asian American veterans were less likely to report alcohol abuse or related problems and less likely to be given a diagnosis of such disorders by VA clinicians. They were less likely than Blacks or Hispanics to report drug abuse problems or be given a diagnosis of such problems, but they were not significantly different from whites in reporting or being given a diagnosis of such problems.[12]

[2]How Common is PTSD? National Center for PTSD, June 2007 <http://www.ncptsd.va.gov/ncmain/ncdocs/fact_shts/fs_how_common_is_ptsd.htm>

[3]Alexander N. Ortega and Robert Rosenheck, “Posttraumatic Stress Disorder Among Hispanic Vietnam Veterans,” American Journal of Psychiatry 157 (April 2000): 615-619.

[4]Javier I. Escobar, Eugenia T. Randolph, and Maryann Hill, “Symptoms of Schizophrenia in Hispanic and Anglo Vetreans,” Culture, Medicine and Psychiatry 10.3 (1986): 259-276.

[5]M.O. Howard, R.D. Walker, RT. Suchinsky and B. Anderson, “Substance-use and Psychiatric Disorders among American Indian Veterans,” Substance Use and Misuse 31 (1996): 581-598.

[6]Robert Rosenheck and Alan Fontana, “Black and Hispanic Veterance in Intensive VA Treatment Programs for Posttraumatic Stress Disorder,” Medical Care 40.1 (January 2002) I-52-I-61.

[7]J. Zeber, C. Laurel, J. Zeber, M. Valenstein, and F.C. Blow, “Ethnic Disparity in the Use of Atypical Antipsychotic Medications among Veterans,” Academy Health Meeting Abstracts 20 (2003): abstract no. 155.

[8]Jay H. Shore, Spero M. Manson, “Telepsychiatric Care of American Indian Veterans with Post-Traumatic Stress Disorder: Bridging Gaps in Geography, Organizations, and Culture,” Telemedicine Journal and e-Health 10 (2004): S-64.

[9]U.S. Department of Veterans Affairs

[10]Wesley J. Kasprow and Robert Rosenheck, “Substance Use and Psychiatric Problems of Homeless Native American Veterans,” Psychiatric Services 49 (March 1998): 345-350.

[11]Sabina Lim, Wesley J. Kasprow, and Robert A. Rosenheck, “Psychiatric Illness and Substance Abuse among Homeless Asian-American Veterans,” Psychiatric Services 57.5 (May 2006).

[12] Ibid.

American Indian and Alaska Native

A report from the Boston Globe on 9/17/07 discusses the high incidence of trauma in Native American veterans, and difficulties in both reaching out to Native Americans and establishing trust between the VA and Native Americans. Read the article here...

Information for American Indian and Alaska Native populations from NAMI's Multicultural Action Center can be found here...

African Americans

African American Warriors is a Web site devoted to the history of African Americans in the military from the American Revolution through the Korean War.

Another site, History of Black Military Service, looks at the history of black military service, from the Colonial Era through World War II.

Information for African Americans from NAMI's Multicultural Action Center can be found here...

Latino/Hispanic Populations

A fact sheet by the Pew Hispanic Center on Hispanics in the military, released 3/27/03.

Information for Latino/Hispanic populations from NAMI's Multicultural Action Center can be found here...

Asian American and Pacific Islander

A 5/28/02 article from the U.S. Air Force Press Release archives gives a brief history of Asian American service in the

U.S.

military. Read the article here...

A Web site created by the Asian American Studies Program at the University of Maryland entitled, "Asian Americans in the U.S. Military," provides links on the contributions and experiences of Asian Americans in the

U.S.

military.

Information for Asian American and Pacific Islander populations from NAMI's Multicultural Action Center can be found here...

Ethnic Minorities and PTSD

The National Center for PTSD developed a fact sheet on PTSD among ethnic minority veterans. The fact sheet includes results from studies on ethnic minorities with PTSD. There is also advice for mental health professionals treating minorities with PTSD as well as minorities seeking treatment. Read the fact sheet here...

Gay/Lesbian/Bisexual/Transgender (GLBT) Populations

American Veterans for Equal Rights (AVER) is a nonprofit organization dedicated to equal rights and treatment for all members of the U.S. military, past and present.

Information for GLBT populations from NAMI's Multicultural Action Center can be found here...

NAMI Resources

NAMI's Multicultural Action Center provides information and resources on mental health care for culturally diverse and underserved populations.

Other Resources

The above titles are videos for providers, veterans, and their families available through the National Center for Posttraumatic Stress Disorder. The purpose of the video series is to increase awareness of the cultural aspects of PTSD care for Latino and African American U.S. Veterans.

Veterans of Culturally Diverse Populations