A Needs Assessment of New York State Veterans: Final Report to the New York State Health Foundation, Summary

Mental health disorders and other types of impairments resulting from deployment experiences are beginning to emerge, but fundamental gaps remain in our knowledge about the needs of veterans returning from Iraq and Afghanistan, the services available to meet those needs, and the experiences of veterans who have tried to use these services. The current study focuses directly on the veterans living in New York state; it includes veterans who currently use U.S. Department of Veterans Affairs (VA) services as well as those who do not; and it looks at needs across a broad range of domains. The authors collected information and advice from a series of qualitative interviews with veterans of Operation Iraqi Freedom (OIF)/Operation Enduring Freedom (OEF) residing in New York, as well as their family members. In addition, they conducted a quantitative assessment of the needs of veterans and their spouses from a sample that is broadly representative of OEF/OIF veterans in New York state. Finally, they conducted a review the services currently available in New York state for veterans. The study found substantially elevated rates of post-traumatic stress disorder (PTSD) and major depression among veterans. It also found that both VA and non-VA services are critically important for addressing veterans' needs, and that the health care systems that serve veterans are extremely complicated. Addressing veterans' mental health needs will require a multipronged approach: reducing barriers to seeking treatment; improving the sustainment of, or adherence to, treatment; and improving the quality of the services being delivered. Finally, veterans have other serious needs besides mental health care and would benefit from a broad range of services

Physical and psychological health following military sexual assault: recommendations for care, research, and policy /

This paper reviews data on the prevalence of sexual assault among servicemembers, predictors of disclosure, efforts to improve disclosure, victim needs and DoD efforts to provide necessary resources in the immediate aftermath of a sexual assault. The authors compared civilian and DoD guidelines for care and found them to be generally consistent. However, little is known about the fidelity with which DoD recommendations are implemented.Print version record.Cover; Copyright; Physical and Psychological Health Following Military Sexual Assault; Bibliography; About This Paper.This paper reviews data on the prevalence of sexual assault among servicemembers, predictors of disclosure, efforts to improve disclosure, victim needs and DoD efforts to provide necessary resources in the immediate aftermath of a sexual assault. The authors compared civilian and DoD guidelines for care and found them to be generally consistent. However, little is known about the fidelity with which DoD recommendations are implemented.Includes bibliographical references (pages 19-23).JSTO

In their own words: lessons learned from those exposed to anthrax

Objectives. We evaluated perceptions of workers at the US Postal Service Brentwood Processing and Distribution Center and US Senate employees regarding public health responses to the anthrax mailings of October 2001. We generated recommendations for improving responses to bioterrorism on the basis of the perceptions we recorded. Methods. Transcripts from focus groups conducted with Brentwood and US Senate employees were examined, and qualitative analysis identified common domains. Results. Brentwood focus groups consisted of 36 participants (97% African American and 19% hearing impaired). US Senate focus groups consisted of 7 participants (71% White and 0% hearing impaired). The focus groups revealed that participants’ trust in public health agencies had eroded and that this erosion could threaten the effectiveness of communication during future public health emergencies. Among Brentwood participants, lack of trust involved the perception that unfair treatment on the basis of race/ethnicity and socioeconomic status had occurred; among US Senate participants, it derived from perceptions of inconsistent and disorganized messages. Conclusions. Effective communication during a public health emergency depends on the provision of clear messages and close involvement of the affected community. Diverse populations may require individualized approaches to ensure that messages are delivered appropriately. Special attention should be given to those who face barriers to traditional modes of communication

A Bitter Pill to Swallow: Nonadherence with Prophylactic Antibiotics during

ABSTRACT To generate recommendations for improving adherence to public health advice during public health crises, we conducted semi-structured interviews with employees at the Brentwood Road Postal Facility and on Capitol Hill to identify key themes associated with decisions to adhere to recommended antibiotic prophylaxis during the 2001 anthrax attacks. Factors used in deciding to adhere to recommended prophylactic antibiotics and concerns about the official response were similar in Brentwood and Capitol Hill employees, and in adherent and nonadherent participants. All participants used multiple sources of information and support as they weighed the risk from anthrax against the advantages and disadvantages of antibiotics. We found that nonadherent participants were commonly following the advice of private physicians, whereas adherent participants commonly described ongoing support from multiple sources when discussing their decisions. Our findings highlight the need for better integration between the public and private health care systems during public health crises and the importance of equipping private physicians for their key role in aiding decision-making during a public health crisis. Special attention also should be given to enhancing support and information from multiple sources throughout the entire period of risk