Psychosocial Factors that Shape Substance Abuse and Related Mental Health of Women Military Veterans who Use Community-Based Services

Evans, Elizabeth; Glover, Dawn L.; Washington, Donna L.; Hamilton, Alison B.

doi:10.1080/10826084.2018.1441309

Cited by 10 publications

(12 citation statements)

References 73 publications

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“…Women veterans report their transition out of the military to be hard and isolating, an experience that is made more challenging by substance abuse, fractured personal relationships, unemployment and homelessness, and an unstructured daily life (Derefinko et al, 2018; Evans, Glover, et al, 2018). In the present study, we found that the burden of finding and receiving VA health care is placed on women veterans’ shoulders, not borne by the system itself, which can be an additional stressor in the lives of women veterans.…”

Section: Discussionmentioning

confidence: 99%

“…This model conceptualizes health services utilization as a function of both individual characteristics and external contexts (e.g., health care system, societal norms). In our previous work, we examined how health care utilization by women veterans is shaped by their individual psychosocial characteristics, including the need for care, predisposing factors, and personal experiences (Evans, Glover, Washington, & Hamilton, 2018). In the present article, we focus on whether and how women veterans' use of VA care is affected by contextual factors, for example, women's prior experiences of accessing VA care, and VA organizational characteristics.…”

Section: Introductionmentioning

confidence: 99%

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Why Women Veterans Do Not Use VA-Provided Health and Social Services: Implications for Health Care Design and Delivery

Evans

Tennenbaum

Washington

et al. 2019

Journal of Humanistic Psychology

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Background: The Veterans Administration (VA) is transforming its historically male-dominated health care system to better serve women veterans, few of whom, nevertheless, use VA health care. We describe the factors affecting women veterans' use of VA-provided health care. Methods: We conducted in-person interviews with 22 women veterans in Los Angeles, California, from 2013 to 2015 who received some non-VA health care. Using grounded theory, we inductively identified the major themes and selected illustrative quotations. Results: Why women veterans do not use VA health care is shaped by factors related to the safety, quality, and value of health care, including poor linkage to VA services during and after military service, limited knowledge and inaccurate beliefs regarding

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Why Women Veterans Do Not Use VA-Provided Health and Social Services: Implications for Health Care Design and Delivery

Evans

Tennenbaum

Washington

et al. 2019

Journal of Humanistic Psychology

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“…Additionally, women who have experienced trauma or who have posttraumatic stress disorder (PTSD) are at an elevated risk for developing AUD [6]. When asked about factors relating to their substance use, women veterans frequently cited childhood trauma, as well as military sexual assault and harassment [7]. Similar to the general population of incarcerated women, 36% of incarcerated women veterans self-reported having an AUD during an in-person visit with outreach staff who work in prisons [8], and 41% of women veterans who received outreach while in jail or court were diagnosed with AUD within a year of that outreach [9].…”

Section: Introductionmentioning

confidence: 99%

Receipt of pharmacotherapy for alcohol use disorder by justice-involved women in the Veterans Health Administration

Taylor

Timko

Harris

et al. 2019

Addict Sci Clin Pract

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BackgroundAlcohol use disorder (AUD) and unhealthy drinking are prevalent among women involved in the criminal justice system and women military veterans. Pharmacotherapy—including naltrexone, topiramate, acamprosate, and disulfiram—for AUD is one form of effective treatment that is associated with better health and criminal justice outcomes. The current study examined the association of justice involvement with receipt of pharmacotherapy for AUD, as well as other patient factors that may explain variation in receipt of pharmacotherapy for AUD among women veterans who receive care at Veterans Health Administration (VHA) facilities. MethodsUsing national VHA clinical records, we examined all women VHA patients who received an AUD diagnosis during an outpatient or inpatient visit in fiscal years (FY) 2014–2017. We compared patient characteristics by justice status, defined as contact with one of the VHA’s justice outreach programs, and used a mixed-effects logistic regression model to test whether justice involvement was independently associated with odds of receiving pharmacotherapy for AUD.ResultsOf 10,511 women veterans diagnosed with AUD in FY2017, 852 (8%) met our definition of justice-involved. Since FY2014, the percentage of women veterans who received pharmacotherapy for AUD increased (14–21%). Women justice-involved veterans and those who were homeless had higher odds of receiving pharmacotherapy for AUD (OR 1.29, CI 1.15–1.45; OR 1.35, CI 1.25–1.47). Women veterans age 55 or older or who were African-American had lower odds of receiving pharmacotherapy (OR 0.74, CI 0.67–0.82; OR 0.73, CI 0.68–0.79).ConclusionsWhile women involved in the criminal justice system face many barriers to accessing health and social services, women justice-involved veterans had higher odds of receiving pharmacotherapy for AUD at VHA facilities compared to women veterans with no justice involvement. Legal mandates and supportive programming directed towards veterans in the criminal justice system may explain the higher rate of receipt of pharmacotherapy observed among justice-involved women veterans. Women veterans who are homeless may also have more opportunities to access and use pharmacotherapy for AUD compared to their housed counterparts.

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“…Also, Black adults are less likely to be prescribed opioids (Burgess et al, 2014) or monitored by a pain specialist (Hausmann et al, 2013). Furthermore, untreated physical pain is a critical reason why women veterans initiate illicit use of opioids and other substances (Evans et al, 2018). Therefore, Black women veterans may have significant unmet needs for pain relief services, which could elevate their risk for opioid and other substance use disorders.…”

Section: Discussionmentioning

confidence: 99%

Gender Differences in Use of Complementary and Integrative Health by U.S. Military Veterans with Chronic Musculoskeletal Pain

Evans

Herman

Washington

et al. 2018

Women's Health Issues

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Psychosocial Factors that Shape Substance Abuse and Related Mental Health of Women Military Veterans who Use Community-Based Services

Abstract: Findings can inform interventions and services that ameliorate vulnerability to substance abuse and other health risks among women Veterans.

Cited by 10 publications

References 73 publications

Why Women Veterans Do Not Use VA-Provided Health and Social Services: Implications for Health Care Design and Delivery

Why Women Veterans Do Not Use VA-Provided Health and Social Services: Implications for Health Care Design and Delivery

Receipt of pharmacotherapy for alcohol use disorder by justice-involved women in the Veterans Health Administration

Gender Differences in Use of Complementary and Integrative Health by U.S. Military Veterans with Chronic Musculoskeletal Pain

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