2 - (SYM 98) Racial and Ethnic Differences in VHA Mental Health Care Utilization Among OEF/OIF Veterans Enrolled in a PTSD Registry

Veterans of Color experience health care disparities, including being less likely to receive individual therapy than white Veterans (Spoont et al., 2017); however, it is unknown to what extent variations in mental health care utilization are due to individual characteristics, such as patient preference, or systematic issues, such as available of resources or provider referrals. Using a longitudinal registry of veterans oversampled for posttraumatic stress disorder (PTSD) (N = 1,649), we explored differences in utilization by race/ethnicity and gender and to what extent differences may vary by medical facility type and rural vs. urban settings. We focused our analyses on Black, Latino/a/e, and white Veterans because these are the three largest racial/ethnic groups served by Veteran Health Administration (VHA). Analyses adjusted for sociodemographic variables (e.g., age, education, marital status) and treatment need (e.g., PTSD, depression). There were no differences across racial/ethnic groups regarding likelihood of receiving an adequate dose of individual therapy or group therapy. Consistent with previous work, Black Veterans were more likely to receive group therapy than white Veterans (OR_adj = 1.63, p = .04). However, there were no differences in receipt of individual therapy across groups. Next, we examined differences in mental health care utilization related to race/ethnicity by gender. Black Veteran women, compared with white Veteran women, were more likely to receive group therapy (OR_adj = 1.88, p = .04) but there were no racial/ethnic differences for Veteran men. Overall, results indicate that Black Veterans, especially Black Veteran women, receive more group therapy than white veterans. These results indicate the need for research on Black veterans’ preferences and experiences with therapy in VHA to better understand factors driving greater utilization of group therapy and how utilization relates to symptom change.