Marginalized Women Veterans Krystle Jaynes BSN, RN Chamberlain College of Nursing
MARGINALIZED WOMEN: VETERANS WITH PTSD 2 Marginalized Women: Veterans with PTSD
In 2015 a study was conducted that showed an increase of about 47 percent of women veterans that are utilizing the Veteran Administration healthcare system, (Shivakumar, Anderson, Suris, & North, 2017). These women are much younger than their male colleagues in the same positions. Post-traumatic stress disorder, or PTSD is one of the most common diagnosis among women the ages 18-44, (Shivakumar, Anderson, Suris, & North, 2017). Around 7.5 percent of the total patients seen by the VA healthcare system in 2015 consisted of women. (Kehle-Forbes, Harwood, Spoont, Sayer, Gerould, & Murdoch, 2017). It was shown that women use the VA services more frequently than males, but care of those veteran women is lacking and needs to be enhanced. Women report feeling not welcomed and an inconsiderateness to their needs was apparent. The woman studied, discontinued their care because they felt as though the provider was not meeting their needs, (Kehle-Forbes, Harwood, Spoont, Sayer, Gerould, & Murdoch, 2017). Less than half of woman veterans that received services for mental health within the VA system felt as though their needs had been met, (Kehle- Forbes, Harwood, Spoont, Sayer, Gerould, & Murdoch, 2017). This paper examines the common issues women veterans encounter when receiving mental healthcare for PTSD from the VA healthcare system. These issues will be addressed as well as social justice problems, ethical issues, socio-economic problems and strategies of action to bring about positive outcomes. An action plan will be prepared and conveyed to the VA Hospital administration in hopes that it will be taken into consideration to create a new process to help female veterans in obtaining adequate care. Several scholarly studies and evidence-based methods as well as current guidelines will be applied to create this action plan. It is important to consider any gender differences when managing the unique needs of the female veterans. There is room for enhancements in assessment, improved screening tools, and treatments that coincide with current interventions to minimize the psychological impact and encourage recovery.
MARGINALIZED WOMEN: VETERANS WITH PTSD
3
Current Incidence and Prevalence
recent
study
showed
that
17
percent
of
The
National
Guard
and
15
percent
of
active
military
are
A
female.
The
same
study
also
showed
that
20
percent
of
new
recruits
are
women,
(Conard
&
Sauls,
2013).
About
half
of
these
woman
deploy
to
Iraq
and
Afghanistan.
These
missions
place
these
women
right
in
the
middle
of
the
action
in
war
zone
territories,
(Conard
&
Sauls,
2013).
they
are
not
in
direct
combat,
they
Even if
are
exposed
to
the
war
zone
in
other
ways
such
as
medical
units.
In
today’s
military,
woman
take
on
the
same
roles
and
tasks
as
the
men
they
serve
beside
including
combat
pilots,
police,
intelligence,
medical
personal,
etc,
(Conard
&
Sauls,
2013).
Suicide
and
car
bombings,
roadside
bombs,
and
ambushes
are
just
some
of
the
hostile
situations
these
woman
endure.
Even
when
in
noncombat
type
rolls,
they
are
exposed
to
these
violent
a
encounters
and
witness
other
traumatic
events
such
as
sexual
assault,
torture,
and
death.
This
can
be
a daily
occurrence
and
when
unable
to
return
home
and
step
away
from
these
situations,
leads
to
post
traumatic
stress
it a
it
disorder,
or
PTSD,
(Conard
&
Sauls,
2013).
Sensory
exposure
happens
to
many
medical
service
women
due
to
the
constant
exposure
to
dying
patients
and
leads
to
woman
having
difficulty
caring
for
the
wounded
in
combat
zone,
(Conard
&
Sauls,
2013).
Anxiety,
depression
and
PTSD
go
hand
in
hand
and
commonly
present
together
increasing
the
risk
of
suicide
among
this
group.
The
reports
are
outstanding,
with
woman
veterans
times
more
likely
to
commit
suicide
than
non-military
woman,
(Conard
&
Sauls,
2013).
These
woman
being 3 a
have
an
absence
of
personal
hygiene
and
privacy
as
well
as
other
issues
that
their
male
counterparts
do
not
experience.
Along
with
the
added
stress
of
war,
these
women
also
have
chance
of
extended
deployments,
a
(Conard
&
Sauls,
2013).
About
20
percent
of
female
veterans
deployed
to
Iraq
have
been
diagnosed
with
PTSD,
(National
Center
for
PTSD,
20118).
Socioeconomic Aspects of Women Veterans with PTSD
A
PTSD
impacts
the
female
veteran’s
quality
of
life
and
vulnerability
while
deployed.
study
showed
that
59
percent
of
the
woman
veterans
had
unmet
medical
needs
and
also
screened
positive
for
PTSD
in
the
12
months
prior.
Cost
was
reported
as
the
delay
in
seeking
care,
(Lehavot,
Der-Martirosian,
Simpson,
Sadler,
&
MARGINALIZED WOMEN: VETERANS WITH PTSD 4 A
PTSD is a it
Social Justice
The effect of social justice and injustice of mental health and the VA Healthcare system majorly impact female veterans and their treatment for PTSD. In a survey of female veterans with PTSD that deployed to Iraq or Afghanistan, found that their opinion of treatment of their mental illness from the VA to be negative rather than positive, (Fox, Meyer, & Vogt, 2015). They also felt that male veterans were treated better than the female veterans and swayed their longing to seek out treatment at the VA, (Fox, Meyer, & Vogt, 2015). There is a stigma that accompanies any mental illness in itself, but for women veterans with PTSD to feel as though they are being treated differently because of sex is an injustice to not only them, but the entire VA system.
Ethical Issues
Suicide and PTSD in our veterans has been a big topic in the mainstream media. There is a huge stigma associated with mental illness and suicides, veterans with PTSD owning firearms, and the VA system in general, (Bongar, Sullivan, & James, 2017). Politics and avoidance of responsibility has dominated over ethical obligations to the female veterans with PTSD. Cost and financial obligation have become more of an ethics issue when dealing with our female veterans. Fear of judgement sometimes tends delay woman from seeking care and treatment, (Koven, 2017). The substandard care of women veterans with PTSD has a negative effect on the nations citizens because it causes distrust of the government. Theses woman risk their lives for a country that refuses to give quality mental health care, (Koven, 2017).
Washington,
2013).
recent
study
found
that
most
of
the
women
with
PTSD
did
not
have
any
insurance
other
than
the
VA
and
they
did
not
know
that
they
were
eligible
for
VA
benefits,
(Lehavot,
Der-Martirosian,
Simpson,
Sadler,
&
Washington,
2013).
Recent
reports
have
shown
that
many
female
veterans
feel
uneasy
in
societal
institutions
because
of
instances
that
occurred
in
combat.
(Jackson,
2014).
Morbidity
and
mortality
of
not
directly
related
to
socioeconomic
status
however,
may
impede
the
accessibility
of
seeking
treatments
and
in
turn
lower
the
chance
of
positive
outcome.
MARGINALIZED WOMEN: VETERANS WITH PTSD 5
Plan to address this group
Change needs to happen in regard to treatment strategies for our female veterans who suffer with PTSD.
The
American
Psychological
Association
(APA)
Practice
Guidelines
for
the
Treatment
of
Post-traumatic
Stress
Disorder
(PTSD)
will
need
to
be
evaluated
and
improved.
This
needs
to
start
in
the
primary
care
setting
and
can
easily
be
done
by
recognizing
and
screening
all
veteran
females,
(Sarah
&
Christopher,
2017).
Social
support
has
been
shown
to
drastically
impact
female
veterans
who
return
from
deployment.
Symptoms
are
more
controlled
when
women
are
able
to
talk
about
their
feelings
of
PTSD
with
people
close
to
them.
Reports
have
shown
that
they
adjust
better
when
accepted
by
group
and
are
able
to
have
that
release,
(National
Center
for
a
Conclusion
In conclusion, the VA system needs to convey accessibility, trustworthiness, and discretion for woman with PTSD. Recognizing PTSD symptoms by utilizing better screening tools and the clinical practice guidelines will lead to earlier treatment and education of female veterans with PTSD. Social stigmas associated with mental health need to be recognized and demolished so that female veterans can feel as if the care they need is achievable. The VA will start to enroll female veterans with PTSD to patient specific programs because the evidence supports this new process and provides them with the adequate care that is required for healing. Encouragement to join support groups, social clubs, and any positive group settings to help reintroduce these female veterans back into the community and help create a support system.
PTSD,
2018).
Positive
motivation
should
be
given
to
join
groups
like
the
VFW
to
get
involved
with
functions
to
give
those
needed
outlets
veterans
in
order
to
help
create
social
connections,
(National
Center
for
PTSD,
2018).
MARGINALIZED WOMEN: VETERANS WITH PTSD 6
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