MENTAL HEALTH SERVICE DELIVERY TO TRAUMA VICTIMS

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The purpose of this project is to develop the candidate as an independent researcher, investigating issues related to mental health service delivery to racially diverse trauma victims. The project will focus initially on male combat veterans with PTSD receiving services within and outside the VA system, with a plan to broaden the scope of research focus in the last phase to include civilian trauma victims. At this point we know almost nothing about service delivery to combat veterans across different types of service settings. Most of the current treatment research has been conducted at VA research centers, and therefore, we do not have empirical data on a host of relevant variables (e.g., appropriateness of care, treatment effectiveness) in applied, real-world settings such as Vet Centers, community, or primary care clinics. The Career Development Plan includes training to design and conduct research in three important areas: (1) veterans' concerns about services; (2) racial differences; and (3) service costs and effectiveness. This training plan will consist of three components; (a) individually administered mentoring from a multidisciplinary team of specialists; (b) formal course work and seminars to further develop a body of knowledge in relevant areas; and (c) completion of relevant research projects. The mentorship team will be led by Albert O. Santos, M.D., and includes Samuel M. Turner, Ph.D., Terence M. Keane, Ph.D., Dean Kilpatrick, Ph.D., and Judith Cooke, Ph.D. The Research Development Plan consists of three phases: (I) exploration and identification, via focus groups, of salient dimensions of concern, need, and cultural acceptance of mental health services currently delivered, as perceived by service recipients among male veterans with combat-related PTSD; (II) investigation of the hypothesis that African-American combat veterans with PTSD manifest poorer functioning, lower quality of life, and a higher rate of psychiatric symptoms associated with their clinical presentation than Caucasians; (III) development of a series of grant proposals to examine costs and effectiveness associated with treatment for combat-related PTSD, incorporating what was learned in phases I and II; and development of projects to examine service needs among racially diverse groups of civilian trauma victims.