Veteran Reintegration, Mental Health and Substance Use in the Inner-City

描述（由申请人提供）：返回市中心的退伍军人面临药物滥用、精神健康障碍和相关平民重返社会问题的高风险。然而，这些退伍军人的经历尚未得到详细的直接研究。为了减少他们的健康风险、解决他们的问题并增加他们继续对社会的贡献，需要更多地了解导致他们风险增加的复杂因素、成功的应对战略、有效的治疗和治疗障碍。本项目试图通过三个相互关联的分析来填补研究中的这一重要空白：(1)为期五年的小组研究，(2)嵌入式民族志研究，以及(3)对两个主要的具有全国代表性的数据集进行集中的二次分析。为此，本研究纳入了以下创新研究要素：i)直接关注以非洲裔美国人为主的退伍军人返回内城；Ii)药物、心理健康和重返社会问题与治疗和生活经历之间动态相互作用的纵向分析；Iii)多方法设计，以提供更丰富的统计结果，并正确看待人种学的发现；iv)运用理论视角将研究分析整合到文献综合中。该项目的具体目标如下（注：所有三个研究组成部分都涉及所有三个具体目标）：目标A：物质使用。了解从阿富汗（持久自由行动或OEF）和伊拉克（伊拉克自由行动或OIF）返回内城的退伍军人在物质使用（包括非法药物、无处方心理治疗药物、酒精和烟草）、问题使用、治疗经历和治疗障碍方面的变化。这包括影响增加使用和负面后果以及恢复的社会力量和个人经历。目标B：精神健康障碍。记录OEF/OIF退伍军人返回内城的心理健康问题（特别是创伤后应激障碍（PTSD）、创伤性脑损伤（TBI）和抑郁症的后果）的路径，以及促进或阻碍恢复力和有效使用治疗的因素。目标三：平民重返社会。确定成功的应对战略，促进健康、富有成效地重新融入市中心的平民生活，以及在家庭、艾滋病毒感染/风险、工作和社区生活方面挑战退伍军人的个人问题、非生产性行为和社会力量。

DESCRIPTION (provided by applicant): Veterans returning to the inner-city face elevated risks for substance abuse, mental health disorders, and related civilian reintegration problems. However, the experiences of these veterans have not yet been directly studied in detail. To reduce their health risks, address their problems and increase their continued social contributions, more information is needed about the complex of factors that lead to their elevated risks, successful coping strategies, effective treatments and barriers to treatment. This project seeks to fill this important gap in the research using three interrelated analyses: (1) a five-year panel study, (2) an embedded ethnography, and (3) a focused secondary analysis of two major nationally-representative datasets. To this end, the study incorporates the following innovative research elements: i) a directed focus on the predominately African American veterans returning to the inner city; ii) a longitudinal analysis of the dynamic interactions of substance, mental health, and reintegration problems with treatment and life experiences; iii) a multi-methods design to provide richer statistical findings and to place ethnographic findings in perspective; and iv) use of theoretical perspectives to integrate the study's analyses into a synthesis of the literature. The specific aims of the project are as follows (Note: all three research components address all three specific aims): AIM A: Substance use. To understand changes over time in substance use (including illegal drugs, psychotherapeutic drugs without a prescription, alcohol, and tobacco), problem use, treatment experiences, and barriers to treatment among veterans returning from Afghanistan (Operation Enduring Freedom or OEF) and Iraq (Operation Iraqi Freedom or OIF) to the inner city. This includes the social forces and personal experiences that affect increased use and negative consequences as well as recovery. AIM B: Mental health disorders. To document the path to mental health problems (especially Post-Traumatic Stress Disorder (PTSD), consequences of Traumatic Brain Injury (TBI) and depression) among OEF/OIF veterans returning to the inner city, as well as factors that promote or impede resilience and effective use of treatment. AIM C: Civilian reintegration. To identify successful coping strategies that promote healthy, productive reintegration to civilian life in the inner-city, as well as personal problems, unproductive behaviors, and social forces that challenge veterans with regard to family, HIV infection/risk, work and community life.