Assessing Mental Health Needs of Vietnam Veterans in N. Florida/S. Georgia

1. NEEDS ASSESSMENT:MENTAL HEALTH SERVICES VIETNAM VETERANS IN THE N. FLORIDA/ S. GEORGIA REGION NEED, PREFER, AND RECOMMEND Proposal by: Patricia Linn, Daniel Chung, and Lisa Hufford RCS 6740 Sect. 3121 April 18, 2006

2. Study Rationale The overall purpose of this investigation is to assess the mental health needs of Vietnam veterans and determine if current services available meet these needs. The objectives of this study include, but are not limited to: • Identifying which mental health services Vietnam Veterans in the North Florida/ South Georgia region have used. • Identifying which mental health services Vietnam veterans in the North Florida/ South Georgia region need. • Identifying which mental health services Vietnam veterans in the North Florida/ South Georgia region prefer. • Identify the ways in which Vietnam Veterans are informed of these services. • Make recommendations for current mental health service improvements based on what the Vietnam veterans in the North Florida/ South Georgia region recommend.

3. Tentative Study Team • Principal Investigators- Patricia Linn, Daniel Chung, and Lisa Hufford • Supervisor- Stephen Pruett, PhD. • Qualitative Analyst- Brian Dodge, PhD. • We hope to have 4 other scientific advisors who are familiar with Veterans mental health needs • We hope to have at least 2 social workers and 2 mental health professionals that work at the Veterans administration involved in research. • We plan to hire 2 research assistants

4. Research Design • Qualitative design in which Vietnam veterans in the North Florida/ South Georgia region will participate in a videotaped in-depth interview regarding their mental health needs, preferences and satisfaction with current mental health services. The interview consists of 30 open-ended questions. • It is a phenomenological qualitative design because veterans will describe their lived experiences in this interview and what their experiences mean to them. • We hope to have an underlying or general understanding of their feelings towards mental health services and how we can possibly better meet these needs.

5. Advantages and Limitations of the Qualitative Research Design • Advantages • Expand knowledge in our chosen area • Vast information is gathered through the in-depth interview which will result in more detailed and comprehensive information • Limitations • Could be many underlying variables • Lack of experimental control • Greater possibility for experimenter bias • Only allows for correlations rather than causations

6. Research Questions • Questions: • What mental health services are currently available to Vietnam veterans in the North Florida/South Georgia region? • Which mental health services have Vietnam Veterans in the North Florida/South Georgia region used? • Which mental health services do Vietnam veterans in the North Florida and South Georgia region need? • Which mental health services do Vietnam veterans in the North Florida/ South Georgia region prefer? • Which mental health services do Vietnam veterans in the North Florida/ South Georgia region recommend?

7. Hypotheses • Hypotheses: • Based on the current services available we hypothesize that counseling for Post Traumatic Stress Disorder (PTSD) will be the most used service because many people do not possess the ability to cope with the intense and traumatic experiences of war. • We hypothesize that counseling for adjustment and transitioning issues will be the most needed service based on the participants individual responses to the interview because after being in a war-time environment, it is difficult to adjust to a peace- time environment. • We hypothesize that psychiatric prescription drug services will be most preferred based on the participants’ individual responses to the interview due to the minimal time commitment required for these services. • We are unsure as to which mental health service(s) will be recommended.

8. Variables • The interview • Whether or not the participant has ever used mental health services provided by the Veteran’s Administration • The mental health status of the participant

9. Sampling Procedures • Convenient Sampling- due to the volunteer nature of the participants • Participants will call the phone number listed on the Ads, poster displays or news. • If they are found eligible, based on prescreening questionnaire, they will be given information about study including: location, dates, and incentives.

10. Measurement Techniques • Veterans will undergo a brief prescreening process to determine study eligibility. • Eligible participants will undergo an intensive videotaped interview in which they will be asked questions regarding mental health needs, preferences, and recommendations. • Taped interview sessions will be systematically analyzed to enhance the services currently available and develop future needs-based mental health services.

11. Sample Prescreening Questions PRELIMINARY QUESTIONAIRE 1. What branch of the armed forces were you in? 2. Did you serve in Vietnam? 3. Do you have transportation? 4. Can you attend a two hour interview between the dates of May 1, 2006 and July 3, 2006? If you qualify for this survey an appointment time will be made for your interview, and directions will be given to the location of the interview.

12. NEEDS ASSESSMENT INTERVIEW Demographics: Participant Age: ___________________ Religious affiliation: _______________ Participant Gender: ________________ Current household income: __________ Participant Race: __________________ Last grade completed: ______________ Marital Status: ____________________ Current employment status: __________ Number of years in service: __________ Questions: 1. Please describe how you’re feeling today. 2. Please describe you’re experiences in Vietnam. 3. What was positive about your Vietnam experience? 4. What was negative about your Vietnam experience? 5. Once you were home from Vietnam, how was your transition back into your life? 6. Did your experiences in Vietnam affect you mentally or emotionally? 7. How have your experiences affected you? 8. Did your experiences in Vietnam affect your relationships with friends and family? 9. How did your experiences effect your relationships or not effect your relationships? 10. Are you aware the Veterans Administration provides mental health services? 11. If so, how did hear about the mental health services? 12. If you are not aware that the VA provides mental health services, what do you think would be a good way for the VA to let you know about current services available? 13. Have you used any of the V.A. mental health services? 14. Do you feel that Vietnam veterans need mental health services? 15. What are the reasons that you feel Vietnam veterans need or do not need mental health services? 16. If you have used VA mental health services in the past or are currently using these services, which mental services are/have you using/used? Please describe. 17. Do you feel comfortable with the services you have received? Please describe. 18. Which mental health service(s) was/were the most helpful for you? 19. What are the reasons that they were most helpful? 20. Which mental health service(s) was/were the least helpful for you? 21. What are the reasons that they were the least helpful? 22. Are there areas you feel are lacking with these services? Please describe. 23. Are there any services not offered by the Veterans Administration that you feel would better suit your needs? 24. Are you aware of any services offered in your community that are not affiliated with the Veterans Administration? Please describe. 25. How did you hear about the community services? 26. Are currently or have you in the past participated in the community services? 27. Were you given a formal diagnosis? 28. What is your diagnosis? 29. Do you agree or disagree with this diagnosis? 30. What are the reasons that you agree or disagree with the diagnosis? Example Questions: 1.Please describe how you’re feeling today. 2.Please describe you’re experiences in Vietnam. 3.What was positive about your Vietnam experience? 4.What was negative about your Vietnam experience? Sample Interview Questions

13. Plans for Analysis • We will use interviews in which “open ended questions and probes yield in-depth responses about peoples experiences, opinions, perceptions, feelings and knowledge. Data will consist of verbatim quotations with sufficient context to be interpretable.” (Simpson, 2006) • Phenomenological Qualitative design • Phenomenological- Moustakas, 1994, p. 13: “to determine what an experience means for the persons who have had the experience and are able to provide a comprehensive description of it. From the individual descriptions, general or universal meanings are derived, in other words, the essences of structures of the experience.” . • Qualitative Design- “A holistic approach to questions- a recognition that human realities are complex.” (Simpson, 2006) • Data analysis begins during data collection. We will organize data to get sense of the whole and we will code for recurrent themes and categories (Simpson, 2006).

14. Possible Study Advantages and Limitations • Advantages • Vietnam veterans who need services and are not currently receiving services will be given referrals to services. • Monetary compensation for participating. • Food compensation as well. • Limitations • Study only looks at Vietnam veterans, may not generalize to all veterans. • Study has small sample size that may not be representative of the entire Vietnam veteran population.

15. Implications of Research and FutureRecommendations • It is hoped that this study will inform the Veterans Administration: • Which mental health services are being used • Which mental health services are needed • Which mental health services are preferred • What are the strengths and weaknesses of current services being provided • It is hoped that the Veterans Administration will use the data to reform areas of weakness and develop new programs to meet Veterans needs. • Compare Vietnam Veterans needs, preferences and recommendations with current Iraqi veterans needs, preferences, and recommendations (Therefore, have two samples). • Are mental health needs even combat-related?