The demographics of Veterans in America are changing. Although the overall Veteran population is expected to decline, the number of minority Veterans is projected to increase. Minority Veterans (all races/ethnicities excluding non-Hispanic white Veterans) currently make up about 25% of the total Veteran population but will make up just over 35% by 2040.
Why is this important? Minority Veterans are typically considered “vulnerable patient populations,” according to the Department of Veterans Affairs (VA), meaning they are at risk of receiving worse medical care and having poorer patient outcomes than their non-minority counterparts.
As a whole, Veterans already struggle with substance use and co-occurring disorders, such as post-traumatic stress disorder (PTSD), at high rates. Knowing that minority Veterans are vulnerable to lower-quality care and that the numbers of minority Veterans will rise significantly in the next two decades, the need for culturally competent treatment is more significant than ever.
I am a Veteran and first-generation Filipino-American who sought out treatment for addiction and PTSD, and I’ve spent the last decade reaching out to other Veterans in need. And I know the multifaceted challenges that minority Veterans face in accessing and participating in treatment, including language barriers, cultural stigmas, stereotypes, and more.
To reach and best treat minority Veterans, we must embrace their complex struggles and meet them where they are. We cannot continue to take one standard approach with all Veterans. Basic steps we must take include 1) creating inclusive and culturally competent programs, 2) making minority Veterans aware of these services, and 3) making efforts to hire a diverse workforce.
For example, we know that women Veterans experience military sexual trauma (MST) at high rates. When we approach women Veterans, we should be sensitive to this. For example, I will let them know we have an MST track for female Veterans in which participants are separated from the rest of the population by gender, a feature that may make them feel more comfortable. Similarly, suppose I’m approaching a Veteran in the LGBTQ+ community. In that case, I’ll discuss our specific LGBTQ+ services so they know we offer a welcoming place and understanding of their needs and experiences.
Once a Veteran enters treatment, their culture should continue to be part of the conversation; we miss an opportunity to help Veterans fully heal if we leave this out. When you think about how we treat addiction, we know we must get to the root to find long-term recovery. Getting to the root involves many things, including your relationship with your family, your history, where you come from, etc.
One of the most powerful things I did in treatment for my substance use disorder was to create a family tree and see where some of these behaviors were present in my family line. So, it’s essential to see that there may be more of a pattern than you realize, and when you dig a little deeper, you may find cultural implications as well. Do people in my culture regularly seek support, or do they tend to sweep addiction and mental health issues under the rug? Do they prefer to get help in the community or deal with it quietly within the family unit or tribe? Taking the time to dig into some of these questions can help patients gain a greater understanding of the factors contributing to their addiction and become better equipped to recover.
We can also creatively bring a patient’s culture into the treatment process. For example, food can be healing. Think of chicken soup and how it’s traditional for Americans to eat it when sick. In Filipino culture, we have arroz caldo. It’s a very hot rice chicken soup. Many cultures have something like this, and eating food tied to your background, family, and culture feels very healing. This isn’t to say that every treatment center needs to change its menus, but this is what we need to do when considering cultural inclusivity in treatment.
It can also make a huge difference for patients to see their cultures represented by a treatment center’s staff. If a patient sees a care provider who looks like them, speaks their language, or has a similar background in some other way, they build a connection there, which paves the way for an improved treatment experience.
There isn’t a one-size-fits-all approach to creating a more culturally inclusive addiction treatment program. Many different populations will have different needs, so treatment programs will need to make inclusivity an ongoing process. It starts by acknowledging the vast diversity among the veteran population and that other cultures translate to different treatment needs. As care providers, we must ask patients about their cultural backgrounds and spend time reflecting on our own. Doing this creates a healing space that supports stronger connections and creates better treatment outcomes. As the Veteran population becomes more diverse, it is our duty to move beyond the status quo when it comes to treating all our nation’s heroes.
