This study compares the process and outcomes of treatment in specialized intensive Posttraumatic Stress Disorder (PTSD) programs among black and Hispanic veteran as compared with white patients. Four types of programs are evaluated: short inpatient programs, residential programs, day hospitals, and traditional long-term programs. Data were drawn from a national Veterans Affairs initiative implemented to monitor clinical outcomes from intensive programs that provide specialized treatment for veterans with military-related PTSD. Forty-nine of the existing sixty-two programs are represented in these data. The evaluation program took place between 1993 and 2000.

The sample included 12,447 patients: 71.2% white, 23.4% black, and 5.3% Hispanic. Racial patterns in treatment process and treatment outcome were compared across all 4 program types and within each program type separately. All analyses adjusted for racial differences in sociodemographic, symptom, and treatment history variables. It is noteworthy that black veterans had more severe substance abuse problems but less severe PTSD symptoms at admission compared with both white and Hispanic patients. Hispanic patients had more comorbid psychiatric conditions and were more likely to report suicide attempts.

There were few observed differences. With regard to treatment process, Hispanics had significantly greater satisfaction ratings overall and in the residential program. Blacks were less committed to treatment in the day programs. With regard to treatment outcomes, Blacks had greater improvement in PTSD symptoms overall and in the traditional program, worse drug index scores in the residential program, and worse violent behavior scores in the inpatient program. Hispanics had worse employment outcomes overall.

Noting previous evidence of racial patterns in VA studies of other types of health care, the authors comment that it is possible “group differences are less likely to be found in mental health service programs because of greater emphasis on the psychosocial aspects of care in the mental health service delivery.”