Kelly, Walter J.

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  • Publication
    INEQUALITIES IN MENTAL HEALTH TREATMENT RELATED TO RACE AMONG SEEKERS OR RECIPIENTS OF SERVICE AT NAVY FLEET AND FAMILY SUPPORT CENTERS
    (2022-05-14) Kelly, Walter J.
    Abstract A cross-sectional design and regression analysis were used to test the hypotheses that negative racial climate and perceived racism outside of treatment setting would significantly impact the odds of self-referring to treatment, that negative racial climate and perceived racism outside of treatment setting would significantly impact the odds of completing treatment, that negative racial climate and perceived racism outside of treatment setting would significantly predict the number of sessions attended, and that treatment-specific negative racial climate and perceived racism would impact the odds of treatment completion. Methods: 79 Black male sailors completed an online survey consisting of the Racial Microaggressions in Counseling Scale (RMCS), the Everyday Discrimination Scale (EDS), and the Racial Microaggression Scale (RMAS). Demographic questions about age and rank in the Navy were solicited, as was the number of sessions attended. Results: There was no significant relationship between perceived racism outside of treatment, negative racial climate, the number of treatment sessions, and treatment completion. However, the hypothesis that treatment-specific negative racial climate and perceived racism would impact the odds of completing treatment was supported. A total of N=79 men identifying as Black or African American and are currently or had been active members of the Navy qualified for the study. Of those, n=35 sought or received services from the Navy Fleet and Family Support Centers and were included in these analyses. Less than 30% of participants reported completing 7-8 or more treatment sessions (n=9, 27%) - did not attend the minimum number for completed treatment. Only 7 (21%) reported completing treatment. Placing the sample’s median scores within the context of the scale range suggest that the sample as a whole experienced high rate of racial discrimination and microaggressions in their everyday lives as well as high rates of treatment-specific microaggressions. Median score (midway point) for the EDS scale = 23, the median score for the sample = 42. Median score for the RMCS scale = 10, median score for the sample = 24. Median score for the RMAS scale = 64, median score for the sample = 121. Significant results were: RMCS and completing treatment: odds of completing treatment decreased by 23% with each addition ¼ of a point increase in racial microaggression in counseling score. Age significantly predicted a 1-2 session increase in the number of treatment sessions with every 17 to 20-year increase in age. Agreeing on a treatment plan was associated with significantly higher rates of completing treatment. Lastly, the race of the counselor results, despite the small number, indicated that more respondents who reported completing treatment and had a counselor they believed to be of Asian descent. Conclusion: Results point to the importance of both the client and the therapist agreeing on the course of treatment and addressing racial microaggressions within the treatment dyad as major elements determining treatment success.