Stigma and Barriers to Care in Service Leavers with Mental Health Problems

Summary: Military service can place personnel at a greater risk of developing mental health difficulties yet both serving personnel and military veterans (defined herein as anyone who has served a day in the Armed Forces) are reluctant to seek help for mental health difficulties. Although much research has been conducted on potential barriers and facilitators to help seeking, the majority of this research is drawn from the US, where there are significant differences in both military and veteran experiences in comparison to the UK. Such research typically focuses on: the stigma of mental health; an individual’s perceived lack of need for treatment; negative treatment perceptions; and logistical barriers to accessing mental health services. The relationship between such barriers and facilitators to help seeking is still unclear with contradictory findings throughout the scientific literature. This research explores the barriers and facilitators to care for the UK veteran population, as well as the dynamics between these factors and help seeking behaviour. In addition to this, the importance of barriers and facilitators at different stages in a veteran’s journey to mental health support will be investigated, from recognition of a mental health problem through to the maintenance of mental health treatment. Case studies examining veterans with multiple interactions with mental health services will be conducted to distinguish patterns of recurrent barriers and potential levers to expedite progression to successful mental health treatment. Sixty-two in-depth telephone interviews were conducted with male UK military veterans who had left the Armed Forces in the last five years. All participants had taken part in a previous research study where objective mental health measures had been collected alongside information on their perceptions of their own mental health. All veterans included in this research had screened positive for a degree of mental health distress on self-report questionnaires covering common mental disorders (anxiety or depression), Post-Traumatic Stress Disorder, or alcohol misuse. Based on the participants perceptions of their own mental health, veterans were divided into three participant groups: those who stated that they were not currently experiencing a mental health problem; those who stated that they had a current mental health problem but were not seeking formal mental health treatment; and those who were currently in formal mental health treatment. Interviews focused on exploring veterans’ perceptions of their own mental health, barriers and facilitators to help seeking, and any mental health care experiences. Preliminary results were shared with key providers of veterans’ mental health (both charity and government funded organisations) at a stakeholder meeting to discuss the implications of this research for the future provision of services for UK veterans.