Psychological stigma costs as barriers to healthcare use in former soldiers of the German Armed Forces: A qualitative analysis

Veteran help-seeking behaviour for mental health issues: a systematic review

INTRODUCTION

Serving military personnel and veterans have been identified to have a high prevalence of mental health disorders. Despite this, only a significantly small number seek mental healthcare. With the UK beginning to invest further support to the armed forces community, identification of barriers and facilitators of help-seeking behaviour is needed.

METHODS

Corresponding literature search was conducted in PsycINFO, PsycArticles, Medline, Web of Science and EBSCO. Articles which discussed barriers and facilitators of seeking help for mental health concerns in the veteran population were included. Those which discussed serving personnel or physical problems were not included within this review. A total of 26 papers were analysed.

RESULTS

A number of barriers and facilitators of help-seeking for a mental health issue within the veteran population were identified. Barriers included stigma, military culture of stoicism and self-reliance, as well as deployment characteristics of combat exposure and different warzone deployments. Health service difficulties such as access and lack of understanding by civilian staff were also identified. Facilitators to help combat these barriers included a campaign to dispel the stigma, including involvement of veterans and training of military personnel, as well as more accessibility and understanding from healthcare staff.

CONCLUSIONS

While some barriers and facilitators have been identified, much of this research has been conducted within the USA and on male veterans and lacks longitudinal evidence. Further research is needed within the context of other nations and female veterans and to further indicate the facilitators of help-seeking among veterans.

Integrativer Modellentwurf zu Coping und Abwehr ehemaliger BundeswehrsoldatInnen

Verglichen mit dem profunden Wissen über die Erfahrungen und Bedürfnisse US-amerikanischer Soldaten, ist der Kenntnisstand über die psychische Gesundheit und die Bewältigungsmechanismen aktiver deutscher BundeswehrsoldatInnen eher gering. Über ehemalige EinsatzsoldatInnen, die inzwischen aus dem militärischen System ausgeschieden und Teil der deutschen Zivilgesellschaft geworden sind, ist noch viel weniger bekannt. Ziel der Pilotstudie war die Identifikation und Darstellung von Coping- und Abwehrmechanismen ehemaliger BundeswehrsoldatInnen mithilfe einer methodisch-strukturierten, qualitativen Datenerhebung. Zu diesem Zweck wurden 43 Interviews mit ehemaligen EinsatzsoldatInnen geführt, transkribiert und der thematischen Analyse unterzogen. Die identifizierten Coping- und Abwehrmechanismen wurden den Bereichen Verhalten, Beziehung, Emotion, Reflexion und Zeit zugewiesen und modellhaft in Achsenform veranschaulicht. Durch die bewusste Synthese von kognitiv-behavioralen und psychoanalytischen Perspektiven konnte ein differenziertes Bild erstellt sowie ein eigenständiges, schulenübergreifendes, integratives Achsenmodell zur Darstellung der bewussten und unbewussten Bewältigung belastender Erfahrungen entwickelt werden.