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Hitch C, Toner P, Champion H, Armour C. Lifetime trauma, mental well-being, alcohol and help-seeking; the phenomenological experience of veterans residing in Northern Ireland. BMC Psychol 2024; 12:479. [PMID: 39256824 PMCID: PMC11386114 DOI: 10.1186/s40359-024-01978-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 09/03/2024] [Indexed: 09/12/2024] Open
Abstract
BACKGROUND Veteran residents in Northern Ireland (NI) are an under-researched population. Little is known about their experiences of trauma and mental health management. The overall mental well-being of veterans living in NI may be poorer than other veteran populations, due to the challenges presented by the unique landscape. Understanding their experiences is crucial for providing appropriate, targeted support. METHOD Six male veterans, who had received a mental health diagnosis, living in NI and all aged > 40 years participated. Semi-structured interviews, using open-ended questions, were conducted over the telephone. Interpretative phenomenological analysis was used to explore their experiences. RESULTS Two experiential themes were identified each containing three experiential statements. Statements for 'an extreme lack of' included: lack of mental health literacy/awareness; lack of expectations of official support; lack of a sense of perceived appreciation. Statements for 'an extreme abundance of' included: exacerbated exposure to a range of extreme environments; high levels of ruled-based living; high levels of engaging with informal/local level support. CONCLUSIONS Several experiential statements aligned with existing literature, including having poor mental health literacy and problem recognition, and heavily utilising social support versus formal help-seeking. Some novel findings included bouncing between extreme positive and negative environments which could be as detrimental to mental health as experiencing conflict trauma. Heavy alcohol use was just another rule soldiers followed. Positive help-seeking experiences failed to improve poor opinions of support organisations. Finally, poor self-perceptions connected to military status are pertinent in NI, which seems to fuel self-marginalisation and distrust. A combination of factors likely contributes to many veterans living in NI having poorer mental well-being. Novel findings would benefit from further exploration as understanding how NI veterans interpret their experiences is key to providing adequate healthcare.
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Affiliation(s)
- Catherine Hitch
- School of Psychology, Queen's University Belfast, David Keir Building, 18-30 Malone Road, Belfast, BT9 5BN, Northern Ireland.
- School of Psychology, Arden University, Arden House, Middlemarch Park, Coventry, CV3, UK.
| | - Paul Toner
- School of Psychology, Queen's University Belfast, David Keir Building, 18-30 Malone Road, Belfast, BT9 5BN, Northern Ireland
| | - Hannah Champion
- 4FJSchool of Psychology, Swansea University, Singleton Park Campus, Swansea, SA2 8PP, UK
| | - Cherie Armour
- School of Psychology, Queen's University Belfast, David Keir Building, 18-30 Malone Road, Belfast, BT9 5BN, Northern Ireland
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Morgan L, Hooks C, Fossey M, Buxton E, Rose Godier-McBard L. UK female veterans' physical health: perceived impact of military service and experiences of accessing healthcare. Findings of a qualitative study. BMJ Mil Health 2024:e002713. [PMID: 39153827 DOI: 10.1136/military-2024-002713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 07/19/2024] [Indexed: 08/19/2024]
Abstract
INTRODUCTION Women make up almost 14% of the UK's veteran population; however, little is known about female veterans' physical health and experiences of accessing healthcare after military service. As part of a qualitative study to understand female veterans' experiences of statutory and charitable support, participants were asked if they felt anything about their military service had impacted their physical health as civilians. They were also asked about their experiences with accessing healthcare and any associated challenges. The aim of this paper is to outline participants' responses to inform the development of further research. METHODS 85 women who had served in the British Armed Forces took part in semistructured interviews conducted via Microsoft Teams between June and December 2022. Reflexive thematic analysis of interview transcripts was conducted to identify, analyse and report repeated patterns in responses to questions. RESULTS Participants reported a range of physical health consequences that they attributed to military service. These included injuries sustained during training and deployment, 'wear and tear' through training and the impact of sometimes unsuitable clothing. They reported chronic pain, tendonitis, arthritis, slipped discs, broken bones and hearing loss. Some described their lives as severely restricted as a result. Challenges to accessing healthcare included perceived stigma associated with help-seeking, inconsistency around the transfer of medical records and a widespread lack of veteran awareness among civilian healthcare professionals. CONCLUSIONS There is a distinct lack of research in the UK against which to compare these findings; thus, further research is required in all areas of female veterans' physical health and experiences of accessing healthcare. Research should begin by establishing the nature and prevalence of health conditions among female and male veterans to identify the unique needs of both and tailor support accordingly.
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Affiliation(s)
- Louise Morgan
- Centre for Military Women's Research, Anglia Ruskin University, Chelmsford, UK
| | - C Hooks
- Centre for Military Women's Research, Anglia Ruskin University, Chelmsford, UK
- School of Midwifery and Community Health, Anglia Ruskin University, Chelmsford, UK
| | - M Fossey
- Centre for Military Women's Research, Anglia Ruskin University, Chelmsford, UK
| | - E Buxton
- Department of Criminology, Sociology and Social Policy, Loughborough University, Loughborough Campus, Loughborough, UK
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Ein N, Gervasio J, St. Cyr K, Liu JJW, Baker C, Nazarov A, Richardson JD. A rapid review of the barriers and facilitators of mental health service access among Veterans and their families. FRONTIERS IN HEALTH SERVICES 2024; 4:1426202. [PMID: 39105142 PMCID: PMC11298457 DOI: 10.3389/frhs.2024.1426202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Accepted: 06/25/2024] [Indexed: 08/07/2024]
Abstract
Introduction Transitioning to civilian life after military service can be challenging for both Veterans and their families. Accessible mental health services are crucial during this period to provide support. The objective of this review was to conduct a rapid review to capture the barriers and identify facilitators that influence access to mental health services for Veterans and their families during the post-service transition period. Methods This review was conducted using the Cochrane Handbook for Systematic Reviews of Interventions as a methodological framework and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses - Rapid Review (PRISMA-RR). Results A total of 60 articles and 67 independent samples were included in the final data analyses. Across the included articles, this review identified 23 barriers and 14 facilitator themes. Issues navigating the mental health care system was identified as the main challenge among Veterans and their families, and those who received support navigating the system identified this as a significant facilitator. Applying the Theoretical Domains Framework, most of the identified barriers and facilitators were categorized into environmental context and resources domain. Discussion The heterogeneity in Veterans' and Veteran families' experiences with mental health care-seeking may suggest that access to mental health care for Veterans and Veteran families cannot be solved by addressing one type of barrier alone. Instead, coordinated efforts to address prioritized systemic, logistical, social, and inter-/intrapersonal obstacles are essential for improving access and optimizing mental health care outcomes. These insights underscore the complexity of considerations for Veterans and families accessing mental health care.
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Affiliation(s)
- Natalie Ein
- MacDonald Franklin OSI Research and Innovation Centre, Lawson Health Research Institute, London, ON, Canada
- Department of Psychiatry, Western University, London, ON, Canada
| | - Julia Gervasio
- MacDonald Franklin OSI Research and Innovation Centre, Lawson Health Research Institute, London, ON, Canada
- Department of Psychology, Toronto Metropolitan University, Toronto, ON, Canada
| | - Kate St. Cyr
- MacDonald Franklin OSI Research and Innovation Centre, Lawson Health Research Institute, London, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Jenny J. W. Liu
- MacDonald Franklin OSI Research and Innovation Centre, Lawson Health Research Institute, London, ON, Canada
- Department of Psychiatry, Western University, London, ON, Canada
| | - Clara Baker
- MacDonald Franklin OSI Research and Innovation Centre, Lawson Health Research Institute, London, ON, Canada
| | - Anthony Nazarov
- MacDonald Franklin OSI Research and Innovation Centre, Lawson Health Research Institute, London, ON, Canada
- Department of Psychiatry, Western University, London, ON, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - J. Don Richardson
- MacDonald Franklin OSI Research and Innovation Centre, Lawson Health Research Institute, London, ON, Canada
- Department of Psychiatry, Western University, London, ON, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- St. Joseph’s OSI Clinic, St. Joseph’s Health Care London, London, ON, Canada
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Williamson C, Croak B, Simms A, Fear NT, Sharp ML, Stevelink SAM. Risk and protective factors for self-harm and suicide behaviours among serving and ex-serving personnel of the UK Armed Forces, Canadian Armed Forces, Australian Defence Force and New Zealand Defence Force: A systematic review. PLoS One 2024; 19:e0299239. [PMID: 38669252 PMCID: PMC11051630 DOI: 10.1371/journal.pone.0299239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 02/06/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Self-harm and suicide behaviours are a major public health concern. Several factors are associated with these behaviours among military communities. Identifying these factors may have important implications for policy and clinical services. The aim of this review was to identify the risk and protective factors associated with self-harm and suicide behaviours among serving and ex-serving personnel of the United Kingdom Armed Forces, Canadian Armed Forces, Australian Defence Force and New Zealand Defence Force. METHODS A systematic search of seven online databases (PubMed, Web of Science, Embase, Global Health, PsycINFO, PTSDpubs and CINAHL) was conducted alongside cross-referencing, in October 2022. Following an a priori PROSPERO approved protocol (CRD42022348867), papers were independently screened and assessed for quality. Data were synthesised using a narrative approach. RESULTS Overall, 28 papers were included: 13 from Canada, 10 from the United Kingdom, five from Australia and none from New Zealand. Identified risk factors included being single/ex-relationship, early service leavers, shorter length of service (but not necessarily early service leavers), junior ranks, exposure to deployment-related traumatic events, physical and mental health diagnoses, and experience of childhood adversity. Protective factors included being married/in a relationship, higher educational attainment, employment, senior ranks, and higher levels of perceived social support. CONCLUSION Adequate care and support are a necessity for the military community. Prevention and intervention strategies for self-harm and suicide behaviours may be introduced early and may promote social networks as a key source of support. This review found a paucity of peer-reviewed research within some populations. More peer-reviewed research is needed, particularly among these populations where current work is limited, and regarding modifiable risk and protective factors.
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Affiliation(s)
- Charlotte Williamson
- King’s Centre for Military Health Research, King’s College London, London, United Kingdom
| | - Bethany Croak
- King’s Centre for Military Health Research, King’s College London, London, United Kingdom
| | - Amos Simms
- Academic Department of Military Mental Health, King’s College London, London, United Kingdom
- British Army, London, United Kingdom
| | - Nicola T. Fear
- King’s Centre for Military Health Research, King’s College London, London, United Kingdom
- Academic Department of Military Mental Health, King’s College London, London, United Kingdom
| | - Marie-Louise Sharp
- King’s Centre for Military Health Research, King’s College London, London, United Kingdom
| | - Sharon A. M. Stevelink
- King’s Centre for Military Health Research, King’s College London, London, United Kingdom
- Department of Psychological Medicine, King’s College London, London, United Kingdom
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Croak B, Archer M, Harwood H, Stevelink SAM, Greenberg N, Rafferty L. Evaluation of Community Reinforcement and Family Therapy in the UK military community. Eur J Psychotraumatol 2023; 14:2282904. [PMID: 38010161 PMCID: PMC10993804 DOI: 10.1080/20008066.2023.2282904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 11/06/2023] [Indexed: 11/29/2023] Open
Abstract
Background: Partners and family can play a key role in encouraging military service and ex-service personnel to seek help for their mental health. Community Reinforcement Approach and Family Training (CRAFT) was developed to equip concerned significant others (CSOs) of those experiencing substance use disorders with skills to encourage their loved one to enter treatment and improve their own well-being. It was adapted in the US for CSOs of ex-service personnel with post-traumatic stress disorder (PTSD) (VA-CRAFT).Objective: This study aimed to evaluate an adaptation of VA-CRAFT for use with CSOs of serving and ex-service personnel experiencing PTSD and Common Mental Disorders in the UK (UKV-CRAFT).Method: Acceptability of UKV-CRAFT was assessed with interviews with experts, namely key stakeholders (n = 15) working in support provision for serving and ex-service personnel. In addition, individuals who took part in a small-scale demonstrative trial of UKV-CRAFT (three CSOs and three facilitators who delivered UKV-CRAFT) provided feedback.Results: UKV-CRAFT was viewed positively, with interviewees highlighting that programmes like UKV-CRAFT filled a gap in provision for UK Armed Forces families as most services were only available to the serving or ex-service personnel. Interviewees praised how UKV-CRAFT enhanced CSO well-being and communication with their loved one. Concerns over the confidentiality of taking part in UKV-CRAFT were raised due to the perceived negative effects of highlighting a loved one's mental ill health, especially for CSOs of serving personnel. Ideas for improvement included broadening access to all CSOs regardless of whether their loved one was seeking treatment.Conclusion: Interviewees regarded UKV-CRAFT as a potentially useful intervention suggesting it could be proactively offered universally to support timely help-seeking if required. We recommend further evaluation of UKV-CRAFT on a wider scale, incorporating our recommendations, to assess its effectiveness accurately.
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Affiliation(s)
- Bethany Croak
- King’s Centre for Military Health Research, Department of Psychological Medicine, King’s College London, London, United Kingdom
| | - Marc Archer
- King’s Centre for Military Health Research, Department of Psychological Medicine, King’s College London, London, United Kingdom
- School of Health, Social Care and Life Sciences, University of the Highlands and Islands, Inverness, United Kingdom
| | - Hannah Harwood
- King’s Centre for Military Health Research, Department of Psychological Medicine, King’s College London, London, United Kingdom
| | - Sharon A. M. Stevelink
- King’s Centre for Military Health Research, Department of Psychological Medicine, King’s College London, London, United Kingdom
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Neil Greenberg
- King’s Centre for Military Health Research, Department of Psychological Medicine, King’s College London, London, United Kingdom
| | - Laura Rafferty
- King’s Centre for Military Health Research, Department of Psychological Medicine, King’s College London, London, United Kingdom
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Er F, Duyan V. I'm About to Explode, I'm About to Strangle: Emotional Experiences of Turkish Veterans and Their Spouses Diagnosed with Post Traumatic Stress Disorder. JOURNAL OF EVIDENCE-BASED SOCIAL WORK (2019) 2023; 20:780-799. [PMID: 37843265 DOI: 10.1080/26408066.2023.2213231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
INTRODUCTION The aim of this study is to examine in depth the experiences of Turkish veterans diagnosed with Posttraumatic Stress Disorder (PTSD) and their spouses in the dimension of affective development in the light of their trauma experiences with a qualitative design and phenomenological approach. METHODS The study group of the research consisted of 21 veterans diagnosed with PTSD and accepted as veterans, and the spouses of the 21 veterans. The data of the study were collected through in-depth interviews with the participants used a semi-structured interview form (Appendıx). Data analyses were performed used the MAXQDA 2020 software. RESULTS Study, the main themes determined as pretraumatic positive emotions and posttraumatic negative emotions. There were 4 themes under negative emotions after trauma and 24 sub-themes under 4 themes. DISCUSSION AND CONCLUSION As a result of the study, it was understood that trauma experience and PTSD affect the affective development dimension of veterans and their spouses at different levels, and these effects have negative elements. According to these findings, it was determined that veterans and their spouses need psychosocial services that address the affective development dimension.
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Affiliation(s)
- Filiz Er
- Faculty of Health Sciences, Department of Social Work, Sinop University, Sinop, Turkey
| | - Veli Duyan
- Faculty of Health Sciences, Department of Social Work, Ankara University, Ankara, Turkey
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Hitch C, Toner P, Armour C. A Qualitative Systematic Review of Enablers and Barriers to HelpSeeking for Veterans that have Completely Left the Military Within the Context of Mental Health and Alcohol. JOURNAL OF VETERANS STUDIES 2023. [DOI: 10.21061/jvs.v9i1.376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
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Hitch C, Toner P, Armour C. Enablers and barriers to military veterans seeking help for mental health and alcohol difficulties: A systematic review of the quantitative evidence. J Health Serv Res Policy 2023:13558196221149930. [PMID: 36636855 PMCID: PMC10363942 DOI: 10.1177/13558196221149930] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVE Research exploring the enablers and barriers that exist for military veterans seeking to address their poor mental health has produced ambiguous results. To identify the enablers and barriers correctly, this study systematically reviews the literature, including research that included alcohol and had a clearly defined veteran population. METHODS Six databases were searched. Inclusion criteria specified that empirical studies related to veterans that had ceased military service and were seeking help for poor mental health and/or alcohol difficulties. Critical Appraisal Skills Programme and AXIS appraisal tools were used to assess quality and bias. A narrative synthesis approach was adopted for analysis. From 2044 studies screened, 12 were included featuring 5501 participants. RESULTS Forty-four enablers and barriers were identified, with thirty-two being statistically significant. Post-traumatic stress disorder had the greatest number of enabler/barrier endorsements to veterans seeking help. Depression, anxiety, experience and attitudes also acted as enablers/barriers. Most studies were of fair methodological quality. Limitations included that samples were skewed towards US army veterans. Little research exists concerning those that have ceased military service. CONCLUSIONS Veteran help-seeking is likely enabled by poor mental health symptomology and comorbidity, which suggests veterans reach a crisis point before they seek help. Further research on alcohol misuse and attitude formation is required. The field would also benefit from alternative study designs including qualitative studies with non-US participants.
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Affiliation(s)
- Catherine Hitch
- Stress Trauma and Related Conditions (STARC) Research Lab, School of Psychology, 1596Queen's University Belfast, Northern Ireland, UK
| | - Paul Toner
- School of Psychology, 1596Queen's University Belfast, Northern Ireland, UK
| | - Cherie Armour
- Stress Trauma and Related Conditions (STARC) Research Lab, School of Psychology, 1596Queen's University Belfast, Northern Ireland, UK
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Problem drinking recognition among UK military personnel: prevalence and associations. Soc Psychiatry Psychiatr Epidemiol 2023; 58:193-203. [PMID: 35661230 PMCID: PMC9922231 DOI: 10.1007/s00127-022-02306-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 05/12/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE Despite the higher prevalence of problem drinking in the UK military compared to the general population, problem recognition appears to be low, and little is known about which groups are more likely to recognise a problem. This study examined prevalence of problem drinking recognition and its associations. METHODS We analysed data from 6400 regular serving and ex-serving personnel, collected in phase 3 (2014-2016) of the King's Centre for Military Health Research cohort study. MEASUREMENTS Participants provided sociodemographic, military, health and impairment, life experiences, problem drinking, and problem recognition information. Problem drinking was categorised as scores ≥ 16 in the AUDIT questionnaire. Associations with problem recognition were examined with weighted logistic regressions. FINDINGS Among personnel meeting criteria for problem drinking, 49% recognised the problem. Recognition was most strongly associated (ORs ≥ 2.50) with experiencing probable PTSD (AOR = 2.86, 95% CI = 1.64-5.07), social impairment due to physical or mental health problems (AOR = 2.69, 95% CI = 1.51-4.79), adverse life events (AOR = 2.84, 95% CI = 1.70-4.75), ever being arrested (AOR = 2.99, CI = 1.43-6.25) and reporting symptoms of alcohol dependence (AOR = 3.68, 95% CI = 2.33-5.82). To a lesser extent, recognition was also statistically significantly associated with experiencing psychosomatic symptoms, feeling less healthy, probable common mental health disorders, and increased scores on the AUDIT. CONCLUSION Half of UK military personnel experiencing problem drinking does not self-report their drinking behaviour as problematic. Greater problem drinking severity, poorer mental or physical health, and negative life experiences facilitate problem recognition.
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Harris MPJ, Palmedo PC, Fleary SA. "What gets people in the door": An integrative model of student veteran mental health service use and opportunities for communication. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022:1-11. [PMID: 36227710 DOI: 10.1080/07448481.2022.2129977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 08/02/2022] [Accepted: 09/25/2022] [Indexed: 06/16/2023]
Abstract
Objective: To explore barriers and facilitators to mental health care among the student service member and veteran (SSM/V) population, develop an integrative model of mental health service use, and identify health communication opportunities. Participants: Participants were 21 current and former SSM/Vs recruited online and via snowball sampling. Methods: We conducted an emergent thematic analysis of in-depth interviews that took place in February 2021. Results: We identified eight major themes. Two were contextual (military culture, SSM/V identities), three were navigational (career repercussions, recognizing need, service availability/quality), and three were paths forward (high-quality accessible services, veteran peers/spaces, relevant outreach). Conclusions: We recommend higher education institutions promote SSM/V spaces, position mental health care as utilitarian, improve everyday mental health literacy, highlight service accessibility and quality, and deliver communications that reflect the diversity of SSM/V identities beyond the "warrior" archetype.
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Affiliation(s)
- Magdalen P J Harris
- Community Health and Social Sciences, City University of New York Graduate School of Public Health and Health Policy, New York, New York, USA
| | - P Christopher Palmedo
- Community Health and Social Sciences, City University of New York Graduate School of Public Health and Health Policy, New York, New York, USA
| | - Sasha A Fleary
- Community Health and Social Sciences, City University of New York Graduate School of Public Health and Health Policy, New York, New York, USA
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Turner NR, Hardiman ER, Matteson AL, Fletcher S. Pathways to program entry: Factors promoting entry and participation in veteran peer-support programs. EVALUATION AND PROGRAM PLANNING 2022; 92:102078. [PMID: 35338981 DOI: 10.1016/j.evalprogplan.2022.102078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 06/09/2021] [Accepted: 03/13/2022] [Indexed: 06/14/2023]
Abstract
Given the documented underutilization of community-based services by veterans, this study aims to identify factors promoting engagement in programs. Qualitative data from interviews with 154 veterans in peer support programs were analyzed to identify factors promoting program entry and participation. Findings confirm the importance of both internal and external factors for program engagement. Internal factors included feeling a sense of disconnection, dissatisfaction with other programs, emotional needs, concrete needs, and a desire to serve others. External factors included encouragement from others, program culture, and program climate. Implications for program development and evaluation are discussed. While much of the current literature on veterans focuses on individual characteristics promoting or impeding service use, this study provides insight into programmatic features such as culture and climate which foster participation and meaningful engagement. Ultimately, programs serving veterans need input and influence by veterans, and should emphasize peer support and other opportunities for social connection.
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Affiliation(s)
- Natalie R Turner
- School of Social Welfare, University at Albany, State University of New York, Albany NY, USA
| | - Eric R Hardiman
- School of Social Welfare, University at Albany, State University of New York, Albany NY, USA.
| | - Amanda L Matteson
- School of Social Welfare, University at Albany, State University of New York, Albany NY, USA
| | - Samantha Fletcher
- National Association of Social Workers New York State, Albany NY, USA
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Skellon N, Barrett A, Hacker Hughes J, McGuire J. Importance of understanding military veterans’ perspectives of ‘the right support’ provided by an NHS-commissioned military veterans’ mental health service. BMJ Mil Health 2022; 168:5-8. [DOI: 10.1136/bmjmilitary-2021-002066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2022] [Indexed: 11/04/2022]
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13
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Champion H, Pritchard A, Dighton G, Dymond S. Gambling problems and help-seeking in serving United Kingdom military personnel: A qualitative study. Front Psychiatry 2022; 13:1003457. [PMID: 36620678 PMCID: PMC9816802 DOI: 10.3389/fpsyt.2022.1003457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 12/07/2022] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION In military personnel are vulnerable to gambling problems, yet many are reluctant to seek help. The aim of the current study was to explore the lived experience of problem gambling and help-seeking among serving members of the United Kingdom Armed Forces. METHODS Seventeen individuals from a larger, cross-sectional survey of gambling and wellbeing in the Royal Air Force (RAF) completed semi-structured interviews. Interview questions focused on personal experiences, the context of the RAF and its influence, knowledge and experiences of treatment and support services, and the impact of COVID-19. RESULTS Reflexive thematic analysis revealed four themes: (1) harmful and protective occupational factors; (2) socio-cultural and personal influences; (3) organizational attitudes toward mental health and help-seeking, and (4) current support pathways and provision. DISCUSSION Findings also indicated that gambling and alcohol use are common within the RAF, and that personnel are actively coping with mental health challenges.
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Affiliation(s)
- Hannah Champion
- School of Psychology, Swansea University, Swansea, United Kingdom
| | - Amy Pritchard
- School of Psychology, Swansea University, Swansea, United Kingdom.,Department of Mental Health and Social Work, Middlesex University, Hendon, United Kingdom
| | - Glen Dighton
- School of Psychology, Swansea University, Swansea, United Kingdom.,King's Centre for Military Health Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Simon Dymond
- School of Psychology, Swansea University, Swansea, United Kingdom.,Department of Psychology, Reykjavík University, Reykjavík, Iceland
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14
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Sobczak S, Olff M, Rutten B, Verhey F, Deckers K. Comorbidity rates of Posttraumatic Stress Disorder in dementia: a systematic literature review. Eur J Psychotraumatol 2021; 12:1883923. [PMID: 33968318 PMCID: PMC8075086 DOI: 10.1080/20008198.2021.1883923] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Background: Post Traumatic Stress Disorder (PTSD) has been described as an independent risk factor for cognitive decline and dementia. At the same time, cognitive deterioration and increased loss experiences in dementia may increase liability for the reactivation of traumatic memories and thereby PTSD symptoms. Objective: In order to investigate co-occurrence of PTSD in dementia this systematic literature review summarizes all the available evidence on reported comorbidity rates of PTSD in patients with dementia. Method: PubMed, Embase, PsycINFO and CINAHL were searched for potential publications investigating the co-occurrence of PTSD in dementia until 25 November 2019. Cohort and cross-sectional studies were included. To assure current comorbidity of PTSD in dementia, only publications with a recent PTSD diagnosis (<2 years before onset of dementia) were selected. Results: Of the 860 identified abstracts, three studies (0.35%) met the eligibility criteria and were included. These three studies concerned only military veteran populations, and they comprised two cross-sectional cohort studies and one prospective cohort study. The estimated comorbidity rate of PTSD in veterans with dementia varied between 4.7% and 7.8%. Conclusions: The limited research available shows comorbidity rates only in military veterans, which were possibly dependent on investigated population with respect to dementia severity and possibly associated behavioural and psychiatric symptoms of dementia (BPSD). In dementia patients the comorbidity with PTSD may be high and we suggest that worldwide the impact of PTSD in dementia is high and probably underestimated. Research and care on this topic should improve urgently with the current expanding prevalence of dementia. A first step to improve quality of dementia research and care would be to develop a structured tool to diagnose PTSD in these patients.
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Affiliation(s)
- Sjacko Sobczak
- School for Mental Health and Neuroscience (MHeNs), Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre+, Maastricht, The Netherlands.,Alzheimer Centrum Limburg, Maastricht, The Netherlands.,Department of Old Age Psychiatry, Mondriaan Hospital, Heerlen, Maastricht, The Netherlands
| | - Miranda Olff
- Arq Psychotrauma Research, AMC/University of Amsterdam, Amterdam
| | - Bart Rutten
- School for Mental Health and Neuroscience (MHeNs), Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Frans Verhey
- School for Mental Health and Neuroscience (MHeNs), Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre+, Maastricht, The Netherlands.,Alzheimer Centrum Limburg, Maastricht, The Netherlands
| | - Kay Deckers
- School for Mental Health and Neuroscience (MHeNs), Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre+, Maastricht, The Netherlands.,Alzheimer Centrum Limburg, Maastricht, The Netherlands
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15
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Wheeler M, Cooper NR, Andrews L, Hacker Hughes J, Juanchich M, Rakow T, Orbell S. Outdoor recreational activity experiences improve psychological wellbeing of military veterans with post-traumatic stress disorder: Positive findings from a pilot study and a randomised controlled trial. PLoS One 2020; 15:e0241763. [PMID: 33237906 PMCID: PMC7688151 DOI: 10.1371/journal.pone.0241763] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 10/15/2020] [Indexed: 11/19/2022] Open
Abstract
Exposure to the natural environment is increasingly considered to benefit psychological health. Recent reports in the literature also suggest that outdoor exposure that includes recreational pursuits such as surfing or fishing coupled with opportunities for social interaction with peers may be beneficial to Armed Forces Veterans experiencing Post-Traumatic Stress Disorder (PTSD). Two studies were conducted to evaluate this possibility. In particular, these studies aimed to test the hypothesis that a brief group outdoor activity would decrease participants’ symptoms as assessed by established measures of PTSD, depression, anxiety and perceived stress, and increase participants’ sense of general social functioning and psychological growth. Experiment one employed a repeated measures design in which UK men and women military veterans with PTSD (N = 30) participated in a group outdoor activity (angling, equine care, or archery and falconry combined). Psychological measures were taken at 2 weeks prior, 2 weeks post, and at 4 month follow up. We obtained a significant within participant main effect indicating significant reduction in PTSD symptoms. Experiment two was a waitlist controlled randomised experiment employing an angling experience (N = 18) and 2 week follow up. In experiment 2 the predicted interaction of Group (Experimental vs. Waitlist Control) X Time (2 weeks pre vs. 2 weeks post) was obtained indicating that the experience resulted in significant reduction in PTSD symptoms relative to waitlist controls. The effect size was large. Additional analyses confirmed that the observed effects might also be considered clinically significant and reliable. In sum, peer outdoor experiences are beneficial and offer potential to complement existing provision for military veterans with Post Traumatic Stress Disorder.
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Affiliation(s)
- Mark Wheeler
- Department of Psychology, University of Essex, Colchester, Essex, United Kingdom
| | - Nicholas R. Cooper
- Department of Psychology, University of Essex, Colchester, Essex, United Kingdom
- * E-mail:
| | - Leanne Andrews
- Department of Health and Social Care, University of Essex, Colchester, Essex, United Kingdom
| | - Jamie Hacker Hughes
- Northern Hub for Veterans and Families Research, University of Northumbria, Newcastle upon Tyne, United Kingdom
| | - Marie Juanchich
- Department of Psychology, University of Essex, Colchester, Essex, United Kingdom
| | - Tim Rakow
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience; King’s College, London, United Kingdom
| | - Sheina Orbell
- Department of Psychology, University of Essex, Colchester, Essex, United Kingdom
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16
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Scheepstra KWF, Pauw HS, van Steijn ME, Stramrood CAI, Olff M, van Pampus MG. Potential traumatic events in the workplace and depression, anxiety and post-traumatic stress: a cross-sectional study among Dutch gynaecologists, paediatricians and orthopaedic surgeons. BMJ Open 2020; 10:e033816. [PMID: 32878750 PMCID: PMC7470507 DOI: 10.1136/bmjopen-2019-033816] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 05/13/2020] [Accepted: 07/10/2020] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To compare the prevalence of work-related potential traumatic events (PTEs), support protocols and mental health symptoms across Dutch gynaecologists, orthopaedic surgeons and paediatricians. DESIGN Cross-sectional study, supplementary analysis of combined data. SETTING Nationwide survey between 2014 and 2017. PARTICIPANTS An online questionnaire was sent to all Dutch gynaecologists, orthopaedic surgeons and paediatricians, including resident physicians (4959 physicians). 1374 questionnaires were eligible for analysis, corresponding with a response rate of 27.7%. OUTCOME MEASURES Primary outcome measures were the prevalence of work-related PTEs, depression, anxiety, psychological distress and traumatic stress, measured with validated screening instruments (Hospital Anxiety and Depression Scale, Trauma Screening Questionnaire). Secondary outcomes were the association of mental health and defensive practice to traumatic events and support protocols. RESULTS Of the respondents, 20.8% experienced a work-related PTE at least 4 weeks ago. Prevalence rates indicative of depression, anxiety or post-traumatic stress disorder (PTSD) were 6.4%, 13.6% and 1.5%, respectively. Depression (9.2% vs 5.2%, p=0.019), anxiety (18.2% vs 8.2%, p<0.001) and psychological distress (22.8% vs 12.5%, p<0.001) were significantly more prevalent in female compared with male attendings. The absence of a support protocol was significantly associated with more probable PTSD (p=0.022). Those who witnessed a PTE, reported more defensive work changes (28.0% vs 20.5%, p=0.007) and those with probable PTSD considered to quit medical work more often (60.0% vs 35.8%, p=0.032). CONCLUSION Physicians are frequently exposed to PTEs with high emotional impact over the course of their career. Lacking a support protocol after adverse events was associated with more post-traumatic stress. Adverse events were associated with considering to quit medical practice and a more defensive practice. More awareness must be created for the mental health of physicians as well as for the implementation of a well-organised support system after PTEs.
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Affiliation(s)
| | - Hannah S Pauw
- Faculty of Medicine, Amsterdam UMC - Locatie AMC, Amsterdam, The Netherlands
| | - Minouk Esmee van Steijn
- Obstetrics and Gynaecology, OLVG Locatie Oost, Amsterdam, The Netherlands
- Obstetrics and Gynaecology, Amsterdam UMC - Locatie AMC, Amsterdam, The Netherlands
| | | | - Miranda Olff
- Psychiatry, Amsterdam UMC - Locatie AMC, Amsterdam, The Netherlands
- Psychotrauma Research, Arq National Psychotrauma Center, Diemen, North Holland, The Netherlands
| | - Maria G van Pampus
- Obstetrics and Gynaecology, OLVG Locatie Oost, Amsterdam, The Netherlands
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17
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Scheepstra KWF, van Lent EM, Lok A, Olff M, van Pampus MG. Exploring the impact of work-related potential traumatic events among Dutch psychiatrists. Psychiatry Res 2020; 288:112981. [PMID: 32371313 DOI: 10.1016/j.psychres.2020.112981] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 03/31/2020] [Accepted: 03/31/2020] [Indexed: 11/25/2022]
Abstract
Psychiatrists are frequently exposed to work-related potential traumatic events (PTEs). A survey was sent to the members of the Dutch Society of Psychiatrists of which 250 questionnaires were eligible for analysis. At least one work-related PTE was reported by 196 (78.4%) of the respondents, of which 177 described the PTE. Witnessing or experiencing verbal aggression (29.2%), physical violence (29.2%) or completed suicide (26.8%) were the most common PTEs. This survey implies that psychiatrists frequently experience work-related PTEs, often with a significant emotional impact. The majority of respondents considered current support as insufficient.
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Affiliation(s)
- K W F Scheepstra
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
| | - E M van Lent
- Arkin Institute for Mental Health, Klaprozenweg 111, 1033 NN, Amsterdam, The Netherlands
| | - A Lok
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - M Olff
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands; Arq Psychotrauma Expert Group, Nienoord 5, 1112 XE, Diemen, The Netherlands
| | - M G van Pampus
- OLVG, Department of Obstetrics and Gynecology, Oosterpark 9, 1090 HM, Amsterdam, The Netherlands
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18
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Madigan A, Baumann J, Murphy D. Exploring the Facilitation of Successfully Completing Treatment within a Residential Setting with Veterans Diagnosed with PTSD. JOURNAL OF VETERANS STUDIES 2020. [DOI: 10.21061/jvs.v6i1.149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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19
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Gordon K, Burnell K, Wilson C. Outside the Military "Bubble": Life After Service for UK Ex-armed Forces Personnel. Front Public Health 2020; 8:50. [PMID: 32195216 PMCID: PMC7062665 DOI: 10.3389/fpubh.2020.00050] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 02/11/2020] [Indexed: 11/25/2022] Open
Abstract
Military personnel who have seen active service can be affected by their experiences. Much of the literature on the mental and physical health battles faced by men and women who leave the Armed Forces is dominated by research in the United States (US) (1), and is particularly focused on exposure to deployment, combat conditions, and effects on mental health. Research in the United Kingdom (UK) tends to focus on depression or alcohol misuse and the impact these issues have on currently serving personnel. This study aimed to present UK veterans' first-hand experiences related to military service, access to and use of mental healthcare and interventions, and the impact of transition on the military family. Semi-structured interviews explored experiences of 30 participants (27 male, 3 female). Participants ranged in age from 26 to 92 years (M = 53.33), and across multiple war cohorts (from WWII to Iraq and Afghanistan). Data were analyzed using Thematic Analysis and Narrative Analysis. Findings show meaning-making from experiences of transition across veteran cohorts. Main themes were reasons for leaving Armed Forces, life outside the military, and mental health concerns after service. Subordinate themes additionally focused on evaluation of identity and mental health service provision. Future clinical research should include the experiences of UK serving personnel and the effects of pre-and post-military adversity, alongside the impact of deployment experiences. Interventions designed to address transition into life after service are discussed.
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Affiliation(s)
- Kim Gordon
- School of Life Sciences and Education, Clinical Psychology, Staffordshire University, Stoke-on-Trent, United Kingdom
| | - Karen Burnell
- School of Sport, Health and Social Sciences, Solent University, Southampton, United Kingdom
| | - Clare Wilson
- Department of Psychology, University of Portsmouth, Portsmouth, United Kingdom
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20
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Phillips R. The Stigmatized Hero? A Review of UK Opinion Polls and Surveys on Perceptions of British Veterans in UK Society. JOURNAL OF VETERANS STUDIES 2020. [DOI: 10.21061/jvs.v6i1.150] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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21
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Rafferty LA, Wessely S, Stevelink SAM, Greenberg N. The journey to professional mental health support: a qualitative exploration of the barriers and facilitators impacting military veterans' engagement with mental health treatment. Eur J Psychotraumatol 2020; 10:1700613. [PMID: 33488992 PMCID: PMC7803083 DOI: 10.1080/20008198.2019.1700613] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: It is often claimed that military veterans are reticent to seek help for mental disorders, even though delayed treatment may impair recovery and impact the wellbeing of those close to the veteran. Objective: This paper aims to explore the barriers and facilitators to accessing professional mental health support for three groups of veterans who met criteria for a probable mental health disorder and: (1) do not recognize a probable mental disorder; (2) recognize they are affected by a mental disorder but are not seeking professional support; or (3) are currently seeking professional mental health support. Method: Qualitative telephone interviews were conducted with 62 UK military veterans. Thematic analysis identified core themes along an illustrative journey towards professional mental health support. Results: Distinct barriers and facilitators to care were discussed by each group of veterans depicting changes as veterans moved towards accessing professional mental health support. In contrast to much of the literature, stigma was not a commonly reported barrier to care; instead care-seeking decisions centred on a perceived need for treatment, waiting until a crisis event occurred. Whilst the recognition of treatment need represented a pivotal moment, our data identified numerous key steps which had to be surmounted prior to care-seeking. Conclusion: As care-seeking decisions within this sample appeared to centre on a perceived need for treatment future efforts designed to encourage help-seeking in UK military veterans may be best spent targeting the early identification and management of mental health disorders to encourage veterans to seek support before reaching a crisis event.
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Affiliation(s)
- Laura A Rafferty
- Kings' Centre for Military Health Research, King's College London, London, UK
| | - Simon Wessely
- Kings' Centre for Military Health Research, King's College London, London, UK
| | - Sharon A M Stevelink
- Kings' Centre for Military Health Research and Department of Psychological Medicine, King's College London, London, UK
| | - Neil Greenberg
- Kings' Centre for Military Health Research, King's College London, London, UK
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22
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Burns-O'Connell G, Stockdale D, Hoare DJ. Soldiering on: a survey on the lived experience of tinnitus in aged military veterans in the UK. MEDICAL HUMANITIES 2019; 45:408-415. [PMID: 31740577 PMCID: PMC7029250 DOI: 10.1136/medhum-2019-011671] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/22/2019] [Indexed: 05/16/2023]
Abstract
Tinnitus has long been interrogated as a medical conundrum, with little discourse between medicine and other disciplines. It involves the perception of sound in the ears or head without any external sound source, most likely a natural consequence of some form of hearing loss. For many people, tinnitus is bothersome and associated with various problems such as insomnia, difficulty concentrating and impaired listening ability. Nevertheless, with little attention from humanities or the social sciences, our understanding of the wider perspectives and psychosocial context of adults with tinnitus is limited, especially among UK military veterans. The aim of this study was to explore the impact of tinnitus on aged UK veterans, and to consider the support they receive and require to live well with tinnitus. In all, 120 aged UK veterans took part in this study. Data revealed similarities and differences between UK veteran and other study populations. For example, tinnitus symptom severity was higher in aged veterans than a general (younger) research population, particularly so on measures of intrusiveness and the effect of tinnitus on listening ability. Veterans had mixed views on social support. Many did not want to talk about tinnitus with others and/or did not want to burden their family, preferring to deal with their tinnitus 'backstage'. Others appreciated empathy or sympathy; many implied a desire that their family and/or friends could better understand their experience of living with tinnitus and the problems it caused them. These complexities support a need for cross-disciplinary work to understand and respond to tinnitus-related problems in veterans.
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Affiliation(s)
- Georgina Burns-O'Connell
- British Tinnitus Association, Sheffield, UK
- Department of Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
| | | | - Derek James Hoare
- Department of Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre, University of Nottingham, Nottingham, UK
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23
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Jones N, Sharp ML, Phillips A, Stevelink SAM. Suicidal Ideation, Suicidal Attempts, and Self-Harm in the UK Armed Forces. Suicide Life Threat Behav 2019; 49:1762-1779. [PMID: 31290563 DOI: 10.1111/sltb.12570] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 02/21/2019] [Indexed: 11/28/2022]
Abstract
INTRODUCTION In the UK military, suicide is infrequent and studies of self-harm behavior in this population are rare. OBJECTIVES To compare lifetime self-harm rates estimated on three occasions between 2004 and 2016 and to explore the associates of lifetime self-harm. METHOD Three phases of a UK AF cohort study (n = 10,272, 9,990, and 8,581, respectively) provided data. Telephone interviews assessed associates of self-harm among cohort members who reported subjective mental health problems in the past 3 years (n = 1,448). Validated measures of mental health and related stigmatization, social support, and help-seeking were obtained. RESULTS Lifetime self-harm increased significantly (p < .001) from 1.8% among serving personnel and 3.8% among veterans in 2004/06 to 1.9% and 4.5% in 2007/09 and to 4.2% and 6.6% in 2014/16 in the two groups, respectively. Veterans were consistently significantly more likely to report lifetime self-harm than serving personnel. Significant determinants of lifetime self-harm included current mental disorder symptoms, stigmatization, poor social support, suicidal ideation, and seeking help from formal medical sources. CONCLUSION Self-harm has increased over time in the UK serving and veteran community. Suicide prevention should focus on ameliorating mental disorder by encouraging engagement with health care, reducing negative views of mental illness, and fostering social support.
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Affiliation(s)
- Norman Jones
- Academic Department of Military Mental Health, Floor 3 Weston Education Centre, King's College London, London, UK
| | - Marie-Louise Sharp
- King's Centre for Military Mental Health Research, Weston Education Centre, King's College London, London, UK
| | - Ava Phillips
- Academic Department of Military Mental Health, Floor 3 Weston Education Centre, King's College London, London, UK
| | - Sharon A M Stevelink
- King's Centre for Military Mental Health Research, Weston Education Centre, King's College London, London, UK.,Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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24
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van Bennekom MJ, de Koning PP. Reducing the stigma on posttraumatic stress disorder in militaries through virtual reality. Mhealth 2018; 4:5. [PMID: 29683127 PMCID: PMC5897704 DOI: 10.21037/mhealth.2018.03.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 02/26/2018] [Indexed: 11/06/2022] Open
Affiliation(s)
- Martine J van Bennekom
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Pelle P de Koning
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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