Catherine Hitch

My name is Catherine Hitch; I am a 3rd year PhD researcher at Queens University, Belfast.  I have a personal interest in the Armed Force community and have tailored all research projects where possible towards this population.  My PhD relates to help-seeking behaviour within the context of mental health and alcohol difficulties, and it specifically targets Northern Ireland veterans.  NI veterans are a particularly under researched sub-population and I am honoured to be involved in a seminal project exploring them, funded by the Royal British Legion. I advocate taking a mixed methods approach to attempt to answer those ‘why?’ questions.

What are the enablers and barriers to help-seeking for military veterans with mental health and alcohol difficulties? A systematic review

Background: Research remains unclear regarding veteran help-seeking (HS); some veterans do HS whilst others do not. A possible cause of ambiguity relates to research methods, particularly the tendency to mix veterans with other populations within studies. This is problematic because diverse populations experience different difficulties and face distinctive HS barriers (Bs) and enablers (Es). Therefore, there is a need to systematically review the HS literature relating to veterans only.

Methods: Searches were conducted across 15 databases. Search terms related to enablers, barriers, veterans, alcohol, mental health and help-seeking. A narrative synthesis approach was adopted for data analysis.

Results: From 1,658 studies screened, ten met the inclusion criteria. The total number of individual HS Bs and Es identified was 39, 29 of which were statistically significant. There were more Es than Bs. PTSD was the E/B with the highest number of HS E endorsements, followed by depression, income and socially related Es/Bs. Findings relating to alcohol were unclear. Attitudes, as a category of Es/Bs, had the most individual Es/Bs. Most studies were of fair methodological quality, although none were without limitation. The variety of scales used (30) contributed to the large number of individual Es and Bs identified. Differences in study design made comparison difficult. Participants were mainly Caucasian Army veterans, therefore, findings had limited generalisability.

Conclusions: Overall findings align with existing research. Further research regarding attitude formation and alcohol is needed. Close attention is also required to improve research designs.

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