TY - JOUR
T1 - Pathways to mental health care in active military populations across the Five-Eyes nations
T2 - An integrated perspective
AU - Fikretoglu, Deniz
AU - Sharp, Marie Louise
AU - Adler, Amy B.
AU - Bélanger, Stéphanie
AU - Benassi, Helen
AU - Bennett, Clare
AU - Bryant, Richard
AU - Busuttil, Walter
AU - Cramm, Heidi
AU - Fear, Nicola
AU - Greenberg, Neil
AU - Heber, Alexandra
AU - Hosseiny, Fardous
AU - Hoge, Charles W.
AU - Jetly, Rakesh
AU - McFarlane, Alexander
AU - Morganstein, Joshua
AU - Murphy, Dominic
AU - O'Donnell, Meaghan
AU - Phelps, Andrea
AU - Richardson, Don J.
AU - Sadler, Nicole
AU - Schnurr, Paula P.
AU - Smith, Patrick
AU - Ursano, Robert
AU - Hooff, Miranda Van
AU - Wessely, Simon
AU - Forbes, David
AU - Pedlar, David
N1 - Funding Information:
No financial support was provided for the preparation of this manuscript.
Publisher Copyright:
© 2021
PY - 2022/2
Y1 - 2022/2
N2 - Military service is associated with increased risk of mental health problems. Previous reviews have pointed to under-utilization of mental health services in military populations. Building on the most recent systematic review, our narrative, critical review takes a complementary approach and considers research across the Five-Eyes nations from the past six years to update and broaden the discussion on pathways to mental healthcare in military populations. We find that at a broad population level, there is improvement in several indicators of mental health care access, with greater gains in initial engagement, time to first treatment contact, and subjective satisfaction with care, and smaller gains in objective indicators of adequacy of care. Among individual-level barriers to care-seeking, there is progress in improving recognition of need for care and reducing stigma concerns. Among organizational-level barriers, there are advances in availability of services and cultural acceptance of care-seeking. Other barriers, such as concerns around confidentiality, career impact, and deployability persist, however, and may account for some remaining unmet need. To address these barriers, new initiatives that are more evidence-based, theoretically-driven, and culturally-sensitive, are therefore needed, and must be rigorously evaluated to ensure they bring about additional improvements in pathways to care.
AB - Military service is associated with increased risk of mental health problems. Previous reviews have pointed to under-utilization of mental health services in military populations. Building on the most recent systematic review, our narrative, critical review takes a complementary approach and considers research across the Five-Eyes nations from the past six years to update and broaden the discussion on pathways to mental healthcare in military populations. We find that at a broad population level, there is improvement in several indicators of mental health care access, with greater gains in initial engagement, time to first treatment contact, and subjective satisfaction with care, and smaller gains in objective indicators of adequacy of care. Among individual-level barriers to care-seeking, there is progress in improving recognition of need for care and reducing stigma concerns. Among organizational-level barriers, there are advances in availability of services and cultural acceptance of care-seeking. Other barriers, such as concerns around confidentiality, career impact, and deployability persist, however, and may account for some remaining unmet need. To address these barriers, new initiatives that are more evidence-based, theoretically-driven, and culturally-sensitive, are therefore needed, and must be rigorously evaluated to ensure they bring about additional improvements in pathways to care.
KW - Help-seeking
KW - Military
KW - Service member
KW - Service use
KW - Treatment engagement
UR - http://www.scopus.com/inward/record.url?scp=85120456765&partnerID=8YFLogxK
U2 - 10.1016/j.cpr.2021.102100
DO - 10.1016/j.cpr.2021.102100
M3 - Article
AN - SCOPUS:85120456765
SN - 0272-7358
VL - 91
JO - Clinical Psychology Review
JF - Clinical Psychology Review
M1 - 102100
ER -