Based on a focus group study of 41 veteran participants, researchers suggest that while the Veterans Health Administration (VA) works to increase availability of mental health care to veterans, the increased access may not in itself decrease some barriers to seeking treatment, and more work is needed to address the variety of barriers identified in the study.
Balancing Life Circumstances and Coping Resources
Veterans who felt that their coping resources were sufficient to manage stressors preferred self-management over formal mental health treatment. In some cases, specific symptoms, such as suicidal ideation, were described as being sufficient motivators to seek help.
As one veteran said, “If something that you can’t handle develops then, of course, you’ll ask for assistance, otherwise, you’ve just been through enough that we know we have to just cope with whatever happens.”
Some veterans reported that although they knew a treatment would be beneficial, some personal qualities hindered them from seeking services. These personal qualities included self-reliance, being “set in my ways” or stubborn, and older age.
Beliefs and Experiences of Mental Health Services
Negative beliefs and experiences were identified as barriers for veterans with and without mental health treatment experience. For example, participants often described themselves as fearful of any mental health treatment or professional, and veterans with no prior MH contact expressed fear of “opening up” to someone unfamiliar.
Many felt they would not be helped by nonveteran MH providers, citing that these providers would not understand military experiences or the impact of military culture on veterans’ MH. “Civilians can’t understand. Never will….If you have somebody that wasn’t in the military then they really can’t get into you and know what you’re all about.”
Cultural Messages and Stigma
Veterans frequently cited ingrained military values that influence their present-day beliefs and behavior. For instance, many discussed the importance of “getting the job done,” referring to prioritizing the fulfillment one’s mission over addressing personal discomfort.
Multiple veterans commented on the need to “just suck it up and get back on the line” and stated or implied that they continued to carry this value postdischarge: “You don’t need help. If you can’t ﬁx it yourself, get the heck out of the room. So that’s probably the biggest challenge.”
Media portrayals of mental health and its treatment, usually in relation to military figures, were also mentioned as a potential barrier veterans. Movies and television commercials were cited as reinforcing the military cultural value of outward emotional toughness.
Wray, Laura O., et al. “Veterans’ Mental Health Beliefs: Facilitators and Barriers to Primary Care-Mental Health Use.” Families, Systems, & Health, vol. 34, no. 4, 2016, pp. 404 – 413.