Does mental health comorbidity predict help-seeking in veterans residing in Northern Ireland

Background - It is suspected that Northern Ireland (NI) veterans have higher rates of poor mental health due to exacerbated trauma exposure. However, security issues create the tendency to self-marginalise, therefore, help-seeking (HS) for poor mental health is likely reduced.

Aims - This study examined the predictors of actual HS behaviour, as these findings have implications for veteran care within NI.

Methods – Logistic regression was conducted on data from 603 participants. HS was defined as ever/currently having medication or therapy, with predictors being mental health comorbidities (alcohol, anxiety, depression, PTSD, C_PTSD, dissociation), attitudes towards mental health and transition. Analysis was adjusted for military and demographic factors.

Results – The main predictor of medication use was mental health comorbidity, with comorbidity having a greatest effect on current use. ‘High comorbid all disorders’ was the most salient predictor (OR4.37 ‘ever’; OR9.64 ‘current), followed by anxiety/depression (OR3.61 ‘ever’; OR4.71 ‘current’) and PTSD with moderate depression/alcohol (OR3.86 ‘current’). Being female (OR3.35) and deployment outside NI (OR2.07) predicted historic medication use. Poor transition, shorter length of service, positive attitudes and mental health diagnosis since discharge had positive but smaller effects on HS via medication. Therapy use was only predicted by transition (OR2.32), length of service (OR.96), attitudes (OR.47) and diagnosis since discharge (OR.13).

Discussion – Therapy and medication use had differing predictors, which is likely due to access to services and the need to self-marginalise. NI veterans will HS mainly via medication, yet other factors seem to drive therapy use in NI. Findings suggest there are likely other environmental factors veterans prefer for support.