Exploring enablers and barriers to help-seeking for military veterans with mental health and alcohol difficulties: A qualitative systematic review

Systematic reviews exist on help-seeking (HS) but none are veteran specific in the context of alcohol and mental health issues. Research is also typically quantitative. These tendencies are problematic as veterans-specific barriers and enablers may be unique, and it is difficult to understand the HS process through a quantitative methodology. Systemically reviewing qualitative studies which have focused on veteran HS studies would aid our understanding. Ten databases were searched. Search terms linked to veterans, mental health, alcohol, HS, qualitative. Data were analysed thematically. The initial search produced 953 articles; six were reviewed. Four main themes were identified: ‘Military culture – culturised norms’, ‘severity of the problem’, ‘the System’ and ‘relationships and support’. Barriers and enablers exist at individual and group levels. Collectively, themes indicated that HS is a journey. Some methodological aspects were reported sufficiently (data collection, themes, quotes), yet, no study justified taking a specific qualitative approach, or described analysis taken. Other issues included participant selection, researcher input and ethical considerations. Veteran HS is a process, impacted by individual and group-level factors, which change over time. The HS process can be explored qualitatively, but research rigor and reporting require improvement.