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

There is a paucity of research specific to veteran help-seeking (HS) in the context of alcohol usage and mental health difficulties. Also, there are methodological issues that hinder our understanding of this field of research. Mixing traumatised populations within the same research confuses findings, as barriers and enablers to HS may be different for civilians, serving personnel, and veterans. This review aims to clarify the topic by reviewing veteran-specific, HS literature. Fifteen databases were screened. Search terms related to enablers, barriers, veterans, alcohol, mental health, and HS. A narrative synthesis approach was adopted for data analysis. From 1,658 studies, ten were examined. Thirty-nine barriers and enablers (items) were identified and of these the majority were enablers. Seven categories were constructed. PTSD had the highest number of single enablement endorsements, followed by depression, income and social support. Findings relating to alcohol were unclear. Attitudes, as a category, had the most items. Generalisability of results are difficult due to issues with study design, and mixed participant populations. Attitudes are important for HS but further research regarding attitude formation is needed. The filed would benefit for a greater degree of standardisation of research designs.