Women veterans are often underserved in both the research into and provision of mental health treatment. This study explored women veterans’ experiences of mental health difficulties, help-seeking, and treatment provision. Semistructured telephone interviews with 19 U.K. women veterans who met criteria for posttraumatic stress disorder were conducted and Reflexive Thematic Analysis was used in analysis. Three superordinate themes encompassing participants’ experiences were developed: (a) attitudes toward mental health and help-seeking; (b) the need to acknowledge the uniqueness of women veterans; and (c) the structural elements of care provision. The findings indicate that women veterans have additional gender-specific challenges and needs concerning tailored pathways into help and support, as well as the environment and modality of treatment delivery, as distinct from veteran men.
AciernoR.JaffeA. E.GilmoreA. K.BirksA.DenierC.MuzzyW.LopezC. M.TuerkP.GrubaughA. L. (2021). A randomized clinical trial of in-person vs. Home-based telemedicine delivery of Prolonged Exposure for PTSD in military sexual trauma survivors. Journal of Anxiety Disorders, 83, 102461. https://doi.org/10.1016/j.janxdis.2021.102461
2.
BacaS. A.CrawfordJ. N.AllardC. B. (2021). PTSD, depression, and suicidality among survivors of childhood sexual trauma (CST), military sexual trauma (MST), and sexual revictimization (CST + MST). Psychological Trauma: Theory, Research, Practice, and Policy, Military Psychology. Advance online publication. https://doi.org/10.1037/tra0001149
3.
BaumannJ.WilliamsonC.MurphyD. (2022). Exploring the impact of gender-specific challenges during and after military service on female UK Veterans. Journal of Military, Veteran and Family Health, 8(2), 72–81. https://doi.org/10.3138/jmvfh-2021-0065
4.
BergA. M.HemE.LauB.EkebergØ. (2006). Help-seeking in the Norwegian police service. Journal of Occupational Health, 48(3), 145–153. https://doi.org/10.1539/joh.48.145
5.
BlaisR. K.BrignoneE.FargoJ. D.GalbreathN. W.GundlapalliA. V. (2018). Assailant identity and self-reported nondisclosure of military sexual trauma in partnered women veterans. Psychological Trauma: Theory, Research, Practice, and Policy, 10(4), 470–474. https://doi.org/10.1037/tra0000320
BraunV.ClarkeV. (2021a). One size fits all? What counts as quality practice in (reflexive) thematic analysis?Qualitative Research in Psychology, 18(3), 328–352. https://doi.org/10.1080/14780887.2020.1769238
8.
BraunV.ClarkeV. (2021b). To saturate or not to saturate? Questioning data saturation as a useful concept for thematic analysis and sample-size rationales. Qualitative Research in Sport, Exercise and Health, 13(2), 201–216. https://doi.org/10.1080/2159676X.2019.1704846
9.
BrownM. C.CreelA. H.EngelC. C.HerrellR. K.HogeC. W. (2011). Factors associated with interest in receiving help for mental health problems in combat veterans returning from deployment to Iraq. Journal of Nervous & Mental Disease, 199(10), 797–801. https://doi.org/10.1097/NMD.0b013e31822fc9bf
10.
BuyseK.GoortsK.PeetersD.DhondtE.PortzkyG. (2021). Sexual harassment at work within Belgian Defence: A prevalence study. BMJ Military Health. Advance online publication. https://doi.org/10.1136/bmjmilitary-2021-001855
11.
CarrollT. D.CurrierJ. M.McCormickW. H.DrescherK. D. (2017). Adverse childhood experiences and risk for suicidal behavior in male Iraq and Afghanistan veterans seeking PTSD treatment. Psychological Trauma: Theory, Research, Practice, and Policy, 9(5), 583–586. https://doi.org/10.1037/tra0000250
12.
ClancyC. P.GraybealA.TompsonW. P.BadgettK. S.FeldmanM. E.CalhounP. S.ErkanliA.HertzbergM. A.BeckhamJ. C. (2006). Lifetime trauma exposure in veterans with military-related posttraumatic stress disorder: Association with current symptomatology. The Journal of Clinical Psychiatry, 67(9), 1346–1353. https://doi.org/10.4088/JCP.v67n0904
13.
ColemanS. J.StevelinkS. A. M.HatchS. L.DennyJ. A.GreenbergN. (2017). Stigma-related barriers and facilitators to help seeking for mental health issues in the armed forces: A systematic review and thematic synthesis of qualitative literature. Psychological Medicine, 47(11), 1880–1892. https://doi.org/10.1017/S0033291717000356
14.
Godier-McBardL. R.CableG.WoodA. D.FosseyM. (2022). Gender differences in barriers to mental healthcare for UK military veterans: A preliminary investigation. BMJ Military Health, 168(1), 70–75. https://doi.org/10.1136/bmjmilitary-2020-001754
15.
Godier-McBardL. R.GillinN.FosseyM. J. (2022). ‘Treat everyone like they’re a man’: Stakeholder perspectives on the provision of health and social care support for female veterans in the UK. Health & Social Care in the Community, 30, e3966–e3976. https://doi.org/10.1111/hsc.13790
16.
Godier-McBardL. R.WoodA.KohomangeM.CableG.FosseyM. (2022). Barriers and facilitators to mental healthcare for women veterans: A scoping review. Journal of Mental Health, 5, 1–11. https://doi.org/10.1080/09638237.2022.2118686
17.
GrahamK.MurphyD.HendrikxL. J. (2022). Exploring barriers to mental health treatment in the female veteran population: A qualitative study. Journal of Veterans Studies, 8(3), 151–164. https://doi.org/10.21061/jvs.v8i3.323
18.
HendrikxL. J.WilliamsonC.BaumannJ.MurphyD. (2021). Understanding the mental health needs of a community-sample of UK Women Veterans. Illness, Crisis & Loss, 31, 385–402. https://doi.org/10.1177/10541373211070487
19.
HendrikxL. J.WilliamsonV.MurphyD. (2021). Adversity during military service: The impact of military sexual trauma, emotional bullying and physical assault on the mental health and well-being of women veterans. BMJ Military Health. Advance online publication. https://doi.org/10.1136/bmjmilitary-2021-001948
20.
HogeC. W.CastroC. A.MesserS. C.McGurkD.CottingD. I.KoffmanR. L. (2004). Combat duty in Iraq and Afghanistan, mental health problems, and barriers to care. New England Journal of Medicine, 351(1), 13–22. https://doi.org/10.1056/NEJMoa040603
21.
HomM. A.StanleyI. H.Spencer-ThomasS.JoinerT. E. (2018). Mental health service use and help-seeking among women firefighters with a career history of suicidality. Psychological Services, 15(3), 316–324. https://doi.org/10.1037/ser0000202
22.
JonesN.GreenbergN.PhillipsA.SimmsA.WesselyS. (2019). Mental health, help-seeking behaviour and social support in the UK armed forces by gender. Psychiatry, 82, 256–271. https://doi.org/10.1080/00332747.2019.1626200
23.
KatonJ. G.LehavotK.SimpsonT. L.WilliamsE. C.BarnettS. B.GrossbardJ. R.SchureM. B.GrayK. E.ReiberG. E. (2015). Adverse childhood experiences, military service, and adult health. American Journal of Preventive Medicine, 49(4), 573–582. https://doi.org/10.1016/j.amepre.2015.03.020
24.
LaneJ.LeM.MartinK.BickleK.CampbellE.RicciardelliR. (2022). Police attitudes toward seeking professional mental health treatment. Journal of Police and Criminal Psychology, 37(1), 123–131. https://doi.org/10.1007/s11896-021-09467-6
25.
LiddonL.KingerleeR.BarryJ. A. (2018). Gender differences in preferences for psychological treatment, coping strategies, and triggers to help-seeking. British Journal of Clinical Psychology, 57(1), 42–58. https://doi.org/10.1111/bjc.12147
26.
McCauleyH. L.BlosnichJ. R.DichterM. E. (2015). Adverse childhood experiences and adult health outcomes among veteran and non-veteran women. Journal of Women’s Health, 24(9), 723–729. https://doi.org/10.1089/jwh.2014.4997
27.
MellotteH.MurphyD.RaffertyL.GreenbergN. (2017). Pathways into mental health care for UK veterans: A qualitative study. European Journal of Psychotraumatology, 8(1), 1389207. https://doi.org/10.1080/20008198.2017.1389207
MoreauC.BedretdinovaD.DuronS.BohetA.PanjoH.BajosN.MeynardJ. B. (2021). From sexual harassment to sexual assault: Prevalence and correlates of sexual trauma in the French military. PLOS ONE, 16(11), e0259182. https://doi.org/10.1371/journal.pone.0259182
30.
MotaN.SommerJ. L.BoltonS.-L.EnnsM. W.El-GabalawyR.SareenJ.MacLeanM. B.HallA. L.SudomK.SilinsS.GarberB.AfifiT. O. (2022). Prevalence and correlates of military sexual trauma in service members and veterans: Results from the 2018 Canadian Armed Forces Members and Veterans Mental Health Follow-up Survey. The Canadian Journal of Psychiatry. Advance online publication. https://doi.org/10.1177/07067437221125292
31.
MurphyD.HuntE.LuzonO.GreenbergN. (2014). Exploring positive pathways to care for members of the UK Armed Forces receiving treatment for PTSD: A qualitative study. European Journal of Psychotraumatology, 5(1), 21759. https://doi.org/10.3402/ejpt.v5.21759
32.
MurphyD.KaratziasT.BusuttilW.GreenbergN.ShevlinM. (2021). ICD-11 posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) in treatment seeking veterans: Risk factors and comorbidity. Social Psychiatry and Psychiatric Epidemiology, 56(7), 1289–1298. https://doi.org/10.1007/s00127-021-02028-6
33.
North Atlantic Treaty Organization. (2019). Summary of the national reports of NATO member and partner nations to the NATO committee on gender perspectives. https://www.nato.int/cps/en/natohq/topics_132342.htm
34.
OakleyT.KingL.KetchesonF.RichardsonJ. D. (2020). Gender differences in clinical presentation among treatment-seeking Veterans and Canadian Armed Forces personnel. Journal of Military, Veteran and Family Health, 6(2), 60–67. https://doi.org/10.3138/jmvfh-2019-0045
35.
PaigeC.DoddsC.JonesC. (2021). Mental health and well-being of LGBT+ Veterans dismissed from the British Armed Forces before January 2000. Journal of Military, Veteran and Family Health, 7(Suppl. 1), 122–126. https://doi.org/10.3138/jmvfh-2021-0032
36.
RandlesR.FinneganA. (2022). Veteran help-seeking behaviour for mental health issues: A systematic review. BMJ Military Health, 168(1), 99–104. https://doi.org/10.1136/bmjmilitary-2021-001903
37.
ScheppersE.van DongenE.DekkerJ.GeertzenJ.DekkerJ. (2006). Potential barriers to the use of health services among ethnic minorities: A review. Family Practice, 23(3), 325–348. https://doi.org/10.1093/fampra/cmi113
38.
ShapiroM. O.ShortN. A.RainesA. M.FranklinC. L.TrueG.ConstansJ. I. (2022). Pain and posttraumatic stress: Associations among women veterans with a history of military sexual trauma. Psychological Trauma: Theory, Research, Practice, and Policy, Military Psychology. Advance online publication. https://doi.org/10.1037/tra0001272
39.
StaigerT.StiawaM.Mueller-StierlinA. S.KilianR.BeschonerP.GündelH.BeckerT.FraschK.PanzirschM.SchmaußM.KrummS. (2020). Masculinity and help-seeking among men with depression: A qualitative study. Frontiers in Psychiatry, 11, 599039. https://doi.org/10.3389/fpsyt.2020.599039
40.
St CyrK.AikenA. B.CrammH.WhiteheadM.KurdyakP.MaharA. L. (2021). Sex-specific differences in physical health and health services use among Canadian Veterans: A retrospective cohort study using healthcare administrative data. BMJ Military Health. Advance online publication. https://doi.org/10.1136/bmjmilitary-2021-001915
41.
StevelinkS. A. M.JonesN.JonesM.DyballD.KheraC. K.PernetD.MacCrimmonS.MurphyD.HullL.GreenbergN.MacManusD.GoodwinL.SharpM.-L.WesselyS.RonaR. J.FearN. T. (2019). Do serving and ex-serving personnel of the UK armed forces seek help for perceived stress, emotional or mental health problems?European Journal of Psychotraumatology, 10(1), 1556552. https://doi.org/10.1080/20008198.2018.1556552
42.
ThompsonA. E.AnisimowiczY.MiedemaB.HoggW.WodchisW. P.Aubrey-BasslerK. (2016). The influence of gender and other patient characteristics on health care-seeking behaviour: A QUALICOPC study. BMC Family Practice, 17(1), 38. https://doi.org/10.1186/s12875-016-0440-0
43.
WeathersF. W.BlakeD. D.SchnurrP. P.KaloupekD. G.MarxB. P.KeaneT. M. (2013). The Life Events Checklist for DSM-5 (LEC-5). National Center for PTSD. www.ptsd.va.gov
44.
WeathersF. W.LitzB. T.KeaneT. M.PalmieriP. A.MarxB. P.SchnurrP. P. (2013). The PTSD Checklist for DSM-5 (PCL-5). National Center for PTSD. www.ptsd.va.gov
45.
WendtD.ShaferK. (2016). Gender and attitudes about mental health help seeking: Results from national data. Health & Social Work, 41(1), e20–e28. https://doi.org/10.1093/hsw/hlv089
46.
WilliamsonC.BaumannJ.MurphyD. (2022). Adverse childhood experiences, military adversities, and adult health outcomes among female Veterans in the UK. Journal of Military, Veteran and Family Health, 8, 62–71.
47.
WilliamsonV.GreenbergN.StevelinkS. A. M. (2019). Perceived stigma and barriers to care in UK Armed Forces personnel and veterans with and without probable mental disorders. BMC Psychology, 7(1), 75. https://doi.org/10.1186/s40359-019-0351-7
48.
WilsonL. C. (2018). The prevalence of military sexual trauma: A meta-analysis. Trauma, Violence, & Abuse, 19(5), 584–597. https://doi.org/10.1177/1524838016683459
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