Are veterans different? Understanding veterans’ help-seeking behaviour for alcohol problems

Kiernan, Matthew D.; Osbourne, Alison; McGill, Gill; Greaves, Peta Jane; Wilson, Gemma

doi:10.1111/hsc.12585

Cited by 20 publications

(25 citation statements)

References 31 publications

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“…Additionally, veterans discussed being on the receiving end of out‐group biases such as experiencing mental health stigmatization from other residents who sometimes viewed them as dangerous due to their mental illness, a common stigma veterans with PTSD face (Hipes & Gemoets, 2019). Overall, our findings align with previous research on veterans’ inability to relate to civilians or feeling misunderstood by them (Ahlin & Douds, 2016; Hinojosa & Hinojosa, 2011; Kiernan et al, 2018; Sayer et al, 2010). Results also highlight ways OH and other community settings can better support veterans by increasing mental health awareness and education for residents to reduce the stigma that veterans encounter.…”

Section: Discussionsupporting

confidence: 91%

“It's like a Brotherhood”: Thematic analysis of veterans’ identity processes in substance abuse recovery homes

Guerrero

Wiedbusch

Abo

et al. 2021

Journal Community Psychology

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This exploratory study aimed to understand how veterans' social identity influenced their experiences living in Oxford Houses (OH)-the largest network of substance use recovery homes in the United States. We conducted three focus groups, with 20 veterans who were current or former OH residents. Thematic analysis revealed several ways in which participants' veteran identity influenced their experiences living in OH, including: (1) thriving through OH organizational similarities with the military, (2) relationships with other OH residents, and (3) and growth and reintegration. The themes were interpreted using the Social Identity Theory and the Social Identity Model of Identity Change perspectives. Social identity processes were found to play an influential role in veterans' experiences in their recovery homes and reintegration into civilian life. Findings highlight the importance of veterans developing a community within a culturally congruent setting to facilitate their recovery from substance use disorders and adjustment to life post-military service.

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Section: Discussionsupporting

confidence: 91%

“It's like a Brotherhood”: Thematic analysis of veterans’ identity processes in substance abuse recovery homes

Guerrero

Wiedbusch

Abo

et al. 2021

Journal Community Psychology

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“…A study of over 22 million Americans with current substance use disorders who had not sought care in the past year found the most commonly stated reasons were feeling unready to stop drinking and a lack of health insurance or means to pay for treatment (44). Lack of problem recognition and stigma are also common reasons for not seeking substance abuse treatment (8,45,46). A review of 17 population studies indicated that alcohol misuse is less likely to be perceived as a mental illness and is more stigmatized than other psychiatric disorders (47), which may account for the lower rate of treatment engagement across our sample for alcohol use disorder compared with PTSD and depression.…”

Section: Discussionmentioning

confidence: 91%

Mental Health Treatment Delay: A Comparison Among Civilians and Veterans of Different Service Eras

Goldberg

Simpson

Lehavot

et al. 2019

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The study compared delay of treatment for posttraumatic stress disorder (PTSD), major depressive disorder, and alcohol use disorder among post-9/11 veterans versus pre-9/11 veterans and civilians. Methods: The 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III), a nationally representative survey of U.S. noninstitutionalized adults, was used. Participants included 13,528 civilians, 1,130 pre-9/11 veterans, and 258 post-9/11 veterans with lifetime diagnoses of PTSD, major depression, or alcohol use disorder. Cox proportional hazard models, controlling for relevant demographic characteristics, were used to estimate differences in treatment delay (i.e., time between diagnosis and treatment). Results: Post-9/11 veterans were less likely to delay treatment for PTSD and depression than pre-9/11 veterans (adjusted hazard ratios [AHRs]=0.69 and 0.74, respectively) and civilians (AHRs=0.60 and 0.67, respectively). No differences in treatment delay were observed between post-9/11 veterans and pre-9/11 veterans or civilians for alcohol use disorder. In an exploratory analysis, post-9/11 veterans with past-year military health care coverage (e.g., Veterans Health Administration) had shorter delays for depression treatment compared with post-9/11 veterans without military coverage, pre-9/11 veterans regardless of health care coverage, and civilians, although past-year coverage did not predict treatment delay for PTSD or alcohol use disorder. Conclusions: Post-9/11 veterans were less likely to delay treatment for some common psychiatric conditions compared with pre-9/11 veterans or civilians, which may reflect efforts to engage recent veterans in mental health care. All groups exhibited low initiation of treatment for alcohol use disorder, highlighting the need for further engagement efforts.

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“…Complex presentations are common amongst veteran service users and findings from research concur that this is a typical presentation pattern [e.g. 11 13 25 41 ]. In the proposed ‘hub and spoke’ model, upon identification of a veteran, a multi-agency support worker would be assigned to the veteran to see them through accessing and engaging in the relevant services.…”

Section: Discussionmentioning

confidence: 99%

“…Participants cited key reasons for a lack of effective engagement of veterans in services including: a lack of understanding of veterans and the term ‘veteran’ itself, complexity of services, a normalisation of alcohol consumption and complex case presentations [e.g. 11 25 33 34 35 ]. In interviews with service planners, commissioners, and providers during phase one of the wider study; it was acknowledged that services have become more complex to navigate [ 11 ] and an acceptance that reluctance from competing services to work together was due to reduction in funding sources.…”

Section: Discussionmentioning

confidence: 99%

“…This phase of the study found that veterans appeared to excuse or normalise their excessive alcohol consumption, which led to a delay in meaningful engagement in substance misuse services, resulting in complex and complicated presentations to health and social care services. The findings of this phase clearly suggested that veterans who misuse alcohol have a range of distinctive and unique difficulties that subtly differentiate them from the wider civilian substance misuse population, and that the use of peer-support models would appear to mitigate against veterans disengaging from alcohol treatment services [ 25 ].…”

Section: Methodsmentioning

confidence: 99%

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Developing an Integrated Model of Care for Veterans with Alcohol Problems

Osborne

McGill

Greaves

et al. 2022

International Journal of Integrated Care

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Introduction: Veterans often do not present with alcohol problems in isolation, they may have a wide range of social, physical, and psychological needs. The aim of this study was to facilitate the development of a co-designed integrated model of care for veterans with alcohol problems.Methods: Following the development model by the Agency for Clinical Innovation, a planning symposium was held in North East of England to engage health and social care planners, public health leads, clinical commissioning groups and providers. Service users were empowered in discussions to provide insights and look for solutions (N = 43).Results: Using diagramming techniques, three examples of health and social care provision were created demonstrating the current commissioning landscape, one veteran's experience of accessing services and a proposal for a new integrated model of care for veterans with alcohol problems. Discussion: By engaging stakeholders and service users, the model proposed a potential solution to reducing the number of veterans 'falling through the gaps' or disengaging from services. The collaborative approach highlighted the difficulties in navigating the current complex health and social care systems. The co-designed hub and spoke model aims to enable alcohol misuse services to adapt and evolve so that they better fit the needs of veterans.

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Are veterans different? Understanding veterans’ help-seeking behaviour for alcohol problems

Cited by 20 publications

References 31 publications

“It's like a Brotherhood”: Thematic analysis of veterans’ identity processes in substance abuse recovery homes

“It's like a Brotherhood”: Thematic analysis of veterans’ identity processes in substance abuse recovery homes

Mental Health Treatment Delay: A Comparison Among Civilians and Veterans of Different Service Eras

Developing an Integrated Model of Care for Veterans with Alcohol Problems

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