Lifetime trauma, mental health, alcohol and help-seeking; the phenomenological experience of veterans residing in Northern Ireland

Abstract

Abstract Background Veteran residents in Northern Ireland (NI) are an under-researched population. Little is known of their experiences of trauma and mental health management. The overall mental health of veterans living in NI may be poorer than other veteran populations, due to the challenges presented by the unique landscape. Understanding their experiences is crucial for providing appropriate, targeted support. Method Six male veterans, who had received a mental health diagnosis, living in NI and all aged > 40 years agreed to partake. Interpretative phenomenological analysis was used to explore their experiences. Semi-structured interviews, using open-ended questions, were conducted over the telephone. Results Two experiential themes were identified each containing three experiential statements. Statements for ‘an extreme lack of’ included: lack of mental health literacy/awareness; lack of expectations of official support; lack of a sense of perceived appreciation. Statements for ‘an extreme abundance of’ included: exacerbated exposure to a range of extreme environments; high levels of ruled-based living; high levels of engaging with informal/local level support. Conclusions Several experiential statements aligned with existing literature, including having poor mental health literacy and problem recognition, and heavily utilising social support versus formal help-seeking. Some novel findings were elicited, including bouncing between extreme positive and negative environments (e.g., rapidly between conflict trauma and extreme sports or partying). This could be as detrimental to mental health as experiencing conflict trauma. Heavy alcohol use was just another rule soldiers followed, with veterans reflecting alcohol autonomy only presented itself post-military. Positive help-seeking experiences failed to improve poor opinions of support organisations. Finally, poor self-perceptions connected to military status are pertinent in NI, which fuels self-marginalisation and distrust. Veterans living in NI likely have elevated levels of lifetime trauma exposure, due to their affiliation with the Troubles, other military-related traumas and general lifetime traumas. Moreover, NI veterans often demonstrate a reluctance to help-seek due to security concerns, resulting in potentially poorer mental health outcomes. Understanding how NI veterans interpret their experiences is key to providing adequate healthcare. Novel findings would benefit from further exploration.