Hitting the wall: The impact of barriers to care and cumulative trauma exposure on PTSD among Northern Ireland Veterans

Abstract

LAY SUMMARY The Northern Ireland (NI) population has high rates of trauma exposure and posttraumatic stress disorder (PTSD) but many barriers prevent people from seeking help/care, which can worsen mental health conditions. For Veterans, these barriers can include a lack of access to or availability of services, a lack of trust in the mental health system, and stigma — negative beliefs about themselves if they were to seek help. Additionally, many UK Armed Forces veterans in Northern Ireland choose not to disclose Veteran status because of security concerns. The Armed Forces Covenant promises available, accessible, and guaranteed care to service members and Veterans, but the covenant is not in place in Northern Ireland, leaving NI Veterans in need without support and relying on charity organizations. This study explored the relationship among trauma exposure, PTSD, and barriers to care among NI Veterans. Analysis showed that an increased number of traumatic event exposures and increased barriers to care predicted a higher amount of PTSD symptoms and distress, meaning the more trauma a Veteran witnessed or experienced and the more barriers preventing them from seeking care, the worse their mental health was likely to be.