A systematic review into the barriers to engagement with veteran mental health services as reported by veterans; and, An explorative study into the impact of the coronavirus pandemic on veterans’ wellbeing

BACKGROUND: Veterans who engage with mental health services consistently report better wellbeing outcomes. Despite this not all veterans engage in mental health services due to specific veteran centric barriers. However, much of this research is often quantitative in nature, thus ignoring the experiences from the veteran community. Similarly, the experiences of the veteran community are also limited regarding the consequences of the coronavirus pandemic on this population. Currently, there is lack of research into this topic despite expected population wide consequences on health and wellbeing. AIMS: This current thesis portfolio aimed to systematically review and synthesise qualitative data into the barriers to engagement with veteran mental health services as reported by military veterans. Following this, an empirical project then explored the impact of the coronavirus pandemic on military veteran wellbeing. METHODS: Firstly, a systematic search across several electronic databases was completed to include relevant studies. After this a meta-ethnography was conducted on these included studies. The empirical project included ten veterans who were interviewed to explore their own experiences of living through the pandemic. Following this Interpretative Phenomenological Analysis (IPA) was used to analyse these documented experiences. RESULTS: The review highlighted five key veteran centric barriers to engagement: (1) the availability of trained professionals, (2) long waiting times to be seen, (3) a lack of service information, (4) recognising the problem and (5) stigma. From the analysis of the empirical project three key superordinate themes were stated: (1) the benefits of a military mindset, (2) the negative impact on veteran wellbeing, (3) relationships. DISCUSSION: The above results from both the systematic review and empirical project are summarised within the below chapters. In addition, methodological strengths and limitations are discussed along with specific clinical implications and suggestions for further research