Publication year
2013
Citation Title
Perceived barriers to care and provider gender preferences among veteran men who have experienced military sexual trauma: A qualitative analysis.
Journal Name
Psychological Services
Journal Volume
10
Issue Number
2
Page Numbers
213-222
DOI
10.1037/a0029959
Summary
Twenty male Veterans who received care from the Veterans Health Administration (VHA) and reported a military sexual trauma (but had not received VHA care for it) participated in semi-structured interviews to identify potential barriers to accessing military-sexual trauma care. Veterans reported a number of barriers, including lack of knowledge about available services and worries about stigma.
Key Findings
A number of perceived barriers were identified in three broad categories (stigma-related, gender-related, knowledge) as reasons why males with a history of military sexual assault who were experiencing trauma-related difficulties may not seek VHA care.
Most (95%) did not know that specific military sexual assault-related mental health services were offered in the VA or that such services would not involve a copay.
Regarding the stigma-related barriers, most Veterans endorsed not wanting to talk about problems (65%) or embarrassment/shame (60%) as preventing them from seeking care.
Of the gender-related barriers, most Veterans endorsed that their preference for a specific gender of practitioner (75%), concerns about detracting from their masculinity (55%), and questions about their sexuality/sexual orientation (45%) prevented them from seeking care.
Implications for Program Leaders
Educate families and Service members about the prevalence and impact of military sexual assault
Provide information on military and civilian services available for military sexual assault, as well as information about how to access those services.
Offer workshops to professionals who work with military families on the impact of military sexual assault on general functioning and readiness
Implications for Policy Makers
Continue to support programs that expand outreach and education efforts about the military sexual assault-related services available for Service members
Encourage collaboration among DoD programs and community-based organizations to better coordinate access to mental health resources for Service members
Recommend professional education including information on military culture, trauma, and resilience for professionals who work with Service members and their families
Methods
Administrative data from the VHA were used to identify male Veterans who screened positive for military sexual trauma, were not receiving any military sexual assault-related care from the VA Palo Alto Health Care System since the 2006 fiscal year, but had received at least one outpatient encounter at that facility in fiscal year 2009-2010.
Men within 25 miles of the facility were sent mailings inviting them to participate.
Approximately 45 minute semi-structured interviews were conducted that assessed general demographic and military background, knowledge of services available for military sexual assault, and opinions on two military sexual assault brochures.
Participants
Twenty male Veterans participated in the study. The average age of the sample was 62.2 years (SD = 12.85).
Among the participants, 80% were White, 10% were Latino/Latina, 5% were Black, and 5% were Asian-American. The sample was 45% married, 35% divorced/separated/widowed, and 20% never married.
Sixty percent of the sample represented the Army, 20% represented the Marines, 10% represented the Air Force, and 10% represented the Navy. Participants served in the Vietnam era (55%), Korean War era (25%), Post Vietnam (10%), and Persian Gulf/OIF/OEF (10%); approximately 45% served in combat theater.
Limitations
The sample size was small and from only one geographic location, so results may not generalize.
Only men who had not received military sexual assault -related care were interviewed; it is unknown how those who had accessed services would respond.
No data were provided regarding if participants also experienced non-military related sexual assault, which may have impacted their decision to seek services or where they sought services.
Avenues for Future Research
Replicate the study with current Service members who are survivors of military-related sexual assaults
Collect data on identifying factors that facilitate access to care for Service members who report military sexual assault, including an examination of personality charactersitics that may increase the likelihood of seeking out services
Develop and assess the effectiveness of treatments for Service members who are survivors of military-related sexual assault
Focus
Multiple Branches
Target Population
Population Focus
Military Component
Abstract
Research suggests that there may be unique barriers to accessing care among men who have experienced sexual trauma. The primary goal of the current research was to elucidate potential barriers to accessing military sexual trauma (MST)-related care for male veterans. A secondary goal was to explore whether veterans have preferences regarding the gender of clinicians providing MST-related care. Qualitative analyses were used to examine data collected from semistructured interviews conducted with 20 male veterans enrolled in Veterans Health Administration care who reported MST but who had not received any MST-related mental health care. Veterans identified a number of potential barriers, with the majority of reported barriers relating to issues of stigma and gender. Regarding provider gender preferences, veterans were mixed, with 50% preferring a female provider, 25% a male provider, and 25% reporting no gender preference. These preliminary data suggest that stigma, gender, and knowledge-related barriers may exist for men regarding seeking MST-related care. Interventions to address potential barriers, such as outreach interventions and providing gender-specific psychoeducation, may increase access to care for male veterans who report MST.
Abstract Document
Attach