Mental health treatment experiences of commonwealth veterans from diverse ethnic backgrounds who have served in the UK military
Abstract: Introduction: Research has shown that the likelihood of ex-military personnel developing mental health problems following service is around one in five. Little is known about the barriers to accessing mental health in veterans from diverse ethnic backgrounds. This study aims to explore mental health treatment experiences of veterans from commonwealth countries and therefore diverse ethnic backgrounds. Methods: Semi-structured interviews were conducted over the telephone with veterans from commonwealth countries. Veterans were recruited from a mental health charity and were at various stages of treatment. Results: We interviewed six veterans who were from a diverse range of commonwealth countries including St Lucia, Gambia, Ghana, Fiji and South Africa. All had served in the UK army in combat roles. Our findings consisted of key themes: (1) feeling that they are treated differently, (2) they felt as though they were unheard when reaching out for help, (3) systemic pressures such as financial difficulties, missed opportunities and lack of insight about mental health and (4) the importance of involving the wider community in care. Conclusion: Our findings highlight some distinct barriers to mental health treatment that commonwealth veterans experience. The themes reported by the participants appear to suggest they had experience signs of institutional racism. Suggesting the importance of highlighting these issues, and to help overcome these potential barriers to accessing services. Given that commonwealth veterans involvement in the UK military is significant and increasing, the findings in this study should be used to support this population by implementing service provision and policy.
Abstract: Disordered eating is a prevalent and relevant health concern that remains understudied among U.S. military veterans. Avoidant/restrictive food intake disorder (ARFID) is a newly recognized feeding and eating disorder characterized by overly restrictive eating due to (a) picky eating, (b) lack of appetite, and (c) fear of aversive consequences related to eating. The Nine-Item ARFID Screen (NIAS) is a recently developed ARFID screening tool with initial validation studies demonstrating psychometric support. However, the psychometric properties of the NIAS have not been investigated in a veteran sample. To advance our understanding of ARFID screening tools that may be appropriate for use in veterans, the present study examined the factor structure of the NIAS using survey data from a large national sample of recently separated veterans (N = 1,486). Measurement invariance across key subgroups was tested in addition to exploring differential associations between the NIAS and related constructs. Results suggested that a three-factor model provided an excellent fit of the data and demonstrated scalar invariance across self-identified men and women, race and ethnicity, and sexual and gender minority (SGM) identity. Some subgroups had higher latent means on the picky eating (women, SGM, non-Hispanic Black), appetite (women, SGM), and fear (women) factors. The NIAS had some overlap with another measure of disordered eating and was moderately correlated with psychosocial impairment and mental health. Overall, the NIAS may be a useful screening tool for ARFID in veterans, given support for the three proposed subscales and equivalence across diverse identities.