Academic journal article European Journal of Psychotraumatology

Exploring Positive Pathways to Care for Members of the UK Armed Forces Receiving Treatment for PTSD: A Qualitative Study

Academic journal article European Journal of Psychotraumatology

Exploring Positive Pathways to Care for Members of the UK Armed Forces Receiving Treatment for PTSD: A Qualitative Study

Article excerpt


Exploring positive pathways to care for members of the UK Armed Forces receiving treatment for PTSD: a qualitative study

Dominic Murphy1*, Elizabeth Hunt1, Olga Luzon2 and Neil Greenberg1

1King's Centre for Military Health Research, King's College London, London, UK; 2Department of Clinical Psychology, Royal Holloway University, London, UK


Objective : To examine the factors which facilitate UK military personnel with post-traumatic stress disorder (PTSD) to engage in help-seeking behaviours.

Methods : The study recruited active service personnel who were attending mental health services, employed a qualitative design, used semi-structured interview schedules to collect data, and explored these data using interpretative phenomenological analysis (IPA).

Results : Five themes emerged about how participants were able to access help; having to reach a crisis point before accepting the need for help, overcoming feelings of shame, the importance of having an internal locus of control, finding a psychological explanation for their symptoms and having strong social support.

Conclusions : This study reported that for military personnel who accessed mental health services, there were a number of factors that supported them to do so. In particular, factors that combated internal stigma, such as being supported to develop an internal locus of control, appeared to be critical in supporting military personnel to engage in help-seeking behaviour.

Keywords: Military health; PTSD; depression; pathways; stigma; barriers

*Correspondence to: Dominic Murphy, KCMHR, Weston Education Centre, Cutcombe Road, SE5 9PR London, UK, Email:

For the abstract or full text in other languages, please see Supplementary files under Article Tools online

Received: 17 June 2013; Revised: 4 October 2013; Accepted: 20 November 2013; Published: 17 February 2014

European Journal of Psychotraumatology 2014. © 2014 Dominic Murphy et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 Unported (CC-BY 4.0) License (, allowing third parties to copy and redistribute the material in any medium or format, and to remix, transform, and build upon the material, for any purpose, even commercially, under the condition that appropriate credit is given, that a link to the license is provided, and that you indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.

Citation: European Journal of Psychotraumatology 2014, 5: 21759 -

Since 2002, the UK and US military's have conducted highly challenging operations in Afghanistan and Iraq. These military operations have been the focus of a number of large-scale epidemiological research studies, which have investigated the psychological health of US and UK service personnel. Studies in the United States have observed rates of post-traumatic stress disorder (PTSD) in deployed personnel to be between 8 and 18% (Hoge et al., 2004; Smith et al., 2008). Further, 13% of participants met criteria for alcohol problems and 18% for symptoms of anxiety and depression, with a very high co-morbidity rate between these disorders and PTSD (Riddle et al., 2007; Smith et al., 2008). This increase in the rate of PTSD following deployment has been replicated prospectively (Vasterling et al., 2006). However, in the UK, the effects of the conflict upon the mental health of service personnel have been quite different.

The most extensive UK epidemiological studies of service personnel since 2003 have been carried out at King's College London. This study is based on a randomly selected representative sample of the UK military, and in 2006, this study reported rates of PTSD to be 4% and symptoms of common mental health problems (including anxiety and depression) to be 20% (Hotopf et al. …

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