Australian military and veteran’s mental health care part 1: an introduction to cultural essentials for clinicians

Abstract

Objective: This article aims to define the cultural specificity of Australian military and veterans, and introduce some of the essential clinician knowledge, skills and attitudes required for effective cultural competence in the management of mental health (MH) conditions in this population. Conclusion: Military culture has the defining characteristics of the military as an organisation with a formal structure, as a cultural group governed by norms and shared values, and as a social group that provides people with identities. Key requirements for cultural competence introduced here are basic knowledge of the military structure, norms and identity; clinical skills including basic assessment and awareness of the commonly occurring MH disorders; and an exploration of attitudes of both the clinician and the military or veteran patient. Further research is needed, particularly in terms of assessing clinician’s cultural competence.

Causal theoretical frameworks that explain veteran mental health help-seeking behavior: a scoping review protocol

“…For example, the Theory of Planned Behavior has been criticized for neglecting the role of social cognition, emotions, and self-identification, which may be particularly important in people with mental illness and veterans. [7][8][9] Mental health help-seeking research frequently adopts descriptive-correlational approaches that identify correlations (eg, barriers, facilitators, attitudes, beliefs, norms) and help-seeking intentions. This is problematic as health research indicates that even though individuals intend to seek help, they often do not.…”

“…The role of social identity may be particularly important to veterans because they have been subject to military enculturation. 8 The extent to which veterans maintain military values, such as stoicism, self-reliance, and distrust of medical confidentiality, will likely affect their help-seeking intention and subsequent behavior. Consequently, this review will examine theoretical frameworks to determine whether they account for social and cultural influences, such as social identity.…”

“…21 Appointment attendance is monitored and enforced, with sometimes punitive repercussions for non-attendance. 8 For example, in the Australian Defence Force, if a military member misses a medical appointment, they may be charged or infringed for being absent from duty, in line with the Defence Force Discipline Act 1982. 22 Although the authors recognize available support differs between militaries and services, many of these factors are not available to veteran populations.…”

“…It is unclear to what extent these models (and others) have been used to examine veteran mental health help-seeking and whether these models account for the complex cultural, social, and affective experiences of veterans that may drive both engagement with (or avoidance of) mental health help-seeking. For example, the Theory of Planned Behavior has been criticized for neglecting the role of social cognition, emotions, and self-identification, which may be particularly important in people with mental illness and veterans 7-9 …”

Australian military and veterans’ mental health care: improving assessment of military personnel and veterans

“…This is the second paper in a three-part series designed to address the need for improved training for psychiatrists in military mental health. Lane and Wallace 2 defined the cultural specificity of Australian military and veterans, and introduced some of the essential clinician knowledge, skills and attitudes required for effective cultural competence in the management of mental health conditions in this population. This paper aims to provide practical advice to clinicians to improve their assessment of military personnel and veterans.…”