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Perceived barriers and facilitators of mental health service utilization in adult trauma survivors: A systematic review
Open accessAbstract
Many trauma survivors seem to be reluctant to seek professional help. The aim of the current review was to synthesize relevant literature, and to systematically classify trauma survivors' perceived barriers and facilitators regarding mental health service utilization. The systematic search identified 19 studies addressing military personnel and 17 studies with trauma survivors of the general population. The data analysis revealed that the most prominent barriers included concerns related to stigma, shame and rejection, low mental health literacy, lack of knowledge and treatment-related doubts, fear of negative social consequences, limited resources, time, and expenses. Perceived facilitators lack attention in research, but can be influential in understanding mental health service use. Another prominent finding was that trauma survivors face specific trauma-related barriers to mental health service use, especially concerns about re-experiencing the traumatic events. Many trauma survivors avoid traumatic reminders and are therefore concerned about dealing with certain memories in treatment. These perceived barriers and facilitators were discussed regarding future research and practical implications in order to facilitate mental health service use among trauma survivors.
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“The barriers to an accurate and timely PTSD diagnosis may also be attributable to the lack of disclosure of trauma history by patients [19] and the limited awareness and knowledge of trauma-associated symptoms among physicians within a civilian context, including limited training and resources in trauma care [20,33].”
From Patient journey before and after a formal post-traumatic stress disorder diagnosis in adults in the United States-a retrospective claims study (2023) · cites this paper as [19]
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“Adult survivors of traumatic events show specific barriers to treatment that are related to their trauma symptoms [21].”
From A brief transdiagnostic psychological intervention for Afghan asylum seekers and refugees in Austria: A randomized controlled trial (2020) · cites this paper as [21]
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“Likewise, research has shown that traumatized individuals perceive additional barriers (e.g. concerns related to stigma, shame and rejection), which may hinder them to seek for adequate treatment [13].”
From HELP@APP: Development and evaluation of a self-help app for traumatized Syrian refugees in Germany- A study protocol of a randomized controlled trial (2019) · cites this paper as [13]
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Self-citationArtime, T. M., Rosenfeld, E. A., Ong, L. E., Lisha, N. E., Dilley, J., Shumway, M., Edward, D., Ceja, A., Einhorn, L., Lubensky, M. E., et al. (2024) · Journal of Gay & Lesbian Mental Health · doi:10.1080/19359705.2024.2315976 · Cited by 13
Metadata
- Authors
- Kantor, V., Knefel, M., & Lueger-Schuster, B.
- Affiliations
- University of Vienna (AT)
- Corresponding author
- Kantor, Viktoria
- Venue
- Clinical Psychology Review
- Publisher
- Elsevier BV
- Published
- 2017-03
- Volume
- 52
- Pages
- 52-68
- ISSN
- 0272-7358 (ISSN-L)
- OpenAlex
- W2560518899
- Cited by
- 294
- References
- 113
- Citations by year
- 2026: 26 · 2025: 47 · 2024: 33 · 2023: 33 · 2022: 47 · 2021: 30 · 2020: 34 · 2019: 21 · 2018: 13 · 2017: 10
- FWCI
- 2.28
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Clinical Psychology Review (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- Austrian Science Fund (P26584)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
- Keywords
- mental health service utilization, trauma survivors, help-seeking barriers, help-seeking facilitators, mental health stigma, shame, mental health literacy, military personnel, help-seeking reluctance
- MeSH terms
- Health Services Accessibility, Humans, Mental Health Services, Military Personnel, Patient Acceptance of Health Care, Stress Disorders, Post-Traumatic, Survivors, Social Stigma
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