Perceived barriers and facilitators of mental health service utilization in adult trauma survivors: A systematic review

Clin Psychol Rev. 2017 Mar:52:52-68. doi: 10.1016/j.cpr.2016.12.001. Epub 2016 Dec 8.


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.

Keywords: Adult trauma survivors; Barriers; Facilitators; Mental health service utilization; Military; PTSD.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Health Services Accessibility
  • Humans
  • Mental Health Services / statistics & numerical data*
  • Military Personnel / psychology
  • Patient Acceptance of Health Care / psychology*
  • Social Stigma*
  • Stress Disorders, Post-Traumatic / psychology
  • Stress Disorders, Post-Traumatic / therapy*
  • Survivors / psychology*