Barriers to PTSD treatment in veterans with traumatic brain injury: A mixed-methods analysis

• Long Delay in Treatment Seeking: Veterans with PTSD following a traumatic brain injury (TBI) wait an average of 3.57 years before seeking treatment, with some waiting up to 37 years. • High PTSD Prevalence: 63% of the veteran cohort demonstrated probable PTSD symptoms after sustaining a TBI. • Impact on Health Outcomes: The study highlights the need for improved understanding of the barriers to seeking treatment and aims to enhance mental healthcare delivery by addressing these delays. Traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD) are prevalent among veterans, often leading to significant functional, social, and occupational impairments, as well as chronic health issues and increased suicide risk. The objective of this study was to evaluate PTSD symptom severity and the time elapsed between diagnosis and treatment-seeking among veterans with TBI. Using online recruitment via social media platforms and veteran databases, 150 veterans participated between January 2021 and July 2022. The study utilized qualitative interviews and an online survey to explore the decision-making process and barriers to seeking PTSD treatment. All data were self-reported. The severity of PTSD symptoms was assessed using the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5), with a score above 31 indicating probable PTSD. Findings revealed that 63% of veterans had probable PTSD. Notably, the time taken to seek treatment ranged from 1 to 37 years, with an average delay of 3.57 years. These results highlight the need for improved mental healthcare delivery among veterans and the importance that prolonged treatment-seeking behaviors can have on veterans' PTSD symptoms and ultimately their health.