“We don't complain about the little things:” Focus group explorations of the views of Veterans and military family members on healthcare needs and gaps

The Whitehouse’s Joining Forces initiative aims to highlight and address the health and psychosocial needs of American Veterans and military families. Evidence suggests that these populations are confronted with unique challenges that service delivery systems are not always equipped to handle. In an attempt to understand the healthcare gaps and needs from the perspective of Veterans and military families, we conducted four focus groups: two with male Veterans (n=7; n=9), and one each with female Veterans (n=7) and military family members (n=10). Following transcription and verification, transcripts were examined using content analysis. Researchers met regularly to compare themes and resolve discrepancies. For Veterans and military families, themes centered on providers (perceived lack of knowledge, providers who dismiss or underestimate problems, lack of understanding of military culture) and the healthcare system (overburdened, unresponsive). For female Veterans, additional themes included being devalued (military service is not always recognized; mandatory military sexual trauma screens are perceived to interfere with care for other problems). Some positive themes also emerged, particularly regarding providers who evidenced respect, attentiveness, and transparency, as did some unexpected themes having to do with strategies Veterans and families used to navigate the complicated healthcare system, including engaging more vigorously (sometimes with an advocate), supplementing with care from outside of the system, and disengaging (giving up). Findings from this study underscore the need for cultural competence when working with Veterans, and can inform graduate training programs for helping professionals and organizations that serve Veterans and military families.