Military service is associated with increased risk of mental health problems. Previous reviews have pointed to under-utilization of mental health services in military populations. Building on the most recent systematic review, our narrative, critical review takes a complementary approach and considers research across the Five-Eyes nations from the past six years to update and broaden the discussion on pathways to mental healthcare in military populations. We find that at a broad population level, there is improvement in several indicators of mental health care access, with greater gains in initial engagement, time to first treatment contact, and subjective satisfaction with care, and smaller gains in objective indicators of adequacy of care. Among individual-level barriers to care-seeking, there is progress in improving recognition of need for care and reducing stigma concerns. Among organizational-level barriers, there are advances in availability of services and cultural acceptance of care-seeking. Other barriers, such as concerns around confidentiality, career impact, and deployability persist, however, and may account for some remaining unmet need. To address these barriers, new initiatives that are more evidence-based, theoretically-driven, and culturally-sensitive, are therefore needed, and must be rigorously evaluated to ensure they bring about additional improvements in pathways to care.

服兵役与心理健康问题的风险增加有关。先前的评论指出，军人心理健康服务的利用不足。在最近的系统评价的基础上，我们的叙述性、批判性评价采取了一种互补的方法，并考虑了过去六年在五眼国家的研究，以更新和扩大关于军人心理保健途径的讨论。我们发现，在广泛的人口水平上，心理健康服务的几个指标都有所改善，初始参与、首次治疗接触的时间和对护理的主观满意度都有较大的提高，而在护理充分性的客观指标方面则有较小的提升. 在寻求护理的个人层面障碍中，在提高对护理需求的认识和减少耻辱问题方面取得了进展。在组织层面的障碍中，服务的可用性和就医的文化接受程度有所提高。然而，其他障碍，例如对保密性、职业影响和可部署性的担忧仍然存在，并可能导致一些未满足的需求。为了解决这些障碍，需要更多以证据为基础、理论驱动和文化敏感的新举措，并且必须进行严格评估，以确保它们能够进一步改善护理途径。然而，可部署性仍然存在，并且可能会解释一些剩余的未满足需求。为了解决这些障碍，需要更多以证据为基础、理论驱动和文化敏感的新举措，并且必须进行严格评估，以确保它们能够进一步改善护理途径。然而，可部署性仍然存在，并且可能会解释一些剩余的未满足需求。为了解决这些障碍，需要更多以证据为基础、理论驱动和文化敏感的新举措，并且必须进行严格评估，以确保它们能够进一步改善护理途径。