U.S. Army Combat Medic serves as both Soldier and provider of combat casualty care, often in the heat of battle and with limited resources. Yet little is known about their help-seeking behavior and perceived stigma and barriers to care. Participants were three groups of U.S. Army Combat Medics surveyed at 3- and 12-months postdeployment from assignment with line units vs. those Medics who had never deployed to combat. The primary data source was surveys of mental health service utilization, perceived stigma and barriers to care, and depression and post-traumatic stress disorder screens. Medics who received help in the past year from a mental health professional ranged from 18% to 30%, with 18% to 30% seeking mental health assistance from other sources. Previously deployed Medics were more likely to obtain assistance than those who never deployed. Those meeting a mental health screening criteria were more likely to report associated stigma and barriers to care. Findings indicate that Medics in need of assistance report greater perceived barriers to mental health care, as well as stigma from seeking treatment, and that depression may be a salient issue for Medics. The longitudinal nature of the ongoing study will help determine the actual trajectory and onset of depression and post-traumatic stress disorder.

Military health care providers experience considerable stressors related to their exposure to death and traumatic injuries in others. This study used survey data from 799 active duty U.S. Army Combat Medics deployed to Operation Iraqi Freedom/Operation Enduring Freedom. Military experiences, combat exposures, and mental health care seeking of active duty Combat Medics were explored and compared across both genders. Barriers to care were also assessed. Male and female Combat Medics reported surprisingly similar experiences, exposures, and health issues. Overall, results indicate no striking differences in barriers for females compared to their male counterparts, suggesting the barriers to utilization of mental health services may be consistent across gender. Although medics endorsed barriers and stigma related to mental health counseling services, they still sought these health services. Female and male medics who endorsed barriers were more likely to report seeking services than those who did not endorse barriers. This study provides an initial description of utilization of mental health counseling services for U.S. Army Combat Medics, the majority of whom were involved in combat operations in Afghanistan or Iraq. Our findings indicate that comprehensive assessment of the military experiences and combat exposures is needed to appreciate their potential influence on military health care providers.

The U.S. Army Combat Medic faces enormous stress as both soldier and trauma care provider. This study provides an initial assessment of the mental health attitudes and behaviors of these soldiers. To date, there is no known research assessing Combat Medic behavioral health or their help seeking behavior following deployment. Medics who were 12 months post-deployment from a yearlong deployment to combat were compared with a baseline group of Medics who had never been deployed to war. Participants completed a survey containing measures of mental health service utilization, perceived stigma and barriers to care, depression and posttraumatic stress disorder (PTSD) symptoms. Medics screening positive for a mental health issue were more likely to report concerns about stigma and barriers to care compared to those who screened negative. Medics who had deployed to the combat were more likely to screen positive for major depression, and have sought care for mental health issues compared to the baseline group. There were no differences in PTSD screenings between the deployed group and the baseline group. Findings indicate that depression may be a salient issue for previously deployed Combat Medics.

While combat-related loss is likely to result in the development of lingering stress responses, little is known about its impact on behavioral health. The purpose of this study was to present preliminary results on war-related losses and behavioral health among Operations Enduring Freedom/Iraqi Freedomveterans. Veterans who suffered losses, to include noncombat losses (relationships back home) that occurred while the combatant was in the combat theater, reported more stress, depressive symptoms, and combat experiences. Outcomes were worse for veterans reporting two losses. Most notable was the decline in social support as losses increased. Also of note, avoidance and arousal symptom clusters were the most endorsed. While the pattern was more pronounced for those experiencing loss, results were consistent regardless of number of losses.

This paper examines the relationship between export diversification and economic growth in Small Island Developing States (SIDS), an area for which theory has conflicting views and virtually no empirical research has been undertaken. Empirical evidence shows a significant gap in the export diversification and economic growth experience of SIDS generally, although several small nation states have managed to close the gap with respect to key indicators and successfully evolve from developing to advanced economy status, suggesting that there may be a path by which SIDS can become economically advanced. Utilizing data from 1995 to 2007 for 69 economies segmented by country classification and geography, the empirical results find a non-linear, U-shaped relationship between export concentration and economic growth. This finding is consistent with previous research and robust to different specifications of the growth equation. Further, the study finds that the U-shaped relationship is moderated by the size of the population whereby small nation states, inclusive of small island states, seem to benefit more from export diversification as compared to mid-size and large economies. The findings have noteworthy policy implications for SIDS policymakers seeking to strengthen and improve the diversification, stability and economic growth trajectory of their economies.