An Examination of the Roles of Mental Health Literacy, Treatment-Seeking Stigma, and Perceived Need for Care in Female Veterans’ Service Use

Abstract

Little is known about the role of mental health literacy in military veterans' treatment-seeking stigma and service use, or the impact of these factors on perceived need for mental health care. In addition, most research has focused on mixed-gender samples. This study examined the relationships among mental health literacy, treatment seeking stigma, perceived need for mental health care, and service use in a national, longitudinal study of female veterans.Methods: A sample of 171 female veterans were drawn from a larger three-wave prospective national survey conducted between 2014 and 2017.Results: Path analyses revealed that treatment seeking stigma had a direct negative effect on service use and an indirect effect that was mediated by perceived need for care, such that higher treatment seeking stigma was associated with lower perceived need for mental health care. Mental health literacy had an indirect effect on service use via its inverse association with treatment-seeking stigma. In contrast, mental health literacy was not associated with perceived need.Conclusions: Mental health literacy, treatment-seeking stigma, and perceived need for care affect female veterans' service use in unique ways. Further longitudinal research is needed to better understand these pathways in diverse samples.

Veteran help-seeking behaviour for mental health issues: a systematic review

“…36 Recommendations included an awareness campaign that would normalise the help-seeking process through the use of personal stories from other veterans as well as improving veteran awareness of available services. 22 36 Enhanced awareness as a facilitator is supported by Williston et al, 35 who reported that veterans with higher MH literacy endorsed less negative beliefs about help-seeking and that there was no relationship between literacy and actual utilisation of MH services.…”

“…28 37 This lack of significant effect could be due to a veteran's perceived need for care, mediating the relationship between internalised stigma and help-seeking. 35 Anticipated stigma refers to stigma that veterans would expect to receive from others. 34 38 As many as 29.9% of veterans believed that, if they had a MH problem, their friends and family would feel uncomfortable around them.…”

Mental health literacy in veterans: What do U.S. military veterans know about PTSD and its treatment?

“…As suggested by Zisman-Ilani, Barnett, Harik, Pavlo, and O’Connell (2017), these factors (e.g., motivation, symptom severity) may be important moderators of these processes and therefore are important to consider in future research. Finally, a recent study found that mental health literacy increased female veterans’ service use vis a vis a reduction in their endorsement of treatment-seeking stigma (Williston et al, 2019), a finding that highlights the importance of attending to both direct and indirect effects of stigma and mental health literacy factors in future research.…”

“…Based on prior research, we hypothesized that veterans would show relatively higher levels of PTSD problem recognition, and lower levels of knowledge about evidence-based treatments and treatment-seeking. In addition, we examined associations between mental health literacy, anticipated stigma, and negative mental health beliefs, as emerging research has highlighted the link between these constructs (Williston, Bramande, Vogt, Iverson, & Fox, 2019). We hypothesized that mental health literacy would be inversely associated with negative beliefs about mental health problems, treatments, treatment-seeking, as well as anticipated mental health stigma from loved ones and coworkers.…”

Primary Care Veteran Preferences for Receiving Information about Mental Health Services: Cross-Sectional Survey

“…Mental health literacy may be one barrier to treatment. For example, greater mental health literacy is associated with increased help-seeking behaviors (Gorczynski et al, 2017;Smith & Shochet, 2011;Waldmann et al, 2020) and service utilization Williston et al, 2020). found that veterans who identified their symptoms as problematic were more likely to have current or recent mental health treatment than to have no past year treatment.…”