Barriers and Facilitators of Mental Health Treatment‐Seeking in U.S. Active Duty Soldiers With Sexual Assault Histories

Zinzow, Heidi M.; Britt, Thomas W.; Pury, Cynthia L. S.; Jennings, Kristen S.; Cheung, Janelle H.; Raymond, Mary Anne

doi:10.1002/jts.22026

Cited by 33 publications

(23 citation statements)

References 33 publications

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“…A common theme for all participants, found frequently in previous research, was reaching a crisis point prior to seeking help (Zinzow, Britt, Pury, Raymond & Burnette, 2013). One reason for reaching a crisis point seemed to be veterans’ inability to recognize their own mental health difficulties.…”

Section: Discussionmentioning

confidence: 79%

Pathways into mental health care for UK veterans: a qualitative study

Mellotte

Murphy

Rafferty

et al. 2017

European Journal of Psychotraumatology

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Background: It is well established that veterans suffering from mental health difficulties under use mental health services. Objective: This study aimed to understand more about the barriers that prevent veterans from seeking professional help and the enablers that assist veterans in seeking professional help. It also aimed to explore potential mechanisms to improve veterans’ help-seeking and pathways to care. Method: The study employed a qualitative design whereby 17 veterans who had recently attended specialist veteran mental health services took part in semi-structured interviews. The resultant data were analysed using grounded theory. Results: Participants described two distinct stages to their help-seeking: initial help-seeking and pathways through treatment. Specific barriers and enablers to help-seeking were identified at each stage. Initial barriers included recognizing that there is a problem, self-stigma and anticipated public stigma. Initial enablers included being in crisis, social support, motivation and the media. Treatment pathway barriers included practical factors and negative beliefs about health services and professionals. Treatment pathway enablers included having a diagnosis, being seen in a veteran-specific service and establishing a good therapeutic relationship. Participants provided some suggestions for interventions to improve veterans’ help-seeking in future; these focussed on enhancing both veterans and health professionals’ knowledge regarding mental health difficulties. Conclusions: This study identified a number of barriers and enablers that may impact a veteran’s journey in seeking help from professional services for mental health difficulties. Enablers such as reaching a crisis point, social support, the media, having a diagnosis of PTSD and veteran-specific mental health services appeared to be important in opposing stigma-related beliefs and in supporting veterans to engage in help-seeking behaviours.

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Section: Discussionmentioning

confidence: 79%

Pathways into mental health care for UK veterans: a qualitative study

Mellotte

Murphy

Rafferty

et al. 2017

European Journal of Psychotraumatology

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“…An example item had soldiers rate how often they had been bothered by “Feeling down, depressed, hopeless;” items were rated on a 4‐point scale (1 = Not at all to 4 = Nearly everyday ). The PHQ has been validated among military samples and sexual assault victims, and the reliability for the PHQ in previous studies was high (e.g., Hoge et al, ; Kroenke et al, ; α = .90, Zinzow et al, ). In the present study, Cronbach's alpha was .89.…”

Section: Methodsmentioning

confidence: 97%

“…The PCL has been demonstrated as an effective tool at assessing symptoms of PTSD in reference to criteria in correspondence to the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM‐IV‐TR; American Psychiatric Association, ). The PCL has been validated among vehicular trauma and sexual assault victims, with Cronbach's α being .94 and .95 (Blanchard, Jones‐Alexander, Buckley, & Forneris, ; Zinzow et al, ). In the present study, Cronbach's α was .95.…”

Section: Methodsmentioning

confidence: 99%

Savouring as a moderator of the combat exposure–mental health symptoms relationship

et al. 2018

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Engaging in firefights or witnessing death and other types of combat experiences are occupational hazards associated with Post Traumatic Stress Disorder (PTSD) and depression in military personnel returning from combat deployments. The present study examined savouring beliefs as a moderator of the relationship between combat exposure and mental health symptoms among U.S. Army soldiers deployed to Operation Iraqi Freedom and Operation Enduring Freedom. Soldiers (N = 885) completed measures of combat exposure, savouring beliefs, PTSD, and depression. Savouring was negatively related to symptoms of PTSD and depression and moderated the relationship between combat exposure and PTSD and depression among military personnel. These findings demonstrate that savouring positive life experiences may be beneficial to overall positive mental health and potentially buffer negative mental health symptoms related to traumatic experiences. Discussion focuses on the possibility of training individuals exposed to trauma in savouring techniques.

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“…Recent studies showed that self-stigma and fear of societal stigma increased the likelihood of treatment dropout and decreased the likelihood of treatment utilization in military populations. 21,22 Although less well studied, clinician-held biases can compromise both a patient's willingness to accept services and the quality of clinical care that patients receive. 4,14,[23][24][25][26] Aspects of clinician behavior that can discourage patients from seeking or continuing treatment include communication styles that are negative or condescending (patronizing, dismissive) and/or emphasis on limitations and barriers (pessimism about recovery) rather than strengths and successes.…”

mentioning

confidence: 99%

Neurobiology of Implicit and Explicit Bias: Implications for Clinicians

Reihl¹,

Hurley²,

Taber³

2015

JNP

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FIGURE 1. Cultural stereotypes are used to infer information about an individual based on how they are categorized. Prejudices and biases derived from the applied stereotype may result in predictable changes in behavior (i.e., discrimination). The stereotype content model systematizes stereotypes along the social judgment dimensions of warmth and competence. 1-5 The dimension of warmth rates intentions (benevolent, malevolent) and provides a basis for inferring whether someone will be a friend or enemy. The dimension of competence rates the ability to enact intentions (capable, ineffectual) and correlates very highly with status across cultures. The two dimensions separate groups into four clusters, each associated with a particular combination of expectations and emotional biases. These, in turn, can influence behaviors, including delivery of clinical care. 4 Groups stereotyped as high on warmth but low on competence, such as individuals with intellectual disabilities, may be institutionalized unnecessarily. Groups stereotyped as low on both dimensions, such as homeless individuals, are more likely to receive a lower level of care in general. A study assessing where groups with mental illnesses fell within this framework reported that when evaluated as a category, people with mental illnesses were rated very much like poor people, somewhat low on both warmth and competence. 5 When specific mental illnesses were rated, the categories of anxiety or eating disorders were rated as relatively more competent and warm than the serious mental illnesses such as schizophrenia or sociopathy. 5

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Barriers and Facilitators of Mental Health Treatment‐Seeking in U.S. Active Duty Soldiers With Sexual Assault Histories

Cited by 33 publications

References 33 publications

Pathways into mental health care for UK veterans: a qualitative study

Pathways into mental health care for UK veterans: a qualitative study

Savouring as a moderator of the combat exposure–mental health symptoms relationship

Neurobiology of Implicit and Explicit Bias: Implications for Clinicians

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