Do stigma and other perceived barriers to mental health care differ across Armed Forces?

Abstract

Summary Objectives Military organizations are keen to address barriers to mental health care yet stigma and barriers to care remain little understood, especially potential cultural differences between Armed Forces. The aim of this study was to compare data collected by the US, UK, Australian, New Zealand and Canadian militaries using Hoge et al.'s perceived stigma and barriers to care measure (Combat duty in Iraq and Afghanistan, mental health problems and barriers to care. New Engl J Med 2004;351:13–22). Design Each member country identified data sources that had enquired about Hoge et al.'s perceived stigma and perceived barriers to care items in the re-deployment or immediate post-deployment period. Five relevant statements were included in the study. Setting US, UK Australian, New Zealand and Canadian Armed Forces. Results Concerns about stigma and barriers to care tended to be more prominent among personnel who met criteria for a mental health problem. The pattern of reported stigma and barriers to care was similar across the Armed Forces of all five nations. Conclusions Barriers to care continue to be a major issue for service personnel within Western military forces. Although there are policy, procedural and cultural differences between Armed Forces, the nations studied appear to share some similarities in terms of perceived stigma and barriers to psychological care. Further research to understand patterns of reporting and subgroup differences is required.

Stigma of mental illness: A study in the Indian Armed Forces

“…However, multinational studies conducted in militaries have reported that stigma is pervasive. 18 A large study reported that active duty soldiers with a mental health problem had significantly higher stigma and significantly lower rates of service utilization than others. 3 A Royal Navy study also found the presence of internal stigma to be substantial and especially for distressed personnel a significant barrier to help.…”

An Interprofessional Education Project to Address Veterans’ Healthcare Needs

“…In addition to physical injuries associated with military conflicts, psychological consequences have been recognized following all the major wars in the world (Jones et al, 2002). Military organizations in several nations strived to identify barriers to mental care, especially in delineating the potential stigma and cultural differences between Armed Forces (Gould et al, 2010). Findings indicate that military personnel across all nations underreport mental health issues due to the stigma associated with psychological problems (Gould et al, 2010).…”

“…Military organizations in several nations strived to identify barriers to mental care, especially in delineating the potential stigma and cultural differences between Armed Forces (Gould et al, 2010). Findings indicate that military personnel across all nations underreport mental health issues due to the stigma associated with psychological problems (Gould et al, 2010). Mental illness is perceived to be contradictory to military culture and core military values (Gould et al, 2010) which mandate strength, courage, honor and leadership.…”

“…Findings indicate that military personnel across all nations underreport mental health issues due to the stigma associated with psychological problems (Gould et al, 2010). Mental illness is perceived to be contradictory to military culture and core military values (Gould et al, 2010) which mandate strength, courage, honor and leadership. Therefore, health providers must learn to understand and be sensitive to the psychological and physical problems of military veterans.…”

“…The military is a distinct cultural group with its own language, structure, and belief system (Gould et al, 2010;Kuehner, 2013;Reger, Etherage, Reger, & Gahm, 2008) , and military culture has a strong influence on a veteran's thinking and life extending beyond their military service. These influences play a pivotal role in the successful transitioning from active military service to civilian life that can result in a sense of "culture shock," as if immigrants in their own country (Coll, Weiss, & Yarvis, 2011).…”