Perceptions of stigma and barriers to care among UK military personnel deployed to Afghanistan and Iraq

Abstract

Perceived stigma and organizational barriers to care (stigma/BTC) can influence the decision to seek help for military personnel when they are suffering from mental health problems. We examined the relationship between stigmatizing beliefs, perceived BTC, and probable post-traumatic stress disorder (PTSD) in 23,101 UK military personnel deployed to Afghanistan and Iraq both during and after deployment; and in a smaller group some six months later. Overall, our results suggest that stigma/BTC perceptions were significantly, and substantially higher during deployment than when personnel are returning home; however, within the smaller follow-up group, the rates climbed significantly over the first six-months post-deployment although they still remained lower than during-deployment levels. Male personnel, those who reported higher levels of PTSD symptoms and/or greater combat exposure were significantly more likely to endorse more stigma/BTC at both sampling points. Rates of stigma/BTC on deployment are substantially higher than rates measured when personnel are in less threatening environments. We suggest that the considerable efforts that military forces make to encourage effective help seeking should take account of the fluctuating levels of stigma/BTC. Commanders should be aware that encouraging help seeking may be more difficult in operational environments than when personnel have returned home.

Cohesion, leadership, mental health stigmatisation and perceived barriers to care in UK military personnel

“…Please rate each of the possible concerns that might affect YOUR decision to receive help: aware of the value of speaking to peers about mental health matters. For UK military personnel, stigma/BTC is considerably higher during deployment than in the home base (Osorio et al, 2012), however, levels appear to fall significantly immediately post-deployment, which might be related to a generally positive state of mind related to relief about leaving a dangerous and stressful situation. Considerable efforts are made by leaders to minimise stigma/BTC through psychoeducation which is delivered immediately postdeployment; our data suggest that stigma/BTC levels increased from initially low levels despite all personnel receiving psychoeducation during TLD.…”

“…Osorio et al (2012) argue however, that during deployment, heightened stigma/BTC might serve a positive military function by contributing to operational resilience. Postdeployment, stigma/BTC might be reduced through leadership activities that foster unit cohesion as this may well promote the discussion of mental health issues and help to identify those in need.…”

The mental health of the UK Armed Forces in the 21st century: resilience in the face of adversity

“…Another potential impediment to assessing the true prevalence of mental disorder symptoms is the unwillingness of military personnel to declare symptoms as a consequence of stigmatising beliefs about mental health. While psychiatric stigma among UK forces is reducing with time,50 it persists as a potential barrier to help-seeking 51. However, a recent study which compared US and UK troops, along with troops from Australia and Canada, who had just left Afghanistan found comparable rates of reported stigma 52…”

Mental Health, Stigmatising Beliefs, Barriers to Care and Help-Seeking in a Non-Deployed Sample of UK Army Personnel

“…Osorio et al [21] reported that stigma at this level has a mean frequency of approximately 60% among deployed military personnel. All analyses were conducted in the Statistical Package for Social Sciences version 20.…”

“…A count variable was generated, giving a scale ranging from 0-11. Agreeing with three or more items was used to give an estimate of high levels of stigma/ BTC [21].…”