UK military doctors; stigma, mental health and help-seeking: a comparative cohort study

Abstract

IntroductionStudies suggest that medical doctors can suffer from substantial levels of mental ill-health. Little is known about military doctors’ mental health and well-being; we therefore assessed attitudes to mental health, self-stigma, psychological distress and help-seeking among UK Armed Forces doctors.MethodsSix hundred and seventy-eight military doctors (response rate 59%) completed an anonymous online survey. Comparisons were made with serving and ex-military personnel (n=1448, response rate 84.5%) participating in a mental health-related help-seeking survey. Basic sociodemographic data were gathered, and participants completed measures of mental health-related stigmatisation, perceived barriers to care and the 12-Item General Health Questionnaire. All participants were asked if in the last three years they had experienced stress, emotional, mental health, alcohol, family or relationship problems, and whether they had sought help from formal sources.ResultsMilitary doctors reported fewer mental disorder symptoms than the comparison groups. They endorsed higher levels of stigmatising beliefs, negative attitudes to mental healthcare, desire to self-manage and self-stigmatisation than each of the comparison groups. They were most concerned about potential negative effects of and peer perceptions about receiving a mental disorder diagnosis. Military doctors reporting historical and current relationship, and alcohol or mental health problems were significantly and substantially less likely to seek help than the comparison groups.ConclusionsAlthough there are a number of study limitations, outcomes suggest that UK military doctors report lower levels of mental disorder symptoms, higher levels of stigmatising beliefs and a lower propensity to seek formal support than other military reference groups.

COVID 19–Depression and Neurosurgeons

“…It cannot be said with conviction if this frequency is higher than that before the pandemic but a study performed in 2003 among surgeons 12 showed an increase in prevalence of depression after the severe acute respiratory syndrome outbreak, with a 30% increase in suicide. Poor mental health is a social stigma 13 ; moreover, a fear of being judged may explain why neurosurgeons have a lower depression score, as found in another study assessing level of stress among surgeons. 11 This may be one of the reasons that despite mental health problems and psychosocial issues among health care workers, most do not often seek mental health care.…”

Similarities between military and medical service: stigma of seeking mental health assistance

“…Studies have identified that there are many differing barriers to mental health treatment in military populations, including stigma 5–7. As discussed by Sharp et al ,8 many of us feel that if we acknowledge a perceived weakness, there would be concerns about our leadership and competency, and being seen as weak or as malingering.…”

“…Common symptoms of burnout include treating patients and colleagues as objects rather than human beings, feeling emotionally depleted, physical exhaustion, poor judgement, cynicism, guilt, feelings of ineffectiveness and a sense of depersonalisation in relationships with coworkers or patients 12. The detrimental effects of stress in an emergency department or in a Regimental Aid Post12 and those events seen on deployment5–7 are well documented and have included doctors reporting suicidal thoughts 4. The perspective detailed in box 3 provides a reflection following a colleague’ s death in emergency medicine.…”

“…The prevalence of PTSD, stress, anxiety and burnout are a significant contributor to suicide among military and medical personal 5–7 14 15. Even with targeted internal programmes, the stigma of seeking mental health assistance in the military is common8 and is believed to contribute to increased suicide rates.…”

Dispatches from the editor: highlights of the August 2018 edition

“…In recognition of this I have made the Editor’s choice for this issue their study looking at stigma, mental health and help-seeking in UK military doctors 12. I have also seen considerable interest from authors submitting to JRAMC on resuscitative endovascular balloon occlusion of the aorta, and we have three papers and two letters to the editor on the subject between this issue and forthcoming issues on the subject 4.…”