Abstract
Introduction: Stigmatising beliefs about seeking help for mental health problems and perceived barriers to care (stigma/BTC) are commonplace among military personnel; how they influence help-seeking is unclear. Aim: To explore the role of stigma/BTC in mental health help-seeking among British Army personnel. Method: Randomly selected non-deployed personnel were assessed by questionnaire for mental health and alcohol use status, stigma/BTC levels, help-seeking and mental health related perceptions. Results: The response rate was 81.5% (n=484). 35.0% screened positive for harmful alcohol use, 25.2% for common mental disorder symptoms, and 12.4% for probable PTSD. 40.0% of symptomatic personnel had not sought help. 70.3% of alcohol misusers had not sought any form of help; over 80% of probable mental health cases believed that seeking support was helpful or necessary and required courage or strength. Non-medical help sources were accessed more frequently than military medical services. Stigma/BTC significantly affected probable mental health cases but not alcohol misusers. Greater stigmatisation/BTC were associated with both interest in and receiving support. Friends or family were the commonest preferred and actual help source; unit commanders were among the least preferred but were the second most commonly accessed help source. Conclusion: A substantial number of symptomatic personnel had not sought help. The highest levels of stigma/ BTC were most strongly associated with interest in receiving help. Perceptions of potential negative occupational and social consequences of help-seeking and current mental health status may influence the decision to seek support. Military stigma reduction strategies may need to focus upon reassuring personnel and their families that adverse consequences are not inevitable and that help-seeking from any source may be a useful step in addressing mental health problems. Alcohol misusers may benefit from a strategy that helps them to view their alcohol use as potentially socially and occupationally problematic.
Highlights
Stigmatising beliefs about seeking help for mental health problems and perceived barriers to care are commonplace among military personnel; how they influence help-seeking is unclear
Our research question was, is there a relationship between perceived stigmatisation, barriers to care and help-seeking and if so, what role does current mental health status have in modulating the decision to seek help? We chose to sample military personnel in a garrison setting as this area is under-researched and the bulk of our previous studies have been conducted with deployed personnel as described by Osorio et al [7]
This study describes the association between help-seeking, potential stigmatising beliefs about help-seeking and mental health problems in a randomly chosen sample of non-deployed British Army personnel; there were a number of key findings
Summary
Stigmatising beliefs about seeking help for mental health problems and perceived barriers to care (stigma/BTC) are commonplace among military personnel; how they influence help-seeking is unclear. Some research suggests that military personnel may fail to recognise that sub-threshold mental health symptoms are often linked to occupational impairment and may need to be addressed [4]. In this case, stigma is not the prime driver of non-help seeking. Given the lack of any clear evidence of a direct relationship between help-seeking and stigma/BTC and variable research findings about how stigma/BTC might operate when deciding whether to seek help, we sought to examine the association of stigmatising beliefs, perceived barriers to care, mental health symptoms and mental health help-seeking in UK military personnel and to define the nature of any such relationship. Our research question was, is there a relationship between perceived stigmatisation, barriers to care and help-seeking and if so, what role does current mental health status have in modulating the decision to seek help? We chose to sample military personnel in a garrison setting (some of whom had previously deployed) as this area is under-researched and the bulk of our previous studies have been conducted with deployed personnel as described by Osorio et al [7]
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