Abstract
BackgroundAs with the general population, a proportion of military personnel with mental health problems do not seek help. As the military is a profession at high risk of occupational psychiatric injury, understanding barriers to help-seeking is a priority.MethodParticipants were drawn from a large UK military health study. Participants undertook a telephone interview including the Patient Health Questionnaire (PHQ); a short measure of PTSD (Primary Care PTSD, PC-PTSD); a series of questions about service utilisation; and barriers to care. The response rate was 76% (821 participants).ResultsThe most common barriers to care reported are those relating to the anticipated public stigma associated with consulting for a mental health problem. In addition, participants reported barriers in the practicalities of consulting such as scheduling an appointment and having time off for treatment. Barriers to care did not appear to be diminished after people leave the Armed Forces. Veterans report additional barriers to care of not knowing where to find help and a concern that their employer would blame them for their problems. Those with mental health problems, such as PTSD, report significantly more barriers to care than those who do not have a diagnosis of a mental disorder.ConclusionsDespite recent efforts to de-stigmatise mental disorders in the military, anticipated stigma and practical barriers to consulting stand in the way of access to care for some Service personnel. Further interventions to reduce stigma and ensuring that Service personnel have access to high quality confidential assessment and treatment remain priorities for the UK Armed Forces.
Highlights
As with the general population, a proportion of military personnel with mental health problems do not seek help
The most common barriers to care reported are those relating to the anticipated public stigma associated with consulting for a mental health problem
Despite recent efforts to de-stigmatise mental disorders in the military, anticipated stigma and practical barriers to consulting stand in the way of access to care for some Service personnel
Summary
As with the general population, a proportion of military personnel with mental health problems do not seek help. In this paper we explore three barriers to care; the anticipated public stigma of mental health problems, which is a set of ideas, beliefs, and expectations that a person believes that others hold about mental illness [6]; attitudes towards mental health providers and mental health treatments/services; and practical barriers impeding access to services. Previous studies from both the UK and the US have suggested that stigma and lack of trust/confidence in mental health providers are leading barriers to helpseeking in Service personnel [7,8,9]. We know from our previous work that rates of help-seeking for alcohol misuse are low and yet alcohol problems have a high prevalence in military populations [14], and we seek to extend Hoge’s work to include perceived barrier data by specific common mental disorder diagnoses including alcohol
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