Attitudes towards disclosing a mental illness among German soldiers and their comrades

Rüsch, Nicolas; Rosé, Carolyn Penstein; Holzhausen, Fabian; Mulfinger, Nadine; Krumm, Silvia; Corrigan, Patrick W.; Willmund, Gerd; Zimmermann, Peter

doi:10.1016/j.psychres.2017.08.028

Cited by 35 publications

(69 citation statements)

References 30 publications

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“…, & Wessely, 2004;Hoge et al, 2004), with some of the reasons being related general career harm, not wanting to link medical information to employment (i.e. military) records, and concerns that medical information will not remain confidential (Bonar, Bohnert, Walters, Ganoczy, & Valenstein, 2015;Gould et al, 2010;Hom, Stanley, Schneider, & Joiner, 2017;Rüsch et al, 2017). Some of these concerns are not unfounded, considering that there is substantial ambiguity surrounding medical confidentiality in military medical settings (Auster, 1985;Hoyt, 2013).…”

Section: Discussionmentioning

confidence: 99%

Help-seeking for mental health issues in deployed Canadian Armed Forces personnel at risk for moral injury

Nazarov

Fikretoglu

Liu

et al. 2020

European Journal of Psychotraumatology

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Objective: Potentially morally injurious experiences (PMIE) (events that transgress an individual's subjective moral standards) have been associated with psychologically distressing moral emotions such as shame and guilt. Military leaders and clinicians have feared that those with PMIEs may be less likely to seek help due to the withdrawing nature of shame/ guilt; however, to date, help-seeking patterns of military personnel with PMIEs has not been explored. Our objective is to address this research gap. Method: Data from a nationally-representative mental health survey of active Canadian military personnel were analysed. To assess the association between exposure to three PMIEs and past-year help-seeking across different provider categories (i.e. professionals, para-professionals (those delegated with mental health advisory tasks but are not licenced to practice as medical professionals), non-professionals), a series of logistic regressions were conducted, controlling for exposure to other deployment and non-deployment-related psychological trauma, psychiatric variables, military factors, and sociodemographic variables. Analytical data frame included only personnel with a history of Afghanistan deployment (N = 4854). Results: Deployed members exposed to PMIEs were more likely to seek help from their family doctor/general practitioner (OR = 1.72; 95%CI = 1.25-2.36), paraprofessionals (OR = 1.72; 95% CI = 1.25-2.36), and non-professionals (OR = 1.44; 95%CI = 1.06-1.95) in comparison to members not exposed to PMIEs. Those exposed to PMIEs were also more likely to seek professional care from the civilian health care system (OR = 1.94; 95%CI = 1.27-2.96). Conclusion: Contrary to long-held, but untested, assumptions regarding the impact of PMIEs on help-seeking, we found those with PMIEs are more likely to seek help from gatekeeper professionals (i.e. general practitioners), para-professionals, and nonprofessionals rather than specialized mental health professionals (e.g. psychologists). Increased utilization of civilian professionals raises concerns that active military members may be avoiding military health services. Clinically, this highlights the need to increase awareness of moral injury to ensure that actively serving military members are provided with appropriate advice and treatment.

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Section: Discussionmentioning

confidence: 99%

Help-seeking for mental health issues in deployed Canadian Armed Forces personnel at risk for moral injury

Nazarov

Fikretoglu

Liu

et al. 2020

European Journal of Psychotraumatology

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“…Rüsch et al also emphasized the relevance of fear and experience of stigmatization and discrimination among soldiers in their qualitative work on the self-revelation of psychiatric disease (Rüsch et al 2017). This finding raises the question of whether it is time to take a different approach.…”

Section: Risksmentioning

confidence: 99%

Fighter, Corpsman, Partisan an Attempt to Typify Former Soldiers Based on their Coping and Defense Mechanisms

Brants

Schuy

Dors

et al. 2019

Integr. psych. behav.

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This work strives to develop a typological classification of the use of conscious and unconscious defense and coping mechanisms based on methodically and structurally collected data from a qualitative survey of 43 former soldiers in Germany. Seven coping and defense types were identified: the Fighter, the Comrade, the Corpsman, the Strategist, the Partisan, the Self-Protector and the Infantryman. The types identified differed with regard to the accumulation, combination, and use of their conscious and unconscious defense and coping mechanisms in the superordinate areas of behaviour, relationships, emotions, reflexivity and time focus. The typological classification could offer psychotherapeutic interventions tailored to individuals and their defense and coping mechanisms, which could lead to improved therapy use and compliance.

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“…Unsere Studie soll daher einen Beitrag dazu leisten, ein besseres Verständnis über den Zusammenhang von Stigma und Inanspruchnahme von Hilfeleistungen in der hier untersuchten Gruppe von Vetera-nInnen der Bundeswehr zu gewinnen. Dies ist v. a. auch deshalb wichtig, da eine kürzlich veröffentlichte Untersuchung zu stigmatisierenden Haltungen bei aktiven Soldaten der Bundeswehr [15] zeigt, dass psychische Erkrankungen in dieser Gruppe durchaus stigmabehaftet sind. Es kann daher vermutet werden, dass ähnliche Einstellungen auch bei VeteranInnen als ehemalige SoldatInnen der Bundeswehr erwartet werden können und dass diese ein Hindernis bei der Hilfesuche darstellen können.…”

Section: Stigma Und Inanspruchnahme Von Hilfeleistungenunclassified

“…Als psychisch kranker ehemaliger Soldat, der sich nach internalisiertem Stigma als schwach und hilflos erlebt, erfüllt man nicht mehr die eigenen Erwartungen an einen Soldaten. Dies könnte v. a. im Prozess des Sich-Öffnens, der ja für die Hilfesuche notwendig ist, eine Rolle spielen [8,15]. Da Studien [12] belegen, dass v. a. internalisiertes Stigma in einem engen Zusammenhang mit Hilfesuche steht, sollte man Prozessen, die zur Internalisierung von Stigma führen, vermehrt Aufmerksamkeit schenken.…”

Section: Labeling Stereotypisierung Und Abgrenzungunclassified

“…VeteranInnen scheint dringend angeraten. Die Antizipation vorhandener negativer Stereotype und Vorurteile zu psychischen Erkrankungen und deren Behandlung kann dazu beitragen, keine Hilfe in Anspruch zu nehmen [23] und die Krankheit vor anderen zu verbergen, da Hilfesuche mit drohender Stigmatisierung gleichgesetzt wird [7,15]. In Anbetracht der erheblichen gesundheitlichen, sozialen und psychologischen Kosten, die das Verbergen einer psychischen Erkrankung mit sich bringt [24], erscheint es dringend geboten, eine Atmosphäre zu schaffen, die es erkrankten SoldatInnen und VeteranInnen noch besser ermöglicht, ohne Angst vor Stigmatisierung zu ihrer Erkrankung zu stehen.…”

Section: Offenes Klima Und Vertraulichkeitunclassified

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„Treffer im Kopf“ – Stigma psychischer Erkrankungen als Einflussfaktor auf die Inanspruchnahme von Hilfsangeboten durch VeteranInnen der Bundeswehr

et al. 2018

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Attitudes towards disclosing a mental illness among German soldiers and their comrades

Cited by 35 publications

References 30 publications

Help-seeking for mental health issues in deployed Canadian Armed Forces personnel at risk for moral injury

Help-seeking for mental health issues in deployed Canadian Armed Forces personnel at risk for moral injury

Fighter, Corpsman, Partisan an Attempt to Typify Former Soldiers Based on their Coping and Defense Mechanisms

„Treffer im Kopf“ – Stigma psychischer Erkrankungen als Einflussfaktor auf die Inanspruchnahme von Hilfsangeboten durch VeteranInnen der Bundeswehr

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