Help-Seeking Behaviors Among Active-Duty Military Personnel: Utilization of Chaplains and Other Mental Health Service Providers

Morgan, Jessica Kelley; Hourani, Laurel L.; Lane, Marian E.; Tueller, Stephen

doi:10.1080/08854726.2016.1171598

Cited by 32 publications

(22 citation statements)

References 23 publications

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“…Several factors may account for this difference. First, CAF personnel suffering from major depression may be more likely to seek care than their American counterparts, and may, therefore, be more likely to receive a formal diagnosis; previous studies have found that 75% of depressed Canadian soldiers access mental health care in a 12-month period [11], compared to less than 50% in the US military [20][21][22]. This apparent difference in care-seeking propensity may be partly explained by the substantial difference in age composition between the two militaries; on average, CAF personnel are older than their American counterparts [23,24], and older age is associated with higher mental health service use in depressed patients [25].…”

Section: Discussionmentioning

confidence: 99%

Incidence of major depression diagnoses in the Canadian Armed Forces: longitudinal analysis of clinical and health administrative data

Thériault

Hawes

Garber

et al. 2019

Soc Psychiatry Psychiatr Epidemiol

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Purpose Major depression is a leading cause of morbidity in military populations. However, due to a lack of longitudinal data, little is known about the rate at which military personnel experience the onset of new episodes of major depression. We used a new source of clinical and administrative data to estimate the incidence of major depression diagnoses in Canadian Armed Forces (CAF) personnel, and to compare incidence rates between demographic and occupational factors. Methods We extracted all data recorded in the electronic medical records of CAF Regular Force personnel, at every primary care and mental health clinical encounter since 2016. Using a 12-month lookback period, we linked data over time, and identified all patients with incident diagnoses of major depression. We then linked clinical data to CAF administrative records, and estimated incidence rates. We used multivariate Poisson regression to compare adjusted incidence rates between demographic and occupational factors. Results From January to December 2017, CAF Regular Force personnel were diagnosed with major depression at a rate of 29.2 new cases per 1000 person-years at risk. Female sex, age 30 years and older, and non-officer ranks were associated with significantly higher incidence rates. Conclusions We completed the largest study to date on diagnoses of major depression in the Canadian military, and have provided the first estimates of incidence rates in CAF personnel. Our results can inform future mental health resource allocation, and ongoing major depression prevention efforts within the Canadian Armed Forces and other military organizations.

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Section: Discussionmentioning

confidence: 99%

Incidence of major depression diagnoses in the Canadian Armed Forces: longitudinal analysis of clinical and health administrative data

Thériault

Hawes

Garber

et al. 2019

Soc Psychiatry Psychiatr Epidemiol

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“…whether presence of military chaplains enhances the effectiveness of secular psychological counseling has not been thoroughly studied. What is clearer is that some veterans turn to chaplains not because they necessarily perceive their health services are relatively more effective, but because religious counseling carries less military career risk and is accompanied by far less social stigma (Morgan et al 2016). Research examining military policies and institutional cultural norms that reinforce this stigma, as well as work uncovering the relative mental health benefits of secular as compared to religious counseling, including how these effects may differ across servicemembers, will be important for designing military chaplain policies that maximize the welfare of veterans.…”

Section: Discussionmentioning

confidence: 99%

“…Along the same lines, Kopacz et al (2017) find that about one-third of suicide attempt survivors received chaplaincy services in the 30 days following their suicide attempt. Moreover, there is evidence that those who seek out chaplain services are often most in need of psychological services (Morgan et al 2016).…”

Section: Existing Literature On War and Religiositymentioning

confidence: 99%

“…Alternatively, the adverse physical and mental health effects of warfare, including fear of death, could increase religiosity by increasing the demand for social support networks or doctrinal philosophies that promise life after death (Bentzen 2019). Moreover, because seeking religious counseling for mental health problems is perceived to carry less military career risk and less social stigma than seeking professional psychological counseling services (Morgan et al 2016;Besterman-Dahan et al 2012), combat service could increase religiosity. In addition, war could create tighter bonds among combat units that generate religious peer effects.…”

Section: Introductionmentioning

confidence: 99%

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Traumatic Health Shocks and Spiritual Capital

Cesur¹,

Freidman²,

Sabia³

2018

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While the relationship between adverse health shocks and health care utilization has been studied extensively, next to nothing is known about the effect of health shocks on religiosity, which may serve as an alternative to secular psychological services and interventions. Filling this gap in knowledge is important given that religious-based psychological counseling services have grown substantially in recent decades, and the relative mental health benefits of religion as compared to secular counseling services are not well-known. This study uses the setting of war to study the impact of health trauma on religiosity. Exploiting the administrative procedures by which U.S. Armed Forces senior commanders conditionally randomly assign active-duty servicemen to war deployments as a natural experiment, we find that post-9/11 combat exposure substantially increases the probability that a serviceman subsequently attends religious services and engages in private prayer. Estimated effects are largest for enlisted servicemen, those under age 25, and servicemen wounded in combat. The physical and psychological health effects of war, as well as the presence of military chaplains in combat zones, emerge as partial mechanisms to explain increases in religiosity. We find only weak evidence that combat service differentially affects servicemen's demand for religious counseling as compared to secular psychological services.

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“…For military members, disclosure of MI exposure may be easier with family (e.g. spouses), friends, military peers, and spiritual advisors such as chaplains (Morgan, Hourani, Lane, & Tueller, 2016); these individuals may facilitate subsequent, more formal help-seeking from mental health professionals; similarly, a family physician or general practitioner (GP) that a military member has known for years may be easier to disclose MI events and associated mental health symptoms to; in turn, family physicians or GPs may act as gatekeepers to more specialized mental health services with social workers, psychiatrists, and psychologists. Unfortunately, to date, there has been little research looking at distinctions in patterns across different sources of help.…”

Section: Introductionmentioning

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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Help-Seeking Behaviors Among Active-Duty Military Personnel: Utilization of Chaplains and Other Mental Health Service Providers

Cited by 32 publications

References 23 publications

Incidence of major depression diagnoses in the Canadian Armed Forces: longitudinal analysis of clinical and health administrative data

Incidence of major depression diagnoses in the Canadian Armed Forces: longitudinal analysis of clinical and health administrative data

Traumatic Health Shocks and Spiritual Capital

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

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