Mental Health, Stigmatising Beliefs, Barriers to Care and Help-Seeking in a Non-Deployed Sample of UK Army Personnel

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.

Longitudinal determinants of mental health treatment-seeking by US soldiers

“…In a notable exception, Jones et al found that stigma concerns did not account for military medical treatment-seeking in military personnel; however, seeking help from friends was associated with greater stigma concerns. 7 Recent studies have identified that other attitudes may need to be considered. For example, in the US National Comorbidity Survey, 8 the most commonly endorsed reason for not seeking treatment was 'Wanted to handle problem on own', or a preference for self-reliance or self-management.…”

“…In a notable exception, Jones et al found that stigma concerns did not account for military medical treatment-seeking in military personnel; however, seeking help from friends was associated with greater stigma concerns. 7…”

Understanding why veterans are reluctant to access help for alcohol problems: Considerations for nurse education

“…An understanding of armed forces culture is particularly important as due to the social norms associated with mental health and alcohol use in the armed forces, personnel often do not seek help (Jones et al, 2013).…”

Support needs and experiences of family members of wounded, injured or sick UK service personnel

“…This finding is cited in the literature, where it has been suggested that family members may fear adverse consequences (eg, negative occupational and social outcomes) of seeking help 16. Family members of service personnel with mental health diagnoses may be more likely to seek help if they are offered systematic reassurance from support service providers regarding their feared, adverse consequences of help-seeking 16…”