Mental Illness–Related Stigma in Canadian Military and Civilian Populations: A Comparison Using Population Health Survey Data

Weeks, Murray; Zamorski, Mark A.; Rusu, Corneliu; Colman, Ian

doi:10.1176/appi.ps.201600398

Cited by 23 publications

(30 citation statements)

References 33 publications

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“…A total of 36,984 individuals (for an individual response rate of 89.0%) provided responses for the survey. We followed procedures from two recent papers to restrict the civilian sample in order to more closely match the socio-demographic and health characteristics of the military population [30, 37]. Our matched civilian sample included only those who: 1) were full-time employed; 2) were aged 17 to 60 (the age range of the military sample); 3) had not immigrated in the past 5 years (who were therefore not eligible for citizenship and hence, military service); and 4) had not reported any chronic conditions that would typically preclude military service (e.g., heart disease, severe obesity) [30].…”

Section: Methodsmentioning

confidence: 99%

“…A disproportionate burden of mental disorder-related stigma has been posited in military personnel [37]. The same factors that explain why a disproportionate risk of mental-health stigma may exist also relate to why there may be a disproportionate risk of physical-health stigma.…”

Section: Introductionmentioning

confidence: 99%

“…Empirical evidence of the excess burden of stigma in military personnel relative to civilians had been limited until the recent publication of findings showing CAF military personnel were 1.7 times more likely to have mental health-related stigma relative to a comparable civilian sample, even after careful adjustment for the important differences in sociodemographic and need-related factors between the populations [37]. Additionally, CAF personnel also reported perceived stigma had more negatively affected their workplace experience compared to civilians.…”

Section: Introductionmentioning

confidence: 99%

“…Additionally, CAF personnel also reported perceived stigma had more negatively affected their workplace experience compared to civilians. However, the analyses by Weeks and colleagues [37] did not distinguish between felt and enacted stigma and only looked at stigma related to mental health problems (and not physical health problems).…”

Section: Introductionmentioning

confidence: 99%

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Stigma doesn’t discriminate: physical and mental health and stigma in Canadian military personnel and Canadian civilians

2018

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BackgroundIllness-related stigma has been identified as an important public health concern. Past research suggests there is a disproportionate risk of mental-health stigma in the military, but this same finding has not yet been established for physical-health stigma. The current study aimed to assess the independent contribution of mental and physical health on both enacted stigma (discriminatory behaviour) and felt stigma (feelings of embarrassment) and to determine whether these associations were stronger for military personnel than civilians.MethodsData were obtained from the 2002 Canadian Community Health Survey - Mental Health and Well-being and its corresponding Canadian Forces Supplement. Logistic regressions were used to examine a potential interaction between population (military [N = 1900] versus civilian [N = 2960]), mental health, and physical health in predicting both enacted and felt stigma, with adjustments made for socio-demographic information, mental health characteristics, and disability.ResultsMental health did not predict enacted or felt stigma as a main effect nor in an interaction. There was a strong link between physical health and enacted and felt stigma, where worse physical health was associated with an increased likelihood of experiencing both facets of stigma. The link between physical health and enacted stigma was significantly stronger for military personnel than for civilians.ConclusionsPhysical health stigma appears to be present for both civilians and military personnel, but more so for military personnel. Elements of military culture (e.g., the way care is sought, culture of toughness, strict fitness requirements) as well as the physical demands of the job could be potential predictors of group differences.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Stigma doesn’t discriminate: physical and mental health and stigma in Canadian military personnel and Canadian civilians

2018

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“…These surveys have provided valuable information on the prevalence of major depression across different military organizations [1,3,8]. They have also shed new light on the occupational factors associated with major depression in military personnel [9] and on stigma perceptions [10] and care-seeking behaviors [11] related to this condition. However, cross-sectional surveys cannot provide information on the rate of major depression incidence.…”

Section: Introductionmentioning

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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Pathways to mental health care in active military populations across the Five-Eyes nations: An integrated perspective

Fikretoglu

Sharp

Adler

et al. 2022

Clinical Psychology Review

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Mental Illness–Related Stigma in Canadian Military and Civilian Populations: A Comparison Using Population Health Survey Data

Cited by 23 publications

References 33 publications

Stigma doesn’t discriminate: physical and mental health and stigma in Canadian military personnel and Canadian civilians

Stigma doesn’t discriminate: physical and mental health and stigma in Canadian military personnel and Canadian civilians

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

Pathways to mental health care in active military populations across the Five-Eyes nations: An integrated perspective

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