Military Mental Health Stigma Challenges: Policy and Practice Considerations

Gibbons, Susanne W.; Migliore, Laurie; Convoy, Sean P.; Greiner, Shawna; DeLeon, Patrick H.

doi:10.1016/j.nurpra.2014.03.021

Cited by 17 publications

(17 citation statements)

References 27 publications

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“… 30 SMs might be less likely to report mental health issues due to the social stigma that these issues may be misinterpreted as weakness or laziness. 48–51 The association between post-traumatic stress scores and visual depiction of psychological injury suggests that this might be a forum for safe self-expression.…”

Section: Discussionmentioning

confidence: 99%

Observational study of associations between visual imagery and measures of depression, anxiety and post-traumatic stress among active-duty military service members with traumatic brain injury at the Walter Reed National Military Medical Center

et al. 2018

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ObjectivesThe study aimed tocompare recurring themes in the artistic expression of military service members (SMs) with post-traumatic stress disorder (PTSD), traumatic brain injury and psychological health (PH) conditions with measurable psychiatric diagnoses. Affective symptoms and struggles related to verbally expressing information can limit communication in individuals with symptoms of PTSD and deployment-related health conditions. Visual self-expression through art therapy is an alternative way for SMs with PTSD and other PH conditions to communicate their lived experiences. This study offers the first systematic examination of the associations between visual self-expression and standardised clinical self-report measures.DesignObservational study of correlations between clinical symptoms of post-traumatic stress, depression and anxiety and visual themes in mask imagery.SettingThe National Intrepid Center of Excellence at the Walter Reed National Military Medical Center, Bethesda, Maryland, USA.ParticipantsActive-duty military SMs (n=370) with a history of traumatic brain injury, post-traumatic stress symptoms and related PH conditions.InterventionThe masks used for analysis were created by the SMs during art therapy sessions in week 1 of a 4-week integrative treatment programme.Primary outcomesAssociations between scores on the PTSD Checklist–Military, Patient Health Questionnaire-9 and Generalized Anxiety Disorder 7-item scale on visual themes in depictions of aspects of individual identity (psychological injury, military symbols, military identity and visual metaphors).ResultsVisual and clinical data comparisons indicate that SMs who depicted psychological injury had higher scores for post-traumatic stress and depression. The depiction of military unit identity, nature metaphors, sociocultural metaphors, and cultural and historical characters was associated with lower post-traumatic stress, depression and anxiety scores. Colour-related symbolism and fragmented military symbols were associated with higher anxiety, depression and post-traumatic stress scores.ConclusionsEmergent patterns of resilience and risk embedded in the use of images created by the participants could provide valuable information for patients, clinicians and caregivers.

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Section: Discussionmentioning

confidence: 99%

Observational study of associations between visual imagery and measures of depression, anxiety and post-traumatic stress among active-duty military service members with traumatic brain injury at the Walter Reed National Military Medical Center

et al. 2018

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“…This is most likely due to scarcity in the available literature describing stigma from the lens of intersectionality [28] or other perspectives to include the relational and contextual features arising from unique military circumstances that effect stigma over time. Of the available research literature, most researchers focus narrowly on the idea that service members are not presenting for mental health services due to misperceptions they have of mental health care, misperceptions of treatment, and misperceptions of career effects [29,55,56,57,58,59,60,61,62,63,64]. This locates the person as the creator of stigma in their head, thereby stigma is traditionally problem solved from this perspective.…”

Section: Researcher’s Conclusion and Responses To Participant’s Dmentioning

confidence: 99%

Putting Suicide Policy through the Wringer: Perspectives of Military Members Who Attempted to Kill Themselves

LeFeber

Solórzano

2019

IJERPH

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In response to the Air Force Surgeon General, Lieutenant General Mark Ediger’s call for medical services to be guided by service members’ values, preferences, and experiences within the medical system, we conducted an interpretive phenomenological analysis of transcripts in which service members shared their experiences of military mental health policy and practices after being identified as suicidal. Themes of their experiences underscore nuances as it relates to intersectionality of policy when faced with unique military contextual factors and power differentials; both of which were missing in available research literature. Their experiences also illuminate further the innate “Catch 22” which happens when accessing help. Catch 22 basically means if you know you need help than you are rational; but if you actually seek help, then you are crazy and not trustworthy to do your job. Themes presented center on the lack of confidentiality of Service Members in the Workplace, effects of Unit Members’ Surveillance and Command Directed Evaluations, and experiences of Military Mental Health Services. Critical discussions of policy and taken for granted assumptions that often drive narrow responses to suicide, treatment, prevention, and stigma are presented. Particular attention is given to the lived experiences of service members when placed under the demands of circumstances created by policy that may inadvertently lead in some cases to further suffering. The paper closes with recommendations from participants and the authors for policy makers and future directions in research.

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“…For example, evidence suggests that veterans with PTSD are at increased risk of developing dementia, though the mechanisms linking these disorders are not fully understood ( 6 ). Mental health stigma, which may be unintentionally amplified by military culture, is a barrier to care that further complicates assessment and treatment of mental health disorders ( 7 ). The complex interplay among these factors highlights the need for focused research to address the health care needs of veterans.…”

Section: Introductionmentioning

confidence: 99%

Enhancing Health Care in the Veteran Community Through Synergistic Research Funding

et al. 2021

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The veteran population faces myriad health burdens, particularly regarding mental health. As veterans age, combined genetic, environmental, and biochemical factors with natural biological processes may increase their susceptibility to mental health disorders as well as neuropsychiatric and dementia-related disorders that present as persistent cognitive impairment. Multi-organizational, multidisciplinary research partnerships help explore relevant evidence-based methodologies and create a two-way continuum between basic science and clinical application to address veterans', often complex, health care needs. The Congressionally Directed Medical Research Programs (CDMRP), a global funding organization located within the U.S. Army Medical Research and Development Command (USAMRDC), fosters novel approaches to biomedical research in response to the expressed needs of stakeholders and, as directed by Congress, many CDMRP programs focus on topics that are relevant to the health care of veterans. The CDMRP's foundation as a research management organization includes a two-tier review process and fully integrates consumer advocates. The CDMRP complements the U.S. Department of Veterans Affairs (VA) research through collaborative partnerships and synergistic award mechanisms tailored to areas of greatest need. Continued partnerships between the VA and CDMRP can facilitate translation of basic research to clinical application and enhance health care in the veteran community. This perspective highlights the need for research to address mental health issues affecting the veteran community, describes how the CDMRP integrates veterans into its processes, and discusses how the CDMRP's processes and collaborations with the VA have the capacity to improve mental health care for veterans.

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Military Mental Health Stigma Challenges: Policy and Practice Considerations

Cited by 17 publications

References 27 publications

Observational study of associations between visual imagery and measures of depression, anxiety and post-traumatic stress among active-duty military service members with traumatic brain injury at the Walter Reed National Military Medical Center

Observational study of associations between visual imagery and measures of depression, anxiety and post-traumatic stress among active-duty military service members with traumatic brain injury at the Walter Reed National Military Medical Center

Putting Suicide Policy through the Wringer: Perspectives of Military Members Who Attempted to Kill Themselves

Enhancing Health Care in the Veteran Community Through Synergistic Research Funding

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