Mental Health-Related Beliefs as a Barrier to Service Use for Military Personnel and Veterans: A Review

National Center for PTSD, U.S. Department of Veterans Affairs Boston Healthcare System, 150 South Huntington Ave. (116B-5), Boston, MA 02116, USA.
Psychiatric services (Washington, D.C.) (Impact Factor: 2.41). 02/2011; 62(2):135-42. DOI: 10.1176/
Source: PubMed


Although military personnel are at high risk of mental health problems, research findings indicate that many military personnel and veterans do not seek needed mental health care. Thus it is critical to identify factors that interfere with the use of mental health services for this population, and where possible, intervene to reduce barriers to care. The overarching goal of this review was to examine what is known with regard to concerns about public stigma and personal beliefs about mental illness and mental health treatment as potential barriers to service use in military and veteran populations and to provide recommendations for future research on this topic.
Fifteen empirical articles on mental health beliefs and service use were identified via a review of the military and veteran literature included in PsycINFO and PubMed databases.
Although results suggest that mental health beliefs may be an important predictor of service use for this population, several gaps were identified in the current literature. Limitations include a lack of attention to the association between mental health beliefs and service use, a limited focus on personal beliefs about mental illness and mental health treatment, and the application of measures of mental health beliefs with questionable or undocumented psychometric properties.
Studies that attend to these important issues and that examine mental health beliefs in the broader context within which decisions about seeking health care are made can be used to best target resources to engage military personnel and veterans in health care.

Download full-text


Available from: Dawne Vogt,
  • Source
    • "The more balanced definition proposed here via an analytical framework informed through Bourdieu's theory of practice underscores how individual choice is constrained and/or elicited within fields. Adopting a nuanced, multidimensional, and situated notion of culture is an imperative first step toward identifying the multitude of factors that inform and structure health beliefs and practices, such as help seeking for mental illness, among those with a background in the U.S. military (see calls for cultural analyses in Hsu & Ketchen, 2013; Vogt, 2011). Defining the U.S. military as a field that hosts numerous habitus moves research closer to answering the call to integrate factors outside the individual , such as sociocultural, social network, and systemlevel factors (Sayer et al., 2009) into a more complex conceptual framework for exploring help seeking for mental illness in research. "
    [Show abstract] [Hide abstract]
    ABSTRACT: This theoretical treatise uses the scientific literature concerning help seeking for mental illness among those with a background in the U.S. military to posit a more complex definition of military culture. The help-seeking literature is used to illustrate how hegemonic masculinity, when situated in the military field, informs the decision to seek formal treatment for mental illness among those men with a background in the U.S. military. These analyses advocate for a nuanced, multidimensional, and situated definition of U.S. military culture that emphasizes the way in which institutional structures and social relations of power intersect with individual values, beliefs, and motivations to inform and structure health-related practices. © The Author(s) 2015.
    American journal of men's health 07/2015; DOI:10.1177/1557988315596037 · 1.15 Impact Factor
    • "couraged by military culture, where soldiers are expected to " tough out " difficult emotions (Vogt, 2011), but the role of military culture has not been assessed by existing scales. Negative perceptions of mental health treatment may also inhibit treatment seeking among soldiers, including beliefs that mental health professionals are untrustworthy, treatment does not work, treatment should be a last resort, or that medications will have negative side effects (Hoge et al., 2004; Kim et al., 2011; Sayer et al., 2009). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Despite significant mental health needs among sexual assault (SA) victims in the military, little is known about treatment-seeking patterns or factors associated with service use. This study examined service use behavior, barriers, and facilitators of mental health treatment-seeking in an active duty sample of 927 U.S. Army soldiers with mental health problems. SA victims (n = 113) did not differ from non-victims on barriers or facilitators after adjusting for demographic and mental health variables, with stigma rated as the largest barrier. Most SA victims (87.6%) had sought informal support and 59.3% had sought formal treatment. One third of treatment-seekers had dropped out of treatment. Multivariate logistic regression analyses identified several correlates of treatment-seeking among SA victims: Black race (OR = 7.57), SA during the military (OR = 4.34), positive treatment beliefs (OR = 2.22), social support for treatment (OR = 2.14), self-reliance (OR = 0.47), and stigma towards treatment seekers (OR = 0.43). Mental health symptoms were not associated with treatment seeking. Findings suggested that treatment-facilitating interventions should focus on improving recognition of mental health symptoms, altering perceptions related to self-reliance, and reducing stigma. Interventions should also enlist support for treatment-seeking from unit members, leaders, and significant others. © 2015 International Society for Traumatic Stress Studies.
    Journal of Traumatic Stress 07/2015; 28(4). DOI:10.1002/jts.22026 · 2.72 Impact Factor
    • "Recognizing these issues, the Department of Defense (DOD) and the various service branches have intensified efforts to provide returning service members and their families with a wide array of services designed to facilitate post deployment adjustment. Unfortunately, these services may be persistently underutilized due to pervasive stigma associated with help seeking, as well as perceptions of negative career impact associated with seeking care for personal issues (Hoge et al. 2004; Vogt 2011). There is some evidence indicating that many military personnel rely primarily on informal supports such as friends and family members to help them to cope with the aftermath of stressful wartime experiences, and that these supports are in fact quite helpful (Greenberg et al. 2003). "
    [Show abstract] [Hide abstract]
    ABSTRACT: This study examined the relations among three different types of naturally occurring social support (from romantic partners, friends and neighbors, and unit leaders) and three indices of service member well-being (self reports of depressive symptoms, satisfaction with military life, and perceptions of unit readiness) for service members who did and did not report negative experiences associated with military deployment. Data were drawn from the 2011 Community Assessment completed anonymously by more than 63,000 USAF personnel. Regression analyses revealed that higher levels of social support was associated with better outcomes regardless of negative deployment experiences. Evidence of moderation was also noted, with all forms of social support moderating the impact of negative deployment experiences on depressive symptoms and support from unit leaders moderating the impact of negative deployment experience on satisfaction with military life. No moderation was found for perceptions of unit readiness. Subgroup analyses revealed slightly different patterns for male and female service members, with support providing fewer moderation effects for women. These findings may have value for military leaders and mental health professionals working to harness the power of naturally occurring relationships to maximize the positive adjustment of service members and their families. Implications for practices related to re-integration of post-deployment military personnel are discussed.
    American Journal of Community Psychology 07/2015; 56(1-2). DOI:10.1007/s10464-015-9726-y · 1.74 Impact Factor
Show more