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.

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Available from: Dawne Vogt
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    • "Taken together, findings suggest that Iraq and Afghanistan veterans with mental health conditions are a particularly important veteran subpopulation to examine with regard to MOVE! participation . While prior research has shown that Iraq and Afghanistan veterans with mental health conditions experience significant barriers to care (Vogt, 2011), little is known about whether existing programs like MOVE! are reaching this younger cohort. Because of the high prevalence of mental health diagnoses, with PTSD being the most common (Department of Veteran Affairs, 2015; Hoge et al., 2004; Seal et al., 2007), better understanding the role that PTSD and other mental health problems may play in Iraq and Afghanistan veterans' participation in weight loss programs can have a significant public health impact. "
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    ABSTRACT: Three-quarters of Iraq and Afghanistan veterans enrolled in Veterans Health Administration (VHA) care are overweight or obese. The VHA MOVE!® weight management program can mitigate the risks of obesity-related morbidity. However, many Iraq and Afghanistan veterans experience barriers to VHA services, which may affect participation, especially among those with posttraumatic stress disorder (PTSD) and/or depression. Little is known about MOVE! engagement among recent veterans. We describe a retrospective evaluation of MOVE! participation among Iraq and Afghanistan veterans with and without mental health problems.
    Full-text · Article · Mar 2016 · Journal of Affective Disorders
    • "Mental health stigma is of particular concern to the military because, together, individual and social stigmatizing beliefs and behaviors influence service members' willingness to seek professional help (Mojtabai, 2010; Vogel, Wade, & Haake, 2006; Vogt, 2011). These stigmatizing beliefs can be adopted in a couple of ways. "
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    ABSTRACT: Our past lessons from war trauma have taught us that mental health-care stigma and other issues surrounding mental health–seeking behaviors can negatively impact the healing trajectory and long-term function for service members and their families. It can take years to decades before a service member seeks professional help for psychological distress, if he or she seeks it at all. Unfortunately, signs of personal and family problems can be subtle, and consequences, such as suicide, tragic. In this chapter, we consider the story one military health-care provider submitted in response to a study solicitation that read: Please provide your personal story telling me about any psychological distress you may have experienced after returning from deployment and your personal challenges accessing care and/or remaining in treatment. This story is analyzed to explore the moral implications of his experience for the military and for other service members. The main points to be highlighted are that altruism can leave altruists more vulnerable, military mental health stigma may exacerbate this risk, and military families may profoundly be affected.
    No preview · Chapter · Jan 2016
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    • "Thus, as a first step, family may want their SM to recognize problems such as mood swings, sleep difficulties, or social withdrawal. Even if they realize they are having problems, SMs may be reluctant to seek help due to skepticism about the efficacy of psychotherapy, concerns about what peers will think, or concerns about cost and access to care (Tanielian & Jaycox, 2008; Vogt, 2011). Thus, as a second step, family may want to overcome obstacles that otherwise could result in SMs resisting their advice by highlighting the efficacy and downplaying any potential drawbacks of seeking help (Feng & MacGeorge, 2010). "
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    ABSTRACT: Drawing on the goals-plans-action (GPA) model and confirmation theory, this study explores associations between family members’ primary and secondary goals, planning (i.e., subgoals related to accomplishing the primary goal), and messages encouraging military service members (SMs) to seek behavioral health care. Family members (N = 244) of SMs who had been deployed to Iraq or Afghanistan described what they would say in a scenario where their SM was displaying mental health symptoms and provided importance ratings for primary and secondary goals as well as subgoals. Based on confirmation theory, messages were coded for levels of acceptance, challenge, and autonomy support. Primary goals predicted multiple dimensions of confirmation, both directly and indirectly through subgoals, but the direction of these effects often ran contrary to one another. Secondary goals also predicted confirmation after controlling for primary goal importance. Implications for the GPA model, confirmation theory, and programs that support military families are discussed.
    Full-text · Article · Dec 2015 · Communication Research
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