Stigma surrounding mental health care treatment in the military remains a difficult and complex issue that all levels of leaders are expected to address.
Earlier this year, Lt. Gen. John Mulholland, chief of Army Special Operations Command, tasked his staff to review policies and procedures related to behavioral health stigma throughout the command.
The final product, published in the April-June 2012 issue of Special Warfare, highlights specific factors associated with accessing behavioral health care and recommends ways to reduce stigma. This week, I'll talk about factors that can be barriers to care, which apply across the services. In my next column, I'll talk about the recommendations.
• Confidentiality. Fear of personal information being released to third parties and being identified as a "mental patient" are strong motivators for service members to avoid behavioral health clinics. Perceptions of weakness and ineffectiveness — unfortunately often associated with mental health consultation — can have real consequences for service members and units.
• Career impact. There's a widespread belief that seeking behavioral health care can negatively affect promotion, special school selections and security clearances. In reality, seeking behavioral health care rarely creates problems in these areas. But not seeking care can lead to serious interpersonal, occupational and legal problems.
• Self and peer perceptions. Considering that the cultural norms of strength, dependability and ability to overcome adversity are valued traits, any perceptions — personally held or from others — can erode trust, confidence and operational readiness.
• Accessibility of quality care. Service members want to see behavioral health providers who understand the military and its unique challenges. But due to an increased operational need for behavioral health professionals, the military has hired civilian providers to fill positions in military treatment facilities and also is referring troops to civilian providers off base.
• Abuse of the system. Commanders and providers alike are aware that some troops try to "game" the system, feigning or exaggerating psychiatric problems to get out of unwanted duty or to get out of the military. However, the majority are truly interested in getting help.
• Command climate. This is one of the most important variables. If unit leaders display positive attitudes toward behavioral health care, more troops will use those services. Negative attitudes promote just the opposite.
Bret A. Moore is a clinical psychologist who served in Iraq and is the author of "Wheels Down: Adjusting to Life after Deployment." Email firstname.lastname@example.org">email@example.com. Names and identifying details will be kept confidential. This column is for informational purposes only. Readers should see a mental health professional or physician for mental health problems.