title: Stigma and mental health in the Royal Navy: a mixed methods paper.
abstract: BACKGROUND
  US research suggests that military personnel suffering from mental health problems are reluctant to seek help because of stigma.
  
  
  OBJECTIVE
  First, to identify the prevalence of mental health stigma beliefs in a UK military sample. Second, to investigate whether distressed personnel report more stigma than those who are not distressed.
  
  
  METHODS
  A survey of 1599 naval personnel was undertaken as part of a larger trial prior to examining the effectiveness of a novel trauma support program.
  
  
  RESULTS
  The presence of internal stigma was substantial and significantly higher for distressed personnel. The prevalence of stigma about other people's mental health problems was low. Junior personnel reported being more uncomfortable in discussing emotional issues with their peer group than senior staff.
  
  
  CONCLUSIONS
  Internal stigma remains a significant barrier to help seeking within the Royal Navy, especially for distressed personnel. This may be especially problematic for junior personnel who are known to be particularly vulnerable to developing mental health problems.
authors.affiliation: King's Centre for Military Health Research, King's College London, London, UK.
authors.forename: Victoria
authors.initials: V
authors.lastname: Langston
authors.forename: Neil
authors.initials: N
authors.lastname: Greenberg
authors.forename: Nicola
authors.initials: N
authors.lastname: Fear
authors.forename: Amy
authors.initials: A
authors.lastname: Iversen
authors.forename: Claire
authors.initials: C
authors.lastname: French
authors.forename: Simon
authors.initials: S
authors.lastname: Wessely
mesh_terms: D000328:Adult; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology*; D008603:Mental Health; D008887:Military Medicine / Q000706:statistics & numerical data; D008889:Military Personnel / Q000523:psychology*; D009326:Naval Medicine / Q000706:statistics & numerical data; D016017:Odds Ratio; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D012649:Self Concept; D013315:Stress, Psychological / Q000523:psychology; D011795:Surveys and Questionnaires; D055815:Young Adult