title: Do stigma and other perceived barriers to mental health care differ across Armed Forces?
abstract: OBJECTIVE
  Military organizations are keen to address barriers to mental health care yet stigma and barriers to care remain little understood, especially potential cultural differences between Armed Forces. The aim of this study was to compare data collected by the US, UK, Australian, New Zealand and Canadian militaries using Hoge et al.'s perceived stigma and barriers to care measure (Combat duty in Iraq and Afghanistan, mental health problems and barriers to care. New Engl J Med 2004;351:13-22).
  
  
  METHODS
  Each member country identified data sources that had enquired about Hoge et al.'s perceived stigma and perceived barriers to care items in the re-deployment or immediate post-deployment period. Five relevant statements were included in the study.
  
  
  METHODS
  US, UK Australian, New Zealand and Canadian Armed Forces.
  
  
  RESULTS
  Concerns about stigma and barriers to care tended to be more prominent among personnel who met criteria for a mental health problem. The pattern of reported stigma and barriers to care was similar across the Armed Forces of all five nations.
  
  
  CONCLUSIONS
  Barriers to care continue to be a major issue for service personnel within Western military forces. Although there are policy, procedural and cultural differences between Armed Forces, the nations studied appear to share some similarities in terms of perceived stigma and barriers to psychological care. Further research to understand patterns of reporting and subgroup differences is required.
authors.affiliation: Defence Clinical Psychology Service, UK Ministry of Defence DCMH, PP6, Sunny Walk, HMNB, Portsmouth PO1 3LT, UK.
authors.forename: Matthew
authors.initials: M
authors.lastname: Gould
authors.forename: Amy
authors.initials: A
authors.lastname: Adler
authors.forename: Mark
authors.initials: M
authors.lastname: Zamorski
authors.forename: Carl
authors.initials: C
authors.lastname: Castro
authors.forename: Natalie
authors.initials: N
authors.lastname: Hanily
authors.forename: Nicole
authors.initials: N
authors.lastname: Steele
authors.forename: Steve
authors.initials: S
authors.lastname: Kearney
authors.forename: Neil
authors.initials: N
authors.lastname: Greenberg
mesh_terms: D000328:Adult; D001315:Australia; D002170:Canada; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000523:psychology*; D008605:Mental Health Services / Q000706:statistics & numerical data; D008875:Middle Aged; D008889:Military Personnel / Q000523:psychology*; D009520:New Zealand; D010342:Patient Acceptance of Health Care; D011287:Prejudice; D011581:Psychological Tests; D012938:Social Perception; D011795:Surveys and Questionnaires; D014481:United States; D055815:Young Adult
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