title: Perceptions of stigma and barriers to care among UK military personnel deployed to Afghanistan and Iraq.
abstract: Perceived stigma and organizational barriers to care (stigma/BTC) can influence the decision to seek help for military personnel when they are suffering from mental health problems. We examined the relationship between stigmatizing beliefs, perceived BTC, and probable post-traumatic stress disorder (PTSD) in 23,101 UK military personnel deployed to Afghanistan and Iraq both during and after deployment; and in a smaller group some six months later. Overall, our results suggest that stigma/BTC perceptions were significantly, and substantially higher during deployment than when personnel are returning home; however, within the smaller follow-up group, the rates climbed significantly over the first six-months post-deployment although they still remained lower than during-deployment levels. Male personnel, those who reported higher levels of PTSD symptoms and/or greater combat exposure were significantly more likely to endorse more stigma/BTC at both sampling points. Rates of stigma/BTC on deployment are substantially higher than rates measured when personnel are in less threatening environments. We suggest that the considerable efforts that military forces make to encourage effective help seeking should take account of the fluctuating levels of stigma/BTC. Commanders should be aware that encouraging help seeking may be more difficult in operational environments than when personnel have returned home.
authors.affiliation: a Academic Centre for Defence Mental Health, Academic Department of Psychological Medicine , Institute of Psychiatry , London , UK.
authors.forename: Carlos
authors.initials: C
authors.lastname: Osório
authors.forename: Norman
authors.initials: N
authors.lastname: Jones
authors.forename: Mohammed
authors.initials: M
authors.lastname: Fertout
authors.forename: Neil
authors.initials: N
authors.lastname: Greenberg
mesh_terms: D000293:Adolescent; D000328:Adult; D055826:Afghan Campaign 2001-; D001294:Attitude to Health; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D054542:Iraq War, 2003-2011; D008297:Male; D008875:Middle Aged; D008889:Military Personnel / Q000523:psychology* / Q000706:statistics & numerical data; D057545:Social Stigma; D013240:Stereotyping; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology* / Q000628:therapy; D006113:United Kingdom; D055815:Young Adult