title: Stigma, American military personnel and mental health care: challenges from Iraq and Afghanistan.
abstract: BACKGROUND
  Since 2001, more than 2.5 million United States military personnel have been deployed for combat. Over one million have served multiple deployments. Combat generally involved repeated exposure to highly traumatic events. Personnel were also victims of military sexual trauma (MST), a major risk factor for psychiatric illness. Most survivors do not seek or receive mental health care. Stigma is one of the main barriers to that care.
  
  
  OBJECTIVE
  To explore the impact of stigma on personnel with psychiatric illness, and suggest some innovative ways to potentially reduce stigma and improve care.
  
  
  METHODS
  Cinahl and PubMed databases were searched from 2001 to 2014.
  
  
  RESULTS
  Anonymity, the use of non-stigmatizing language, peer-to-peer, and stigma-reduction programs help military personnel receive mental health care. Technology offers the opportunity for effective and appropriate education and treatment.
  
  
  CONCLUSIONS
  Although stigma is formidable, several innovative services are available or being developed for military victims of trauma. Commitment of resources for program development and further research to explore which interventions offer the best clinical outcomes are needed to increase efforts to combat stigma and ensure quality care.
authors.affiliation: South End Community Health Center , Boston, MA , USA and.
authors.forename: Michael
authors.initials: M
authors.lastname: Schreiber
authors.forename: Geoffry Phillips
authors.initials: GP
authors.lastname: McEnany
mesh_terms: D055826:Afghan Campaign 2001-; D003219:Confidentiality; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007171:Implosive Therapy; D054542:Iraq War, 2003-2011; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008889:Military Personnel / Q000523:psychology*; D012742:Sex Offenses / Q000523:psychology; D057545:Social Stigma; D040921:Stress Disorders, Traumatic / Q000517:prevention & control; D013315:Stress, Psychological / Q000517:prevention & control; D017216:Telemedicine; D014481:United States; D014857:Warfare; D014947:Wounds and Injuries / Q000523:psychology
keywords: Afghanistan; Iraq; PTSD; mental health; military; stigma; technology; veterans