title: Provider and Nonprovider Sources of Mental Health Help in the Military and the Effects of Stigma, Negative Attitudes, and Organizational Barriers to Care.
abstract: OBJECTIVE
  This study examined sources of help (providers or nonproviders) used by soldiers for mental health problems. Differences in perceived barriers to care by type of help used were also assessed.
  
  
  METHODS
  Active-duty soldiers from four brigade combat teams (N=3,380) were surveyed in 2008-2009. Items assessed posttraumatic stress disorder; depression; anxiety; help needed because of a stress, emotional, alcohol, or family problem; stigma; negative attitudes toward care; and organizational barriers. Participants reported receipt of help in the past three months from providers (mental health or medical professionals or an Army resource hotline) or nonproviders (fellow soldier, medic, chaplain, or chain of command).
  
  
  RESULTS
  Nearly a third (31%) were identified as being in need of mental health care. Of those, 5% reported using nonprovider help exclusively, 14% used provider help exclusively, and 7% used both types. Stigma was rated significantly lower as a barrier among those who used help exclusively from providers than among those who did not use help from any source; however, no significant differences in stigma scores were found between those who used help from nonproviders and those who did not use help from any source. Soldiers who used help from nonproviders were more likely than those who used help from providers to perceive organizational barriers.
  
  
  CONCLUSIONS
  Results show that soldiers may view nonproviders as alternative sources of mental health help, suggesting that the Army should ensure that such resources are adequately trained and integrated into the mental health community so that soldiers can receive the help they need.
authors.affiliation: Except for Dr. Toblin, the authors are with the Military Psychiatry Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland (e-mail: paul.y.kim12.ctr@mail.mil ). Dr. Toblin is with the Research Transition Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland.
authors.forename: Paul Y
authors.initials: PY
authors.lastname: Kim
authors.affiliation: Except for Dr. Toblin, the authors are with the Military Psychiatry Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland (e-mail: paul.y.kim12.ctr@mail.mil ). Dr. Toblin is with the Research Transition Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland.
authors.forename: Robin L
authors.initials: RL
authors.lastname: Toblin
authors.affiliation: Except for Dr. Toblin, the authors are with the Military Psychiatry Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland (e-mail: paul.y.kim12.ctr@mail.mil ). Dr. Toblin is with the Research Transition Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland.
authors.forename: Lyndon A
authors.initials: LA
authors.lastname: Riviere
authors.affiliation: Except for Dr. Toblin, the authors are with the Military Psychiatry Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland (e-mail: paul.y.kim12.ctr@mail.mil ). Dr. Toblin is with the Research Transition Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland.
authors.forename: Brian C
authors.initials: BC
authors.lastname: Kok
authors.affiliation: Except for Dr. Toblin, the authors are with the Military Psychiatry Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland (e-mail: paul.y.kim12.ctr@mail.mil ). Dr. Toblin is with the Research Transition Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland.
authors.forename: Sasha H
authors.initials: SH
authors.lastname: Grossman
authors.affiliation: Except for Dr. Toblin, the authors are with the Military Psychiatry Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland (e-mail: paul.y.kim12.ctr@mail.mil ). Dr. Toblin is with the Research Transition Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland.
authors.forename: Joshua E
authors.initials: JE
authors.lastname: Wilk
mesh_terms: D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000523:psychology / Q000628:therapy; D001007:Anxiety / Q000523:psychology / Q000628:therapy; D001294:Attitude to Health; D003863:Depression; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology / Q000628:therapy*; D008605:Mental Health Services / Q000458:organization & administration; D008889:Military Personnel / Q000523:psychology*; D010379:Peer Group; D057545:Social Stigma; D012944:Social Support; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology / Q000628:therapy; D013315:Stress, Psychological / Q000523:psychology / Q000628:therapy; D011795:Surveys and Questionnaires; D055815:Young Adult