title: Mental Illness-Related Stigma in Canadian Military and Civilian Populations: A Comparison Using Population Health Survey Data.
abstract: OBJECTIVE
  This study sought to compare the prevalence and impacts of mental illness-related stigma among Canadian Armed Forces personnel and Canadian civilians.
  
  
  METHODS
  Data were from two highly comparable, population-based, cross-sectional surveys of Canadian military personnel and Canadian civilians: the 2013 Canadian Forces Mental Health Survey (N=6,696) and the 2012 Canadian Community Health Survey-Mental Health (N=25,113), respectively. Perceived stigma was assessed among those who reported care seeking for a mental health problem in the past 12 months. Follow-up questions assessed the impact of stigma in various domains. Modified Poisson regression and linear regression were used to examine population differences (military versus civilian) in terms of care seeking, stigma, and stigma impact, with adjustments for sociodemographic characteristics and the need for care.
  
  
  RESULTS
  Military personnel were significantly more likely than civilians to have perceived stigma (adjusted prevalence ratio [PR]=1.70, 95% confidence interval [CI]=1.11-2.60). Stigma had a greater impact on military personnel, particularly in terms of work or school life (b=1.01, CI=.57-1.47). However, military personnel were also significantly more likely than civilians to have sought care (PR=1.86, CI=1.53-2.25).
  
  
  CONCLUSIONS
  Military personnel reported a disproportionate amount of mental illness-related stigma, compared with Canadian civilians, and a greater impact of stigma. Nevertheless, military personnel were more likely to seek care, pointing to a complex relationship between stigma and care seeking in the military.
authors.affiliation: Dr. Weeks, Dr. Zamorski, and Dr. Rusu are with the Canadian Forces Health Services Group, Department of National Defence, Ottawa. Dr. Colman is with the Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa. Send correspondence to Dr. Colman (e-mail: icolman@uottawa.ca ).
authors.forename: Murray
authors.initials: M
authors.lastname: Weeks
authors.affiliation: Dr. Weeks, Dr. Zamorski, and Dr. Rusu are with the Canadian Forces Health Services Group, Department of National Defence, Ottawa. Dr. Colman is with the Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa. Send correspondence to Dr. Colman (e-mail: icolman@uottawa.ca ).
authors.forename: Mark A
authors.initials: MA
authors.lastname: Zamorski
authors.affiliation: Dr. Weeks, Dr. Zamorski, and Dr. Rusu are with the Canadian Forces Health Services Group, Department of National Defence, Ottawa. Dr. Colman is with the Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa. Send correspondence to Dr. Colman (e-mail: icolman@uottawa.ca ).
authors.forename: Corneliu
authors.initials: C
authors.lastname: Rusu
authors.affiliation: Dr. Weeks, Dr. Zamorski, and Dr. Rusu are with the Canadian Forces Health Services Group, Department of National Defence, Ottawa. Dr. Colman is with the Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa. Send correspondence to Dr. Colman (e-mail: icolman@uottawa.ca ).
authors.forename: Ian
authors.initials: I
authors.lastname: Colman
mesh_terms: D000328:Adult; D002170:Canada; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology*; D008875:Middle Aged; D008889:Military Personnel / Q000706:statistics & numerical data*; D015995:Prevalence; D057545:Social Stigma; D055815:Young Adult
keywords: Epidemiology; Military psychiatry