Stigma can be a barrier for a service member seeking support for their mental health. Recognizing mental health as part of overall health and changing attitudes are key to addressing it.
“Stigma poses a significant challenge in seeking help for mental health,” said Dr. Nancy Skopp, a researcher and clinical psychologist with the Defense Health Agency. Center of Excellence in Psychological Health.
Cultural bias, lack of trust in the system and even feelings of shame and embarrassment are some of the reasons why many do not seek mental health care services, according to Skopp.
Skopp acknowledged that within the military, some service members view seeking help as a sign of “weakness, social inferiority and/or lack of resourcefulness.” These feelings can be attributed to the culture within each military unit.
“For example, the warrior ethos emphasizes discipline, mental toughness and self-reliance, and above all successful execution of the mission,” she added.
Skopp stressed the importance of normalizing conversations about mental health, making it easier to take the first step in reaching out and asking for help.
How stigma is evolving
The Office of the Deputy Secretary of Defense recently released a document recommend that the Department of Defense initiate a review of policies aimed at eliminating stigmatizing language related to mental health.
“I think the military, as it relates to mental health, has done a great job of addressing some of the concerns around stigma,” said U.S. Navy Lt. Cmdr. Nick Guzman, head of the mental health department, Portsmouth Naval Medical Center.
“Military personnel are subject to all kinds of stressors typical of the traditional American population, such as having to move every few years, possibly overseas, adjusting to a new mission, and uprooting their families, which can lead to professional and financial challenges. These factors generate stress and anxiety in efforts to quickly adapt to a new sense of normal,” Guzman said.
Guzman explained that many younger service members are more willing to seek help and talk about mental health. Mental health is now an integral part of military entry programs and is discussed more openly.
He mentioned that services are now introducing mental health education and resilience training into their introductory programs. The U.S. Navy, for example, used a human performance program at a bootcamp designed to strengthen a Sailor’s mental, physical, and spiritual capacity to strive for peak performance.
Older generations of military personnel are less likely to talk about mental health issues or seek help, he added.
“If they think it could potentially negatively impact their career, or affect their security clearance, or put them out of commission a little bit, they’re more hesitant,” Guzman said.
According to the Defense Counterintelligence and Security Agency, out of more than 2.3 million security clearance reviews between 2012 and 2018, only 12 people (0.005% of all cases) had their clearances denied or revoked due to psychological health concerns.
Guzman also noted that service members with specialized tasks or missions may be more hesitant to seek help.
“They may see it as a negative reflection on themselves, such as a deficiency or character flaw, or a fear that others may judge them for seeking help,” Guzman said. “It exists a little bit, but I see a decline in the stigma.”
He noted that the recent COVID-19 pandemic has helped alleviate stigma as the number of service members and their families seeking mental health help has increased, given the degree of isolation and unpredictability created by the pandemic.
“Mental health in general is no longer viewed as negatively as it once was, in part because of perceived benefits from those who proactively sought help and remain mission-ready” , Guzman said.
Skopp said changing this stigma starts at the top, with leadership.
“This will take time and sustained effort at all military levels,” Skopp said. “Leaders are uniquely positioned to influence desired cultural changes. It is essential that military leaders combat aspects of military culture that promote negative beliefs about seeking care and continue efforts to reduce stigma.
Changing the language used to discuss mental health
Changing the language used when working with a service member seeking help, or in promotional materials, is an effort by the military health system to reduce stigma.
“It’s important to avoid negative comments,” Skopp said. “Language can open up discussion about mental health issues and stigma. Mental health providers can use language in helpful ways to begin talking about stigma with their patients.
The Center for Excellence in Psychological Health offers suggestions for how alternative language can be used when discussing mental health.
Alternatives to stigmatizing language may include:
- Avoid language that defines someone by their condition or assumes that their condition cannot be managed or overcome
- Avoid comments that make judgments or imply intention
- Describe without minimizing or becoming too graphic
- Use updated and accurate terminology
Testimonials are another tool to help normalize discussions about mental health care, especially from senior leaders, Guzman suggested.
“I think spreading the stories of leaders who openly want to ask for help is beneficial,” Guzman said. “If anyone was willing to put themselves out there to share their story, that’s great. »
Guzman believes the military needs to rethink what mental health is and “think about it from a different perspective.”
“Mental health is important for staying healthy because it includes different levels of functioning or various aspects of our normal daily functioning,” Guzman said. “It’s linked to our physical health, but also to our social and interpersonal health, our emotional well-being, as well as our ability to perform complicated tasks and under stress.”
The MHS offers many resources and information regarding mental health, including True Warriors Campaign.
