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Stigma as a Barrier to Seeking Health Care Among Military Personnel With Mental Health Problems

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Sharp, M.-L., Fear, N. T., Rona, R. J., Wessely, S., Greenberg, N., Jones, N., Goodwin, L.·2015·Epidemiologic Reviews

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Abstract

Approximately 60% of military personnel who experience mental health problems do not seek help, yet many of them could benefit from professional treatment. Across military studies, one of the most frequently reported barriers to help-seeking for mental health problems is concerns about stigma. It is, however, less clear how stigma influences mental health service utilization. This review will synthesize existing research on stigma, focusing on those in the military with mental health problems. We conducted a systematic review and meta-analysis of studies between 2001 and 2014 to examine the prevalence of stigma for seeking help for a mental health problem and its association with help-seeking intentions/mental health service utilization. Twenty papers met the search criteria. Weighted prevalence estimates for the 2 most endorsed stigma concerns were 44.2% (95% confidence interval: 37.1, 51.4) for "My unit leadership might treat me differently" and 42.9% (95% confidence interval: 36.8, 49.0) for "I would be seen as weak." Nine studies found no association between anticipated stigma and help-seeking intentions/mental health service use and 4 studies found a positive association. One study found a negative association between self-stigma and intentions to seek help. Counterintuitively, those that endorsed high anticipated stigma still utilized mental health services or were interested in seeking help. We propose that these findings may be related to intention-behavior gaps or methodological issues in the measurement of stigma. Positive associations may be influenced by modified labeling theory. Additionally, other factors such as self-stigma and negative attitudes toward mental health care may be worth further attention in future investigation.

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See all 402

Authors: Sharp, M.-L., Fear, N. T., Rona, R. J., Wessely, S., Greenberg, N., Jones, N., & Goodwin, L.
Affiliations: King's College London (GB)
Corresponding author: Sharp, M.-L.
ORCID: Sharp, M.-L.
Fear, N. T.
Rona, R. J.
Wessely, S.
Greenberg, N.
Jones, N.
Goodwin, L.
Venue: Epidemiologic Reviews
Publisher: Oxford University Press (OUP)
Published: 2015-01-01
Volume: 37
Issue: 1
Pages: 144-162
ISSN: 0193-936X (ISSN-L)
1478-6729
DOI: 10.1093/epirev/mxu012
OpenAlex: W2167714940
Cited by: 402
References: 90
Citations by year: 2026: 37 · 2025: 40 · 2024: 30 · 2023: 58 · 2022: 30 · 2021: 39 · 2020: 37 · 2019: 41 · 2018: 35 · 2017: 29 · 2016: 19 · 2015: 6
FWCI: 4.63
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Epidemiologic Reviews (publishedVersion)
PubMed (publishedVersion)
Research Portal (King's College London) (publishedVersion, other-oa)
Lancaster EPrints (Lancaster University) (submittedVersion)
HighWire Press Open Archive (submittedVersion)
University of Birmingham Research Portal (University of Birmingham) (submittedVersion, other-oa)
Funders: U.S. Department of Defense
Royal British Legion
National Institute for Health and Care Research (NF-SI-0512-10003)
King's College London
Economic and Social Research Council (1254620)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
Social Sciences › Gender Studies › Gender Roles and Identity Studies
Keywords: mental health stigma, help-seeking, military personnel, mental health service utilization, anticipated stigma, self-stigma, help-seeking intentions, intention-behavior gap, labeling theory, stigma prevalence
MeSH terms: Australia, Mental Disorders, United Kingdom, Humans, Military Personnel, New Zealand, Patient Acceptance of Health Care, United States, Social Stigma

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Stigma as a Barrier to Seeking Health Care Among Military Personnel With Mental Health Problems

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