I work in a military hospital. US military personnel prefer not to seek immediate medical care if they experience an injury. Only a minority of service members seek treatment for mental health problems and physical health problems. This problem is significant to nursing practice because it is the nurse’s goal to improve health care delivery in the military setting.
It is important for the healthcare community to understand the reluctance by military personnel to seek treatment for mental and physical health problems. Health care delivery should be adapted to emphasize what service members care about, which is their ability to manage the problems on their own. The preference for handling problems oneself reflects the occupational culture’s emphasis on being resilient in the face of both mental and physical demands. Physical injury could result in a non-deployable determination when being ready to deploy is considered a condition of service. Service members also need to recognize when they can no longer manage problems on their own and need professional help.
According to the National Alliance of Mental Illness (2020) 1 in 4 military personnel struggle with mental illness. The top 3 diagnosis for this group is PTSD, depression, and traumatic brain injuries (TBI). Many resources are available for in person as well as resources for more of a discrete nature for those to call. You are very correct that many service members prefer to keep their struggles a secret or on the down low as they do not want to be characterized or labeled by those around them. It is important for those around to help support the physical and mental health of active duty as well as veterans as they have many struggles others could have trouble understanding. I know as a wife of a veteran he at times struggles with things I can not understand. When he first returned from his second deployment items at the side of the road made him flinch. In his sleep he would toss and turn and a loud noise would make him wake straight up in bed. We are lucky that is the only side effects of the trauma he endured but I know now everyone is as lucky. However, I know dealing with the VA can also be a challenge as the first thing they wanted to do was throw medication at him without any sort of therapy. They also tried to diagnosis him with depression and anxiety when he didn’t feel like that was the problem.
National Alliance of Mental Illness (2020). Veterans & Active Duty. Retrieved from https://www.nami.org/Your-Journey/Veterans-Active-Duty
Hello “clstein.” Thank you for reading my post. Those are definitely the top three diagnoses I see at work. I would also add chemical dependency to the list of top diagnoses. I am sorry that your husband has some lingering effects from his experiences and what he has seen in war. It must be hard for him and yourself. Yes, you are lucky that it is mild. The local VA hospital in my community usually has long wait times and making a same-day appointment is not always possible. Luckily, there are other clinics that exclusively serve military personnel here in my community. I live in a military town so there is always high demand for their care. It is important for all patients to advocate for themselves. Providers should be non-judgmental and allow patients to express their concerns over medication use and diagnosis labeling.
I find this interesting coming from a military family and being raised on military bases throughout my childhood, adolescence, and until college. My mother worked for 22nd Med Group as a OB/GYN Nurse Practitioner, retiring after 20 years with the rank of Major. Right away my instincts tell me one of the main reasons why military personnel do not want to seek emergent medical treatment or seek help for mental health would be out of fear from losing or being relieved of their official duty to be in the military. That’s my first guess but let me research just a little to see what I find. Here is what I have found from Oxford Academic Epidemiologic Reviews. Approximately 60% of military personnel do not seek mental health treatment, mostly out of fear from that stigma the follows mental health. 44.2% report that their leadership unit my treat them differently and another 42.2 % thought they would be seen as weak. Although the conclusion of this large study found that the stigma amongst coworkers and leadership unit was not found but rather self-stigma was present. It seemed that initial intention was to not seek help mental health but when a crisis became evident individuals relied on other means to find help for mental illness through friends, family, coworkers, etc. Most military personnel who suffer from mental illness and are shy away could benefit greatly from receiving treatment(Sharp, M. et al. 2015).
Reference
Sharp, M. L., Fear, N. T., Rona, R. J., Wesley, S., Greenberg, N., Jones, N., & Goodwin, L. (2015, January 16). Stigma as a Barrier to Seeking Health Care Among Military Personnel With Mental Health Problems. Retrieved from https://academic.oup.com/epirev/article/37/1/144/423274
Hello “jcbrandt.” Thanks for reading my post. And please thank your mom for her service! It is unfortunate that there is this stigma related to seeking assistance. Military personnel deserve our assistance. We honor their lives and their sacrifice. They truly deserve the help they need. The major problem is most do not want to admit that they have a physical or mental problem. Fear of not performing well at work is a legitimate concern. However, delaying treatment may make the illness worse. Nurses need to be more aware of patients that minimize their problems and offer supportive care and encouragement to seek further treatment and assistance.
Eduardo,
This is a very interesting topic and heartbreaking that military personnel have these personal barriers to seek medical and mental health treatment. Fortunately as time has gone by, society has somewhat been accepting of mental health disorders but at the same time we have a long way to go. I’m curious to find out if there are classes regarding mental health during training for military personnel. Also, I’m curious to find out if when service members return from deployment if social workers reach out to them or do they only provide services if the member contacts them directly and asks for assistance?
Hello “jbonilla.” Thanks for reading my post. In my community, there is less of a stigma with mental health disorders. This is true for civilians, veterans, and active duty military personnel. I cannot speak for all military bases and how they function but at the military bases in my community, the military personnel are provided orientation and are provided resources on who to contact for different issues and problems, whether it is a question about housing, family care, recreation, fitness centers, library, career advancement, education center, personal finances, sexual assault prevention and response, transition readiness, community counseling, and substance and alcohol counseling, and other services (tax, automotive, dry cleaning, barber shop, etc.). When service members return from deployment, there is no formal direction or coordination of care that I am aware of. I could be wrong. Service members initiate assistance themselves. All service members are encouraged to see their primary care managers at least annually and more if needed. That is a great suggestion to have an re-orientation program upon return from deployment. Other military bases may already have this in place. I certainly hope so. Nurses should help remove barriers for service members in seeking medical and mental health treatment.