166 7 CHAPTER 7 samples (57, 58). However, it is important to also examine the effectiveness of WRAP in military samples. A pilot study of WRAP is currently being evaluated in the Dutch military. Implications for future research The findings of the current thesis showed that a large proportion of military personnel with MHI experienced stigma, and this mental health stigma was also perceived by military personnel without MHI and mental health professionals. This mental health stigma formed a barrier to treatment-seeking and disclosure of MHI and is therefore expected to have negative consequences for sustainable employment and well-being at work. More research is needed into this important topic to facilitate sustainable employment and well-being at work of military personnel with MHI. As stigma forms a barrier to sustainable employment and well-being at work, the first topic future research could focus on, is on developing and testing interventions to decrease mental health stigma. Both interventions that target the individual with MHI (e.g. HOP and WRAP) and interventions that target the environment of the individual with MHI (e.g. supervisor training, mental health awareness training, HR policy) should be examined. Research is needed to develop new interventions and to evaluate the effectiveness of existing interventions in the Dutch military context. Additionally, the topic of mental health stigma, treatment-seeking, disclosure and sustainable employment, and well-being at work calls for longitudinal research using a representative sample. The current thesis used cross-sectional data, which means that no causality can be presumed concerning the beliefs and attitudes related to the decisions, and the actual decision. Certain attitudes and beliefs may have been formed postdecision. Additionally, a longitudinal study can provide insight into the different types of stigma that play a role in the different phases of symptom development and treatmentseeking. For example, a recent study found that pathways to care are non-linear, with different barriers and facilitators being important at each step (59). Furthermore, the use of a representative sample is important as this would make it possible to draw conclusions on how treatment-seeking and disclosure depend on certain demographics and branches of the military. This could assist in developing targeted interventions. A representative sample is also needed as the current thesis only included active-duty military personnel. This means that those with the most negative consequences of treatment-seeking and disclosure, for example, loss of employment, were not included in the sample of this study. Especially when the effects of disclosure on sustainable employment and well-being are examined, it is important to include military personnel who have left service.
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