184 CHAPTER 1 8 Mixed methods The current thesis used mixed methods, as it included both qualitative and quantitative research methods. First, focus groups were performed, to explore the main barriers and facilitators relating to treatment-seeking and disclosure. Following this, a quantitative questionnaire study was used to confirm and expand the qualitative research findings. This provided an in-depth understanding of a complex topic. Study population Whereas previous research mainly examined military personnel with MHI, the current thesis also included the perspectives of military personnel without MHI and of mental health professionals. Moreover, we also studied those who had not disclosed their MHI and/or had not sought treatment for their MHI. Their perspectives provided valuable input for future research and interventions. However, there is also a limitation in the current thesis regarding the study population. First, the study population only included active-duty military personnel. This means that those who might have suffered the most negative consequences of treatment-seeking and/or disclosure, for example, loss of employment, were not included in this thesis. As this thesis also examined the relationship between disclosure and sustainable employment and well-being at work, it is important that future research also includes the perspective of those who have left the military and studies the long-term effects of disclosure on sustainable employment and well-being at work. Cross-sectional design Due to the cross-sectional design used in this thesis, no causality can be presumed. It is therefore very important that future research examines the proposed relationships of this thesis longitudinally. Measure used for disclosure The disclosure decision was measured as a dichotomous variable, assessing whether someone had disclosed to their supervisor or not. This measure did not consider the different types of disclosure, namely full disclosure (disclosing the diagnosis to the supervisor), partial disclosure (disclosing some information to the supervisor, such as needed work adjustments, but not the diagnosis), and non-disclosure (not disclosing any information to the supervisor). Previous research suggests that the content of the disclosure message can influence the disclosure outcome. Future research into the association between disclosure and sustainable employment and well-being at work should thus consider the different forms of disclosure. Generalizability An overrepresentation of older, higher-ranking, and higher-educated military personnel
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