186 CHAPTER 1 8 of MHI and has been shown to reduce symptoms in civilian samples. Implications for future research As stigma can form 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. disclosure decision aids) and interventions that target the environment of the individual with MHI (e.g. supervisor training) should be examined for their effectiveness in the Dutch military. 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 post-decision. 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 treatment-seeking. Furthermore, the use of a representative sample is important as this would make it possible to draw conclusions on how treatmentseeking and disclosure depend on certain demographics and branches of the military. It should also be noted that the current thesis focused on MHI, including substance use disorder. As the Dutch military has a zero-tolerance policy for substance use, it can be expected that the decision to seek treatment for and disclose substance use disorder is harder compared to making these decisions for other MHI. Therefore, it is important that future research examines the decision to seek treatment for, and disclose, substance use disorder separately from other MHI, to be able to make comparisons. Finally, as the current thesis highlights the crucial importance of the supervisor’s attitudes, knowledge, and support in the disclosure decision, the perspective of the supervisor warrants to be studied in more detail. Implications for military policy Currently, laws and policies are insufficient to end mental health stigma and discrimination, while research suggests that they are essential for ending stigma. Therefore, mental health stigma must be targeted at the level of policy and HR practices, and not only at the level of the individual with MHI and the supervisor. The first recommendation for policymakers in the Dutch military is related to the fear of negative career consequences. The current thesis showed that a quarter of all military personnel feared that seeking treatment for MHI or disclosing MHI to a supervisor would lead to negative career consequences. Previous research has indeed shown that MHI,
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