187 8 SUMMARY disclosure, and treatment-seeking can have negative career consequences. Conversely, several studies have shown that early treatment-seeking was associated with less impact on one’s career, as more severe symptoms could be prevented. Additionally, early disclosure can lead to work adjustments and social support which are essential to stay at work and avoiding adverse consequences for one’s career. Therefore, to promote wellbeing and prevent adverse occupational outcomes, policymakers should implement and enforce policies to avoid stigma and discrimination against those who seek treatment or disclose to a supervisor. Second, as military personnel seek treatment in a late phase, when symptoms are severe, policymakers of the Dutch military should consider promoting regular mental health check-ups, so that symptoms can be caught at an early stage. Third, policymakers in the Dutch military should consider mental health awareness and mental health literacy training in military basic training. This should also include training on how to communicate about MHI, as this was found to be hard for military personnel with and without MHI and supervisors. If MHI awareness and literacy and communication skills are generated in an early stage, this could also decrease the stigma and improve sustainable employment of military personnel. Furthermore, policymakers could also implement stigma awareness campaigns, as the majority of experts on this topic indicate that this is needed to increase stigma awareness. A final recommendation for the policymakers of the Dutch military is related to the zero-tolerance policy for substance use. The findings of the current thesis showed that the fear of negative career consequences formed a barrier to treatment-seeking, and this fear is likely to be even higher for substance use disorders, as the military has a strong zero-tolerance policy. Due to this zero-tolerance policy, we expect that military personnel might not be aware that treatment is available for substance use disorder within the military. Therefore policymakers need to consider whether the possibilities of treatment for substance use disorder can be promoted more and whether the strong zero-tolerance policy should be made less strict. For the sustainable employment and well-being of personnel with MHI, including those with substance use disorder, it is important that they receive treatment. GENERAL CONCLUSIONS The current thesis showed that mental health stigma exists in the Dutch military and that this mental health stigma formed a major barrier for both treatment-seeking and disclosure of MHI to a supervisor and can negatively affect sustainable employment
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