28 2 CHAPTER 2 ABSTRACT Background. Globally, millions are exposed to stressors at work that increase their vulnerability to develop mental health conditions and substance abuse (MHC/SA) (e.g. Soldiers, policemen, doctors). However, especially these types of professionals are expected to be strong and healthy, and this contrast may worsen their treatment gap. Although the treatment gap in the military has been studied before, perspectives of different stakeholders involved have largely been ignored, whereas they play an important role. Aims. To study barriers and facilitators for treatment seeking in the military, from three different perspectives. Method. In total, 46 people participated, divided over 8 homogenous focus groups, including three perspectives: soldiers with MHC/SA (N=20), soldiers without MHC/SA (N=10) and mental health professionals (N=16). Sessions were audio-taped and transcribed verbatim. Content analysis was done by applying a general inductive approach using ATLAS.ti-8.4.4. Results. Five barriers for treatment seeking were identified (fear of negative career consequences, fear of social rejection, confidentiality concerns, the ‘strong worker’ workplace culture, and practical barriers) and three facilitators (social support, accessibility and knowledge, and health care within the military). The views of the different stakeholder groups were highly congruent. Conclusion. Barriers for treatment seeking were mostly stigma related (fear of career consequences, fear of social rejection and the ‘strong worker’ workplace culture) and this was widely recognized by all groups. Social support from family, peers, supervisors and professionals were identified as important facilitators. A decrease in the treatment gap for MHC/SA is needed and these findings provide direction for future research and destigmatizing interventions.
RkJQdWJsaXNoZXIy MjY0ODMw