33 2 TREATMENT SEEKING IN THE MILITARY - A QUALITATIVE STUDY all codes were modified. Coders used an open, bottom-up, inductive coding style. Next, overarching categories were identified by one researcher, and checked by a second. In order to increase validity, multiple members of the research team identified the final categories. Analysis remained on category level, in order to not lose valuable information by summarizing on theme level. RESULTS Five main categories of barriers were found (i.e., fear of negative career consequences, fear of social rejection, confidentiality concerns, the ‘strong worker’ workplace culture, and practical barriers) and three main categories of facilitators (i.e., social support, accessibility and knowledge, and health care within the military). First the overarching results will be discussed, which will be followed by an examination of differences between the groups. For a full overview of the results, see Table 2. Table 2. Barriers and Facilitators Treatment Seeking for Mental Health Conditions/Substance Abuse Category Subcategory Soldiers with MHC/SA Soldiers without MHC/SA Mental Health Professional Barrier 1 Fear of negative career consequences Losing employment (and subsequent financial concerns). √ √ √ Negative differential treatment (different duties, no deployment). √ √ √ Lack of career advancement. √ √ √ Barrier 2 Fear of social rejection Fear of being rejected by/removed from the group. √ √ √ Fear of being seen as weak when having MHC/SA. √ √ v Negative attitude supervisor concerning treatment. x √ √ Barrier 3 Confidentiality concerns Lack of anonymity when seeking help. √ √ √ Lack of trusting relationship with MH professional. √ √ √ Barrier 4 the ‘strong worker’ Workplace culture ‘We can do it’ mentality. √ √ √ Failure to recognize need for treatment. √ √ x Preference for self-management. √ √ √ Feeling shame for having MHC/SA. √ x √ Help is provided within group in order to protect each other from stigma consequences. √ √ √ Barrier 5 Practical barriers Lack of knowledge about who/where to go to for help. √ √ √ Lack of time for treatment (work obligations). √ √ √
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