34 2 CHAPTER 2 Table 2. Continued Category Subcategory Soldiers with MHC/SA Soldiers without MHC/SA Mental Health Professional Facilitator 1 Social support to encourage treatment seeking Family/spouse support. √ x x Peer support (being sent to care by them). √ √ √ Supervisor support (pos attitude supervisor). x x √ Trusting relationship MH professional. √ √ √ Facilitator 2 Accessibility and knowledge of where to get the right health care Accessible health care (low key). √ √ √ Relatively short waiting list, quick referrals. √ √ √ Knowledge of the health care system, and where to find help. √ √ √ Facilitator 3Health care within the military MH professionals that are familiar with and part of the military work context (except substance abuse). √ √ x Anonymity in system through confidentiality MH professionals. √ √ √ Note. MHC/SA = mental health condition and/or substance abuse. √ Indicates that subcategory was brought up and discussed by participants within a specific group of participants. X Indicates that subcategory was not mentioned within specific group of participants. Barriers 1. Fear of negative career consequences All groups mentioned the fear for negative career consequences as a barrier for treatment seeking. Participants indicated that seeking treatment could lead to (1) losing their job, (2) receiving negative differential treatment by not being allowed to do what they like most about their job, e.g. going on deployment and (3) not being able to advance in their careers. The fear of losing their job applied to all MHC/SA, however it appeared especially critical for substance abuse and addiction. Soldier without MHC/SA (male): ‘For us [air force] it is very clear that you will not be allowed to fly [if you have MHC/SA]. And that is what people love most about their job. So, they postpone seeking treatment.’ Soldier with MHC/SA (male): ‘When I was in treatment [for PTSD], I still kept my addiction a secret. I thought – if I tell them now – I will lose my job.’ 2. Fear of social rejection All groups also indicated fear of social rejection as a barrier, especially when MHC/SA
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