38 2 CHAPTER 2 system is important, this creates a different atmosphere for seeking treatment.’ Soldier with MHC/SA (male): ‘It is really important to build a trusting relationship with a MH professional first’. 2. Accessibility and knowledge All groups discussed the importance of easily accessible health care, relatively short waiting lists and quick referrals. Additionally, they mentioned the importance of having knowledge of how the military mental health service works- that they know what help is available and who they should go to for help first. 3. Health care within the military Two properties of the military health care system were mentioned as facilitators. First, participants mentioned the importance of MH professionals who are familiar with and part of the military context – which is the case within the Dutch military. However, this was only the case for participants with mental health conditions, not for substance abuse. The latter indicated a preference for help for substance abuse outside the military out of fear for negative career consequences. Soldier without MHC/SA (male): ‘The MH professional should be someone who understands you and has shared your experiences. Civilians, they have never been through it, you will just end up having to explain everything to them.’ Second, doctor-patient confidentiality, which was on the one hand mentioned as a barrier by some participants, was also mentioned as an important facilitator. Soldiers discussed that it is wise to first go to a MH professional and ask for advice, because they are obligated to keep your information confidential. Differences and similarities in views between groups As can be seen from Table 2, across the 3 different perspectives, the barriers and facilitators identified were highly similar. All main categories of barriers and facilitators were identified by all the different groups. Besides that the groups were highly similar, some subcategories were not discussed in certain groups. For barriers, fear of social rejection by the supervisor was not mentioned by soldiers with MHC/SA, feelings of shame were not mentioned by soldiers without MHC/SA and the failure to recognize need for treatment was not mentioned by MH professionals. For facilitators, support from family was only mentioned by soldiers with MHC/SA, support from the supervisor
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