51 3 TREATMENT SEEKING IN THE MILITARY - A QUANTITATIVE STUDY Self-reported mental illness Personnel were asked whether they had current or had had past mental illnesses. Group membership (i.e. current/past mental illness or no mental illness) was determined based on this. If personnel reported having a mental illness, they received a list of 15 possible types of mental illness (see Appendix B) and were asked to indicate illness presence, currently or past, similar to earlier research (18, 19). Additionally, they were asked whether their mental illnesses were work-related and to rate the severity of their symptoms (during the worst time) on a scale of 0–10. Treatment-seeking intentions Personnel with mental illness were asked whether they had sought treatment (yes/no). Personnel without mental illness were asked whether they would seek treatment if they developed a mental illness in the future and to rate it on a 4-point scale ranging from very unlikely to very likely. Attitudes, beliefs, and needs Based on a recent qualitative study within the Dutch military (6) and literature reviews on barriers and facilitators for treatment seeking (5, 8-11), 14 statements about attitudes and beliefs that could influence treatment-seeking (intentions) were developed (Table 2). As stigma was found to be the main barrier to treatment seeking in an earlier qualitative study, several statements related to stigma concerns were included. Participants were asked to indicate the extent to which they agreed with the statements on a 4-point scale, ranging from completely disagree to completely agree. Examples are ‘I was (would be) afraid that seeking treatment would have negative consequences for my career’ and ‘I preferred (would prefer) to solve my own problems’. Personnel with mental illnesses who indicated having sought treatment received the additional statements ‘I had no choice, my symptoms were too severe’ and ‘I had no choice, I was sent for treatment by someone else, using the same 4-point scale’. Personnel without mental illness received additional questions about their needs regarding treatment seeking if they were to develop mental illness in the future. Based on findings from an earlier qualitative study (6), they were given seven options (e.g. a clear indication of where to go to for help) that they would need when deciding to seek treatment and were asked to rate these on a 4-point scale ranging from ‘Not at all’ to ‘Very much’ (see Table 2). Contextual measures Familiarity Participants were asked about mental illness in their surroundings, using an adaptation of the Level of Contact Report (20), following earlier research (19, 21). The total familiarity
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