68 3 CHAPTER 3 wanting to be an example to others is important for treatment-seeking intentions and is not found in previous research. Involving personnel who have sought treatment, in peer-to-peer programmes would allow them to be examples to others and thereby help them seek treatment. Additionally, they could speak at more general military events to target those who could benefit from treatment but have not yet sought treatment and are not in peer-to-peer programmes. The military is known for high social cohesion, making the social aspect of seeking treatment important (33). On the one hand, receiving advice from others facilitates treatment seeking; on the other hand, there is also fear of social rejection due to treatment-seeking behaviour. Interventions that increase social support could eliminate fears of social rejection. Previous research also indicated that social support is associated with treatment-seeking behaviours (33). A way of targeting social support would be through unit cohesion. Lower unit cohesion was associated with intentions to not seek treatment. Increasing unit cohesion could increase social support, thereby dispelling fears of social rejection and increasing early treatment seeking. Previously, higher unit cohesion has been associated with lower stigma (34) and protection against developing mental illness (35), making unit cohesion important for both selective and indicated prevention. However, previous research has revealed a tendency for personnel to provide help within the group, instead of advising someone to seek treatment (6), which could be strengthened by higher unit cohesion. Training on mental illness in the military should therefore include information on the importance of professional treatment and explain that sometimes the best way to help colleagues is to advise them to seek professional treatment. It should be noted that seeking treatment and intentions to seek treatment were high in this study, especially compared to other studies on the military (5). This could, partly, be due to a self-selection bias and the sample including personnel with severe symptoms, as discussed in the Strengths and limitations section. However, it also suggests that steps taken in the Dutch military to destigmatise mental illness and offer support, such as supervisor training and peer-to-peer programs, might already be successful, which is very encouraging. Earlier experiences Having a positive earlier experience with seeking treatment is associated with higher treatment-seeking intentions. Thus, ensuring high quality (general) health care could facilitate earlier treatment seeking for mental illness. Interestingly, having seen the positive experiences of others was positively associated with not seeking treatment for personnel with mental illness. Previous research has mainly focused on respondents’ previous experiences, not on the experiences of others (11). It is possible that the
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