89 4 DISCLOSURE IN THE MILITARY - A QUALITATIVE STUDY Differences and similarities in views between groups Across the 3 different perspectives, barriers and facilitators mentioned were highly similar, with almost all main categories mentioned by all perspectives. There were only minor differences in the subcategories. MMH-professionals did not mention the gossip culture, the lack of skills of coworkers to talk about MHC/SA, the denial of symptoms, and the importance of disclosing to get better and supervisors who make time for a conversation. Soldiers without MHC/SA did not mention the fear of a lack of career advancement, supervisors lack of time for a conversation, the anticipated positive results as a reason for disclosure, and that it might be easier to disclosure work-related MHC/SA. DISCUSSION Soldiers feared that disclosure would lead to career consequences (losing employment, not being allowed to do what you like most about your job, lack of career advancement) and social rejection (being seen as weak, being rejected, gossip). Additionally, the masculine military culture was found to be a barrier to disclosure as people were expected to be strong, and soldiers with MHC/SA, colleagues and supervisors were found to lack skills to talk about MHC/SA. Supervisor behavior, attitudes, skills and knowledge of MHC/SA played an important role, as it was both a barrier to and facilitator for disclosure. While the workplace can form a barrier for disclosure, results also showed that when soldiers experience support from supervisors and when their MHC/SA are work-related, this can facilitate disclosure. Finally, motivation to disclose was due to hopefulness of recovery and helping others with MHC/SA. Many barriers for disclosure were related to stigma. In line with research within the German military (20), the current study found fear of career consequences and social rejection. Fear of career consequences relates to structural discrimination (rules and regulations which disadvantage individuals with MHC/SA (32)) and fear of social rejection relates to public stigma (prejudice held by member of the general population (33)). These fears are not specific for the military; a study among Dutch employees also found fear of career damage and social rejection as important barriers for disclosure (21). Another form of stigma, self-stigma (internalized prejudices held by individuals with MHC/SA (34)) was not found to play a role in the current study, opposed to the study within the German military. Further quantitative research is needed to examine whether self-stigma influences disclosure within the Dutch military. Comparing the sample of the study within the German military (20), where a fear of career consequences was also found, to the sample of the current study, it should be noted that the current sample included more people with permanent contracts. Still
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