Fear of stigma deters US soldiers from seeking help for mental health
http://www.100md.com
《英国医生杂志》
Fear of stigmatisation resulted in less than half of US combat infantry personnel who developed mental health problems after serving in Iraq or Afghanistan seeking treatment, finds a study in the New England Journal of Medicine (2004;351:13-28).
Soldiers most in need of treatment feared being stigmatised the most, says an accompanying editorial by Dr Matthew Friedman, of the Department of Veterans Affairs?National Center for Post-Traumatic Stress Disorder, Vermont. Dr Friedman suggests soldiers fear that "a scarlet P could doom their careers."
The study, by Dr Charles Hoge, of the department of psychiatry and behavioural science at the Walter Reed Army Institute for Research, Maryland, and colleagues, involved 6201 soldiers serving in four US combat infantry units, who were surveyed either before their deployment to Iraq or three to four months after their return from combat in either Iraq or Afghanistan.
The questions sought to establish the prevalence of major depression, generalised anxiety, and post-traumatic stress disorder.
The prevalence of these conditions was higher among personnel who served in Iraq (15.6% to 17.1% of the participants), where exposure to combat was considerably greater, than in those who served in Afghanistan (11.2%). The prevalence among soldiers who were surveyed before deployment to Iraq was 9.3%. The largest difference between soldiers who were surveyed before combat and those surveyed after was in the rate of post-traumatic stress disorder.
The editorial says this is the first time the prevalence of psychiatric disorders associated with war has been assessed so early and reported while fighting continues. It points out that the data show that the perception of stigmatisation deters soldiers on active duty from seeking help, even when they recognise the severity of their psychiatric problems.
Of the participants who said they had a mental disorder only 23% to 40% sought help. The main deterrents were fear of being seen as weak and of being treated differently by officers.
The all volunteer force deployed to Iraq and Afghanistan and the types of warfare conducted in these regions were very different from previous wars, say the authors. Little of the existing research is useful for guiding policy on promoting access to and delivery of mental health services to the armed forces, they say.
Acknowledgment of the psychiatric costs of war has led to better methods of detecting and treating psychiatric disorders associated with military combat, says the editorial, but "it is now time to take the next step and provide effective treatment . . . along with credible safeguards of confidentiality."(Quebec David Spurgeon)
Soldiers most in need of treatment feared being stigmatised the most, says an accompanying editorial by Dr Matthew Friedman, of the Department of Veterans Affairs?National Center for Post-Traumatic Stress Disorder, Vermont. Dr Friedman suggests soldiers fear that "a scarlet P could doom their careers."
The study, by Dr Charles Hoge, of the department of psychiatry and behavioural science at the Walter Reed Army Institute for Research, Maryland, and colleagues, involved 6201 soldiers serving in four US combat infantry units, who were surveyed either before their deployment to Iraq or three to four months after their return from combat in either Iraq or Afghanistan.
The questions sought to establish the prevalence of major depression, generalised anxiety, and post-traumatic stress disorder.
The prevalence of these conditions was higher among personnel who served in Iraq (15.6% to 17.1% of the participants), where exposure to combat was considerably greater, than in those who served in Afghanistan (11.2%). The prevalence among soldiers who were surveyed before deployment to Iraq was 9.3%. The largest difference between soldiers who were surveyed before combat and those surveyed after was in the rate of post-traumatic stress disorder.
The editorial says this is the first time the prevalence of psychiatric disorders associated with war has been assessed so early and reported while fighting continues. It points out that the data show that the perception of stigmatisation deters soldiers on active duty from seeking help, even when they recognise the severity of their psychiatric problems.
Of the participants who said they had a mental disorder only 23% to 40% sought help. The main deterrents were fear of being seen as weak and of being treated differently by officers.
The all volunteer force deployed to Iraq and Afghanistan and the types of warfare conducted in these regions were very different from previous wars, say the authors. Little of the existing research is useful for guiding policy on promoting access to and delivery of mental health services to the armed forces, they say.
Acknowledgment of the psychiatric costs of war has led to better methods of detecting and treating psychiatric disorders associated with military combat, says the editorial, but "it is now time to take the next step and provide effective treatment . . . along with credible safeguards of confidentiality."(Quebec David Spurgeon)