Mental health stigma is common in the military. Unfortunately, stigma can hold veterans back from receiving sufficient care.
Unfortunately, almost 25% of active-duty service members display mental health symptoms.1 Between 40-60% of military service members don’t seek treatment services for mental health disorders.2 Service members are also more likely to develop conditions such as post-traumatic stress disorder and depression than civilians.1
In this article you’ll learn:
- What stigma is.
- The causes of stigma in the military.
- How the military is working to remove stigma.
- Why stigma is concerning.
- Where to get help for mental health.
What is Stigma?
Stigma is defined as a “defect; a symbol of disgrace, shame or reproach and often involves fear of that which is different.”3 When a condition is stigmatized, it is often viewed negatively. Fear of stigma may lead to avoidance of mental health treatment.2
Active service members and veterans may experience stigma in various contexts, including the following:2, 4, 5
- Public context, where beliefs in society are prejudicial or discriminatory toward people with mental health disorders and those who seek treatment. This can also include military culture, which focuses heavily on being masculine, competent, self-sufficient, and ready for service at all times. Stigma in the public context may include being afraid of being seen as different, less capable, or dangerous.
- Institutional context, such as in the military, where policies may dissuade people from seeking treatment for fear of consequences. Being concerned that having a mental health diagnosis or being in treatment can negatively impact your job is an example of this.
- Social context refers to how the people in your life view mental illness and seeking treatment. This can apply to family, friends, co-workers, unit members, and commanding officers. Being worried that people around you will think less of you for having a mental illness or seeking treatment is an example of being affected by stigma in a social context.
- Individual context, where a person begins to incorporate the stigma into their own beliefs. This changes how people see themselves and can lead people to feel ashamed or inadequate, have low self-worth, and avoid treatment or drop out early. Thinking that you should be able to manage without help or aren’t strong enough to manage your disorder are examples of experiencing stigma on the individual level.
What Leads to Mental Health Stigma in the Military?
Mental health stigma in the military can be attributed to various factors. Military policies and culture have contributed to this stigma and often make service members and veterans reluctant to acknowledge and address mental health issues. This pervasive stigma often carries over post-discharge, affecting veterans after service.2
The military has strict mental health requirements for people to enlist and be considered fit for duty. Certain disorders disqualify people from being able to enlist.5 Knowing this can make active-duty service members uncomfortable disclosing mental health concerns while enlisted, for fear that it could negatively impact their military careers.5, 6, 7
Avoidance of treatment-seeking in military personnel may be based in fear of:2, 6, 7, 8
- Being downgraded.
- Being restricted from duty.
- Being passed over for promotions.
- Getting dishonorably discharged.
- Not being allowed to handle weapons.
- Losing security clearance
While these fears are very real, only 3% of service members who self-referred for mental health treatment experienced harm to their careers, and less than 1% of those being reviewed for clearances are rejected solely based on their mental health.6
Self-sufficiency, strength, resiliency, and masculinity are core values within the military culture.2,9 Service members often believe that they should be able to deal with their problems without professional help.7, 8 Consequently, seeking treatment may be viewed as being weak, shameful, or a disappointment to their peers.2, 5, 8
Privacy is another issue that can contribute to stigma.5 The military provides healthcare to active-duty service members and veterans, but there are often questions and concerns over the confidentiality of medical records.7 Seeking mental health treatment can be complicated by worries that information will be shared with leadership.5, 7
How the Military is Working to Remove Stigma
The military is taking steps to improve policies on how mental health disorders are addressed.
One step the military has taken is the modification of their security clearance questionnaire. Question 21 asks if military service members have sought treatment for any mental health or emotional disorders.1, 6 In 2008, the Defense Department modified this question so that service members who seek treatment for marital counseling or issues related to combat can answer no to this question.1, 6 This ensures that security clearance won’t be endangered if certain types of treatment are sought.1
Rather than grouping service members as fit or unfit for duty, the military is expanding classifications to involve more nuanced categories that reflect a service’s member’s mental health.6 Starting in 2008, the military added designations included “reacting” and “injured”.6
This reflects the array of reactions service members may experience as a result of stressors or trauma that can occur during service or deployment and allows people to receive assistance as needed.6
The military has also been discussing mental health issues more openly to encourage people to seek treatment without fear of harm to one’s career.5 Service members, including ranking officers, have begun to step forward and share their experiences with mental health concerns and treatment to dispel stigma.5, 6
Some also discuss how avoiding treatment has affected them.5 Sharing experiences and helpful resources provides a supportive atmosphere that encourages seeking treatment and helps destigmatize mental health issues.5
Increased access to mental health care providers is another way that the military is working to help service members and veterans.5 Working with additional providers, ensuring that they are available outside of duty hours, and making treatment more accessible are ways that the military is working to help service members and veterans receive the care they need.5, 6
Why is Stigma Concerning?
Stigma is a major concern within the military, particularly its effect on service members.6
When stigma leads to treatment avoidance, symptoms can negatively affect all areas of a service member or veteran’s life.5 Approximately half of the service members in need are not seeking treatment, which can increase the risk of addiction and other mental health disorders and raise suicide risk.5, 10, 11
Stigma and unaddressed mental health issues can potentially harm the military, which is already overextended.6 Stigma carries a financial cost for the military.5, 3 Lost productivity and suicide due to treatment avoidance among active-duty service members is estimated to cost up to $32 million.5 Among veterans, healthcare costs and losses in productivity due to treating mental health disorders costs about $6.2 billion in the first 2 years after separation.6
All military branches are working both individually and together to combat the stigma surrounding mental health to provide better support to troops and veterans.6
Veterans and Mental Health Treatment
Online resources for education about mental health issues and help with finding local support include:12, 13
- Make the Connection, offering education and access to local support for active duty service members, veterans, and family members.12
- Real Warriors, which provides information, support, and links to resources for active duty service members, veterans, and family members.13
American Addiction Centers offers programs that specialize in treating veterans with substance use disorders and co-occurring disorders (addiction that occurs with a mental health disorder). Desert Hope in Las Vegas and Recovery First in Florida offer a program called Salute to Recovery that addresses addiction, mental health, grief, and trauma and offers anger management and couples counseling to help veterans manage their diagnoses and live a healthy, fulfilling life.
Military service can be challenging, but the challenges don’t always end when your enlistment does. It can be hard to ask for assistance, but getting help doesn’t make you weak; it shows how strong you are.
- Sharp, M-L., Fear, N.T., Rona, R.J., Wessely, S., Greenberg, N., Jones, N., & Goodwin, L. (2015). Stigma as a barrier to seeking health care among military personnel with mental health problems. Epidemiologic Reviews, 37(1), 144-162.
- National Alliance on Mental Illness. Veterans and active duty.
- U.S. Department of Veterans Affairs. (2015). Mental health stigma: 10 things you should know about.
- Campbell, D.G., Bonner, L.M., Bolkan, C.R., Lanto, A.B., Zivin, K., Waltz, T.J., … Chaney, E.F. (2016). Stigma predicts treatment preferences and care engagement among Veterans Affairs primary care patients with depression. Annals of Behavioral Medicine: A Publication of the Society of Behavioral Medicine, 50(4), 533-544.
- Acosta, J.D., Becker, A., Cerully, J.L., Fisher, M.P., Martin, L.T., Vardavas, R., … Schell, T.L. (2014). Mental health stigma in the military.
- Dingfelder, S.F. (2009). The military’s war on stigma. Monitor on Psychology, 40(6).
- Psychological Health Center of Excellence. (2019). Reducing military mental health stigma to improve treatment engagement: Guidance for clinicians.
- State of New Jersey Governor’s Council on Mental Health Stigma. (2008). Military and veterans affairs.
- Military Suicide Research Consortium. It’s okay to change: Mental health stigma, mental health care and suicide prevention among military personnel and veterans.
- U.S. Department of Veterans Affairs. (2019). PTSD and substance abuse in veterans.
- U.S. Department of Veterans Affairs. (2020). Co-occurring conditions.
- U.S. Department of Veterans Affairs. (2020). Make the connection.
- Psychological Health Center of Excellence. Real warriors.