"Stigma refers to a cluster of negative attitudes and beliefs that inadvertently motivate Soldiers and leaders to fear, reject, avoid, and discriminate against military and civilian personnel with mental illnesses," according to a U.S. Department of Health and Human Services (2003) fact sheet entitled "Discrimination & Stigma." Stigma is still widespread in the Army.
Research about stigma indicates that it manifests itself in many ways and through various constructs. The roots of stigma are anchored in stereotypes--generalizations that are perceived to be accepted by the population at large--such as "Soldiers who seek behavioral health care are weak." A Mental Health Advisory Team report indicates that "among Soldiers who screened positive for depression, anxiety, or PTSD, many reported that their unit leadership might treat them differently, and reported that they would be seen as weak." Such evidence suggests that in spite of education and training, Army personnel continue to sanction the stigma of "help-seeking," which ultimately acts as a barrier for access to preventive and stabilizing care. Imagine the scenario that is written below. Do the problems sound familiar? They should, because they are based on common experiences.
Problems with his marriage relationship were nothing new for Sgt. Allen. He expended considerable energy to contain his relationship struggles so that they would not negatively affect his military mission, duties and job performance. Allen loved his wife in spite of their marital problems and could not imagine his life without her. When his wife finally announced that she wanted to call it quits and requested a divorce, Allen felt ambushed and emotionally unarmed. Contrary to his stoic character, he became preoccupied by and distracted with his confused thoughts and feelings as he confronted his personal crisis. Allen was uncharacteristically late for formation several days in a row, and his work performance noticeably deteriorated.
Allen felt tense, even angry, as he was counseled by his immediate supervisor. When asked why the change in behavior, Allen simply stated that he had family issues that he would get under control. His supervisor suggested that he speak with someone about the matter. This sounded all too familiar to Allen. On numerous occasions, he had counseled his own Soldiers concerning their personal problems, suggesting that they "seek help." As he confronted his current predicament, Allen barely gave any consideration to the advice of his supervisor.
So, why was Sgt. Allen reluctant to seek help? Reluctance to seek help with personal problems is embedded in the values, beliefs and culture of America and its military. Help-seeking can be perceived as a sign of individual weakness in a culture that values physical, mental and moral fortitude. Many Soldiers believe that help-seeking can negatively affect the progression of a military career or future employability if there is documentation of a behavioral health problem, diagnosis and/or treatment. This belief is reinforced when there is any evidence in practice that Soldiers do, in fact, suffer negative consequences when they seek help.
Allen was caught up in a personal and professional dilemma. He often counseled his own Soldiers to seek the help that could possibly alleviate their suffering, while retaining his own prejudices and believing that in truth, stigma still exists. His personal situation placed him in the most uncomfortable circumstance of having to face his true convictions and awareness that overwhelming life events can present to anyone, not just someone else.
To squarely address stereotypes, prejudice and stigma, it is necessary for Army leaders to ensure that Soldiers can freely seek help without jeopardizing their personal integrity, reputations, work status, career goals and opportunities. Leaders must practice fair treatment in the workplace. Leaders must understand that public service announcements and leadership policy statements will not necessarily change a Soldier's internal feelings about seeking help when needed. It requires compassion, understanding and persistent dedication to truly help Soldiers who need supportive counseling or behavioral health care.
Leaders also should be encouraged to address their own problems by seeking help as a demonstration of their commitment to ending the shame and stigma of "help-seeking." Army leaders must share the truth that anyone can be victimized by life events. Leaders should continuously promote awareness that seeking help with a medical or behavioral health problem shows the resilience and maturity of character that contributes to a strong and effective leadership and military force. Then with the evidence of a supportive leadership, Soldiers can learn that seeking help leads to good recovery and positive outcomes for individuals, families and the military force.
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