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Barriers to Mental Health Care Use for Military Personnel
Barriers to Mental Health Care, or lack of serivce use, refers to the practical, social, and economic causes that prevent military personnel from seeking mental health care. The military population experiences a unique set of stressors that contribute to the formation of psychological disorders. Post-traumatic stress disorder, commonly referred to as PTSD, has a high incidence within this population. Many studies have attributed the trend of Post-Traumatic Stress Disorder in the target population to stressors related to deployment, active duty, lengthy tours, and violence. The underuse of mental health services among active duty military personnel is a growing knowledge front within the field.

Screening for Psychological Disorders in the Military
As a response to the significant loss of resources in pensions and training for soldiers after World War I, efforts were made to screen men prior to enlistment and those already within the forces. The evolution of screening changed with the advancement of wars in America. Initially, psychological testing was based primarily on the Stanford-Binet Intelligence Scales, which was not the most effective method of testing at the tiime. It gave more indication as to what population would do well on the aptitude tests required for enrollment, not necessarily who was pre-disposed to psychological issues. This initial form of psychological testing contained many gaps in knowledge because it failed to follow-up with those rejected from the military. Also, there is no record of those who were deemed “fit” after the initial testing to measure the percentage of soldiers who developed a psychological issue during combat. The limitations of this early stage of psychological testing are substantial. This paper-and pencil method was not generalized for the target for population because there was no consideration of those who were not literate at the time of enrollment. Testing did not progress with the coming of World War II, although it was widely acknowledged that a change in testing had to be made as to not repeat the huge losses places on the military after World War I. Many issues prevented effective psychological testing during World War II. Namely the tool designed by the Information and Education Division and Army Service Forces, Neuropsychiatric Screening Adjunct or NSA, could not be implemented during the rush of providing men for the war. Also, they were not enough psychologists to carry out these measures as well as doing so objectively. The methods used during this time were not carried out to produce generalization. With the pressure to deploy soldiers, the emphasis placed on measured testing was lacking.

Post Traumatic Stress Disorder
Main Page:Post-traumatic stress disorder

Posttraumatic stress disorder is an anxiety disorder that may develop after a person is exposed to one or more traumatic events, such as sexual assault, serious injury, or the threat of death. The diagnosis may be given when a group of symptoms such as disturbing recurring flashbacks, avoidance or numbing of memories of the event, and hyperarousal (high levels of anxiety) continue for more than a month after the traumatic event.

Although PTSD-like symptoms have also been recognized in combat veterans of many military conflicts since, the modern understanding of PTSD dates from the 1970s, largely as a result of the problems that were still being experienced by US military veterans of the war in Vietnam.

Previous diagnoses now considered historical equivalents of PTSD include railway spine, stress syndrome, nostalgia, soldier's heart, shell shock, battle fatigue, combat stress reaction, or traumatic war neurosis.

Percentage of Military Personnel Lacking Mental Health Care
The difference between active-duty personnel who have been diagnosed with a mental disorder and the sector that actually receive treatment is staggering, with less than half of the target population receiving care.

Mental Health Beliefs as a Barrier
Many studies have centered on the beliefs on mental illness that may contribute to the lack of service use by military personnel. Service members, (see Military personnel) often hold beliefs about mental illness that prevent them from seeking treatment. For example, service members report feeling that mental health problems are not serious or that they should be able to handle them on their own. Such beliefs may be more prevalent in military settings, where soldiers are expected to “tough out” difficult emotions. These studies show that the attitude ingrained in service members while in combat exists and effects the amount of treatment an individual will seek. Negative beliefs about mental health care have been associated with decreased likelihood of seeking counseling and medication. Limitations exist on the studies on this subject. Limitations include a lack of attention to the connection between mental health beliefs and service use, and a limited focus on personal beliefs about mental illness and mental health treatment. It has been demonstrated that although military personnel are exposed to extreme triggers and are expected to need therapy, many do not utilize mental health services. The results of this study indicate that more research needs to be dedicated to the relationship between mental illness stigma and the manner in which people make decisions about their care.

Practial Barriers
Certain parts of the military population use practical barriers as a reason for not seeking mental health treatment. Practical barriers such issues as not having reliable transportation to get to treatment, lack of time to get to treatment – namely because of employment – and not having financial resources to pay for treatment. Practical barriers are not felt among most of this population because many may not view themselves as having a problem. Those who have the ability to work and re-join society may deem their psychological issues as not important.

Stigmatization
Stigma, (see Social stigmais defined as a mark of disgrace or infamy on ones’ reputation. It has been found that 61% of soldiers agreed with the statement that admitting a psychological problem would harm their career (compared to 43% for admitting a medical problem) and 45% believed that admitting a psychological problem would cause their co-workers to have less confidence in them (compared to 22% for a medical problem. These concerns are likely to be elevated in the military environment due to the fact that commanding officers have access to service members’ mental health records and service members who are seen as “unfit” for service can be discharged or removed from duty. When faced with the threat of dismissal, many soldiers will internalize their issues instead of risk job insecurity.