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Health Services Research & Development

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2009 HSR&D National Meeting Abstract

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National Meeting 2009

3018 — Similarities in Perceived Stigma Related to Seeking Mental Health Treatment and Reporting Rape in the Military

Cretzmeyer MT ( Iowa City VAMC COE), Mengeling MA (Iowa City VAMC COE and University of Iowa), Booth B ( LR REAP and University of Arkansas for Medical Sciences ), Torner JC (Iowa City VAMC and Carver College of Medicine, University of Iowa Hospitals and Clinics), Reisinger HS ( Iowa City VAMC COE), Silander AB ( Iowa City VAMC COE), Franciscus C ( Iowa City VAMC COE), Sadler AG ( Iowa City VAMC COE)

Objectives:
Stigma related to seeking mental health treatment in the military has recently been cited in military reports as a serious health risk for servicemembers. This study used qualitative methods to explore how perceptions of stigma related to rape/sexual harassment reporting parallel perceptions of the stigma surrounding seeking mental health care in the military. These dual perceptions exacerbate health risks for servicewomen.

Methods:
Eight focus groups were held with groups of OEF/OIF era Reserve/National Guard servicewomen in four Midwestern states (N = 39). Groups were stratified by Officer/Enlisted personnel and deployment status. A portion of attendees were VA users. The research team developed a coding dictionary of relevant themes. Transcripts were independently coded by two researchers and entered into NVivo 8.0 for data management and analysis. Agreement between the coders was 80% or better for the majority of themes/codes.

Results:
Both Officers and Enlisted women identified numerous perceptions of negative consequences related to both rape and harassment reporting, and seeking mental healthcare while in the military. Analyses demonstrated robust similarities between perceptions surrounding both issues. These similarities identify reasons for servicewomen’s reluctance to address these problems in the available venues. Fear of negative career consequences (such as impact on security clearance), as well as censure by peers (“all that’s going to happen is that I’m going to be isolated from the group”) and lack of confidentiality (“it always gets back to you”) were common themes in the focus group discussions. The stigma associated with addressing both issues created barriers to needed support.

Implications:
Both rape/sexual harassment reporting and the need for mental healthcare are perceived as detrimental for advancement in military careers. The reluctance to address both issues creates an unhealthy environment for servicewomen and ultimately contributes to future mental and physical health problems for this growing veteran population.

Impacts:
Identification of barriers to receiving needed care can inform policy and the provision of VA health care services, as well as guide DVA outreach to servicewomen who would benefit from these services.


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