Academic Centre for Defence Mental Health, King's College London, UK.
BMC Public Health. 2012 Sep 17;12:797. doi: 10.1186/1471-2458-12-797.
There is no doubt that the perceived stigma of having a mental disorder acts as a barrier to help seeking. It is possible that personnel may be reluctant to admit to symptoms suggestive of poor mental health when such data can be linked to them, even if their personal details are only used to help them access further care. This may be particularly relevant because individuals who have a mental health problem are more likely to experience barriers to care and hold stigmatizing beliefs. If that is the case, then mental health screening programmers may not be effective in detecting those most in need of care. We aimed to compare mental health symptom reporting when using an anonymous versus identifiable questionnaire among UK military personnel on deployment in Iraq.
Survey among UK military personnel using two questionnaires, one was anonymous (n = 315) and one collected contact details (i.e. identifiable, n = 296). Distribution was by alternate allocation. Data were collected in Iraq during January-February 2009.
No significant difference in the reporting of symptoms of common mental disorders was found (18.1% of identifiable vs. 22.9% of anonymous participants). UK military personnel were more likely to report sub-threshold and probable PTSD when completing questionnaires anonymously (sub-threshold PTSD: 2.4% of identifiable vs. 5.8% of anonymous participants; probable PTSD: 1.7% of identifiable vs. 4.8% of anonymous participants). Of the 11 barriers to care and perceived social stigma statements considered, those completing the anonymous questionnaire compared to those completing the identifiable questionnaire were more likely to endorse three statements: "leaders discourage the use of mental health services" (9.3% vs. 4.6%), "it would be too embarrassing" (41.6% vs. 32.5%) and "I would be seen as weak" (46.6% vs. 34.2%).
We found a significant effect on the reporting of sub-threshold and probable PTSD and certain stigmatizing beliefs (but not common mental disorders) when using an anonymous compared to identifiable questionnaire, with the anonymous questionnaire resulting in a higher prevalence of PTSD and increased reporting of three stigmatizing beliefs. This has implications for the conduct of mental health screening and research in the US and UK military.
毫无疑问，人们对患有精神障碍的看法是寻求帮助的障碍。即使这些数据与他们有关，人员可能也不愿意承认暗示心理健康状况不佳的症状，即使他们的个人详细信息仅用于帮助他们获得进一步的护理。这可能尤其重要，因为有精神健康问题的人更有可能遇到护理障碍并持有污名化的信念。如果是这样，那么心理健康筛查计划可能无法有效地发现最需要护理的人。我们旨在比较在伊拉克部署的英国军人使用匿名和可识别问卷报告心理健康症状的情况。
对英国军人进行调查，使用两种问卷，一种是匿名问卷（n=315），另一种收集联系方式（即可识别问卷，n=296）。分配方式为交替分配。数据于 2009 年 1 月至 2 月在伊拉克收集。
在报告常见精神障碍症状方面，没有发现可识别和匿名参与者之间存在显著差异（可识别参与者中有 18.1%，匿名参与者中有 22.9%）。当匿名填写问卷时，英国军人更有可能报告阈下和可能的 PTSD（阈下 PTSD：可识别参与者中的 2.4%，匿名参与者中的 5.8%；可能的 PTSD：可识别参与者中的 1.7%，匿名参与者中的 4.8%）。在考虑的 11 个护理障碍和感知社会耻辱感陈述中，与填写可识别问卷的参与者相比，填写匿名问卷的参与者更有可能认可以下三个陈述：“领导不鼓励使用心理健康服务”（9.3%对 4.6%），“太尴尬了”（41.6%对 32.5%）和“我会被视为软弱”（46.6%对 34.2%）。
我们发现，与可识别问卷相比，使用匿名问卷会对报告阈下和可能的 PTSD 以及某些污名化信念（但不是常见精神障碍）产生显著影响，匿名问卷导致 PTSD 的患病率更高，并且增加了对三个污名化信念的报告。这对美国和英国军队进行心理健康筛查和研究具有影响。
