Pfeiffer Paul N, Blow Adrian J, Miller Erin, Forman Jane, Dalack Gregory W, Valenstein Marcia
Department of Veterans Affairs, Health Services Research and Development Center for Clinical Management Research, 2800 Plymouth Road, Building 14, Ann Arbor, MI 48109, USA.
Mil Med. 2012 Dec;177(12):1471-6. doi: 10.7205/milmed-d-12-00115.
National Guard soldiers experience high levels of mental health symptoms following deployment to Iraq and Afghanistan, yet many do not seek treatment. We interviewed 30 National Guard soldiers with prior deployments to Iraq or Afghanistan to assess mental health treatment barriers and the role of peers in treatment engagement. Interview transcripts were analyzed by a multidisciplinary research team using techniques drawn from grounded theory. The following themes were identified: (1) personal acceptance of having a mental health problem rather than treatment access is the major barrier to treatment entry; (2) tightly connected, supportive peer networks can decrease stigma related to mental health problems and encourage treatment; however, soldiers in impoverished or conflicted peer networks are less likely to receive these benefits; and (3) soldiers are generally positive about the idea of peer-based programs to improve treatment engagement, although they note the importance of leadership support, peer assignment, and unit specialty in implementing these programs. We conclude that some, but not all, naturally occurring peer networks serve to overcome stigma and encourage mental health treatment seeking by soldiers. Formal peer-based programs may assist soldiers not sufficiently benefitting from natural peer networks, although there are barriers to implementation.
国民警卫队士兵在被部署到伊拉克和阿富汗后出现了高水平的心理健康症状，但许多人并未寻求治疗。我们采访了30名曾被部署到伊拉克或阿富汗的国民警卫队士兵，以评估心理健康治疗的障碍以及同伴在参与治疗中的作用。一个多学科研究团队运用扎根理论的技术对访谈记录进行了分析。确定了以下主题：（1）个人对存在心理健康问题的接受程度而非获得治疗的机会是接受治疗的主要障碍；（2）紧密相连、相互支持的同伴网络可以减少与心理健康问题相关的污名化并鼓励治疗；然而，处于贫困或冲突同伴网络中的士兵获得这些益处的可能性较小；（3）士兵们总体上对基于同伴的项目以改善治疗参与度的想法持积极态度，尽管他们指出了领导支持、同伴分配和单位专业在实施这些项目中的重要性。我们得出结论，一些但并非所有自然形成的同伴网络有助于克服污名化并鼓励士兵寻求心理健康治疗。基于同伴的正式项目可能会帮助那些未从自然同伴网络中充分受益的士兵，尽管实施存在障碍。
