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军队中精神健康帮助的提供者和非提供者来源以及耻辱感、消极态度和护理组织障碍的影响

Provider and Nonprovider Sources of Mental Health Help in the Military and the Effects of Stigma, Negative Attitudes, and Organizational Barriers to Care.

作者信息

Kim Paul Y, Toblin Robin L, Riviere Lyndon A, Kok Brian C, Grossman Sasha H, Wilk Joshua E

机构信息

Except for Dr. Toblin, the authors are with the Military Psychiatry Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland (e-mail:

出版信息

Psychiatr Serv. 2016 Feb;67(2):221-6. doi: 10.1176/appi.ps.201400519. Epub 2015 Oct 1.


DOI:10.1176/appi.ps.201400519
PMID:26423099
Abstract

OBJECTIVE: This study examined sources of help (providers or nonproviders) used by soldiers for mental health problems. Differences in perceived barriers to care by type of help used were also assessed. METHODS: Active-duty soldiers from four brigade combat teams (N=3,380) were surveyed in 2008-2009. Items assessed posttraumatic stress disorder; depression; anxiety; help needed because of a stress, emotional, alcohol, or family problem; stigma; negative attitudes toward care; and organizational barriers. Participants reported receipt of help in the past three months from providers (mental health or medical professionals or an Army resource hotline) or nonproviders (fellow soldier, medic, chaplain, or chain of command). RESULTS: Nearly a third (31%) were identified as being in need of mental health care. Of those, 5% reported using nonprovider help exclusively, 14% used provider help exclusively, and 7% used both types. Stigma was rated significantly lower as a barrier among those who used help exclusively from providers than among those who did not use help from any source; however, no significant differences in stigma scores were found between those who used help from nonproviders and those who did not use help from any source. Soldiers who used help from nonproviders were more likely than those who used help from providers to perceive organizational barriers. CONCLUSIONS: Results show that soldiers may view nonproviders as alternative sources of mental health help, suggesting that the Army should ensure that such resources are adequately trained and integrated into the mental health community so that soldiers can receive the help they need.

摘要

目的:本研究调查了士兵在出现心理健康问题时所使用的帮助来源(提供者或非提供者)。同时还评估了因所使用的帮助类型不同而在感知到的护理障碍方面存在的差异。 方法:2008 - 2009年对来自四个旅战斗队的现役士兵(N = 3380)进行了调查。调查项目包括创伤后应激障碍、抑郁、焦虑、因压力、情绪、酒精或家庭问题而需要的帮助、耻辱感、对护理的负面态度以及组织障碍。参与者报告了在过去三个月中从提供者(心理健康或医疗专业人员或陆军资源热线)或非提供者(战友、军医、牧师或指挥链)那里获得帮助的情况。 结果:近三分之一(31%)的人被确定需要心理健康护理。其中,5%报告仅使用非提供者的帮助,14%仅使用提供者的帮助,7%同时使用两种类型的帮助。与未从任何来源获得帮助的人相比,仅从提供者那里获得帮助的人将耻辱感视为障碍的程度明显更低;然而,在从非提供者那里获得帮助的人和未从任何来源获得帮助的人之间,耻辱感得分没有显著差异。与从提供者那里获得帮助的士兵相比,从非提供者那里获得帮助的士兵更有可能感知到组织障碍。 结论:结果表明,士兵可能将非提供者视为心理健康帮助的替代来源,这表明陆军应确保此类资源得到充分培训并融入心理健康体系,以便士兵能够获得他们所需的帮助。

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