Porcari Carole, Koch Ellen I, Rauch Sheila A M, Hoodin Flora, Ellison Grant, McSweeney Lauren
Psychology Department, Eastern Michigan University, 341 Science Complex, Ypsilanti, MI 48197.
VA Ann Arbor Healthcare System, 2215 Fuller Road (116c), Ann Arbor, MI 48105.
Mil Med. 2017 May;182(5):e1640-e1647. doi: 10.7205/MILMED-D-16-00105.
Despite significant numbers of Afghanistan and Iraqi veterans and service members who report symptoms of posttraumatic stress disorder, depression, anxiety, and substance abuse, the majority do not seek help for these problems. A better understanding of the help-seeking process might aid providers and administrators in outreach and provision of services for those who need them. Past research has shown several variables that influence an individual's help-seeking behavior: demographic variables, the nature and severity of a mental health problem, and psychological variables. The three goals of the study were to determine which variables predicted help-seeking intentions from various sources for a psychological problem, identify barriers to help seeking, and identify sources of help sought in the past year.
All Operation Enduring Freedom and Operation Iraqi Freedom veterans and service members registered with a Midwestern VA Healthcare System between 2001 and 2007 received a letter requesting participation in an Internet-based survey. Participants completed nine questionnaires regarding their current physical and psychological health, social support, self-efficacy, public and self-stigma, and barriers to seeking help for a psychological problem. In addition, patterns of help seeking from informal (i.e., partner/spouse, family, friends) and formal (i.e., physician, psychiatrist, or psychologist, either from Veterans Affairs [VA] or the private sector) sources of help were examined.
Results from the linear regression model including all formal and informal sources of help indicated a significant model fit with attitudes toward psychotherapy, social support, and current mental health status as significant coefficients. Of note, attitudes toward psychotherapy were a significant coefficient in all help-seeking models; stigma was a significant coefficient with formal and VA sources, and social support was found to be a significant predictor with informal sources. Documentation of a mental health problem on one's record was found to be a significant barrier to help seeking and participants indicated they would most likely seek help in the next year from their partner/spouse, family, or friends versus formal VA or non-VA sources.
This is one of the first studies to examine attitudes toward psychotherapy as contributing to help-seeking intentions of veterans and service members and results provide strong support for inclusion of this variable in future studies in addition to social support and stigma. Limitations of the study are discussed as well as suggestions for future research. It is our hope that findings from this study may inform administrators and providers regarding assessment, outreach, and program development for our country's veterans and service members.
尽管有大量阿富汗和伊拉克战争退伍军人及现役军人报告有创伤后应激障碍、抑郁、焦虑和药物滥用症状，但大多数人并未就这些问题寻求帮助。更好地理解求助过程可能有助于医疗服务提供者和管理人员开展外展工作，并为有需要的人提供服务。过去的研究表明，有几个变量会影响个人的求助行为：人口统计学变量、心理健康问题的性质和严重程度以及心理变量。该研究的三个目标是确定哪些变量能预测针对心理问题从各种渠道寻求帮助的意图，找出求助的障碍，并确定过去一年中寻求帮助的渠道。
所有在2001年至2007年期间在中西部退伍军人事务部医疗保健系统登记的持久自由行动和伊拉克自由行动退伍军人及现役军人都收到了一封邀请他们参与基于互联网的调查的信件。参与者完成了九份问卷，内容涉及他们当前的身心健康、社会支持、自我效能感、公众和自我污名感以及寻求心理问题帮助的障碍。此外，还研究了从非正式（即伴侣/配偶、家人、朋友）和正式（即退伍军人事务部[VA]或私营部门的医生、精神科医生或心理学家）帮助渠道寻求帮助的模式。
包含所有正式和非正式帮助渠道的线性回归模型结果表明，该模型与对心理治疗的态度、社会支持和当前心理健康状况显著拟合，这些是显著系数。值得注意的是，对心理治疗的态度在所有求助模型中都是显著系数；污名感在正式和退伍军人事务部渠道中是显著系数，社会支持在非正式渠道中是显著预测因素。在个人记录中有心理健康问题的记录被发现是求助的一个重大障碍，参与者表示他们明年最有可能从伴侣/配偶、家人或朋友那里寻求帮助，而不是从正式的退伍军人事务部或非退伍军人事务部渠道寻求帮助。
这是首批研究对心理治疗的态度如何影响退伍军人及现役军人求助意图的研究之一，研究结果为在未来研究中除了纳入社会支持和污名感之外，还纳入这一变量提供了有力支持。讨论了该研究的局限性以及对未来研究的建议。我们希望这项研究的结果能为管理人员和医疗服务提供者在评估、外展和为我国退伍军人及现役军人制定项目方面提供参考。
