Mental health stigma and military spouses: : the influence of marital conflict and career consequences on help-seeking encouragement
Approximately one-third of Iraq and Afghanistan veterans develop mental health problems, yet only 35-40% of those with mental disorders are seeking mental healthcare (Hoge, et al., 2004; Vogt, 2011). Military spouses may be an important resource for facilitating treatment seeking (Warner, et al., 2008), especially if service member mental health issues are impacting the marriage. Military spouses might be hesitant to encourage service member help-seeking, however, due to perceived threat of adverse military career consequences. For this study, 62 military wives completed an online survey. As part of the survey, participants were randomly assigned to one of four vignettes containing a description of a hypothetical military husband with mental health symptoms. Each vignette presented different combinations of marital conflict (high versus low) and service member concerns about adverse career consequences (high versus low). Wives rated on a five-point scale how likely they were to encourage the hypothetical military husband to seek help. It was hypothesized that spouses would be more willing to encourage help-seeking when concerns about adverse military career consequences were low and marital distress was high. No main effects or interaction effect were found for marriage and career. Perceived stigma about seeking mental health treatment in the military, psychological identification as a military spouse, and experience and familiarity with military mental healthcare policies failed to moderate the relationship between marital conflict, career concerns, and encouragement of help-seeking. Correlational analyses revealed that (1) greater experience with military mental healthcare (first- or secondhand), and (2) greater perceptions of stigma regarding seeking mental healthcare in the military each were associated with decreased perceptions of military supportiveness of mental healthcare. Therefore, although the experimental manipulation in this study did not lead to differences in military spouses' encouragement of a hypothetical military service member to seek mental health services, other findings based on participants' actual experiences suggest that experiences with military mental healthcare may generate or reinforce negative perceptions of military mental healthcare. Altering actual experiences with military mental healthcare, in addition to perceptions of stigma, may be a useful area of intervention for military service members and spouses.