Changes in stigma and barriers to care over time in U.K. Armed Forces deployed to Afghanistan and Iraq between 2008 and 2011

Mil Med. 2013 Aug;178(8):846-53. doi: 10.7205/MILMED-D-13-00079.


Stigmatizing beliefs about seeking help for mental health conditions and perceived barriers to care (BTC) may influence the decision to seek support and treatment in U.K. military personnel. Many coalition partners, including the U.K. Armed Forces (UKAF), have made considerable efforts to reduce stigma/BTC although the impact of these efforts over time has not been assessed. We surveyed a total of 23,101 UKAF personnel who deployed to Afghanistan and Iraq between 2008 and 2011 and examined whether stigma/BTC levels changed during this time. The results suggested that stigma, including the fear of being treated differently by commanders and loss of trust among peers, was greater than perceived BTC. The likelihood of reporting stigma/BTC, although significantly greater during deployment than postdeployment, reduced significantly over the survey period. A similar reduction was less apparent during postdeployment phase. These findings support the notion that UKAF's anti-stigma campaigns may have had some positive effects, particularly among deployed personnel. However, we suggest that stigma still plays a part in inhibiting help-seeking, particularly during deployment when stigma rates are higher, and that a careful balance must be struck between encouraging help-seeking and maintaining the operational effectiveness of deployed personnel.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Afghan Campaign 2001-
  • Female
  • Health Education
  • Humans
  • Iraq War, 2003-2011
  • Male
  • Mental Disorders / psychology*
  • Mental Disorders / therapy*
  • Mental Health Services / statistics & numerical data
  • Middle Aged
  • Military Personnel / psychology*
  • Military Personnel / statistics & numerical data
  • Patient Acceptance of Health Care / psychology*
  • Patient Acceptance of Health Care / statistics & numerical data
  • Program Evaluation
  • Social Stigma*
  • United Kingdom
  • Warfare
  • Young Adult