Evaluation of An Intervention Targeting Stigma & Enhancing Military Leaders' Ability to Encourage Soldiers to Seek PTSD Treatment

Purpose: Stigma about mental illness is pervasive and particularly problematic among military personnel who are at significant risk for developing a psychiatric disorder. Military culture mandates soldiers to be physically strong and mentally tough, making the risk of stigma considerable in any situation where weakness can be perceived.  The need for intervention strategies aimed at reducing stigma is widely recognized, yet few specific interventions have been explored. Research has found that positive leadership can reduce perception of stigma and barriers to care. If an intervention can decrease stigma about PTSD and seeking treatment for PTSD at a leadership level, those serving under the leader are more likely to feel that seeking care is not stigmatized.   Research has shown that non-commissioned officers (NCOs) have higher levels of perceived stigma and practical barriers than officers.   

Methods: The current study targeted NCOs in order to engage their leadership abilities to identify and talk to their soldiers about PTSD.  The study examined the changes in attitudes and knowledge about PTSD and behaviors regarding PTSD treatment-seeking after attending a one-hour briefing intervention.  30 NCOs from a company were selected to attend the briefing intervention with their company.  A total of 172 NCOs attended and completed assessments pre-briefing and post-briefing.  Measures included the Perceived Barriers to Seeking Mental Health Services Scale (Britt, 2000) in addition to other items developed to assess knowledge about PTSD and treatment-seeking behaviors.   

Results: Paired Samples t-tests were conducted to compare changes from pre to post.  Knowledge about PTSD increased significantly from pre to post intervention, t(171) = 10.27, p < .0001, d = .78 in addition to knowledge about local PTSD treatment options , t(168) = 11.43, p < .0001, d = .88.  After the intervention, participants were significantly more likely to talk to their soldiers about PTSD symptoms, t(169) = 5.65, p < .0001, d = .43, and treatment for PTSD, t(169) = 4.15, p < .0001, d = .32.   Attitudes about PTSD and PTSD treatments changed significantly as a result of the intervention.  Most notably, participants were significantly less concerned about being treated differently by their leadership for engaging in PTSD treatment, t(171)= -2.01, p= .046.  Participants were significantly more confident in treatment being successful, t(168)=  -4.73, p< .0001; and believed they had significantly more influence on other soldiers decision to seek treatment, t(168)= 2.64, p = .009. 

Implications: Results support a group-based briefing intervention to increase knowledge about PTSD and PTSD treatments, to improve attitudes related to stigma, and to elicit behavior change with regards to intervention with fellow soldiers and treatment seeking.  Reducing stigma can potentially circumvent the unnecessary suffering and dysfunction in the service member’s personal and professional life and enhance the overall mission effectiveness of the Army.