The influence of military cultural values consisting of unit cohesion (or the subordination of individual needs over the needs of the collective) the devotion to duty and to the mission, stoicism (emotional restraint) and the importance of adhering to the chain of command become guiding belief systems for military personnel. In fact, military culture has been recognized as a distinct sub-culture of American civilian society. Thus, in order to effectively reach veterans, practitioners need to explore the culturally based constructs of the warrior mentality or worldview. Mental health workers need to consider how military cultural values held by veterans interact with perceptions of trauma and affect their help seeking behaviors in general. Data shows that service personnel tend to under-report their mental health symptoms; are reluctant to seek out mental health services and if they do engage in treatment; they prematurely drop out of services. The reasons for this are complex, from the stigma associated with mental health issues, to the potential for negative work-related repercussions especially for the active duty service personnel (i.e., loss of promotion, medical discharge, or losing security clearance).
However, the authors believe that the reluctance for seeking services has more to do with the veteran’s worldview, than with the other reasons noted. Even though the U.S. military is making a concerted effort to de-stigmatize mental health and is attempting to ensure confidentiality and minimize negative career consequences, the reluctance continues to affect early intervention. The phenomenon described here with regards to treatment participation and compliance parallels the findings from the literature on cultural diversity and seeking therapy. It has been well established, that when working with culturally diverse clients, more than half do not return to therapy for a second session (Sue & Sue, 1999).
The authors have borrowed from Brown and Landum-Brown’s (1995) worldview dimensions to help us understand how worldviews and values (as adapted to military culture and “warrior ethos”) can impact a veteran’s attitude about seeking mental health services. Practical examples will be provided of how this model can be applied to combat veterans as a method of understanding their help seeking behaviors in order to more promote wellness in the veteran client population.
|Keywords:||Combat-veteran Help-seeking Attitudes, Influence of Military Culture on Mental Health Services|
Clinical Assistant Professor, School of Social Work, University of Southern California, Los Angeles, California, USA
Clinical Associate Professor, School of Social Work, University of Southern California, Los Angeles, California, USA
MSW Candidate 2013, School of Social Work, University of Southern California, Los Angeles, California, USA