Help a Buddy Take a Knee: Creating Persuasive Messages for Military Service Members to Encourage Others to Seek Mental Health Help

Abstract

Helping service members returning from the wars in Iraq and Afghanistan who need mental health help is an important problem for the United States military. Tanielian and Jaycox (2008) estimated that approximately 14%, or 300,000, of the service members returning from the wars have posttraumatic stress disorder (PTSD), yet just over half of those needing psychological help seek it despite the availability of effective treatments. This article reports the focus group responses of military personnel about message factors associated with persuading individuals to encourage others to seek mental health help. The results have theoretical and practical implications for future message design for promoting increased usage of mental health services among members of this population. Responses are presented in terms of the communication variables of source, message, channel, and receiver factors.

ACKNOWLEDGMENTS

The authors thank the individuals at the research office at the Army post where the focus groups were conducted for their assistance facilitating this research and the participants for sharing their valuable time and insights.

Notes

¹The military has made policy changes to address barriers people may perceive to seeking help. In 2008, to reduce the trend of military members avoiding diagnosis and treatment for PTSD, Secretary of Defense Robert Gates lifted the policy requiring personnel to report mental health treatment over the past 7 years on a security clearance form. This was intended to remove barriers for service members seeking help (Associated Press, 2008).

²COSRs are defined as “the broad group of physical, mental, and emotional signs that result from Combat and Operational Stress exposure. COSR is considered a subclinical diagnosis with a high recovery rate if provided appropriate attention and time” (U.S. Army Medical Department Army Behavioral Health, n.d.).

³The U.S. Army Medical Department Army Behavioral Health (n.d.) notes, “COSR is recognizable immediately or shortly after exposure to traumatic events and captures any recognizable reaction resulting from exposure to that event or series of events. PTSD has specific chronological requirements and symptom markers that must be satisfied in order to diagnose. PTSD is only diagnosable by a trained and credentialed healthcare provider,” and “Military personnel and providers must focus their efforts on the management of COSR and mitigating factors to control COSR in an effort to shape the long term reaction of their organization and individual Soldiers.”

⁴“Encouragement” is used rather than “referral” because within the military “referral” connotes being officially required to seek professional help rather than choosing to seek help; rather, the goal here is to encourage service members to seek help under their own volition.

⁵Majors are officers. Approximately 16% of the Army members are officers while the remaining are enlisted. About 3% of officers are at the rank of major, with approximately 94% under the rank of major, including all officer ranks below major and enlisted ranks (statistics from Department of Defense, 2010). Majors in the Army have typically led groups called “companies” of up to 190 people while at the rank prior to being promoted to major (Army, n.d.-a), and a major “Serves as primary Staff Officer for brigade and task force command regarding personnel, logistical and operational missions” (Army, n.d.b), with a brigade containing approximately 3,000 to 5,000 individuals, commanded by a colonel, two ranks above major (Army, n.d.-b).

⁶Percent agreement is listed in Table 1 next to the frequency for each variable. After establishing reliability, the coders independently coded all turns of talk from all three focus groups and resolved any disagreements through discussion.