Exploring Gender and Symptom Differences in Perceived Barriers to Mental Health Care among Actively Serving Military Personnel

Abstract

Despite efforts over past years to reduce barriers to seeking military mental health care and supports, there are still service members who do not access care due to perceived barriers. This study aimed to increase understanding of the different types of barriers across groups defined by gender and mental health symptomatology. Multivariable logistic regressions examined perceived unmet needs and barriers to care in a representative sample of actively serving Canadian Armed Forces (CAF) members who completed the Health and Lifestyle Information Survey (HLIS) 2013/2014. The most commonly reported barriers were attitudinal barriers reflecting stigma and negative attitudes toward treatment. Results indicated that women were more likely to report accessibility barriers (e.g., scheduling, childcare issues) than men. Differences were also observed across members suffering from different mental health symptoms. For example, members who reported post-traumatic stress disorder (PTSD) symptoms were less likely to report attitudinal barriers compared to members without probable PTSD. Additionally, education and base size were associated with perceived barriers. These results suggest that tailored policies and strategies may help to increase access and mitigate barriers to mental health care based on gender and the type of mental health issue experienced by military personnel.

Keywords:

• Gender differences
• mental health disorders
• mental health therapy
• military
• alcoholism

Acknowledgments

The authors would like to acknowledge the contributions of Dr. François Thériault and Barbara Strauss from the Canadian Forces Health Services Group, to the overall design, data collection, and data cleaning of the 2013/14 Health and Lifestyle Information Survey, which was used in the current study analyses. The authors would also like to thank all Canadian Armed Forces members who completed the survey.

Declaration of interest statement

This work was funded by the Government of Canada. The authors have no conflicts of interest to disclose.

Notes

1 Although the HLIS includes a survey question on respondent sex (male, female), as opposed to gender identity, the focus of the current paper is on the lived experiences (i.e., perceived barriers to mental health care) of participants, rather than biological differences. Thus, the use of the term “gender” is appropriate in this paper (Clayton & Tannenbaum, 2016; Unger, 1979), despite the limitations of the measure used.

2 Attitudinal barriers were referred to as acceptability barriers by Nelson and Park (2006), but the current study instead refers to attitudinal barriers to enhance clarity and to be consistent with other literature on barriers to care.