Priyamvada Mohta
43% of the American war veterans who served in the Iraq or Afghanistan wars have been diagnosed with at least one mental disorder (True et al., 2014). Studies have shown that the prevalence estimates of post-traumatic stress disorder diagnoses in these veterans ranges between 13.5% to 30% (Reisman, 2016). Yet less than 50% of the veterans requiring treatment for conditions like post-traumatic stress disorder receive mental healthcare and less than one third of these veterans receive evidence-based care (Reisman, 2016). It is evident that a stark disparity exists between those veterans requiring mental healthcare and those receiving appropriate care. A variety of factors play a role in creating this treatment gap, including the stigma associated with mental disorders as well as the image associated with military forces.
Military forces inspire an image of power, resolve and courage. It is this idea of unwavering strength that inspires confidence in the masses and instils a sense of security in the citizens of the nation. However, the projection of this image of the military as a whole, onto individual members of military forces leads to the creation and maintenance of a facade of strength and resolve, even in times of personal distress or suffering. In forcing this facade onto soldiers through military cultural norms and training, military organizations compromise the mental well-being of their personnel.
The fundamental way in which the military is organized and functions disregards individual experiences and the vulnerability of human nature. Mental health is undermined by the military culture that promotes traits like ‘Battlemind’ (constant mental toughness and fortitude), self-reliance, stoicism and the prioritization of group needs over individual well-being (True et al., 2014). While these may be necessary survival strategies in conditions of danger or war, these values prevail post-deployment as well, impeding rehabilitation. For instance, the trait of self-reliance, while valuable in dangerous conditions, prevents help-seeking behaviour post-deployment as the requirement of external help is perceived to be a sign of weakness. Additionally, the constant dismissal of personal health as exemplified by the principle of prioritizing the needs of the group over individual well-being, conditions veterans into disregarding their own mental health (True et al., 2014).
Military organizations not only lack in their efforts to ensure successful reintegration of their veterans into society through the unlearning of traits required only in threatening climates, but also actively encourage soldiers to leave mental health services for ‘those who actually need it’ (True et al., 2014). This implies that a hierarchy exists in the experiencing of trauma, pain, and suffering, making some veterans ‘more deserving’ of help than others. Additionally, in situations like these seeking mental healthcare services is perceived to be a sign of weakness which discourages treatment. Thus, militaries undermine individual experiences of trauma. In endorsing techniques of coping, like compartmentalization, which is the complete segregation of the experiences undergone during deployment and post-deployment life, militaries further ignore the pain and trauma of their personnel (True et al., 2014). The internalization of such strategies can prevent catharsis and lead to the repression of trauma which could manifest more severely later. Hence, the disallowing of experience sharing, through the motto of ‘whatever happened over there stays over there ’, prevents healing (True et al., 2014, p. 1447).
Besides the way in which the militaries are organized and active discouragement of treatment seeking, military practices can also create conditions of distress and trauma. For example, the authorized distribution of illegal prescription medications to improve efficiency and to keep soldiers constantly hyper-vigilant and battle-ready in warzones has enormous side-effects on the body, the most debilitating one being addiction. Post-deployment, a lack of access to these medications forces conditions of withdrawal and distress. (True et al., 2014)
Military personnel thus become victims of an exploitative system that utilizes their productivity while disregarding their personal well-being. However, it is important to note that this systemic undermining of trauma by militaries has not developed in isolation. It is fuelled by a society that stigmatizes not only mental disorders but also treatment seeking. This stigma arises in part from the stereotype that those with mental disorders are dangerous and incapable of functioning in personal or work environments. In addition, the perception of having a mental disorder as of being weak or inefficient and incapable, makes veterans fear for their future career prospects and career advancement (True et al., 2014). Seeking healthcare is not a sign of weakness and neither is the presence of disorder due to the traumatic experiences of these veterans.
The facade society imposes on military personnel, combined with the stigma around mental health, often makes veterans feel that the idea of seeking treatment is incompatible with the idea of being a soldier. This could cause cognitive dissonance, for treatment-seeking comes to be at odds with their self-image of belonging in the military. Thus, the way society perceives mental disorders has negative consequences on not only the way individuals approach seeking help but also the way in which the mental healthcare structure is organized in institutions like the military.
A combination of societal perceptions about mental health and military practices create a system which systematically undermines mental health. Individuals are not and cannot be defined by their disorder. The tendency to define people by their mental disorder, leads to the negation of other aspects of their personality. This also leads to discriminatory practices, one of the main caveats to seeking mental healthcare. It is important to challenge and change the misconceptions surrounding mental disorders and treatment-seeking, for they serve to exacerbate the conditions of those already dealing with mental disorders. Just like physical distress and dysfunction does not define a person, neither does mental distress. This awareness is important to change societal perceptions that those with mental disorders and those who seek treatment are weak or incapable. A possible solution to by-pass the stigma around treatment could be the institution of mandatory debriefings with mental health professionals post-deployment. Ultimately, only when there is a large-scale change in attitudes and perceptions towards mental disorder, will institutions like the military be forced to change their practices to create a more supportive and sustainable system for soldiers.
References:
True, G., Rigg, K.K., & Butler, A. (2014). Understanding barriers to mental health care for recent war veterans through Photovoice. Qualitative Health Research, 25(10). 1443-1455. htpps://doi.org/10.1177/1049732314562894
Reisman, M. (2016). PTSD treatment for veterans: What's working, what's new, and what's next. PMC: US National Library of Medicine National Institutes of Health. Retrieved March 6, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5047000/
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