Longitudinal determinants of mental health treatment-seeking by US soldiers.

BACKGROUND Studies with members of the armed forces have found a gap between reports of mental health symptoms and treatment-seeking. AIMS To assess the impact of attitudes on treatment-seeking behaviours in soldiers returning from a combat deployment. METHOD A sample of 529 US soldiers were surveyed 4 months (time 1) and 12 months (time 2) post-deployment. Mental health symptoms and treatment-seeking attitudes were assessed at time 1; reported mental healthcare visits were assessed at time 2. RESULTS Factor analysis of the total time 1 sample revealed four attitude factors: professional concerns, practical barriers, preference for self-management and positive attitudes about treatment. For the subset of 160 soldiers reporting a mental health problem at time 1, and controlling for mental health symptom severity, self-management inversely predicted treatment-seeking; positive attitudes were positively related. CONCLUSIONS Results demonstrate the importance of broadening the conceptualisation of barriers and facilitators of mental healthcare beyond stigma. Techniques and delivery models emphasising self-care may help increase soldiers' interest in using mental health services.