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Study Suggests Negative Mental Health Beliefs are a Significant Barrier to Care for OEF/OIF Veterans with Mental Health Problems

Recent research suggests that many Veterans who might benefit from mental health treatment do not seek care, and accumulating evidence suggests that negative beliefs about mental illness and treatment may serve as barriers to care. However, most studies have been restricted to clinical samples with demonstrated mental health problems, limiting the conclusions that can be drawn about the extent to which these concerns are relevant for the larger Veteran population. The primary aim of this study was to document concerns about stigma and personal beliefs about mental illness and treatment among OEF/OIF Veterans. Investigators also examined how mental health beliefs differ for Veterans with and without mental health problems, and how mental health beliefs are related to the use of mental healthcare among Veterans with probable PTSD, depression, and alcohol abuse. Investigators surveyed a national sample of 640 OEF/OIF Veterans (57% women, 67% Caucasian) from all service branches, who returned from deployment between 2007 and 2009. Participants completed a mailed survey that included measures of mental health symptomatology, mental health beliefs, and use of VA and non-VA mental healthcare.


  • OEF/OIF Veterans endorsed a variety of mental health beliefs that may serve as barriers to care. Concerns about stigma in the workplace were most commonly reported, followed by negative beliefs about treatment-seeking, concerns about stigma from loved ones, and negative beliefs about mental illness.
  • Although more than one-third of the Veterans in the study generally disagreed with survey items reflecting negative beliefs about mental health treatment, 50% of the survey respondents were classified in the "neither agree nor disagree" category, suggesting that they may be neutral or undecided in their beliefs about mental health treatment.
  • Veterans with probable mental health problems were more likely to report negative mental health beliefs than Veterans without mental health problems. Specifically, Veterans with probable diagnoses of depression and PTSD, but not alcohol abuse, were more concerned about stigma from loved ones and in the workplace than Veterans without these conditions.
  • Negative beliefs about treatment-seeking were related to lower likelihood of seeking mental healthcare for Veterans with probable PTSD, depression, and alcohol abuse. Although concern about stigma in the workplace was most commonly reported, it was unrelated to healthcare use.


  • Findings require replication in a longitudinal study.


  • An individual's own mental health beliefs may be a more important barrier to care than concerns about stigma from others, suggesting that interventions targeting Veterans' own beliefs may be more beneficial than those targeting outside sources in efforts to ensure that Veterans receive the care they need.

This study was funded by HSR&D (DHI 06-225). All authors are part of VA's National Center for Post-traumatic Stress Disorder in Boston, MA.

PubMed Logo Vogt D, Fox A, and Di Leone B. Mental Health Beliefs and their Relationship with Treatment Seeking among OEF/OIF Veterans. Journal of Traumatic Stress. June 2014;27(3):307-13.

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