U.S. soldier at a prayer service while on duty in Iraq

blog

July 3, 2012

Stigma Reduction Programs Could Help Those with PTSD, but the Evidence Is Weak

Photo by Spc. Roland Hale/U.S. Army

by Carrie M. Farmer

Post-traumatic stress disorder has been called one of the signature injuries from the wars in Iraq and Afghanistan. It affects around 20 percent of combat veterans and can be crippling for servicemembers, devastating to their families, and costly for society.

A recent RAND study estimated that the two-year cost to society related to the treatment and lost productivity of returning servicemembers with PTSD and depression is $6 billion.

While there are effective treatments for PTSD, military personnel face unique barriers to seeking mental health treatment, including worries about how seeking treatment will affect their military career, concerns about losing security clearance, and the stigma of appearing "weak" to fellow servicemembers.

The Department of Defense has recognized these barriers and has developed and implemented more than 100 programs designed to reduce the stigma of seeking help for mental health problems. The programs are varied in their approach. Some instruct servicemembers in the recognition of early warning signs of mental health problems. Some are targeted to unit leaders, providing training on combat and operational stress, help-seeking resources, and stigma reduction. Other programs, such as the Real Warriors Campaign, take advantage of media and new technology to encourage help-seeking among servicemembers.

While the development of such programs is a step in the right direction, few of them use an evidence-based approach, and even fewer have been evaluated. RAND has begun assessing these programs to understand how well they are working and to provide feedback on how they can be improved. A study of the Real Warriors Campaign found that while the program has several strengths, it may not be effectively reaching its target audience. RAND is in the process of developing a toolkit to support further program evaluation.

Determining which approaches are most effective at reducing stigma and increasing help-seeking is crucial to ensuring that resources are utilized in the most efficient and effective manner. The existence of ineffective programs may result in servicemembers not seeking or receiving the care they need. RAND research will continue to assist the Department of Defense in its efforts to avoid these adverse outcomes.