Air Force Capt. Isaiah Jones (right), 59th Medical Wing licensed clinical social worker, speaks with a patient, Nov. 24, 2020, at the Mental Health Clinic, Wilford Hall Ambulatory Surgical Center, Joint Base San Antonio-Lackland, Texas. Mental health providers guide patients through challenging times, including stress or anxiety due to the pandemic, in person or through telehealth (Photo by: Air Force Airman 1st Class Melody Bordeaux).
"These are all barriers to care," said Marjorie Campbell, a clinical psychologist who leads the Psychological Health Center of Excellence's (PHCoE) Prevention and Early Intervention program.
"As a society, we place a premium on being able to take care of ourselves," she said. "In a nutshell, mental health is invisible, and people tend not to believe [in] things that they can't see."
Cultural and historical factors contribute to the belief that mental health disorders are in your head because you can't see them in the way you would a broken limb or a bleeding wound, so acknowledging them must mean you're weak, she explained. But this notion doesn't consider the physical symptoms of mental health on the brain.
She explained our thoughts are physical occurrences that result from the release of electrical and chemical activity. There are physiological underpinnings to every mental health disorder we experience, she said.
"Everything is interconnected," Campbell said. "You can't just separate out mental health and not consider that it's part of the organism."
Campbell, who has studied mental health stigma over time, noted the No. 1 reason service members give for not wanting to seek mental health care is they think they can handle problems on their own.
"That reveals preconceived stereotypes of self-reliance: 'I can do it,' 'I should be able to do it because I'm tough'," she said.
Another issue is treatment dropout, she said. An individual may start treatment because their spouse or their leadership may be pushing them, but they later drop out because they feel they can handle problems on their own. In the studies she saw, 63% of the people who dropped out said it was because they felt they could handle their problems on their own.
To reduce stigma, there are different levels at which an individual's community can intervene.
"As a provider, it's important to address an individual's concerns with stigma at the onset of treatment," she said. "If nothing is on the table, you can't deal with it."
She recommends providers be proactive and ask their patients how they feel about being there, if they are concerned about what other service members think or what their leaders think, and if they think it makes them feel weak.