Investigating the characteristics of Canadian Armed Forces help-seekers, non-help seekers, and no mental health need groups: A population-based analysis
Abstract: Introduction: This secondary analysis compared three groups of Canadian Armed Forces (CAF) members in their demographics and attitudes toward mental health care: those with a need who have sought help (help-seekers), those with a need who have not sought help (non-help seekers) and those with no current need (no-need). Methods: Data from the 2013 Canadian Forces Mental Health Survey, which included responses from 6,996 Regular Force and 1,469 Reserve Force members, was used. Several variables were applied to classify members according to mental health need and help-seeking status. Results: The three groups had distinct demographic profiles. In addition, results from a discriminant function analysis indicated group differences in attitudes toward mental health care. Help-seekers reported more negative attitudes toward acquiring mental health care for reasons that relate to stigma and career implications, while non-help seekers reported more negative attitudes toward mental health care that reflect a distrust of professionals and preference for self-management. Discussion: These findings suggest more can be done to further support help-seekers who report stigma and to support non-help seekers who may have attitudinal barriers to traditional care but may benefit from innovative care solutions.
Abstract: Introduction: Persistent inequities exist in obstetric and neonatal outcomes in military families despite universal health care coverage. Though the exact underlying cause has not been identified, social determinants of health may uniquely impact military families. The purpose of this study was to qualitatively investigate the potential impact of social determinants of health and the lived experiences of military individuals seeking maternity care in the Military Health System. Materials and methods: This was an Institutional Review Board-approved protocol. Nine providers conducted 31 semi-structured interviews with individuals who delivered within the last 5 years in the direct or purchased care market. Participants were recruited through social media blasts and clinic flyers with both maximum variation and homogenous sampling to ensure participation of diverse individuals. Data were coded and themes were identified using inductive qualitative research methods. Results: Three main themes were identified: Requirements of Military Life (with subthemes of pregnancy notification and privacy during care, role of pregnancy instructions and policies, and role of command support), Sociocultural Aspects of the Military Experience (with subthemes of pregnancy as a burden on colleagues and a career detractor, postpartum adjustment, balancing personal and professional requirements, pregnancy timing and parenting challenges, and importance of friendship and camaraderie in pregnancy), and Navigating the Healthcare Experience (including subthemes of transfer between military and civilian care and TRICARE challenges, perception of military care as inferior to civilian, and remote duty stations and international care). Conclusions: The unique stressors of military life act synergistically with the existing health care challenges, presenting opportunities for improvements in care. Such opportunities may include increased consistency of policies across services and commands. Increased access to group prenatal care and support groups, and increased assistance with navigating the health care system to improve care transitions were frequently requested changes by participants.