Some of the first thoughts many people have when considering seeking out mental health resources are: if I need help, what does that say about me as a person and what will other people think? Whether help is needed for work-related stress or trauma, difficulty modifying an identified unhealthy habit, or navigating a turbulent family life, after considering these questions, some people are left weighing how desperately they feel they need help against the added concern of social judgment in their personal or professional life. While these are prevalent topics that impact people across many professional fields, they are heightened in first responder and military communities due to the nature of the work.
How Cultural Norms Can Help or Harm
A lucky few have grown up in a network of people who encourage counseling, open dialogue to build communication skills with friends and family, self-advocate through skilled providers, and leverage accommodation and privacy laws. For numerous others though, simply having a basic conversation surrounding mental health—and opening that door a crack to emotional vulnerability—is foreign and overwhelming. In the hardest cases, acknowledging or acting on the need for help (openly to one’s friends, family, or colleagues) comes with a pervasive negative connotation and is stigmatized so systemically that it can come with actual professional consequences or loss of relationships. Sadly, this type of cultural toxicity is a legitimate reality for some.
How the Law and Policy is Reshaping Culture
However, gradually over time our legal systems and the development of educational tools through research programs have been pushing back on unhealthy or toxic communities, finding means to make checks and balances. The Americans with Disabilities Act (ADA) has made a big difference in formally outlining a wide range of actions that legally are now considered unacceptable for businesses to practice and by association more broadly culturally unacceptable. Many people only think of extreme disabilities when it too comes to ADA law, but it is actually much more comprehensive in nature. While some businesses are active and adamant about following these guidelines, unfortunately, in others it comes down to the individuals themselves to be aware of the laws and stand up for themselves against inappropriate human resources practices.
The Most Prevalent Stigmas and Barriers
According to research conducted within first responder communities, the most endorsed stigmas and barriers to individuals using services are: concerns surrounding confidentiality, a lack of knowledge surrounding where to get appropriate help, and difficulty in accessibility due to limited scheduling options. Specifically, when it comes to confidentiality, the most prominently tracked stigma concern was the potential for negative career impacts. The largest barrier was scheduling, followed by a lack of understanding of where to access these resources.
The Impact of Not Using Services
Given the well-documented nature of stigmas and barriers within first responder communities, it is fair to say that these groups are at a higher potential risk of developing chronic post-traumatic stress or PTSD. This is a relatively predictable phenomenon if it is accurate that first responders are less likely to seek help when a difficulty initially arises due to stigmas or barriers. Resources are more likely to be sought out only in more extreme cases or at tipping points of inability to cope vs at the initial germination stage of an issue when assistance could potentially prevent the development of chronic, more significant difficulties. This scenario is comparable to many other cause-and-effect areas in life. We all know if a noticeable cut is properly treated, it is less likely to become an infection, or if a small fire is accidentally started, you want to put it out immediately. It is the same with mental health, typically, it is a lot easier to manage the symptoms of trauma or stress if addressed earlier versus later.
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- Haugen, P. T., McCrillis, A. M., Smid, G. E., & Nijdam, M. J. (2017). Mental health stigma and barriers to mental health care for first responders: A systematic review and meta-analysis. Journal of Psychiatric Research, 94, 218-229. doi:http://dx.doi.org/10.1016/j.jpsychires.2017.08.001
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