FAC T SHEET FOR PROVIDERS

A Health Campaign of Uniformed Services University, www.usuhs.edu, and theCenter for the Study of Traumatic Stress, Bethesda, Maryland, www.CSTSonline.org

Primary Care Strategies toFoster Health Care Seeking
in Service Members
Primary care providers have an
Promoting Better Health Care
Military
servicepresents
additional
important role in fostering theirSeeking
patients’ health behaviors. Military
Four factors have been identified
challenges to seeking healthcare,service presents additional challenges
that may reduce the stigma associatedespecially for psychological problems.
to seeking healthcare, especially forwith help-seeking by service members.
psychological problems. Studies
We present these factors below andindicate that military members may
provide talking points that primary
be concerned about harming their career, losing thecare providers can use in discussions around further
confidence of buddies, being treated differently by leaders,evaluation, treatment, or services.
and being seen as weak.
However, underutilization of health and mental health
1) External Stress/events
resources may put service members and their families at
Service members may be more receptive torisk. Importantly, perhaps as many as three out of four suicide acknowledging a problem and to seeking help if thecompleters have visited their health care provider within aproblem is presented in the context of external events
year of their suicide, and a large percentage have had contact(e.g. environmental causes or an injury, rather than anwithin a month.
illness), and not as the result of one’s failures or lapses. This
The traditional model of behavior in service members
approach can normalize the problem and reduce feelings ofemphasizes characteristics such as strength, independence,weakness, embarrassment, and shame.
and emotional control, which may inhibit health careseeking. One may feel vulnerable seeking help and unable
Talking Point
to maintain the view of oneself as powerful, successful,“Many service members describe having your symptoms
and in control. Denial of symptoms, difficulty recognizing(e.g., difficulty sleeping, wanting to be alone, feeling irritable,
the significance of non-specific feelings, and the use ofetc.). It’s understandable given multiple deployments, stress on
alcohol or drugs to decrease pain are other issues that may
families, and difficulty coming back to daily routines. If these
influence the ability to know when help is needed.
symptoms last for more than a few weeks, it’s wise to seek
Primary care providers should also be aware that gender
help, and that’s what we are here for.”roles and socialization may partially explain why helpseeking patterns in men are historically lower, especially in2) Social Benefits vs. Social costs
emotional problems and depressive symptoms. However,Service members often view health-seeking in thethis behavior is by no means unique to males.
context of its social costs (being seen as incompetent,
A number of positive factors have been identified
dependent, and inferior). A more positive approach wouldthat may motivate service members to seek help. This
involve emphasizing social benefits and virtues such asCourage to Care fact sheet describes these positive factors
superiority of judgment, competence, and collaboration.
and translates them into talking points that primary care
These traits are highly valued in the military.
providers can use to influence service members to accessmore timely and appropriate health services.
Talking Point“It was a good decision to come in today. We can work
together to help you feel better” or, “Coming here to see us isContinued

a good sign — it means that you care about getting better”
or,“I know coming to the appointment today took courage
and really shows your commitment to getting better.”

deployments have been stressful on many service members
and families, and his feeling better not only will help him,
but will help you and the children.”3) Obligation to Stay Healthy (note using with #2 above,
can be a powerful combination!)
Help-seeking should be presented as a legitimate means
for service members to ensure their physical and mental
health (to perform, to achieve), and can be discussed in
the context of ‘duty’, as in one’s obligation to protect self,family, and comrades, an intrinsic part of military values
and culture.

Summary
Primary care providers can influence service members’
health and health behaviors by using some positive
approaches. Framing discussions around the need for
medical or psychological help in terms of external events,
the social benefits of help-seeking, fulfilling one’s duty toself, family, friends, and community, and as a collaborative
process may reduce barriers to seeking care. Ultimately,
health care seeking can be seen as a way to increase
self-care and to enhance one’s relationships with family,
especially one’s children, friends, and work.

Talking Point“By taking care of yourself, you are taking care of yourfamily” or, “I know that you are ‘getting by’ — but by getting
help, you can be doing that much better” or, “It was a gooddecision to come in before things get worse, your work reallydepends on you.”4) The Family Factor
Loved ones are often instrumental in encouraging
service members to seek medical attention. Helping
family members who are significant in the lives of service
members affect referrals for professional help and act as animportant link in the chain.
Talking Point“I value your concern about your husband’s symptoms
and his need to seek help. You might tell him that multipleResources■ Real Warrior: Resilience, Recovery, Reintegration

http://www.realwarriors.net/
Contains information on psychological health andtraumatic brain injury for service members and forclinicians. Features real stories of service members who
have sought and received help.
■ Military OneSource

https://www.militaryonesource.mil/
Features comprehensive information on all aspects ofmilitary life and health, and an 800 24/7 helpline for allservices.

Courage to Care is a health promotion campaign of Uniformed Services Universityand its Center for the Study of Traumatic Stress (CSTS). CSTS is the academicarm and a partnering Center of the Defense Centers of Excellence (DCoE) for
Psychological Health and Traumatic Brain Injury.

Center for the Study of Traumatic Stress
Department of Psychiatry
Uniformed Services University
4301 Jones Bridge Road, Bethesda, MD 20814-4799
www.CSTSonline.org