Eradicating Mental Health Stigma in the Military and Beyond

How to raise awareness around mental health

Posted May 06, 2018

Courtesy of U.S. Air Force
Source: Courtesy of U.S. Air Force

When it comes to mental health, stigma and lack of awareness continue to be deterrents to seeking help. Men are significantly less likely to seek treatment than women despite the suicide rate being almost four times higher among men. Some may be ashamed about how they feel and therefore avoid speaking up, especially in communities where mental health is not openly discussed. One such example is in the military.

Studies report that 30 percent of troops returning home from the Iraq war experienced some type of mental health problem, including post-traumatic stress disorder (PTSD), depression, or anxiety. One study looked at the two types of mental health stigma — public and self-stigma — in relation to the likelihood of service members in seeking treatment. The results indicated that the relationship between public stigma and attitudes toward seeking mental health treatment is fully mediated by self-stigma. According to the authors, “Service members are likely to internalize the public’s negative attitude toward seeking mental health treatment and thus view themselves as weak or inadequate.”

Former special ops Navy SEAL senior chief James Hatch knows this all too well. A member of the Naval Special Warfare Development Group and expert military dog trainer, Hatch was involved in 150 missions across Iraq, Bosnia, Africa, and Afghanistan throughout his career, which began when he was 18. This all changed in July of 2009, when a bullet shattered his femur while on a mission attempting to rescue Pvt. Bowe Bergdahl, who was abducted by the Taliban after abandoning his base.

For Hatch, as is the case for thousands of veterans, retirement meant not just the loss of a career. It was the loss of a family he had served alongside for decades. It was the loss of his life’s passion and purpose. It was the loss of his identity.  

In his new memoir, Touching the Dragon: And Other Techniques for Surviving Life’s Wars, Hatch writes about his struggles with depression and PTSD in what he calls the “second war”— the war at home. Below are some of the weapons he used to win the battle against mental illness and fight his way back to health.

Embrace your pain

The title of his book, Touching the Dragon, refers to a technique Hatch was taught in therapy, one that is frequently used in the treatment of trauma. When he was in the psychiatric hospital, his therapist asked him to write down everything he could remember about the night he was shot—a night that he would have preferred to forget. He was to not only write it out once, but over and over again, for several days, down to the smallest of details. He was asked to touch what tormented him the most.

“When I did, I came to see that my anger and condemnation were just paltry Band-Aids on a massive soul wound that had been festering for years,” says Hatch. By blaming others and harboring anger, he was bypassing the real feelings those tactics were masking: those of sadness and loss. When we face our pain rather than deny it, we are allowing it to heal. We are taking away its power. We do no favors to anyone by keeping it in hiding—least of all ourselves. 

Reach out

Hatch credits those around him and the support that they provided as essential to his healing process. When he felt like he was worthless—as depression can often trick you into believing you are—they reminded him that he wasn’t. “You don’t have to be in a special operations unit to have that support,” he says. “It’s around you. You just need to reach out.”

Begin a meditation practice

One of Hatch’s secret weapons in his second war, he says, was yoga, or what he refers to as “moving meditation.” He was affected by yoga in such a positive way, he credits it as one of his strongest tools in his toolbox of mental health care. “I treasure it and use it all the time.”

According to Mental Health America, research is increasingly validating the beneficial effects of meditation for conditions that include depression, schizophrenia, anxiety, PTSD (post-traumatic stress disorder), and ADHD (attention deficit hyperactivity disorder). Yoga is one way to incorporate meditation into your life, but there are many others, including Qi Gong, Tai Chi, and formal sitting meditations, such as mindfulness meditation and Zen meditation.

A new perspective on mental health

“In order to be effective as a team, everyone has to be firing on all cylinders,” says Hatch. “If you’re struggling with [mental illness], you’re not firing on all cylinders, and it’s going to hurt the team.”  

“In the special-op world we are so obsessed with being as good as we can be ... If we don’t work out physically, we don’t have a lot of stamina on the (field), and If one guy on the team can’t keep up, he slows us all down. There’s a chance they’ll fail, and failure in that world means life or death.” This same concept, he says, applies to mental health. “We deal with explosives, for example. To operate at a high level, you have to be mentally okay.”

“Whether in the military or law enforcement, or whatever your vocation," says Hatch, "you are a system, and you can’t omit mental health when you talk about that system. All parts have to be optimal. You can’t ignore one part because it’s uncomfortable.”

Standing up to stigma

Hatch hopes to elevate the conversation around mental health through his writing and his speaking engagements. “By going up on stage, you are in effect giving people permission to say, ‘I’m struggling.’ I went through all this tough training, and if I’m struggling, then someone who looks at it as a measuring stick may think, ‘If he had troubles, it means I can too.’ Having someone in front of you say ‘I’m really struggling” normalizes it.’”

According to a study by the National Institute for Health Research (NIHR), one in four people worldwide struggle with a mental health condition, yet in Europe and the U.S., up to 75 percent do not receive treatment. The data, gathered from 144 studies including over 90,000 participants, determined stigma to be the fourth-highest ranked barrier out of ten to seeking treatment. “We now have clear evidence that stigma has a toxic effect by preventing people seeking help for mental health problems,” says the senior author, Professor Graham Thornicroft, Institute of Psychiatry (IoP) at King’s College London.

Reasons to defy unjustified stigma and seek treatment:

  • Your life is more valuable than the uninformed opinions of others who have not walked in your shoes.
  • By speaking up, you are not only helping yourself, you are giving permission for others to do the same.  
  • You are part of the fight against stigma.
  • You are taking a step toward self-empowerment.
  • Your friends and family will thank you.
  • Your future self will thank you.

It takes a special brand of courage to rise above stereotypes and ignorance to ask for the help you need and deserve. Those who love and care about you will still be there in the end. Those who aren’t were part of the problem to begin with. This is where the need for education and awareness comes in.

Whether fighting a war on the battlefield or the war within, never forget there is a light at the end of the tunnel—even if you can’t yet see it.

References

Hatch, J. and D’Andrea, C. (2018). Touching the Dragon: And Other Techniques for Surviving Life’s Wars. Knopf Doubleday Publishing Group.

Hatch, J. (April, 2018). Phone Interview