The impact of stigma on health care-seeking behavior in military personnel with mental health challenges.

Prolonged armed conflict has raised significant concern about the mental health of military personnel and veterans. Conditions such as post-traumatic stress disorder and depression affect approximately 14-16% of U.S. service members deployed to Afghanistan and Iraq. Other prevalent mental health issues include suicide, traumatic brain injury, substance use disorder, and aggression. Despite the availability of mental health services, stigma remains a major barrier to care, with nearly 60% of affected personnel avoiding treatment. This review examines how stigma influences help-seeking behavior in military populations. A systematic search of PubMed and Scopus was conducted using terms such as "stigma," "health care-seeking behavior," "military personnel," and "mental health," limited to English-language studies published between January 2000 and November 2024. Additional data were obtained from cited references and recent conference materials. The findings indicate that stigma in the military manifests in three main forms: public, self-, and institutional stigma, each of which contributes uniquely to reluctance toward seeking care. There is a consistent negative correlation between stigma and treatment seeking. Programs emphasizing education, peer support, and leadership engagement have shown promise in improving attitudes. Initiatives such as the Real Warriors Campaign and evidence-based treatments like Trauma-Informed Guilt Reduction contribute to reducing stigma and promoting recovery. A multifaceted approach involving policy reform, anti-stigma training, and culturally competent interventions is essential to improving mental health outcomes and service engagement among military members.