Imagine yourself as a young service member, brand new to the military. All you can focus on is doing your job skillfully, fitting in with your team, and showing your leadership that you are a vital part of the organization. When an injury comes along, it can throw all of those thoughts into disarray, especially if it is potentially serious. Your only thought is ‘I need to get back to work and show my team that I am not a quitter, not weak, and able to carry my weight’.
The Stigma still exists
Thoughts like these impede the healthcare of many service members, whether that care is for their mental, physical, or emotional health. The stigma of being perceived as broken, weak, or problematic, creates even more mental stress, which further blocks the chances of a full recovery from any kind of injury. How does a young service member learn that their health is paramount to a long career, to be most effective, and to prevent further injury? How do they learn to advocate for their own care? What are the barriers to a full recovery?
Advocating for your health is a vital skill, but for many military service members, it can feel like an uphill battle. While these men and women are trained to handle high-pressure situations and put the mission first, these same attributes can create barriers when seeking medical care.
An Archaic Mindset
From cultural expectations of toughness to fears about career repercussions, service members often find themselves sidelining their own health needs. Systemic, cultural, and personal challenges make self-advocacy at medical appointments particularly difficult for those in uniform.
Military Culture
- Stoicism and Toughness: The military instills a strong sense of resilience, self-reliance, and mission-first mentality in its members. While these traits are crucial on the battlefield, they can discourage expressions of vulnerability. Service members are often taught to push through discomfort and pain, making it harder for them to voice health concerns during medical appointments. These are also traits that they take back home to their families which can compile into relationship issues stemming from lack of sharing, stress from internalizing issues, and feeling isolated due to the inability to express thoughts to ‘civilians’.
- Fear of Being Perceived as Weak: Seeking medical help, especially for mental health issues, can feel risky for service members. Many worry that speaking up might lead to being viewed as weak by peers or superiors. This fear of judgment can create a significant barrier to self-advocacy, leaving issues untreated. Leadership’s impact on this stigma can make or break a unit and an individual’s morale, as well as their ability to approach self-care options, whether that includes seeking professional help or at-home remedies for all types of injuries or concerns.
- “Suck It Up” Mentality: Military culture often encourages the “suck it up” mindset, where minor injuries or illnesses are dismissed as inconsequential. This ingrained attitude can lead service members to downplay or ignore symptoms, further discouraging them from seeking proper medical care. The ‘ranger candy’, ‘Motrin and water’, jokes stem from this mindset, which is more debilitating than it is helpful.
Career Implications
- Fear of Career Impact: Many service members are hesitant to speak up about medical concerns because of the potential consequences for their careers. A single entry in a medical record could impact deployment status, promotion eligibility, or even lead to reassignment. This fear of jeopardizing their professional future often discourages them from advocating for the care they need.
- Stigma Around Medical Diagnoses: Medical diagnoses, especially related to mental health, can carry a heavy stigma within the military. A diagnosis might lead others to perceive a service member as unfit for duty, regardless of their actual capabilities. This fear of being labeled or sidelined can prevent individuals from addressing serious health issues early on. Command biases also carry a strong voice in the discussion of what is considered serious, dire, or even worthy of attention by any level of command.
Systemic Barriers
- Limited Appointment Times: Medical appointments in military facilities are often brief, leaving little time to address multiple or complex health concerns. Service members may feel rushed, unable to fully explain their issues, or left with unanswered questions about their care.
- Overburdened Healthcare System: Military healthcare facilities frequently face challenges such as understaffing and high patient volumes. These conditions can lead to rushed consultations, where providers may seem dismissive or hurried, making it harder for service members to feel heard or properly cared for.
- Hierarchy in Communication: The hierarchical structure of the military can sometimes create barriers to open communication. Service members may feel intimidated or reluctant to question healthcare providers, especially those who outrank them. This dynamic can hinder honest discussions about medical needs, especially when there is a disagreement on the path to recovery or even the diagnosis. This can become especially problematic when a member of the chain of command is involved in the healthcare of a service member.
Lack of Advocacy Skills
- Unfamiliarity with Civilian Advocacy: Military service members often lack experience in navigating medical systems outside the structured environment of military healthcare. They may not be equipped with the skills or confidence to advocate for their needs effectively, which can leave them feeling uncertain or powerless during medical appointments. During transition times, service members moving into civilian status don’t have the experience or understanding that they can choose their doctors, they can request second opinions, and even push for a more involved care plan.
- Trust in the System: Many service members place significant trust in the military medical system, assuming that providers will automatically understand and prioritize their health concerns. This reliance can lead to a passive approach during appointments, with service members refraining from voicing additional concerns or asking critical questions. It takes a very unique experience to realize that a doctor, civilian or not, will not be as active with your health until the patient is serious about their own care.
Mental Health Stigma
- Reluctance to Address Mental Health Issues: Many service members hesitate to talk about mental health struggles due to the stigma associated with these concerns. The fear of being judged by peers or superiors, combined with worries about how seeking help might affect their reputation, often prevents them from addressing these critical issues.
- Limited Confidentiality: In the military, medical information is not always entirely private, particularly when it could impact a service member’s fitness for duty. This lack of guaranteed confidentiality can discourage individuals from having open and honest discussions about their mental health, leaving important issues unresolved.
Communication Challenges
- Difficulty Articulating Concerns: Service members often find it challenging to clearly describe their symptoms or advocate assertively during medical appointments. This difficulty may stem from a lack of medical knowledge, uncertainty about how to frame their concerns, or discomfort in expressing vulnerability.
- Lack of Trust: Some service members harbor distrust toward the healthcare system due to past negative experiences, such as feeling dismissed or misunderstood by providers. Perceived or actual lack of empathy from medical professionals can further erode trust, making it harder for individuals to engage fully in their own care.
How to Improve Self-Advocacy
Educate Service Members: Provide training on how to communicate effectively with healthcare providers and understand their rights as patients.
Normalize Seeking Help: Address the cultural stigma around medical and mental health care through leadership-led initiatives and peer support.
Streamline Healthcare Access: Improve appointment availability and create opportunities for longer consultations when needed.
Advocate for Policy Changes: Encourage systemic changes to protect confidentiality and reduce career-related fears around seeking care.
Service members dedicate their lives to protecting others, yet they often struggle to prioritize their own well-being. Addressing the barriers to self-advocacy at medical appointments is not just a matter of individual responsibility but a systemic challenge that requires cultural change and institutional support. By fostering an environment where seeking care is normalized and encouraged, we can empower service members to advocate for their health without fear or hesitation—ensuring they receive the care they so deeply deserve.
The education of advocacy should start early in a service member’s career. From day one, their health, their body, and their mind are part of their arsenal. Just like a service member’s weapon, if there is one part of it that doesn’t operate correctly, it needs to be sent to maintenance. This is an imperative lesson for them to learn as their careers start, and even more so as they transition when their military career approaches its end.
