Going AWOL: Alternative Responses to PTSD Stigma in the U.S. Military

Abstract

The psychiatric costs of war have contributed to an ‘epidemic of suicide’ linked to PTSD among United States military service personnel. Current research identifies ‘self-stigma as the barrier to care’ and dominant thinking surrounding interventions focuses on overcoming selfstigma to obtain mental health services. The research and programming is grounded in leading social- cognitive and behavioral models that focus on individual interactions. This descriptive analysis of high-profile AWOL cases provides a counter-narrative to this predominant biomedical discourse. In these cases, soldiers chance increased stigmatization through risking dishonorable discharge in their pursuit of care. The question emerges, is lack of help-seeking taking place due to self-stigmatizing or due to broader structural elements that restrict choices? And more critically, are dominant theories of health behavior that focus on individual choice relevant in contexts where there is limited autonomy? Preliminary ethnographic research with veterans and active duty soldiers in addition to content analysis of online military blogs and investigative news reports explore these questions. Anthropological models are introduced to provide a more fixed consideration of structural influences on individuals’ actions and to offer an alternative approach to intervention.