TY - JOUR U1 - Wissenschaftlicher Artikel A1 - Schuy, Karin A1 - Brants, Loni A1 - Dors, Simone A1 - Horzetzky, Marie A1 - Willmund, Gerd A1 - Zimmermann, Peter A1 - Ströhle, Andreas A1 - Rau, Heinrich A1 - Siegel, Stefan T1 - Psychological stigma costs as barriers to healthcare use in former soldiers of the German Armed Forces: A qualitative analysis JF - Military Psychology N2 - Individuals decide to use healthcare when the expected benefits outweigh the perceived costs. One of these cost factors in this decision can be stigma. So far, it has not been researched how former soldiers of the German Armed Forces with a service-induced mental illness perceive stigma and how it influences their healthcare use. As stigma is shaped by the socio-cultural context, the setting of the potential healthcare use must be considered. Narrative interviews were conducted with 33 former soldiers with mental health problems. The data were analyzed using a thematic analysis approach, in which codes were formed and emerging themes were systemized. The relationship between stigma and healthcare use was analyzed. Occupational discrimination and social exclusion were experienced in both in the military and civilian context, but stigma functioned differently in each context. In the military context, former soldiers’ self-stigma of mentally ill individuals being weak was in stark contrast to their internalized military standards. This contrast let them avoid disclosure and subsequent healthcare use. In civilian context, the participants perceived 2 different stigma costs: mental illness stigma and former soldier stigma (i.e., stigmatization because of their military past). Both were perceived as barriers to healthcare use. A model, illustrating these different stigma costs in the different contexts, was developed. Further research on the link between stigma and healthcare use of this group is urgently needed. KW - Veteran KW - Deutschland / Bundeswehr KW - Trauma KW - Gesundheitsvorsorge KW - Kosten Y1 - 2019 U6 - https://doi.org/10.1080/08995605.2019.1598228 DO - https://doi.org/10.1080/08995605.2019.1598228 VL - 31 IS - 4 SP - 279 EP - 291 ER -