Fleet leaders' attitudes about subordinates' use of mental health services

Mental disorders are a significant source of medical and occupational morbidity for sailors. Stigma, fear of negative career impact, and subordinates concern about leaders' attitudes are significant barriers to the use of mental health services. Semistructured interviews and military policies were data sources used to analyze the language, knowledge, and attitudes of Navy surface fleet leaders about mental illness and mental health treatment using Foucault's concept of discourse analysis. A discourse is a system of knowledge that influences language, perceptions, values, and social practices. The results showed that leaders' concerns about sailors' mental combat readiness, not mental illness stigma, was the dominant discourse about mental illness and mental health services use. In particular, organizational differences between the surface warfare and the mental health communities may influence leaders' attitudes more than stigma. This study provides an elaborated view of mental health knowledge and power within a Navy community.