{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T17:43:24Z","timestamp":1793727804781,"version":"4.6.1"},"reference-count":80,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2024,2,8]],"date-time":"2024-02-08T00:00:00Z","timestamp":1707350400000},"content-version":"unspecified","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Defence Research and Development Canada","award":["nil"],"award-info":[{"award-number":["nil"]}]},{"DOI":"10.13039\/501100018825","name":"Department of National Defence","doi-asserted-by":"crossref","award":["nil"],"award-info":[{"award-number":["nil"]}],"id":[{"id":"10.13039\/501100018825","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,1,18]]},"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The literature presents complex inter-relationships among individual-factors and organisational-factors and barriers to seeking mental health support after deployment. This study aims to quantify longitudinal associations between such factors and barriers to mental health support.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A longitudinal online survey of Canadian Armed Forces (CAF) personnel collected data at 3\u2009months post-deployment (T1), 6\u2009months post-deployment (T2) and 1 year post-deployment (T3).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>In 2020, as part of Canada\u2019s response to the COVID-19 pandemic, 2595 CAF personnel deployed on Operation LASER to support civilian long-term care facilities in Qu\u00e9bec and Ontario.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>All Operation LASER personnel were invited to participate: 1088, 582 and 497 responded at T1, T2 and T3, respectively. Most respondents were young, male, non-commissioned members.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>Barriers to mental health support were measured using 25 self-reported items and grouped into theory-based factors, including eight factors exploring care-seeking capabilities, opportunities and motivations; and two factors exploring moral issues. Logistic regressions estimated the crude and adjusted associations of individual and organisational characteristics (T1) with barriers (T2 and T3).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>When adjusting for sex, military rank and mental health status, increased meaningfulness of deployment was associated with lower probability of endorsing barriers related to conflicts with career goals and moral discomfort in accessing support at T2. Higher scores in trust in leadership were associated with lower probability of endorsing four barriers at T2, and five barriers at T3.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We identified several modifiable organisational-level characteristics that may help reduce perceived barriers to mental health support in military and other high-risk occupational populations. Results suggest that promoting individuals\u2019 sense of purpose, instilling trust in leadership and promoting relatedness among team members may improve perceptions of access to mental health supports in the months following a domestic deployment or comparable occupational exposure.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-076625","type":"journal-article","created":{"date-parts":[[2024,2,8]],"date-time":"2024-02-08T21:41:12Z","timestamp":1707428472000},"page":"e076625","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Role of modifiable organisational factors in decreasing barriers to mental healthcare: a longitudinal study of mission meaningfulness, team relatedness and leadership trust among Canadian military personnel deployed on Operation LASER"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1284-3905","authenticated-orcid":false,"given":"Jennifer","family":"Born","sequence":"first","affiliation":[{"name":"Director General Military Personnel Research and Analysis, Department of National Defence and the Canadian Armed Forces, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aihua","family":"Liu","sequence":"additional","affiliation":[{"name":"Douglas Mental Health University Institute, Montreal, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7101-8361","authenticated-orcid":false,"given":"Kerry","family":"Sudom","sequence":"additional","affiliation":[{"name":"Director General Military Personnel Research and Analysis, Department of National Defence and the Canadian Armed Forces, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0117-7015","authenticated-orcid":false,"given":"Kathy","family":"Michaud","sequence":"additional","affiliation":[{"name":"Director General Military Personnel Research and Analysis, Department of National Defence and the Canadian Armed Forces, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8398-7239","authenticated-orcid":false,"given":"Min","family":"Xi","sequence":"additional","affiliation":[{"name":"Director General Military Personnel Research and Analysis, Department of National Defence and the Canadian Armed Forces, Ottawa, Ontario, Canada"},{"name":"Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, 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