Substance use, self-stigma, and help seeking among military members: Exploring the utility of the emerging adulthood theory

Clary, Kelly Lynn

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Description

Title

Substance use, self-stigma, and help seeking among military members: Exploring the utility of the emerging adulthood theory

Author(s)

Clary, Kelly Lynn

Issue Date

2020-03-27

Director of Research (if dissertation) or Advisor (if thesis)

Smith, Douglas C

Doctoral Committee Chair(s)

Smith, Douglas C

Committee Member(s)

• Ostler, Teresa A
• Carter-Black, Janet D
• Chiu, Chung-Yi

Department of Study

School of Social Work

Discipline

Social Work

Degree Granting Institution

University of Illinois at Urbana-Champaign

Degree Name

Ph.D.

Degree Level

Dissertation

Keyword(s)

Emerging Adults, Military, Veterans, Substance Use, Theory Building, Multi-Method

Abstract

Background: Emerging adults (18-29 year olds) have the highest rates of substance use across the lifespan and many military members often have even higher rates of substance use and related consequences. Unfortunately, those most in need of mental health treatment perceive greater stigma and are less likely to pursue treatment for their past trauma or current mental health or substance use needs. Moreover, few treatments address the unique military culture or one’s developmental status when intervening. This study explored the utility of the five Emerging Adulthood Theory dimensions, a human developmental lens, to military members. It sought to understand developmental factors related to high rates of substance use among military populations, while also providing culturally responsive implications for social workers assisting this vulnerable population. In addition, it evaluated if one interview had a positive impact on substance use frequency, general help seeking behaviors, and stigma on help seeking behaviors. Methods: To answer these research questions, I completed in-depth qualitative interviews utilizing motivational interviewing spirit with 26 emerging adult military members who have high risk substance use behaviors. I asked about their experiences developing into an adult, substance use behaviors, barriers to receiving mental health treatment, and ways to reduce mental health stigma. Most interviews were conducted via Zoom (n=22) with some in-person (n=4). I collected pre-test and post-test data on substance use frequency, self-stigma, and help-seeking behaviors, with a 100% follow-up rate. Qualitative interviews were analyzed following reflexive-thematic driven analysis and were coded using Nvivo. Rigorous coding procedures integrated inter-rater and intra-rater reliability procedures. Quantitative data were cleaned and analyzed in both Excel and SPSS using dependent samples t-tests. Results: We found that this sample related to the five Emerging Adulthood Theory dimensions, but in different ways than is proposed by the theory. We believe these various themes could be attributed to their immersion in military culture. Moreover, data shows that a one-time interview has positive effects on substance use behaviors, help-seeking and stigma about mental health treatment. Follow-up data shows that the research study was well received by participants as they could share their stories, think critically about military culture, and have a genuine conversation with a social worker regarding their military experiences. Implications: Findings provide the framework to effectively support emerging adult military members with high risk substance behaviors. Future research should integrate these findings to produce culturally adaptive interventions to reduce substance use behaviors and stigma around mental health treatment while also encouraging help seeking behaviors. This study fills the literature gap of more thoroughly understanding the utility of the theory among military members. Further, these data shed light on the acceptability and feasibility of brief interventions with military members.

Graduation Semester

2020-05

Type of Resource

Thesis

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Copyright and License Information

Copyright 2020 Kelly Lynn Clary

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