Honest, Open, Proud for Soldiers With Mental Illness

Soldiers with mental illness typically face a two-fold problem. On the one hand, they have to
cope with the symptoms of their mental illness; on the other hand, they often have to deal
with stigma and discrimination. Both due to fear of public stigma and due to self-stigma or
shame, soldiers with mental illness may decide to keep their condition a secret or even to
withdraw from other people altogether in order to minimize the risk of being labeled. Secrecy
can help on the short term to protect individuals from public stigma, but usually it has
negative long-term consequences such as social isolation, distress and avoidance of
help-seeking. Disclosure, on the other hand, carries the risk to be discriminated by others,
but can reduce the burden of secrecy, lead to support by others and reduce public stigma.

In this study investigators aim to test the efficacy (see our outcomes above) of Honest,
Open, Proud run by soldiers with lived experience of mental illness.

Inclusion Criteria:

- At least one self-reported current axis I or axis II disorder according to DSM-5,
which is not restricted to only substance-related disorder(s)

- Age 18 or above

- Ability to provide written informed consent

- Fluent in German (needed for self-report measures)

- At least a moderate level of self-reported disclosure-related distress/difficulty
(score 4 or higher on the screening item 'In general, how distressed or worried are
you in terms of secrecy or disclosure of your mental illness to others?', rated from
1, not at all, to 7, very much)

- Current inpatient, day-clinic or outpatient treatment at the Center for Military
Mental Health, Berlin, Germany

- from April 2018 onwards we decided to also include non-military first responders (fire
fighters or police officers) who are treated in the Center for Military Mental Health,
Berlin, Germany

Exclusion Criteria:

- Self-reported diagnosis of only a substance- or alcohol-related disorder, without
non-substance related current psychiatric comorbidity. We will exclude people who only
have a substance-/alcohol-related disorder because the disclosure of these disorders
is not the topic of the HOP intervention

- Intellectual disability

- Organic disorders