Health and Mental Health Needs of Children in US Military Families

Abstract

The wars in Afghanistan and Iraq have been challenging for US uniformed service families and their children. Almost 60% of US service members have family responsibilities. Approximately 2.3 million active duty, National Guard, and Reserve service members have been deployed since the beginning of the wars in Afghanistan and Iraq (2001 and 2003, respectively), and almost half have deployed more than once, some for up to 18 months’ duration. Up to 2 million US children have been exposed to a wartime deployment of a loved one in the past 10 years. Many service members have returned from combat deployments with symptoms of posttraumatic stress disorder, depression, anxiety, substance abuse, and traumatic brain injury. The mental health and well-being of spouses, significant others, children (and their friends), and extended family members of deployed service members continues to be significantly challenged by the experiences of wartime deployment as well as by combat mortality and morbidity. The medical system of the Department of Defense provides health and mental health services for active duty service members and their families as well as activated National Guard and Reserve service members and their families. In addition to military pediatricians and civilian pediatricians employed by military treatment facilities, nonmilitary general pediatricians care for >50% of children and family members before, during, and after wartime deployments. This clinical report is for all pediatricians, both active duty and civilian, to aid in caring for children whose loved ones have been, are, or will be deployed.

Long-Term Trajectories and Service Needs for Military Families

“…Military children have been likewise affected by parent deployment, with many children showing increased emotional and behavioral problems during and after deployment (Lincoln and Sweeten 2011;Lincoln et al 2008;MacDermid Wadsworth 2010;McFarlane 2009;Paris et al 2010;Siegel and Davis 2013;White et al 2011). In systematic reviews, duration of deployment and parent psychological distress were identified as risk factors for worsened child psychological distress (White et al 2011).…”

Testing a Military Family Stress Model

“…With few exceptions (e.g., Oshri et al., ) studies have typically not gathered multiple‐method (i.e., questionnaire and observational data) and multiple‐informant family data (i.e., from parents, children, and teachers), both of which increase the robustness of findings. Most studies have sampled active‐duty, rather than reserve component families (Siegel, Davis, & Committee on Psychosocial Aspects of Child and Family Health and Section on Uniformed Services, ). Several theoretical and conceptual models have been put forth to understand military family adjustment; few have been tested empirically (see, e.g., Bowen, Martin, & Mancini, ; Lavee, McCubbin, & Patterson, ).…”

Evaluation of a Family-Centered Preventive Intervention for Military Families: Parent and Child Longitudinal Outcomes

“…1,2 Military children and their parents have negotiated the unprecedented challenges of recurrent separations, frequent moves, and the high operational tempo associated with a country engaged in a long war overseas. 3 Many children have also experienced the hardships of parental injury, illness, and even loss within their families, influencing both child and parental well-being over time, 1,4 as well as the reverberating impact of these events within their communities (for review, see Holmes et al 5 ). A rapidly expanding body of research has consistently documented increased social, emotional, behavioral, and academic risk associated with parental wartime military service for children across developmental periods, as well as the direct and indirect reverberations of heightened stress across the family system (for review, see Lester and Flake 6 ).…”