Kids' Mental Health May Dip When Parents Are Deployed

The young children of U.S. service members may suffer more mental health or behavioral problems when a parent is deployed overseas, a study published Monday suggests.

Military researchers found that among more than 640,000 children ages 3 to 8 with a parent in the service, the odds of having a doctor visit for behavioral or mental health problems were somewhat higher when a parent was deployed than when he or she was home.

Over two years, the study found, the overall rate of such doctor visits was 0.6 visits per child per year. That rate was 11 percent higher during a parent's deployment compared with when he or she was home.

The findings, published in the journal Pediatrics, add to evidence that parents' deployments during the wars in Iraq and Afghanistan have been taking a toll on some children's mental well-being.

Recent studies have shown that children of deployed service members tend to have increased levels of anxiety and sadness, and more problems with school work, for example. A 2006 survey of military spouses found that 20 percent of parents said their children "coped poorly" during deployments.

This latest study indicates that these difficulties are also manifesting as increased visits to the doctor, said lead researcher Dr. Gregory H. Gorman, of the Uniformed Services University of the Health Sciences in Bethesda, Maryland.

The precise reasons for the extra visits are not clear, Gorman told Reuters Health. "Is it the separation itself?" he said. "Is it the separation along with the wartime situation?"
In some cases, Gorman noted, the parent at home – who is most often the mother – may be depressed, and could be perceiving those same issues in the child. Alternatively, a child may pick up on the parent's stress and develop his or her own problems.

For the study, Gorman and his colleagues examined medical-claims data for 642,397 children ages 3 to 8 who had a parent on active duty in 2006 and 2007. One-third of parents were deployed at some time during that period.

Over the two years, the children had a total of just over 611,000 doctor visits for mental health or behavioral issues, with attention-deficit hyperactivity disorder (ADHD) accounting for 30 percent and adjustment disorders 15 percent.

Adjustment disorders are stress-related conditions that in children may manifest as sadness, trouble sleeping, nervousness and problems at school, among other symptoms.
Anxiety disorders and mood disorders like depression each accounted for 3 to 4 percent of all mental-health visits in the study group.

Gorman's team found that during deployment, there were 27 excess visits for anxiety-related disorders per 1,000 children per year, compared with non-deployment periods. Similarly, there were 6.5 excess visits for behavioral disorders like ADHD, and 22 extra visits for stress-related problems per 1,000 children each year.

In contrast, the overall rate of doctor visits in general was 11 percent lower during deployment. This may, according to Gorman's team, reflect the fact that the busy single parent at home may have to pick and choose which health problems warrant a visit to the pediatrician.

The findings, Gorman and his colleagues say, underscore the importance of providing support to children whose parents are frequently deployed, as well as to the parent or other caregiver left at home.

"The military has a lot of resources for families," Gorman said. As an example, he pointed to an online resource, MilitaryOneSource (www.militaryonesource.com), that families can use as a "one-stop shop" for finding the type of support-services they need, including free counseling for family-stress and parenting issues.

Gorman pointed out that while military pediatricians are attuned to asking about parents' deployment and any related problems children may be having, their civilian counterparts may not be. This is important, he noted, since two-thirds of all healthcare visits in this study were to civilian doctors.

Gorman suggested that when parents take their children to non-military pediatricians, they mention any deployments, as well as any symptoms – like anxiety, sadness or school problems  –that they think might be related.

In an editorial published with the study, Dr. Beth Ellen Davis, of the Madigan Army Medical Center in Tacoma, Washington, writes that all pediatricians should be aware of military families' needs.

During routine visits, she writes, pediatricians should try to assess family stress levels and coping, and help them anticipate common problems that arise from deployments. She adds that they should also know how to direct families to resources like MilitaryOneSource and the American Academy of Pediatrics' military deployment website.