The Effect of Geographic Moves on Mental Health Care Utilization in Children

Authors
Millegan, J. McLay, R. Engel, C.
Publication year
2014
Citation Title
The effect of geographic moves on mental health care utilization in children.
Journal Name
Journal of Adolescent Health
Journal Volume
55
Issue Number
2
Page Numbers
276-280
DOI
10.1016/j.jadohealth.2014.01.009
Summary
Numerous geographical moves may have a negative impact on children’s mental health. This study examined the relationship between the experience of geographical moves in 2008 and military children and adolescents’ mental health care visits in 2009. Results revealed a positive association between geographical moves and military children and adolescents’ mental health.
Key Findings
Military children and adolescents who experienced a geographical move in 2008 were more likely to have mental health care visits in 2009.
The associations between geographical moves and mental health problems were more prominent in adolescents than in children.
The mental health issues experienced by military children and adolescents after moves were more likely to be externalizing than internalizing problems.
Implications for Program Leaders
Develop workshops that focus on adjustment issues targeted specifically toward military families that just experienced a geographical move
Offer support groups for military adolescents who just had a geographical move so that they can find support from peers with similar experiences
Disseminate information regarding possible negative effects of geographical moves on military children and adolescents’ mental health and the potential benefits of parent education programs
Implications for Policy Makers
Continue to support programs that aim to assist military families before, during, and after Permanent Change of Station
Raise awareness of the potential difficulties that military children and adolescents may experience after geographical moves
Recommend training for professionals who work with military families on how to better support military children and adolescents after geographical moves
Methods
Data were obtained from the Military Health System Medical Data Repository.
Experience of geographical moves was defined as at least one move between cities or towns during 2008, and mental health care utilization meant having at least one mental healthcare visit during 2009.
Data were analyzed to examine the associations between geographical moves and children’s mental health.
Participants
Participants were 548,336 children and adolescents of military parents; 25% of them moved in 2008.
Participants were divided into two age groups: 6-11 years (mean age = 8.4 years, SD = 1.7, 50% male) and 12-17 years (mean age = 14.2 years, SD = 1.7, 51% male); Race/ethnicity of the participants was not reported.
The military branches that the military parents served in were: Army (41%), Air Force (24%), Navy (23%), Marine (8%), and Coast Guard (4%).
Limitations
The study only examined children and adolescents who moved during 2008; it is possible that participants who moved before 2008 were also more likely to experience mental health problems in 2009 than participants who did not move, therefore the results may underestimate the association between geographical moves and mental health care visits.
The study only examined mental health care visits in 2009; it is possible that children who moved in 2008 did not show any mental health symptoms until 2010 or later, therefore the results may underestimate the association between geographical moves and mental health care visits.
Only big geographical moves between cities or towns were included in the study; without also accounting for smaller moves that happen within a city or town, the study may not accurately capture the associations of interest.
Avenues for Future Research
Study the long-term effect of geographical moves on military children and adolescents’ mental health
Investigate the characteristics of military children and adolescents who adjust poorly after moves
Compare the differences between military and civilian children and adolescents regarding the associations between geographical moves and mental health
Design Rating
2 Stars - There are some flaws in the study design or research sample, but those flaws do not significantly threaten the ability to make conclusions based on the data.
Methods Rating
2 Stars - There are no significant biases or deficits in the way the variables in the study are defined or measures and conclusions are appropriately drawn from the analyses performed.
Limitations Rating
2 Stars - There are a few factors that limit the ability to extend the results to an entire population, but the results can be extended to most of the population.
Focus
Multiple Branches
Target Population
Population Focus
Military Component
Abstract
Purpose: Geographic moves have been reported to have a negative impact on the mental health of children, but it is often difficult to separate the effect of the move from the circumstances that impelled it. Military populations may offer a way to examine this issue. Moves are common in military families, but parental employment and healthcare coverage remain constant. Methods: Children of military parents with geographic moves in 2008 were compared with those without geographic moves with regard to the odds of mental health service use in 2009. Results: This study included 548,336 children aged 6-17 years, and 179,486 (25%) children moved in 2008. Children aged 6-11 years with a geographic move had higher odds of mental health and outpatient visits (odds ratio [OR] 1.03; 95% confidence interval [CI] 1.01-1.06). Children aged 12-17 years with a geographic move had higher odds of mental outpatient visits (OR 1.04; 95% CI 1.01-1.07), psychiatric hospitalizations (OR 1.19; 95% CI 1.07-1.32), and emergency psychiatric visits (OR 1.20; 95% CI 1.07-1.32). Conclusion: Children with a geographic move in the previous year have increased odds of mental health encounters. Among adolescents, this increase extends to psychiatric hospitalizations and emergency visits.
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