Publication year
2013
Citation Title
Parental Iraq/Afghanistan deployment and child psychiatric hospitalization in the US Military.
Journal Name
General Hospital Psychiatry
Journal Volume
35
Issue Number
5
Page Numbers
556-560
DOI
10.1016/j.genhosppsych.2013.04.015
Summary
In this retrospective cohort study of children of Active Duty military personnel, administrative records were evaluated to assess the effect of parental deployment on the rate of psychiatric hospitalization among children ages 9-17. The risk of psychiatric hospitalization increased among children with a parent who deployed, particularly for children with prior psychiatric histories. The risk of psychiatric hospitalization also increased with the length of parental deployment.
Key Findings
According to administrative records, less than 1% of the children in the study were hospitalized for psychiatric reasons.
The risk of hospitalization was 10% greater for children of deployed parents, even after adjusting for demographic variables, child and parent psychiatric history, and residential moves.
The odds of child hospitalization increased substantially for children with a past psychiatric history.
Parental deployment greater than six months was associated with increased risk of hospitalization for the child.
Implications for Program Leaders
Offer education for Service members and their co-parents about mental health resources for their children
Provide worshops for young children of military families to promote healthy coping with parental deployment and to possibly stem future mental health problems
Disseminate information regarding the impact deployment can have on child functioning
Implications for Policy Makers
Encourage the development and provision of preventive strategies for children to minimize the negative impact of parental deployment
Recommend continuing education for program staff regarding targeted interventions for at-risk children of military families (e.g., children with prior psychiatric problems)
Support programs that work with families throughout the deployment cycle
Methods
This retrospective cohort study of children of Active Duty military personnel aimed at evaluating the effect of parental deployment on rates of psychiatric hospitalization among children ages 9-17 who were Military Health System beneficiaries.
De-identified health care utilization records and demographic characteristics were evaluated in a longitudinally.
Child's previous psychiatric history, history of geographic moves in 2007, parental deployment in 2008, and child hospitalization in 2009 were assessed.
Participants
The final sample consisted of 377,565 children of members of Active Duty US military.
Thirty-two percent of the children had a parent who deployed in 2008.
The average age of the sample was 12 years (range 9-17 years). Similar numbers of males and females were included.
The Active Duty parents of the children were primarily male (93%), married (90%), and White (62%). Forty-one percent were in the Army; Air Force and Navy each represented about a quarter of the Active Duty parents.
Limitations
Children of dual military families and those with a parent in the Reserves and National Guard were excluded, limiting generalizability to those populations.
Relatively few variables were evaluated in terms of their potential impact on psychiatric hospitalization among children of military families; other variables may have contributed to increased psychiatric hospitalization among children of deployed military personnel.
This study did not assess the impact of multiple deployments on children's psychiatric hospitalizations which could influence the outcome measured.
Avenues for Future Research
Identify children of military personnel who are at greatest risk for mental health problems
Evaluate how factors involving both the deployed parent (e.g., exposure to combat, injury, readjustment difficulties, number of deployments) and nondeployed parent (e.g., stress, mental health problems, and family disruption associated with partner deployment) each contribute to psychiatric hospitalization among children
Replicate this study among dual military families and children of National Guard and Reserve personnel
Focus
Multiple Branches
Target Population
Population Focus
Military Branch
Military Component
Abstract
Objective: Members of the US armed forces have been heavily deployed in support of wars in Afghanistan and Iraq. This study examined the affect of a parent's deployment to war on the rate of psychiatric hospitalization among their children. Methods: This was a retrospective cohort study. Records of children of active duty personnel during fiscal years 2007 through 2009 were linked with their parent's deployment records. Psychiatric hospitalizations were identified using International Classification of Diseases, Ninth Revision codes on admission. Odds ratios (OR) of hospitalization were determined using both univariate and multivariate logistic regression. Lengths of hospital stay were also compared by linear regression using Duan's smearing estimate method. Results: A total of 377,565 children aged 9-17 years were included along with data on both their active duty and civilian parent. Mean child age was 12.53 years (S.D.: 2.5 years); 51% were male. Mean age of active duty parent was 37.8 years (S.D.: 5.2 years); 93% were male, 90% were married and 62% were white. In the study, 2533 children were hospitalized for a mental or behavioral health disorder in fiscal year 2009 with a median length of stay of 8 days. After adjusting for demographic data and past psychiatric history of the child, active duty parent and civilian parent, the OR of hospitalization for children with a recently deployed parent was 1.10 (95% confidence interval: 1.01-1.19). The OR of hospitalization increased with increasing length of deployment with a positive test of trend. There was no statistically significant difference in distribution of admission diagnoses or length of hospital stay based on deployment by the active duty parent. Conclusions: Psychiatric hospitalization increased by 10% among children aged 9-17 years when a military parent was recently deployed. The odds of hospitalization increased with increasing length of a parent's deployment.
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