Children of Deployed Parents Taken for More Mental Health Visits

In military families, the rates of visits to clinicians are quite different if the children's mothers or fathers are deployed overseas than if the parents are stationed stateside.

Children of military parents who were deployed overseas had significantly fewer overall visits to health care providers than did children whose parents were stationed at home, but children of deployed parents had more mental health visits, according to a new study published online November 8 in Pediatrics.

The children of deployed parents recorded 11 percent fewer outpatient visits for physical health issues during the parent's deployment, but 11 percent more visits for mental or behavioral health, wrote Gregory Gorman, M.D., M.H.S., an assistant professor of pediatrics at the Uniformed Services University of the Health Sciences in Bethesda, Md., and colleagues.

Those percentages may seem modest but have significant implications, given the large absolute numbers involved, said Gorman in an interview with Psychiatric News.

“That's an extra 60,000 visits for which providers - mostly in primary care - need to be ready to recognize and manage mental health symptoms at a time when pediatric mental health resources are already in great demand,” he said.

“Visits” covered outpatient office visits to any type of provider, whether primary care or mental health specialists.

The retrospective cohort study linked medical records from October 2005 through September 2007 for 642,397 children of military personnel with the deployment records of 442,722 parents.

The children were aged 3 to 8, with an average age of 5. The deployed parents' average age was 34, and about 90 percent were male.

Over two-thirds of the visits in the study were made to civilian providers under the authority of Tricare, the Department of Defense's health insurance management contractor.

The study covered more than 6.5 million patient visits, including 611,115 mental health visits. The most common mental health diagnosis was attention-deficit/hyperactivity disorder, accounting for 30.1 percent of all mental health diagnoses.

Among the mental health visits, the relative rate of mental disorders was 1.19, and of stress disorders was 1.18. The relative rate of anxiety disorders was 1.14, but was not statistically significant.

“The overall outcomes are not only statistically significant, they are also meaningful in the real world; I'm just relieved that they are not greater,” said Shelley MacDermid Wadsworth, Ph.D., M.B.A., a professor of child development and family studies and director of the Center for Families and the Military Family Research Institute at Purdue University.

The pattern of mental health visits diverged sharply depending on whether the father or mother was deployed. When the mother deployed and the father was home taking care of the children, the incidence rate ratio for mental health visits was 0.70. When the father deployed and the mother was at home, the rate rose to 1.19.