HONOLULU – Deployment of a parent in Afghanistan or Iraq increases the risk of a child’s hospitalization for mental health problems by about 10%, compared with other children in military families, according to a study from the Uniformed Services University of the Health Sciences in Bethesda, Md.
"The longer you are deployed, the more chance of a hospitalization for [your] child," said Dr. Jeffrey Millegan, a disaster and preventive psychiatry fellow at the university and a lieutenant commander in the Navy.
Children with past psychiatric problems are at greatest risk, followed by those with civilian mothers who have their own psychiatric issues. "If the civilian mother has more psychiatric problems during the deployment, that leads to worse outcomes in the child," he said at the annual meeting of the American Psychiatric Association.
Pediatricians and primary care providers should keep the findings in mind when dealing with children from military families.
"Be aware of the fact that these kids may be more vulnerable while [a] parent is deployed," Dr. Millegan said. Ask questions during routine visits about how things are going at home and how kids are dealing with having a parent away, he recommends If problems are identified during routine visits, take the kids to outpatient psychiatric care before they turn into issues that require hospitalization, he added.
To arrive at the findings, he and his colleagues linked the medical records of 377,565 children aged 9-17 years to their parents’ service records from fiscal years 2007-2009. In all, 32% of children and adolescents had a parent who deployed to Afghanistan or Iraq. Psychiatric hospitalizations were identified by ICD-9 codes.
The patients’ mean age was 12.5 years; half were boys, and most had married parents. The mean age of the deployed parent was 38 years; more than 90% were fathers away for a median of 11 months.
The adjusted odds ratio for hospitalization of a child with a deployed parent was 1.10, and 1.12 for deployments longer than 6 months, both findings statistically significant. Hospitalizations lasted about a month on average.
Typically, families do poorly at the start of a deployment, get into a groove toward the middle, and face another tough readjustment as the deployment comes to an end, Dr. Millegan said.
It can be especially hard on adolescents already struggling with boundary and transition issues. "Eleven months is a very significant length of time during a period when a lot of big developmental things are going on," he said.
In addition to paying extra attention to children’s psychological states, it’s also important to keep a close eye on family dynamics during deployment. "Be in tune with the mother and other people in the family," he said. "Everybody affects everybody else. They are all intertwined."
Dr. Millegan said he has no disclosures. The study received no outside funding.