Article

Deployment and the Use of Mental Health Services among US Army Wives

Department of Epidemiology, University of North Carolina, Chapel Hill, USA.
New England Journal of Medicine (Impact Factor: 54.42). 01/2010; 362(2):101-9. DOI: 10.1056/NEJMoa0900177
Source: PubMed

ABSTRACT Military operations in Iraq and Afghanistan have involved the frequent and extended deployment of military personnel, many of whom are married. The effect of deployment on mental health in military spouses is largely unstudied.
We examined electronic medical-record data for outpatient care received between 2003 and 2006 by 250,626 wives of active-duty U.S. Army soldiers. After adjustment for the sociodemographic characteristics and the mental health history of the wives, as well as the number of deployments of the personnel, we compared mental health diagnoses according to the number of months of deployment in Operation Iraqi Freedom in the Iraq-Kuwait region and Operation Enduring Freedom in Afghanistan during the same period.
The deployment of spouses and the length of deployment were associated with mental health diagnoses. In adjusted analyses, as compared with wives of personnel who were not deployed, women whose husbands were deployed for 1 to 11 months received more diagnoses of depressive disorders (27.4 excess cases per 1000 women; 95% confidence interval [CI], 22.4 to 32.3), sleep disorders (11.6 excess cases per 1000; 95% CI, 8.3 to 14.8), anxiety (15.7 excess cases per 1000; 95% CI, 11.8 to 19.6), and acute stress reaction and adjustment disorders (12.0 excess cases per 1000; 95% CI, 8.6 to 15.4). Deployment for more than 11 months was associated with 39.3 excess cases of depressive disorders (95% CI, 33.2 to 45.4), 23.5 excess cases of sleep disorders (95% CI, 19.4 to 27.6), 18.7 excess cases of anxiety (95% CI, 13.9 to 23.5), and 16.4 excess cases of acute stress reaction and adjustment disorders (95% CI, 12.2 to 20.6).
Prolonged deployment was associated with more mental health diagnoses among U.S. Army wives, and these findings may have relevance for prevention and treatment efforts.

Download full-text

Full-text

Available from: Charles C Engel, Dec 14, 2014
7 Followers
 · 
237 Views
    • "In general, there is a lack of empirical literature on partner influence on seeking mental health services. Recent literature concerning couples' mental health utilization has focused on very specific populations, such as military couples and their experiences with stress disorders (Mansfield et al. 2010; Meis et al. 2013). Our study broadens the current literature, as we examine multiple factors that may predict mental health utilization and whether partner influence plays a role in seeking services. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Mental health issues often become apparent as adolescents emerge into young adulthood. The use of mental health services is low among adolescents and young adults, and use is particularly low among minorities. In this study, we examine mental health utilization among diverse young parenting couples. The sample consisted of 296 couples. We used the social-personal framework to examine personal, family, partner relationship, and environmental predictors for using mental health services. We used the Actor-Partner Interdependence Model to assess actor and partner effects on mental health utilization. We also examined moderator effects for gender and internalizing and externalizing behaviors. We found that being female, being White, higher income, more conduct problems, and less anxious romantic attachment predicted mental health utilization. Significant moderator effects included depression × gender, depression × medical insurance, and stress × Latino. Implications for community mental health practice include conducting mental health assessments during medical visits and systematic mental health follow-up for individuals and couples with identified mental health and support needs. Future research should include married couples and the spouse's influence on mental health use and examine relevant parenting factors that may also predict mental health utilization among couples.
    American Journal of Community Psychology 07/2015; 56(1-2). DOI:10.1007/s10464-015-9738-7 · 1.74 Impact Factor
  • Source
    • "The wars in Afghanistan and Iraq have produced behavioral health consequences including combat-related posttraumatic stress syndrome (PTSD) and traumatic brain injuries (Institute of Medicine, 2010; Tanielian & Jaycox, 2008). These wars are also associated with a wide array of other stressrelated behavioral health conditions for both service members and their spouses: depression; suicide; alcohol, tobacco, and drug use/addiction; and the relationship difficulties that disrupt personal, family, and duty functioning (Hoge et al., 2004; Institute of Medicine; Mansfield et al., 2010; Milliken, Auchterlonie, & Hoge, 2007; Seal et al., 2009). For all who serve, either directly as a service member or indirectly as a family member/significant other, military service is an occupational choice that sets one on a unique journey on the road of life and represents a life trajectory that may extend well beyond the period of military service. "
  • Source
    • "Extended deployments, in particular, were associated with worse loneliness, anxiety, depression, household strains, and occupational difficulties for the non-deployed spouse (SteelFisher et al. 2008). Spouse reports of psychological distress during deployment were confirmed using medical claims data: deployment and deployment length were associated with more diagnoses of depression, anxiety, sleep disorders, and acute stress reaction and adjustment disorders among active duty Army wives (Mansfield et al. 2010). Military children have been likewise affected by parent deployment, with many children showing increased emotional and behavioral problems during and after deployment (Lincoln and Sweeten 2011; Lincoln et al. 2008; MacDermid Wadsworth 2010; McFarlane 2009; Paris et al. 2010; Siegel and Davis 2013; White et al. 2011). "
    [Show abstract] [Hide abstract]
    ABSTRACT: The deployment of US military personnel to recent conflicts has been a significant stressor for their families; yet, we know relatively little about the long-term family effects of these deployments. Using data from prior military service eras, we review our current understanding of the long-term functioning and needs of military families. These data suggest that overseas deployment, exposure to combat, experiencing or participating in violence during war deployment, service member injury or disability, and combat-related post-traumatic stress disorder (PTSD) all have profound impacts on the functioning of military families. We offer several recommendations to address these impacts such as the provision of family-centered, trauma-informed resources to families of veterans with PTSD and veterans who experienced high levels of combat and war violence. Recent efforts to address the needs of caregivers of veterans should be evaluated and expanded, as necessary. We should also help military families plan for predictable life events likely to challenge their resilience and coping capacities. Future research should focus on the following: factors that mediate the relationship between PTSD, war atrocities, caregiver burden, and family dysfunction; effective family-centered interventions that can be scaled-up to meet the needs of a dispersed population; and system-level innovations necessary to ensure adequate access to these interventions.
    Clinical Child and Family Psychology Review 07/2013; 16(4). DOI:10.1007/s10567-013-0145-z · 4.75 Impact Factor
Show more