Prevalence of Mental Health Problems, Treatment Need, and Barriers to Care among Primary Care-Seeking Spouses of Military Service Members Involved in Iraq and Afghanistan Deployments

Division of Psychiatry & Behavioral Sciences, Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring MD 20910, USA.
Military medicine (Impact Factor: 0.77). 12/2008; 173(11):1051-6. DOI: 10.7205/MILMED.173.11.1051
Source: PubMed


Military spouses must contend with unique issues such as a mobile lifestyle, rules and regulations of military life, and frequent family separations including peacekeeping and combat deployments. These issues may have an adverse effect on the health of military spouses. This study examined the mental health status, rates of care utilization, source of care, as well as barriers and stigma of mental health care utilization among military spouses who were seeking care in military primary care clinics. The data show spouses have similar rates of mental health problems compared to soldiers. Spouses were more likely to seek care for their mental health problems and were less concerned with the stigma of mental health care than were soldiers. Services were most often received from primary care physicians, rather than specialty mental health professionals, which may relate to the lack of availability of mental health services for spouses on military installations.

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Available from: Stephen Craig Messer, Nov 17, 2014
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    • "Darwin (2009) emphasized how important family members , direct and extended kin, are to deployed soldiers and further noted that all members of the family are affected by deployment. Family members, including children of deployed persons, have been found to be at increased risk for mental health problems compared to the general public (Eaton et al., 2008; Lincoln & Sweeten, 2011; McFarlane, 2009; Mmari et al., 2010). In a study of National Guard members the majority reported concerns about their relationships with spouses or other partners and child-rearing practices, further supporting the need for family-based interventions that are often provided by social workers (Khaylis, Polusny, Erbes, Gewirtz, & Rath, 2011). "
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    ABSTRACT: Researchers surveyed licensed social workers from 5 Mid-Atlantic states to explore their perspectives on the current state of mental health and service delivery for military service workers, families, and contractors. Social workers identified needs in the following areas: mental health, physical health and wellness, social and environmental, interpersonal and family, and military-specific needs. The major- ity of needs were most critical during the postdeployment stage. Education related to the observed needs was reported; social workers were most interested in learning about military culture and how to coordinate resources within the community to support the total military community. Suggestions for social work education and future research are discussed.
    Full-text · Article · Oct 2014 · Journal of social work education
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    • "During the deployment cycle, children are necessarily separated from one parent and experiencing the grief and loss reactions associated with that separation . At the same time, children must rely more heavily on the remaining parent, who is at heightened risk for experiencing distress and emotional symptoms such as those associated with depression and anxiety (Eaton et al., 2008). Given the centrality of the caregiving environment for early child development, the impact of deployment on young children is heavily influenced by parental stress and corresponding sensitivity to child needs (Alink et al., 2009; De Wolff & van IJzendoorn, 1997; Hirsh-Pasek & Burchinal, 2006; Hoffman, Marvin, Cooper, & Powell, 2006; Lincoln, Swift, & Shorteno-Fraser, 2008). "
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    ABSTRACT: Although often eagerly anticipated, reunification after deployment poses challenges for families, including adjusting to the parent-soldier's return, re-establishing roles and routines, and the potentially necessary accommodation to combat-related injuries or psychological effects. Fourteen male service members, previously deployed to a combat zone, parent to at least one child under seven years of age, were interviewed about their relationships with their young children. Principles of grounded theory guided data analysis to identify key themes related to parenting young children after deployment. Participants reported significant levels of parenting stress and identified specific challenges, including difficulty reconnecting with children, adapting expectations from military to family life, and coparenting. Fathers acknowledged regret about missing an important period in their child's development and indicated a strong desire to improve their parenting skills. They described a need for support in expressing emotions, nurturing, and managing their tempers. Results affirm the need for support to military families during reintegration and demonstrate that military fathers are receptive to opportunities to engage in parenting interventions. Helping fathers understand their children's behavior in the context of age-typical responses to separation and reunion may help them to renew parent-child relationships and reengage in optimal parenting of their young children.
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    • "The impact of deployment on service members' mental health is well documented (Cook, Riggs, Thompson, Coyne, & Sheikh, 2004; Hoge, Auchterlonie, & Milliken, 2006), but research examining deployment's impact on military families lags far behind, with extant studies suggesting that military couples are at risk for poor outcomes after deployments (Goff, Crow, Reisbig, & Hamilton , 2007). Furthermore, nondeployed spouses (NDSs) are also at increased risk for clinically significant psychiatric distress during and after their spouse's deployment (e.g., Eaton et al., 2008; Lester et al., 2010). For NDSs, deployment has the potential to undermine feelings of security in the relationship itself. "
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    ABSTRACT: Although much is written about the impact of deployment on nondeployed spouses (NDSs) and couple relationships, few empirical studies address this directly. Using attachment theory as a guiding framework, this study followed 32 NDSs across a military deployment. We examined the prospective association between NDSs' attachment avoidance and their response to relational challenges (assessed using both correlational and experimental designs) during a deployment. Two weeks before deployment, NDSs provided self-reports of their attachment avoidance and relationship satisfaction. During the deployment, they provided stream-of-consciousness speech samples regarding (a) the deployment and (b) their anticipated reunion with their spouse: after each speech sample they reported on their subjective anxiety. Based on random assignment, NDSs then completed either an experimenter-led "personal" or "relational" memory savoring task, reporting on their emotional state before and after the task. Two weeks after the deployment, NDSs reported on their relationship satisfaction. Higher avoidance was associated with more frequent anxiety word use and higher self-reported anxiety when discussing the anticipated reunion. Avoidance moderated the association between savoring condition and postsavoring negative emotion, such that in the relational condition only, greater avoidance was related to more negative emotion. Postsavoring emotional state moderated the longitudinal association between predeployment attachment avoidance and postdeployment relationship satisfaction. Results are discussed in terms of their contribution to the literature on coping during attachment stressors as well as their implications for treatment with NDSs undergoing deployment.
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