More fallout from the wars in Afghanistan and Iraq: Children with an active-duty parent deployed there for long periods were more likely to be diagnosed with a mental health problem than children whose parents were not deployed, researchers reported on Monday.
In the 10 years since the two wars began, more than 2 million servicemen and -women have served in wartime duties, with more than half of them being deployed more than once, according to the National Military Family Association, a support organization.
Those serving in Iraq and Afghanistan are more likely to have families than their counterparts in any wars in U.S. history. A majority of military children -- 75 percent -- are under the age of 11.
The study of more than 300,000 children, conducted by researchers at the National Center for Posttraumatic Stress Disorder in Honolulu, found that 16.7 percent of children with deployed parents had a mental health diagnosis -- most often anxiety, behavioral problems, depression, sleep disorders, and stress disorders -- during the study years, 2003 to 2006.
"We observed a clear dose-response pattern such that children of parents who spent more time deployed between 2003 and 2006 fared worse than children whose parents were deployed for a shorter duration," the researchers wrote in the Archives of Pediatrics and Adolescent Medicine. "Similar to findings among military spouses, prolonged deployment appears to be taking a mental health toll on children." They urged further research among other branches of the military as well as the National Guard and Reserve.
More than 62 percent of parents were deployed at least once during that period, for an average of 11 months. Mental health diagnoses became more common as the length of deployment increased. And older children and teens were more likely to have problems, the team reported.
The study findings were no surprise to Dr. Catherine Mogil, a clinical director and director of training at FOCUS Project, a resiliency training program for military families.
Mogil said she meets children all the time who are stressed out from the deployments and feel there is nowhere to turn.
“Over time, multiple deployments put serious wear and tear on children. It wears on their resiliency, in a group that is very resilient,” she said. “Every kid we talk to worries and has concerns; often they feel like they are in it alone. A lot of times the non-service-member parent is stressed and depressed, and it trickles down to the children.”
The stress does not end when the deployed parent comes home from war, Mogil said. In a study she conducted in 2010, she found that while a caregiver's stress level tended to diminish when the service member returned from war, the child’s stress level remained high.
“We don’t know why their stress level didn’t go down, but we know from speaking with children that they are hypervigilant and constantly concerned about danger. Many children said every time their parent was [deployed], the likelihood of the parent getting injured increased," Mogil said in a telephone interview.
“In a typical culture, they wouldn’t be imagining things like that. The war is raising questions about mortality a little earlier for them,” she added.
The ability to cope with a parent being on active duty becomes increasingly hard for kids who aren’t living on a military installation or in a community where there is a large military presence, Mogil said. She noted that some military offspring complain of being bullied by civilian children for having an absent parent or “a dad who kills people.”
“It’s not just kids being mean,” said Joyce Raezer, director of the National Military Family Association. “Sometimes you have teachers who go on anti-war rants not knowing or even not caring that there is a military child in the class.”
Raezer said that only 30-40 percent of military families actually live on bases -- where they have doctors, educators, and community members aware of the sensitive situations the families are in. Often, children and families are going to medical and mental-health professionals who might not have training in dealing with military families.
For National Guard members and reservists, who do not live on bases and are often not in military communities, access to educators and medical professionals familiar with the stresses on military families can be limited, Mogil said.
National Guard and Reserve members are given military benefits when deployed, but they lose those benefits some time after returning from active duty. Thom Bornemann, director of the mental-health program at the Carter Center in Georgia, said that the Defense Department has extended the length of those benefits with recent investigations into post-traumatic stress disorder. But he noted that details on whether the family members get those same extended benefits are murky.
In some cases, military families might have access to mental-health professionals but won't seek help because of the social stigma surrounding mental-health issues, Bornemann said.
Bornemann studied service members and the families of troops and families coming home from Vietnam as well as Iraq and Afghanistan. While there were cases of mental-health issues after Vietnam, he said, the mental-health outcomes of that war could not be compared to those related to the conflicts in Iraq and Afghanistan because of their length and the multiple deployments.
“The length of this war is unprecedented. These are different wartime conditions,” he said. “That, with the frequency of deployments, really puts families and children at risk for stress. Not all military families experience pathological conditions, but the challenges they are facing are unprecedented.”
The lengthy wars, multiple deployments, and strain on the family could even hurt future military enrollment, Raezer said. Military "brats" have historically been a strong source of recruits, she said, but with kids experiencing a 10-year war and having mental-health diagnoses, she worried that more may choose other careers or be ruled ineligible to serve.
Raezer and Mogil said further research needs to be conducted in the field to get a better understanding of what will happen to children of military families when they enter high school, college, and the work force. Raezer also said that research concerning the children of single-parent active-duty service members, military moms, and dual-deployment families needs to be conducted.