Families of Deployed Reserve, National Guard Soldiers Face Challenges

Bob Roehr

November 16, 2010

November 16, 2010 (Denver, Colorado) — Deployment of American military forces to Iraq and Afghanistan has entailed mobilizing a substantial number of Reserve and National Guard soldiers from the civilian sector for a tour of duty in a war zone, and then reintegrating them into society after their return home.

Although the news media no longer give much attention to these deployments, they continue to take place, even as force levels in Iraq have been reduced. More than 900 such soldiers in the Boston, Massachusetts, area are preparing to deploy overseas, for example; some for the second or third time. The mental health issues of their families at home and the reintegration of returning soldiers into family life and society continue to be concerns.

David Prouty, MSW, from Boston University, presented information here at the American Public Health Association 138th Annual Meeting on a home-based program that addresses these issues for families with young children.

Approximately 1.9 million soldiers have been deployed, more than 40% of whom have served multiple tours of duty. Repeated deployments can exacerbate mental health issues. Mr. Prouty said there is much greater reliance on National Guard/Reserve forces during this war than in the past, which has a different effect on the population than traditional levels of these personnel are used.

"Children are very resilient, but with more months of deployment [by their parents,] they are more prone to behavior problems and mental health issues, such as depression and anxiety. The 0 to 5 [years of age] population are particularly vulnerable" because of their stage of development, he said.

Study Baseline

The study population consists of families with deployed soldiers living within about a 2-hour drive of Boston. The first phase of the program involved qualitative interviews with 39 service members, 31 spouses or partners, and focus groups with childcare providers, which helped identify the needs of the population. Phase 2 was a pilot study of interventions. At this time, the researchers are about a quarter of the way into phase 3, which is a randomized controlled trial of interventions.

Mr. Prouty said the average deployment was 12 months, 54% of the spouses had 2 or more deployments, and there was an average of more than 2 children in the household.

"There was high parenting stress, [measured by] the Parenting Stress Index. Service members in particular were pretty high on the anxiety and hostility scales of the [Parenting Stress Index]: 13% met the criteria for [posttraumatic stress disorder], which is about on par with what other data are showing," Mr. Prouty said. Service members rated themselves lower on indicators of stress than what the evaluations revealed, and spouses rated the service members higher.

The soldiers were more hypervigilant and aggressive. They missed connections with their children and spouses. Many of the spouses who remained at home felt lost and abandoned, Mr. Prouty said.

"Our female service members who were deployed were all single or partnered with another soldier," said Abigail Ross, MSW, senior author of the study.

"The implications of one parent being away get doubled" when both parents are deployed, he said, but the number of families in which this occurred was so small "that it is difficult to say anything conclusive."

"What they told us is that we need to find a way to present their deployment to young kids in terms that they can recognize . . . and to help construct a narrative that will let them all be on the same page, because a lot of the families were getting ready to go for another deployment," said Mr. Prouty.

Phase 2

Phase 2, the pilot program of interventions, involved 9 families and 2 family specialists who went to their homes. The program modules have great flexibility in how to use and adapt them. Participants showed great interest in the program, and all of the families completed their sessions. According to Mr. Prouty, "we did see some improvement in all of the pilot families on the kids' Child Behavior Scale score."

Ms. Ross said that so far they have not stratified any of their analyses by the sex of the child, but anecdotally, "I think it was more the age of the child that influenced the response." Reintegration also depended on what happened to the soldier during the deployment.

Isolation is a major issue, according to Ms. Ross. The families of active-duty soldiers are on or near a large military base, where "people are experiencing the same thing at the same time, which we have heard is a very valuable support."

"The access and utilization really differs" with the families of the National Guard and Reserves, she said. "If the base is 2 and a half hours away, you're not going; it's too hard to get the kids in the car and coordinate getting there, which is why our program is home-based," Ms. Ross explained. "Geographic dispersal is the biggest barrier."

There also is a different social/cultural milieu. Regions surrounding large bases are much more supportive of military personnel and policies than places like Boston, which are not always as supportive of the wars or the military, she noted.

Isolation can be a big issue for school-aged children of National Guard and Reserve soldiers, who may be the only one in their class who has a deployed parent; they are facing the anxiety and isolation alone. The situation is different for children living on or near a military base, where a large number of their peers are facing the same issues.

Ms. Ross's advice is, "with the Guard and Reserve population, the big thing [for the clinician] is to be asking [about a parent's deployment], because it is not a typical part of what pediatricians look for" in developmental issues.

Support for the study was provided by the Department of Defense. The authors have disclosed no relevant financial relationships.

American Public Health Association (APHA) 138th Annual Meeting: Abstract 3065.0. Presented November 8, 2010.

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