Adolescents in Military Families at Higher Risk of Poor Mental Health Outcomes, Compared to Peers, USC Study Finds

Study Suggests Need for Routine Screening and Additional Services by Schools, Health Providers

Contact: Eddie North-Hager at 213-740-9335 or edwardnh@usc.edu.

Nov. 19, 2013 — Adolescents with a parent or a sibling who has been deployed are more likely than their nonmilitary peers to feel depressed, contemplate suicide and report poorer overall well being, according to a USC study of 14,299 adolescents in California. Over 13 percent of those in the study had parents or siblings in the military.

The study was based on surveys collected from the California Department of Education and finds that children and youth from military families who experienced multiple deployments are at a higher risk of feeling sad or hopeless, with according to the study, which appears this month in the Journal of Adolescent Health.

“Given the link between separation and emotional health, it is not surprising that adolescents experiencing deployments were more likely to report feeling sad or hopeless, depressive symptoms, and increased suicide ideation and that more deployments further exacerbated these experiences,” said Julie A. Cederbaum, the lead author of the study and one of a team of researchers from the USC School of Social Work.

Data used came from the California Healthy Kids Survey given to all 7th, 9th, and 11th graders in California.  The current study looked at a subsample of California schools with high concentrations of military students. Unlike most studies on the mental health of military-connected children, this one is drawn from a nonclinical sample of students in public schools.

It also compares military-connected youth with nonmilitary-connected youth attending the same classrooms and schools, and living in the same communities. Past studies have been conducted in settings such as mental health clinics, hospitals, or at therapeutic summer camps specifically designed for military-connected children.

Analysis shows that 33.7 percent of students with a parent in the military and over 35 percent of those with a sibling in the military said they felt sad or hopeless during the past year. Almost 25 percent of 9th and 11th grade students with a military parent and over 26 percent of students with a military sibling thought about ending their lives.

That compares to 31 percent of students with no one in the military who said they felt sad or hopeless during the past year. And 19.1 percent of 9th and 11th grader with no one in the military who thought about ending their lives.

“These findings match those published earlier this year in a similar, separate analysis which focused on substance use among military youth,” said Tamika Gilreath, a co-author for this study and a lead researcher for a series of several papers on the well-being, health behaviors, and experiences ofschool-age children in military families. “It is not military family connection itself but the youths’ and families’ experiences associated with the past 10 years of war. It is important that we begin to take necessary steps to prevent and intervene in the well-being of our military-connected youth.”

As in other studies, girls are more likely than boys to report poor well-being. One reason, the researchers suggest, is that adolescent girls may take on more responsibility at home when one parent is deployed.

The authors also offer other possible explanations for why military children in their early teen years may be experiencing feelings of sadness, suicidal ideation and other depressive symptoms.

Adolescents, more than younger children, may have a better understanding of the consequences of war. And even if they support their deployed parent they may also “perceive deployment as a burden on them and on the nondeployed parent,” the authors write.

Previous research suggests that an adolescent’s mental well-being may also depend on how well the parent at home is handling the stress of the deployment.

The study’s focus on siblings as well as parents in the military is fairly rare, the authors found. A sibling’s deployment can also lead to changes in family roles and dynamics. Less is known about how a young person is affected by a sibling’s deployment. But since adolescence is a time of increasing independence from parents—and a teen may feel more connected to an older brother or sister than a parent during this time—it’s possible that a sibling going off to war may have an even greater impact, as the findings of this study indicate, the authors suggest.

The authors suggest public schools, mental health providers and physicians systematically screen adolescents – especially those in military-connected families and those experiencing parental or sibling deployment – for depression and suicide ideation

“Providers can be trained to identify warning signs that an adolescent may be experiencing problems and should be supported with referrals to evidence-based interventions that can reduce the long-term consequences of deployment-related stressors,” the authors write.

“Increasing capacity of support personnel in medical and school settings can help identify the mental health risks and needs of adolescents with military-connected parents and siblings,” Cederbaum said.

The other authors are Ron Avi Astor, Monica Esqueda and Hazel Atuel, also from the USC School of Social Work, Rami Benbenishty from the School of Social Work at Bar Ilan University in Israel and Kris De Pedro of the Chapman University College of Educational Studies.