There are more than 1.2 million military children ranging between birth and 23 years of age. Their lives are filled with the inherent danger of military operations, frequent moves, intermittent separation, the threat of a terrorist attack, and dramatic and graphic television coverage of military conflict. Children of active duty service members are potentially at a higher risk to develop mental health conditions than children in the general population.
Some indicators of potential difficulties include: preceding family dysfunction, mental health issues, special needs children, particular closeness to the deployed parent and recent family relocation with limited or no support systems in place. Two childhood behavioral health conditions that are especially problematic to military families are obsessive-compulsive disorder and oppositional defiant disorder. The latter condition is a significant problem when military families want to relocate overseas because this disorder in a child can disqualify them from an overseas assignment.
Military children are subjected to an “emotional cycle of deployment.” The signs and symptoms that should alert us to potential problems vary with each age group.
- Among infants, irritability, difficulties with comforting by self or caregiver, and sleep and eating disturbances are common indicators.
- Preschool and kindergarten children may start clinging to people, a favorite toy or a blanket. They may have periods of unexplained crying or tearfulness, may choose adults over same-age friends, may show increased violence toward people or things, start distancing themselves from people, become quieter, have difficulties eating and sleeping, and show regression in behaviors such as bed wetting.
- School aged children may, in addition to the above, present with changes in behavior, stomach aches, headaches, irritability, school problems, school avoidance, and fights.
- Adolescents may, in addition to the above, begin acting out behaviors (trouble at school, home or the law), as well as present with low self-esteem and self-criticism, misdirected anger (excess anger over small incidents), depression and anxiety. They may tend to downplay their worries.
For the deploying parent, it is recommended he or she talk and share feelings with the child about separation, discuss ways to keep in touch, plan a special activity before deployment, swap important personal belongings with the child to keep during separation, take family pictures, and tape a favorite story. Communication with the deployed parent should be encouraged and the deployed parent should be encouraged to send separate letters to each child.
The non-deployed parent or guardian must maintain routines and discipline while being reassuring. He or she should listen, discuss feelings, answer questions honestly and dispel rumors, provide age-appropriate explanations, encourage communication, and allow the child to talk. The parent should monitor the amount of time the child watches news as well. Parents should discuss the news with the child; ask what the child heard and what questions the child may have, while providing reassurance and a sense of safety. Be sure to look for signs of fear and anxiety during your conversation.
Non-deployed parents need support as well. They have real issues related to the deployment and risks to which the deployed family member is exposed. It is important they stay physically and mentally healthy. The reunification of the family can present challenges and requires preparation. Children and spouses have changed and family roles may have to be redefined.
To successfully face and resolve all the challenges present through all the different phases of deployment, the family may need to use external resources for support. For your benefit and use, some of them have been included below.
- Military Family Centers: Army Community Service Centers (ACS), Family Service Center (FSC) (Navy, Marines, Coast Guard), Family Support Center (FSC) (Air Force)
- Resources within Military Installations: family centers, family support groups, legal assistance office, chaplain’s office, pediatric clinic (primary care clinics), mental health clinic, social work services. These are services where you can get reliable information during deployments and have the opportunity to build relationships with others who share common interests. The school system is another source of support and information for the family.
Outpatient Mental Health Visits
Children who may be suffering from any type of mental health problem can receive treatment via the self-referred, outpatient mental health benefit. Visit TRICARE's Mental Health page to learn more on this benefit.
Even if you merely suspect a child has a mental health problem, there is no obligation to continue treatment beyond the initial consultation, so it is important for the child to meet with a qualified provider.
If possible, try to locate an age-specific provider who specializes in the type of disorder you believe the child may have. Be careful to select a provider in the TRICARE network using the Network Provider Directory. Otherwise, TRICARE Prime families will incur additional charges under the TRICARE Prime Point of Service option.
Case Management Services
If you or a family member needs assistance coordinating medical care, therapy or additional resources, our case management program may be able to assist. Visit our case management page for more information, including how to self-refer to the program.