Understanding the emotional health and wellbeing of our Military Children and Young People

Paul Watson RN (mental health) Twitter @Paul_RMHN

Recent conflicts in both Iraq and Afghanistan have seen British Armed Forces at war for over 12 years. The extreme length of combat operations has seen a growth in both governmental and public support for the ‘troops on the ground’. There has been a distinctive escalation in government and private funding specifically to address the needs of military personnel and their families, through both long standing organisations including the Royal British Legion and newly formed charity organisations including Help 4 Heroes and Combat Stress to name a few (Gribble et al. 2014). Importantly there has also been some key policy change within the United Kingdom (UK), namely the Armed Forces covenant (MOD, 2012) to support those men and women returning from combat with both physical and psychological injuries and their reintegration into the civilian population. There are an estimated 170,000 “full time” service children (The Royal Navy and Royal Marines Children’s Fund, 2009). Service Children are defined as having one or both parents serving in Her Majesty’s  Forces (O’Neil, 2013).

The Office of National Statistics (ONS) identified that mental health affects between 10-20% of all children and young people in the UK (ONS, 2005). Furthermore, 12% of 5-16 year old children and young people have a diagnosed mental health condition, with conduct disorder nearing 7% and emotional disorders around 5%. To contextualise, in 2013 records indicated that in the UK there are 13.3 million children and young people up to and including 16 years of age (ONS, 2013). American research shows that there is a further 11% increase of military dependent children and young people who access mental health service when one or both parents are deployed to war (Johnson & Ling, 2012). Arguably within the UK, the effects of parental or sibling deployment could similarly affect the emotional health and well-being of service children and young people (Fossey, 2012). Therefore, potentially creating a greater need for military children and young people to access mental health services and the services of specialist school nurses.

Academics globally including the UK, have explored the impact war has on military personnel and the potential effects they may experience when returning home. In the UK theKing’s Centre for military health and the Academic Centre Defence Mental Health are the predominant facilitators in producing both qualitative and quantitative research around the effects war has on British service personnel and veterans’ health. Their extensive research looks at a multitude of pre and post combative effects on health including: post traumatic stress disorder (PTSD) (Sundin et al. 2010), traumatic brain injuries (TBI) (Jones, Rear, & Wessely, 2007), pre-deployment stress (Sharpley et al. 2008), mental health (MacManus et al. 2014) re-integration and the military family (spouse/partner) (Burgh et al. 2011; Harvey et al. 2011) to mention but a few. Importantly, this indicates  that there is a great amount of effort made to acquiring greater knowledge and develop an evidence base to understanding the effects combat has on some military personnel.

American research highlights the emotional effects that war has on children and young people left behind during parental/sibling deployment, and their need for public and voluntary support. Children and young people also suffer the psychological effects of parental/sibling deployment (Cederbaum et al. 2013). Additionally, children and young people present with a change in behaviours, both internally (Lester et al. 2010) and externally (Reed, Bell, & Edwards, 2011) demonstrating the need for continual social connectivity (Mmari et al. 2010; O’Neil, 2013). Worthy of note is that children and young people also struggle with the reintegration and mental health of a returning deployed parent or sibling (Harvey et al. 2011) in part due to role confussion.

Those who experience Service/Military life are unique and often face very different challenges compared to the civilian population (O’Neil 2013). Service life offers families both positive and negative experiences and in the main families will take these challenges within their stride. This blog highlights that some military children and young people have an increased risk of poor emotional health and behavioural difficulties during parental or sibling deployment. Furthermore, military dependant children and young people are at greater risk of maltreatment due to the increased parental stress and anxiety on the parent who remains at home. Therefore, it is important that structures are in place to support the stay-at-home parent to address their emotional and psychological needs, to enable them to support their child’s emotional and behavioural needs, thus remaining childocused and meeting the needs of the whole family.

Paul Watson was a military child and served in the British Armed Forces 1996-2003. Paul is now a registered mental health nurse, undertaking his SCPHN School Nursing PgDip focusing on the lives of military children.

Join us Wednesday 28th May 2014  20:00 -21:00 for #EBNJC on understanding emotional health needs of military children and young people.

Reference List

Burgh, T. D., White, C., Fear, N., & Iversen, A. (2011). The impact of deployment to Iraq or Afghanistan on partners and wives of military personnel. International Review of Psychiatry , 23, 192-200.

Cederbaum, J., Gilreath, T., Benbenishty, R., Astor, R., Pineda, D., DePedro, K., et al. (2013). Well-Being and Suicidal Ideation of Secondary School Students From Military Families . Journal of Adolescent Health , 1-6.

Fossey, M. (2012). Unsung Heroes: Developing a better understanding of the emotional support needs of service families. Centre for Mental Health. London: Centre for Mental Health.

Gribble, R., Wessely, S., Klein, S., Alexander, D., & Fear, C. D. (2014). Public Awareness of UK Veterans Charities. The RUSI Journal , 159 (1), 50-57.

Harvey, S., Hatch, S., Jones, M., Hull, L., Jones, N., Greenburgh, N., et al. (2011). Coming home: social functioning and the mental health of UK Reservists on return from deployment to Iraq or Afghanistan. Annals of Epidemiolology , 21 (9), 666-672.

Johnson, H., & Ling, G. (2012). Caring for military children in the 21st century. American Acadamy of Advanced Nursing , 1-8.

Jones, E., Rear, N., & Wessely, S. (2007). Shell shock and mild traumatic brain injury: a historical review. American Journal of Psychiatry , 164 (11), 1641-1645.

Lester, P., Peterson, K., & Reeves, J. (2010). The long war and parental combat deployment: Effects on military children and at-home spouses. American Academic Child and Adolescent Psychiatry , 49, 310-320.

MacManus, D., Jones, N., Wessely, S., Fear, N., Jones, E., & Greenberg, N. (2014). The mental health of the UK Armed Forces in the 21st century: resilience in the face of adversity. Army Med Corps Journal , 1-6.

Mmari, K., Bradshaw, C., Sudhinaraset, M., & Blum, R. (2010). Exploring the role of social connectedness among military youth: Perspecptions from youth, parents and school personnel. Children and Youth Care , 39, 351-366.

MOD. (2012). Armed Forces Covenant. Retrieved April 18, 2014, from Gov.uk: https://www.gov.uk/the-armed-forces-covenant

O’Neil, J. (2013, January). Written evidence from Joy O’Neill, Founder and Chair, The Service Children Support Network. Retrieved January 2, 2014, from Parliament – Defence Committee: http://www.publications.parliament.uk/pa/cm201314/cmselect/cmdfence/586/586vw08.htm

ONS. (2005). Mental health of children and young people in Great Britain, 2004. Retrieved December 06, 2012, from http://www.ic.nhs.uk/webfiles/publications/mentalhealth04/MentalHealthChildrenYoungPeopleSummary310805_PDF.pdf

ONS. (2013). Statistical Bulletin: Families and Households. Retrieved April 2, 2014, from Office of National Statistics: http://www.ons.gov.uk/ons/rel/family-demography/families-and-households/2013/stb-families.html#tab-Dependent-children

RBL. (2005). Profile of the Ex-Service Community in the UK. The Royal British Legion. London: RBL.

Reed, S., Bell, J., & Edwards, T. (2011). Adolescent well-being in Washington state military families. American Journal of Public Health , 101, 1676-1682.

Sharpley, J., Fear, N., Greeberg, N., Jones, M., & Wessley, S. (2008). Pre-deployment stress briefing: does it have an effect? Occupational Medicine , 58 (1), 30-34.

Sundin, J., Fear, N., Iversen, A., Rona, R., & Wessley, S. (2010). PTSD after deployment to Iraq: conflicting rates, conflicting claims. Psychological Medicine , 40, 367-382.

The Royal Navy and Royal Marines Children’s fund. (2009). The Overlooked Casualties of Conflict. Portsmouth: The Royal Navy and Royal Marines Children’s fund.

 

 

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