Caring for children and youth from Canadian military families: Special considerations

Question 1

What do the Canadian forces consist of?

Answer 1

1. Regular Force (enrolled full time)

2. Reserve Force

Question 2

What are the medical and dental benefits for Canadian forces?

Answer 2

1. Continuous for regular forces from enrollment to date of release
2. Only during eligible periods for reserve force

Question 3

What is a deployment?

Answer 3

A short-term assignment (1-15m) to a combat or noncombat zone and can be routine training, planned or unexpected

Question 4

What percentage of Canadian military spouses have experienced the deployment of their partner?

Answer 4

70%

Question 5

What percentage of military members are either married or living common-law?

Answer 5

59%

Question 6

What percentage of military couples have children?

Answer 6

75%

Question 7

What percentage of Regular Force families live in civilian communities?

Answer 7

83%

Question 8

What factors distinguish military families from civilian families?

Answer 8

1. Mobility
2. Separation
3. Risk

Question 9

What does relocations impact?

Answer 9

1. Access to and continuity of health care
2. Quality child care or schooling
3. Establishment of social circles
4. Access to immediate and extended families

Question 10

What is health insurance coverage for military families?

Answer 10

Public provincial/territorial health care system
Supplemental insurance and benefits provided through the Public Service Health Care Plan and the Canadian Forces Dental Care Plan

Question 11

What changes occur to health care visits in children when a military parent is deployed?

Answer 11

1. increased mental health visits
2. increased behavioral visits
3. increased injury related visits
4. increased child maltreatment visits in children 3-8yo
5. increased suicide attempts in teens
6. decreased health visits for other diagnoses

Question 12

What are the mental health and behavioral concerns in children of deployed military personnel?

Answer 12

1. increased behavioral concerns
2. decreased school performance
3. higher levels of sadness and worry
4. increased depression
5. increased acute stress disorder and adjustment disorder
6. increased sleep difficulties
7. increased emotional difficulties

Question 13

What is the incidence of child abuse in families with one parent deployed compared to non-deployed military families?

Answer 13

42% higher

Question 14

What is the effect of parental deployment on child development?

Answer 14

Three times more likely to fail the age-appropriate Ages and Stages Questionnaire 3

Question 15

What is the effect of spousal deployment on the at home parent?

Answer 15

1. increased depression
2. increased anxiety
3. spousal underemployment or unemployment

Question 16

What are risk factors for coping difficulties in families during deployment?

Answer 16

1. younger parental age
2. young childrn
3. having a family member with a prior psychopathology
4. having children with special needs
5. having a child with pre-existing emotional or behavioral difficulties
6. pre-deployment marital or financial problems
7. spouse for whom English is a second language
8. recent relocation
9. no firm return date for deployment
10. assignment to higher threat locations
11. Army service
12. lower rank

Question 17

What percentage of soldiers have symptoms of PTSD in the first six months following deployment?

Answer 17

20-30%

Question 18

What percentage of Canadian Forces members report either depression, PTSD, GAD, panic disorder or alcohol use or dependence?

Answer 18

16.5%

Question 19

What is PTSD in parents linked to in children?

Answer 19

1. increased rates of internalizing and externalizing behaviors
2. impaired parent-child bonding
3. general behavior problems
4. increased child neglect

Question 20

How much less likely are Canadian military families to have a family physician than civilian families?

Answer 20

Four times less likely

Question 21

What populations are at especially high risk due to relocations resulting in disrupted continuity of care?

Answer 21

1. Chronic illness
2. Developmental disorders
3. Learning problems
4. Complex medical need

Question 22

What percentage of Canadian Regular Forces families have a child with special needs?

Answer 22

8.2%

Question 23

What are recommendations for health care professionals providing care for military children and youth?

Answer 23

1. identify military families in the community or practice setting and acknowledge their unique needs
2. build awareness around mental health
3. screen for anxiety, depression, behavioral problems, academic difficulties, peer relational problems, or high risk behaviors
4. Respond to treatment needs for mental health in a timely and sensitive manner
5. anticipate common age-specific issues and reactions during deployment and counsel parents accordingly
6. ensure continuity of care
7. carefully review and ensure primary care surveillance (growth, immunizations, development)
8. be aware of supportive resources

Question 24

What recommendations are there for the government re: military families?

Answer 24

1. officially recognize military families as needing special attention within the health care system
2. increase access to medical and mental health services
3. ensure access to appropriate primary health care and pediatric consultative services esp. in remote locations
4. support EMR to assist with continuity of care
5. collect Canadian data related to the health of military families
6. rigorously assess the effectiveness of support programs and services delivered to military families
7. involve the school system in military communities with offering supportive services
8. work collaboratively with federal departments, national organization, local programs and research institutes