By Iris Smith, Ph.D.

In 2023, the total number of military personnel was estimated to be 3,387,858. This number includes 2,509,590 military personnel and 878,268 civilians. Across the Departments of Defense (DOD), 50% of active-duty personnel are members of family units having spouses, children, or other adult dependents.^[1]

Military families often face unique challenges due to frequent relocation, extended absences of parents due to deployment, and other stresses associated with military life. Deployment of a parent or family member is a significant stressor for children, particularly when they are deployed to locations of ongoing conflicts. The impact of deployment varies depending on the duration of separation and the developmental age of children. Some studies have found increased anxiety and other behavioral health issues in young children whose parents have been deployed. Other studies have found an increased risk of child neglect and maltreatment.² A recent review of studies dealing with children of adults with military-related post-traumatic stress disorders found that children can experience emotional and psychological difficulties that persist into adulthood.³ Family-based interventions that increase resilience and mitigate stress have been found to be effective.⁴

Alcohol use disorder (AUD) is also more prevalent in veterans compared to the general population. A 2021 study of 4,069 veterans found that the prevalence of lifetime and past year AUD was 40.8%. The study found that being younger, male, white, unmarried, and retired were independently correlated with increased lifetime prevalence of AUD. This study highlights the importance of screening veterans and recently separated military personnel for AUD. Alcohol use disorder (AUD) is also more prevalent in veterans compared to the general population. A 2021 study of 4,069 veterans found that the prevalence of lifetime and past year AUD was 40.8%.² The study found that being younger, male, white, unmarried, and retired were independently correlated with increased lifetime prevalence of AUD. This study highlights the importance of screening veterans and recently separated military personnel for AUD. It is also important to connect children and other family members with support and resources. Special attention also needs to be paid to families with children. There is extensive research on the emotional, psychological, and social impact of parental alcoholism and drug use, which adds an additional layer of family stress. Despite challenges, prior deployments, levels of parental stress, family conflict, and dysfunction were identified as predictors of participation in a substance abuse prevention program for military families.³

Being part of the military culture can also be protective for children in military families. Living in proximity to other families facing many of the same challenges creates opportunities for shared experiences, social connections, and support. One study found that although school-aged children had increased psychosocial morbidity during parental wartime deployment, they had lower baseline psychosocial symptoms than their civilian peers. There are numerous government-sponsored resources available to military families, including the DOD employee-sponsored child care system, a global health care delivery system, and an education system that serves 7,200 children in 7 states, 11 countries, and 2 territories. However, roughly half of military families receive health care through civilian providers who may not be familiar with aspects of military life and culture or available resources. Providing training and resources to mental and physical health providers should be an important part of any prevention strategy for military families.

Resources

Cramm, Heidi1; Godfrey, Christina M.2; Murphy, Susanne1; McKeown, Sandra3; Dekel, Rachel4. Experiences of Children Growing Up With a Parent Who Has Military-Related Post-Traumatic Stress Disorder: A Qualitative Systematic Review. JBI Evidence Synthesis 20(7): p 1638-1740, July 2022. | DOI: 10.11124/JBIES-20-00229

Muir, C., Adams, E. A., Evans, V., Geijer-Simpson, E., Kaner, E., Phillips, S. M., Salonen, D., Smart, D., Winstone, L., & McGovern, R. (2023). A Systematic Review of Qualitative Studies Exploring Lived Experiences, Perceived Impact, and Coping Strategies of Children and Young People Whose Parents Use Substances. Trauma, Violence & Abuse, 24(5), 3629–3646. https://doi.org/10.1177/15248380221134297

National Academies of Sciences, Engineering, and Medicine; Division of Behavioral and Social Sciences and Education; Board on Children, Youth, and Families; Committee on the Well-Being of Military Families, Le Menestrel, S., & Kizer, K. W. (Eds.). (2019). Strengthening the Military Family Readiness System for a Changing American Society. National Academies Press (US).

Solomon, N., Gribble, R., Dighton, G., Evans, S., Taylor-Beirne, S., Chesnokov, M., & Fear, N. T. (2022). The Mental Health and Well-Being Among Partners and Children of Military Personnel and Veterans with a Combat-Related Physical Injury: A Scoping Review of the Quantitative Research. Disability and Health journal, 15(3), 101283. https://doi.org/10.1016/j.dhjo.2022.101283

Waldrop JB, Schechter JC, Davis NO, et al. The Effectiveness of Parenting Skills Training Programs for Parents with Histories of Sexual Trauma, Serious Mental Illness, or Military Service: A Systematic Review. Washington, DC: Evidence Synthesis Program, Health Services Research and Development Service, Office of Research and Development, Department of Veterans Affairs. VA ESP Project #09-010; 2023. https://www.ncbi.nlm.nih.gov/books/NBK598640/

[1] Department of Defense Demographics (2023) Demographics Profile.

By Cindy Rivera, MS, MSW, Change Consultant, Change Matrix

The 988 Suicide & Crisis Lifeline in July 2022 replaced the previous 10-digit Lifeline toll-free number, marking a significant step forward in the accessibility and responsiveness of mental health and crisis support with an easy to remember three-digit number for anyone experiencing mental health, substance use, or emotional crisis. Connecting      individuals to a robust network of trained crisis counselors, the system is built on three key tenets: someone to contact, someone to respond, and a safe place for help. These pillars not only ensure immediate support but also integrate into broader community-based mental health services, including addressing substance use crises. For substance use preventionists, understanding and leveraging this system is important to effectively support individuals and communities.

Substance use preventionists play a critical role in mitigating the factors that lead to substance misuse and promoting protective factors within communities. However, crises often intersect with substance use issues, requiring an immediate, informed response. By understanding 988 and the crisis system, preventionists can better guide individuals in crisis to timely and appropriate care. The “someone to call” tenet ensures that individuals struggling with substance use, or their loved ones, have access to compassionate, expert support through a single phone call (or text/chat). For preventionists, promoting awareness of this resource can empower communities to seek help when needed.

The second tenet, 'someone to respond,' ideally involves mobile crisis teams equipped to de-escalate crises and provide on-the-ground support. However, the availability of these teams can vary, especially in rural areas. Mobile crisis teams are particularly important for individuals experiencing co-occurring mental health and substance use challenges, as these teams are trained to address complex needs. Preventionists can collaborate with these response systems, prioritizing rural areas as needed, to ensure a continuum of care that extends beyond immediate crisis stabilization, linking individuals to long-term prevention resources and support.

Finally, the tenet of “a safe place for help” addresses the need for individuals in crisis to access stabilization services. Crisis stabilization services can include facility-based services or home and community-based services for adults and youth experiencing crisis. Preventionists can advocate for and support the development of these safe spaces, recognizing their role in comprehensive substance use prevention.

By integrating knowledge of 988 into their work, preventionists not only enhance their own effectiveness but also contribute to a broader, more responsive community safety net. This alignment underscores the interconnectedness of crisis response and substance use prevention, ensuring individuals in need receive holistic, life-saving support.

The South Southwest Prevention Technology Transfer Center is not a crisis center. If you’re thinking about suicide, are worried about a friend or loved one, or would like emotional support, the 988 Suicide & Crisis Lifeline is available 24/7. You can call or text 988 or use their chat service.

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