National Guard Members Research Articles

E-mental health preferences of Veterans with and without probable posttraumatic stress disorder.

Mental health care practices supported by electronic communication, referred to as e-mental health, offer ways to increase access to mental health resources. In recent years, e-mental health interventions using clinical video teleconferencing, Internet-based interventions, social networking sites, and telephones have emerged as viable, cost-effective methods to augment traditional service delivery. Whereas some research evaluates attitudes about e-mental health, few studies have assessed interest in using these approaches in a contemporary sample of U.S. Veterans. This study sought to understand willingness to use e-mental health in a diverse group of Veterans residing in Hawaii. Mailed surveys were completed by 600 Operation Iraqi Freedom/Operation Enduring Freedom Veterans and National Guard members. Results suggest that overall willingness to use e-mental health ranged from 32.2% to 56.7% depending on modality type. Importantly, Veterans who screened positive for posttraumatic stress disorder (PTSD) were significantly less likely to report willingness to use each e-mental health modality than their peers without PTSD, despite their greater desire for mental health services. These results suggest that despite solutions to logistical barriers afforded via e-mental health services, certain barriers to mental health care may persist, especially among Veterans who screen positive for PTSD.

A scope of the problem: Post-deployment reintegration challenges in a National Guard Unit.

More Reserve and Guard members have been activated in the past few years than in any other time in history. In addition to the high rates of psychological and behavioral challenges among military personnel, there are other equally important post-deployment reintegration challenges. Post-deployment reintegration challenges are particularly important to Reserve and Guard members, who transition rapidly from civilian-military-civilian. This study aims to describe the scope of challenges that a battalion of National Guard members (NGM) report experiencing after returning from a one-year deployment to Iraq. This article reports data from a sample of 126 NGM who recently returned from a one-year deployment to Iraq. The scope of post-deployment problems at baseline, 3- and 6-month post-deployment are presented. Overall, the rates of post-deployment psychological and behavioral problems were elevated upon returning from deployment and remained fairly constant for up to 6 months post-deployment. Approximately 30% of respondents were unsatisfied with their relationship and upwards of 30% reported family reintegration challenges. Comparisons with similar research and implications for prevention and improvement of post-deployment quality of life are addressed.

Suicidal Ideation among Florida National Guard Members: Combat Deployment and Non-Deployment Risk and Protective Factors

This study examined relationships among risk/protective factors and suicidal ideation (SI) in deployed and non-deployed National Guard members, particularly examining for possible differential effects of deployment on SI. A total of 3,098 Florida National Guard members completed an anonymous online survey that assessed variables associated with SI including demographics, current psychiatric diagnoses, and pre-, during, and post-deployment experiences. Those deployed had significantly higher rates of SI (5.5%) than those not deployed (3.0%; p < .001). In multivariate analyses, among those not deployed, SI was significantly associated with major depressive disorder (p < .001), posttraumatic stress disorder (PTSD) (p < .001), prior psychological trauma (p < .01), and heavy/hazardous alcohol consumption (p < .05). In contrast, in the deployed, only PTSD (p < .001) and deployment-related mild traumatic brain injury (p < .05) were independently associated with SI. Risk and protective factors differed by deployment status in National Guard members suggesting the possible need for cohort-specific treatment targets to minimize SI.

Assessment of a Postdeployment Yellow Ribbon Reintegration Program for National Guard Members and Supporters

The Yellow Ribbon Reintegration Program (YRRP) was created to meet the needs of National Guard members and their families throughout the deployment cycle. This study examined the perceived utility of the YRRP's delivery of information and assistance during the postdeployment reintegration period by National Guard members and accompanying supporters who were mostly spouses. Over 22 months, from 10 YRRP events, 683 service members and 411 supporters completed questionnaires immediately after the YRRP. We analyzed questions on information and avenues for help, timeliness and concerns related to education, employment, legal, family, and health. Service members and supporters most often endorsed information delivery on education being met (76.8% and 78.2%, respectively) and were least likely to endorse legal information delivery (63.5% and 60%, respectively). Significantly more supporters than service members (p < 0.0001) reported that the YRRP was the first time they learned of available services across all domains. Service members were significantly more likely than supporters to report concerns about education, employment, and health, while supporters were significantly more likely to report concerns about family. Results suggest the YRRP fills gaps in supporter knowledge and provides needed information and resources to most National Guard families 2 to 4 months after a deployment.

Mental health service use in a representative sample of National Guard soldiers.

With Operation Iraqi Freedom and Operation Enduring Freedom winding down, large numbers of National Guard members have recently returned from active deployment. No prospective, longitudinal studies have examined predictors of mental health service use in a representative sample of National Guard soldiers. This study investigated the prevalence and predictors of mental health service use in a representative sample of National Guard soldiers. A representative sample (N=1,189) of Ohio Army National Guard participants was enrolled. Demographic characteristics, mental health problems, and deployment status in 2009-2010 and mental health service use during the subsequent one-year period (2010-2011) were assessed. Approximately 16% of National Guard members used mental health services during the one-year period. Among those with depression, posttraumatic stress disorder, anxiety, alcohol use disorders, or suicidal ideation, a little over one-third (37%) reported using services in the subsequent 12 months. Among all National Guard soldiers, being female, black, Hispanic, and insured and having comorbid general medical and mental health problems predicted mental health service use. Among those with mental health problems, only black race predicted mental health service use. Results suggest that there is a substantial level of unmet need for mental health treatment among National Guard soldiers. Efforts to identify National Guard soldiers with a need for mental health services and improving access to care might be warranted.

Predictors of Army National Guard and Reserve members' use of Veteran Health Administration health care after demobilizing from OEF/OIF deployment.

This study described rates and predictors of Army National Guard and Army Reserve members' enrollment in and utilization of Veteran Health Administration (VHA) services in the 365 days following demobilization from an index deployment. We also explored regional and VHA facility variation in serving eligible members in their catchment areas. The sample included 125,434 Army National Guard and 48,423 Army Reserve members who demobilized after a deployment ending between FY 2008 and FY 2011. Demographic, geographic, deployment, and Military Health System eligibility were derived from Defense Enrollment Eligibility Reporting System and "Contingency Tracking System" data. The VHA National Patient Care Databases were used to ascertain VHA utilization and status (e.g., enrollee, TRICARE). Logistic regression models were used to evaluate predictors of VHA utilization as an enrollee in the year following demobilization. Of the study members demobilizing during the observation period, 56.9% of Army National Guard members and 45.7% of Army Reserve members utilized VHA as an enrollee within 12 months. Demographic, regional, health coverage, and deployment-related factors were associated with VHA enrollment and utilization, and significant variation by VHA facility was found. These findings can be useful in the design of specific outreach efforts to improve linkage from the Military Health System to the VHA.

Care of Military Service Members, Veterans, and Their Families

Over thepast 13 years,more than two million United Statesmilitary service members have been deployed to combat operations overseas, primarily in Iraq and Afghanistan. In addition to over 6,000deaths and several thousandcombat injuries, several hundred thousand service members (and their families) continue to struggle with deployment-related readjustment and medical and mental health challenges. These recent operations and their sequelae are a reminder of the longstanding issues faced by military service members, veterans, and their families in the United States and worldwide from previous wars, in addition to newly returning veterans who present newchallenges inhealingthewoundsassociatedwithmodern warfare. The recent conflicts have also inspired significant efforts to develop new knowledge regarding treatment approaches and new systems of prevention and care delivery that are better suited to effectively support service members and their families. However, more research, infrastructure changes, and resources are required to meet current and future needs. This book is a timely and an important milestone in the literature on the care ofmilitarymembers, veterans, and their families. Its strength lies in the collective expertise of its authors and editors who have produced unified and clear messages, including the message that the health and wellbeing of military service members and veterans is closely linked to that of their familymembers.Thebodyof information about military service, culture, families, and unique challenges (such as frequent separations, relocations and deployments, changes in family roles, stigma, access to care, and injuries and deaths), aswell as about themanystrengthsof servicemembers (such as a sense of pride and belonging, financial stability, role flexibility, family extendedness, and resilience) is a highlight of this book. TheDepartment ofDefense and related communitybased partners have made impressive progress in research, interventions, andresources in thecareofmilitary families(e.g., Child and Youth Services, Family Readiness Groups, Military OneSource, and FOCUS [Families OverComing Under Stress]) that should be widely disseminated. This aspect of this volume will help community providers better understand the needs of their service member and veteran patients and their families and is a considerable contribution to the field. Themost important conceptual contributions of this book are outlined in three fundamental factors: that combat exposure impactsmental and physical health; that deployment/ combat experiences of service members are closely linked to the health and well-being of their family members; and that themilitary is in constantfluxdue to changeand transitioning of members between military and civilian communities. Constant change between military and civilian communities is particularly important among National Guard and Reserve members (who constitute close to one-half of the ready force). Militarymembers/veteranswhomoveto theciviliansectormay live in areas where there is inadequate expertise specifically related to the needs of military members/veterans and their families. Thus, the health and care of military members, veterans,andfamilies isanationalandcommunityconcern,not just aconcern for theDepartmentofDefenseor theVeteransHealth Administration or a few agencies. This volume’s conceptualization and focus is an excellent initial blueprint for the community to support these service members and veterans. Other strengths include the organization of this volume into three broad sections: Fundamentals for Treating Military Service Members, Veterans, and Families; Military Service-Related Conditions and Interventions; and Meeting the Needs of Military and Veteran Children and Families. This greatly helps in enhancing conceptual clarity, knowledge, and awareness for community providers with limited exposure to military members/veterans to effectively direct attention and resources toward addressing the needs of military members/ veterans and their families. The chapters on Collaborative Care and Suicide in the second section are particularly impressive and informative. The ambitiousness of this book is commendable, although there were clearly challenges in deciding what to include in this volume.The authors have negotiated this challenge quite well, striking a good balance between in-depth coverage of important topics, including theoretical and recent research advances, while also offering a lot of practical information and resources for providers. Potentially future editions of this book could expand by including an international perspective of the issues facing veterans so that we might benefit from research and practice in other parts of the world. Additional attention to thewide range ofVeteransHealthAdministration services would be important as well (1). The timeof transitionbetween theDepartment ofDefense and civilian life as a veteran is one of opportunity in which returning service members can be screened, provided information about resources, and connected with services. Lack of basic needs, such as housing and employment support, can potentially exacerbate and contribute to readjustment challengesandshouldbeaddressedinconjunctionwithhealthcare needs. Every Veterans Health Administration medical center has a seamless transition team that provides outreach, case management, and coordination services to support returning veterans and their families. In summary, the experts who contributed to and edited this book have provided an important and much needed contribution to the field of military, veteran, and family care. This book will serve as an excellent resource for a wide range of medical and nonmedical service providers, increasing awareness of resources and new directions in meeting the unique needs of service members, veterans, and their families.

The marginal effects of hazardous alcohol use on the probability of behavioral healthcare utilization among National Guard members

Reads were then assembled to the rhesus genome and annotated using predicted and experimentally verified mRNA sequences. Results: The number of reads per animal ranged from approximately 1 to 10 million (median 6.5 million) and alignment to the rhesus genome ranged from 91.8% to 95.6% (median 94.3%). Of the 373 GPCRs targeted, 354 had complete coverage across the gene. Median coverage for the individual animals was 99.75%. Over 24,000 SNPs were identified including over 14,000 nonsynonymous and over 9,500 synonymous SNPs. As predicted, the majority of SNPs are singletons, though ∼1750 non-synonymous and ∼2900 synonymous SNPs were identified in multiple individuals. Among the non-synonymous SNPs identified in multiple individuals 14 were in the opioid receptors, 36 in the dopamine receptors, 59 in the serotonin receptors, and 2 in the cannabinoid receptors. Bioinformatic and functional characterization of these SNPs and others alongside humans are ongoing. Conclusions: We have identified a large number of potentially functionally relevant SNPs in genes associatedwith drug abuse and pharmaceutical efficacy. Elucidating genetic diversity improves the translational validity of models of addiction and furthers drug discovery and modeling of the pharmacogenetic effects observed in humans. Financial support: This project was supported by NIH grants: OD011103, AA019688. Additional support provided by the NEPRC Primate Genetics Core.

Anger problems and posttraumatic stress disorder in male and female National Guard and Reserve Service members

Anger is a common problem among veterans and has been associated with posttraumatic stress disorder (PTSD). This study aimed to improve understanding of how anger and PTSD co-occur by examining gender differences and differences by whether the triggering traumatic event is deployment-related vs. civilian-related in current service members. A representative cohort of Reserve and National Guard service personnel (n = 1293) were interviewed to assess for deployment- or civilian-related traumas, PTSD, and anger. The prevalence of self-reported anger problems was estimated among male (n = 1036) and female (n = 257) service members. Log Poisson regression models with robust standard errors were used to estimate the associations of problems with anger with PTSD and PTSD symptom severity for men and women. Self-reported anger problems were common among male (53.0%) and female (51.3%) service members. Adjusted prevalence ratios (PR) showed associations between anger and PTSD connected to both civilian- and deployment-related traumas (PR were 1.77 (95% CI 1.52–2.05) and 1.85 (95% CI 1.62–2.12), respectively). PTSD symptom severity was also associated with anger. This study was cross-sectional and so a causal relationship between PTSD and anger cannot be established. Problems with anger are common among male and female current Guard and Reserve members. These findings suggest that anger treatment should be made available to current service members and that clinicians should assess anger problems irrespective of gender. Future research should examine the effectiveness of anger treatment protocols by gender.

Reintegrating National Guard Soldiers After Deployment: Implications and Considerations

U.S. Army National Guard members are serving overseas on deployments at a level well above expectations of reserve service, and successful reintegration of citizen-soldiers postdeployment has become a significant concern. This article examines soldiers’ experiences transitioning postdeployment and offers preliminary observations on one state's Yellow Ribbon Reintegration Program. Data from interviews and participant-observation identified postdeployment experiences in three areas: (1) remembering the positive, (2) dealing with American civilian sociocultural norms and values, and (3) coping with mental and emotional health needs. Data suggest that the social context of reintegration is important and that existing programs may not adequately meet soldiers’ needs.

Internet Use Among Veterans With Severe Mental Illness

Internet Use Among Veterans With Severe Mental Illness

Normative Data for the Neurobehavioral Symptom Inventory (NSI) and Post-Concussion Symptom Profiles Among TBI, PTSD, and Nonclinical Samples

The Neurobehavioral Symptom Inventory (NSI) is a self-report measure of symptoms commonly associated with Post-Concussion Syndrome (PCS) that may emerge after mild traumatic brain injury (mTBI). Despite frequent clinical use, no NSI norms have been developed. Thus, the main objective of this study was to establish NSI normative data using the four NSI factors (i.e., vestibular, somatic, cognitive, and affective) identified by Vanderploeg, Silva, et al. (2014) among nonclinical epidemiological samples of deployed and non-deployed Florida National Guard members as well as a reference sample of Guard members with combat-related mTBI. In addition, NSI subscale profile patterns were compared across four distinct subgroups (i.e., non-deployed-nonclinical, deployed-nonclinical, deployed-mTBI, and deployed-PTSD). The deployed-nonclinical group endorsed greater PCS symptom severity than the non-deployed group, and the mTBI group uniformly endorsed more symptoms than both nonclinical groups. However, the PTSD group endorsed higher symptom severity relative to the other three subgroups. As such, this highlights the non-specificity of PCS symptoms and suggests that PTSD is associated with higher symptom endorsement than mTBI.

The marginal effects of hazardous alcohol use on the probability of behavioral healthcare utilization among National Guard members with psychopathology

The marginal effects of hazardous alcohol use on the probability of behavioral healthcare utilization among National Guard members with psychopathology

Child care and other support programs.

The U.S. military has come to realize that providing reliable, high-quality child care for service members' children is a key component of combat readiness. As a result, the Department of Defense (DoD) has invested heavily in child care. The DoD now runs what is by far the nation's largest employer-sponsored child-care system, a sprawling network with nearly 23,000 workers that directly serves or subsidizes care for 200,000 children every day. Child-care options available to civilians typically pale in comparison, and the military's system, embedded in a broader web of family support services, is widely considered to be a model for the nation. The military's child-care success rests on four pillars, write Major Latosha Floyd and Deborah A. Phillips. The first is certification by the military itself, including unannounced inspections to check on safety, sanitation, and general compliance with DoD rules. The second is accreditation by nationally recognized agencies, such as the National Association for the Education of Young Children. The third is a hiring policy that sets educational and other requirements for child-care workers, and the fourth is a pay scale that not only sets wages high enough to discourage the rapid turnover common in civilian child care but also rewards workers for completing additional training. Floyd and Phillips sound a few cautionary notes. For one, demand for military child care continues to outstrip the supply In particular, as National Guard and Reserve members have been activated during the wars in Iraq and Afghanistan, the DoD has sometimes struggled to provide child care for their children. And force reductions and budget cuts are likely to force the military to make difficult choices as it seeks to streamline its child-care services in the years ahead.

Integrating Life Skills into Relationship and Marriage Education: The Essential Life Skills for Military Families Program

Military personnel and families experience significant challenges and need skills that will prepare them for extended periods of separation and other military demands. Relationship and marriage education programs are often helpful. However, there is a need for life skills programs that also teach military members to manage finances and legal matters, garner social support, and access community resources that are not often accessible to personnel and families in the National Guard and Military Reserves. Essential Life Skills for Military Families was developed to integrate relationship and life skills into a short‐term course that has been offered to National Guard and Military Reserve members and families. This article describes the theoretical basis for the program, the program evaluation, and qualitative findings from participants, and identifies strategies for overcoming challenges to offering this kind of relationship skills program.

Care of Returning Military Personnel

In the ClinicJuly 2, 2013Care of Returning Military PersonnelLaura L. Sessums, JD, MD, Jeffrey L. Jackson, MD, MPH, Deborah Cotton, MD, MPH, Darren Taichman, MD, PhD, and Sankey Williams, MDLaura L. Sessums, JD, MDSearch for more papers by this author, Jeffrey L. Jackson, MD, MPHSearch for more papers by this author, Deborah Cotton, MD, MPHSearch for more papers by this author, Darren Taichman, MD, PhDSearch for more papers by this author, and Sankey Williams, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-159-1-201307020-01001 SectionsSupplemental MaterialAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Large numbers of Americans have deployed in combat operations in the past decade and may seek health care in civilian, Veterans Affairs (VA), or military settings on return from deployment. The U.S. military currently has nearly 1.5 million active-duty members, with another 850 000 in the Reserves or National Guard. (1) Unless exempted for family or medical reasons, all military, Reserve, and National Guard (Selected Reserves) members are eligible for deployment. As of December 2011, approximately 102 000 were deployed to Afghanistan in Operation Enduring Freedom (OEF) and approximately 50 000 to Iraq in Operation New Dawn (previously known as ...

Family Relationships, Mental Health, and Injury Among OEF/OIF Veterans Postdeployment

As the number of military service personnel who have served in Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) approaches 3 million, concern mounts about potential negative effects of long and multiple combat-related deployments on military families. This study used secondary analysis to compare the mental health status and family functioning of postdeployment National Guard members with and without children. Among guard members with children, comparison was made between those who did and did not report behavioral problems in their children. Finally, the study identified how mental health status and deployment experiences (including injury) were jointly and uniquely associated with children's problems. Veterans with children were more likely to be married and older; to endorse more symptoms of depression, interpersonal violence, and anger; and to indicate lower satisfaction with family and social relationships than veterans without children. Veteran parents reporting children's problems had greater mental health symptoms, including depression and anxiety, and lower satisfaction with family and social relationships. Regression modeling indicated that veterans’ age, reported sleep problems, and mental health issues were independent risk factors for children's problems.

Health and Mental Health Needs of Children in US Military Families

The wars in Afghanistan and Iraq have been challenging for US uniformed service families and their children. Almost 60% of US service members have family responsibilities. Approximately 2.3 million active duty, National Guard, and Reserve service members have been deployed since the beginning of the wars in Afghanistan and Iraq (2001 and 2003, respectively), and almost half have deployed more than once, some for up to 18 months' duration. Up to 2 million US children have been exposed to a wartime deployment of a loved one in the past 10 years. Many service members have returned from combat deployments with symptoms of posttraumatic stress disorder, depression, anxiety, substance abuse, and traumatic brain injury. The mental health and well-being of spouses, significant others, children (and their friends), and extended family members of deployed service members continues to be significantly challenged by the experiences of wartime deployment as well as by combat mortality and morbidity. The medical system of the Department of Defense provides health and mental health services for active duty service members and their families as well as activated National Guard and Reserve service members and their families. In addition to military pediatricians and civilian pediatricians employed by military treatment facilities, nonmilitary general pediatricians care for >50% of children and family members before, during, and after wartime deployments. This clinical report is for all pediatricians, both active duty and civilian, to aid in caring for children whose loved ones have been, are, or will be deployed.

Tobacco Product Usage Among Deployed Male and Female Military Personnel in Kuwait

military training failure 1 ; smoking is associated with significant increased hospitalization and lost work days 2 ; and smoking is a strong marker for other causes of low readiness such as alcohol abuse, low physical activity, and illicit drug abuse. 3 Also, smokers in the military are more likely to sustain injuries, especially musculoskeletal injuries. 4 Among deployed male and female military personnel stationed in Kuwait during Summer to Autumn of 2012, 402 military members (383 Enlisted and 19 Officers) with ages ranging from 19 to 55 years (mean age 32 years) were randomly surveyed regarding their tobacco usage habits (cigarette smoking and chewing tobacco). Those randomly surveyed were Active Army, National Guard, and Army Reserve members. The ethnicity of those surveyed were predominantly Caucasian (80%), followed in descending order by African American (9%), Hispanic (5%), Asian (4%), and Pacific Islander/Native American (2%). Of the 402 military members surveyed, 41% (164/402) used tobacco products during the Kuwait deployment. Among the tobacco product users, 87% (142/164) were male and 13% (22/164) were female. The mean age of the tobacco users was 30 years. In contrast, of the 238 nontobacco product users, 73% (173/238) were male and 27% (65/238) were female. The mean age of the nontobacco product users was 34 years. Thus, a higher percentage of males, as opposed to females, used tobacco products. Of the 164 military members using tobacco products, 9% (14/164) did not use tobacco products before the deployment. During the deployment, 21% (35/164) of tobacco users further increased tobacco product usage and 6% (10/164) decreased tobacco usage. Forty-six percent (75/164) of military personnel identified craving/habit as the primary motivating factor for their tobacco usage. Thirty-two percent (53/164) of military personnel blamed anxiety/stress, 16% (26/164) blamed boredom, and 6% (10/164) identified socializing as the primary motivating factor for tobacco use. Fifty-seven percent (94/164) of all tobacco users during deployment wanted to stop tobacco use upon redeployment. Seventy-five percent (40/53) of those members associating their tobacco use with anxiety intended on stopping tobacco use upon redeployment. Based on the above data, tobacco use prevalence for deployed military personnel was approximately two times the U.S. national average, with prevalence of tobacco product usage greater for males than females. Our survey also concluded that during the deployment, a significant number of individual tobacco users further increased the quantity of tobacco consumed. Lastly, among deployed military personnel, craving/habit (addiction) and anxiety/stress are the two main factors influencing tobacco usage, with greater than 50% of tobacco users intending on stopping tobacco use upon return to the United States. The increased use of tobacco during deployment is probably associated with the increased psychological and emotional stresses incurred during deployment. In conclusion, this data demonstrates the magnitude of the tobacco use problem among deployed military personnel. Effective and constructive policies regarding the tobacco use issue in the military are long overdue.

Mental Health Issues of Women Deployed to Iraq and Afghanistan

The number of women serving in the military and deployed to active-duty is unprecedented in the history of the United States. When women became a permanent sector of the U.S. Armed Services in 1948, their involvement was restricted to comprise only 2% of the military population; today women constitute approximately 14.5% of the 1.4 million active component and 18% of the 850,000 reserve component. Yet, little attention has been paid to the mental health needs of women military members. This review article highlights the history of women in the military and then focuses on the impact of combat exposure and injuries, military sexual trauma, alcohol use, and family separations which are associated with PTSD, depression, suicide, difficulty with reintegration, and homelessness.