| The toll on the home front

Depressive disorders spike among war wives

A recent study found that military wives suffer more mental health disorders when their husbands deploy for long periods of time compared to those whose husbands deploy for less or no time. The study was based on electronic medical records collected between 2003 and 2006 on 250,626 wives of active-duty U.S. Army soldiers, and was published in the New England Journal of Medicine. 
The researchers found that for  every 1,000 military wives, there were about 30 extra diagnoses of depressive disorders among those whose husbands were deployed for one to 11 months compared to those who were not – and almost 40 extra among those whose husbands were deployed for over 11 months. The increase in diagnoses was also found for sleep disorders, anxiety disorders, and acute stress reaction and adjustment disorders. 
“In real terms, there are over 170,000 troops in Iraq at any one time alone. That’s a lot of spouses left behind. So based on this analysis, we’re looking at tens of thousands of extra cases of mental health disorders among their wives,” said Jay Kaufman, co-author and a McGill professor.

In 2009, there were close to 250,000 U.S. troops deployed in Operation Iraqi Freedom in the Iraq–Kuwait region and Operation Enduring Freedom in Afghanistan.  
“Fighting a foreign war has huge costs in many ways…. One of these costs is the increase in psychiatric conditions, the suffering and the health care utilization for the spouses and families left behind. That cost is in monetary terms, and it’s in human terms…. The results of [war] causing thousands and thousands of psychiatric cases – that’s a serious cost,” said Kaufman. “This isn’t even getting into people who are killed, crippled, or brain damaged. We’re just talking about the healthy people who aren’t affected directly by the war, but are disrupted by these psychiatric outcomes.”

The authors hope that the results from this study will increase the impetus for the military to improve accessibility and availability of mental health care services for military families. 
“Those of us in the military have been all too aware of the toll [deployment has on] our families, and this study is essentially our chance to show others that, so that we can be appropriately resourced to care for our families and make concerted efforts to develop programs to meet their needs,” said co-author Charles Engel, a psychiatrist and active duty colonel in the U.S army. 
There has been no similar study done looking at families of the almost 3,000 Canadian soldiers who are deployed in Afghanistan. The average Canadian soldier is deployed for six months.

“Deployment in Canada may have a different effect. All these women are together in the United States and in solidarity, so this could mitigate these psychiatric effects. Maybe it’s harder for families in Canada, maybe there is less social support because there are fewer families waiting together for their husbands,” said Kaufman.

In an email to The Daily, Lisa Fiander, communications officer at National Defence, wrote that the health and mental health needs of military families are a top priority for the Canadian Forces. 
“Families of personnel with mental health concerns currently have access to a range of Canadian Forces services and programs including counselling under the Operational Stress Injury Social Support network and the guidance of the more than 40 Military Family Resource Centres located across the country, in the U.S. and in Europe,” she wrote. 
However, despite the availability of these resources, Canadian military wives explained that they are not accessible and that stigma within the military community often prevents them from seeking help. 
“There is definitely stigma when it comes to military spouses seeking any kind of support or outside help as it contradicts the image of the ‘strong military wife.’ Seeking help for psychiatric reasons can adversely affect the military member’s career, which may make it more difficult for the wife or partner to admit the necessity,” a member of the themilitarywife.ca web community, who wished to remain anonymous, told The Daily over Facebook chat. “The biggest challenge…is that it relies entirely on the spouse’s willingness to reach out.”

One Canadian military wife, Joanne Nicholle, who had previously received treatment for depression, explained her frustration with the current system. 
“I first started receiving treatment for depression after the birth of my daughter…. However, there were no [accessible] medical services that the military provides for families. In fact, they practically rip you away from your roots and force you to live in a new province where you’re treated like a foreigner,” said Nicholle. “As for stigma…. I don’t feel there would be any labelling from the general public. On the other hand, within the military community, [young wives] get the ‘suck it up, buttercup’ [attitude] from the more experienced wives and members.” 
Stigma is also a major concern among military spouses in the United States, and was considered by the study’s authors to have decreased the effect they found in their research. However, Engel explained that wives getting assistance through mental health channels do not damage their husbands’ careers, and it is a perceived issue among wives that needs to be addressed. 
Engel also pointed out that younger military wives were not included in the study, which likely further decreased the effect found by the researchers. 
This is the first major study done looking at the health impact on the family members of people in the army who are deployed.

Alyssa Mansfield, the lead researcher on the study, is currently conducting another study looking at the mental health impact deployment has on the children. 
 “There’s never going to be all the answers to these questions,” said Mansfield.


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