Strengthening Military Families: Current Findings and Critical Directions Anita Chandra, Dr.P.H.

1. Strengthening Military Families: Current Findings and Critical Directions Anita Chandra, Dr.P.H. Coordinating Council on Juvenile Justice and Delinquency Prevention October 21, 2011

2. We Now Have a Modest Body of Research Focusing on Deployment and Children and Youth • Studies from prior conflicts show associations between military parental separation and child behavioral problems • Small number of studies from OEF/OIF show increases in youth stress • Modest negative effects have been observed for academic outcomes

3. Gaps Had Remained in What We Knew About How Deployment Affects Children • Programs existed to help families cope, but knowledge to inform program content was limited • Few studies had: • Looked at how children are faring academically, socially, and emotionally • Focused on pre-teens and teens • Included both youth and caregiver perspective

4. Two RAND Studies Shed Light on Military Youth Needs • Study 1: Understanding the experiences of military youth and spouses • Study 2: Examining effects of deployment on academic performance and behavioral well-being of Army children

5. Study 1: Understanding the experiences of military youth and spouses

6. Peer relationships Academic engagement How Are These Youth Faring Comparedto Other U.S. Youth? Functioning at or above U.S. average Functioning below U.S. average Family relationships Emotional difficulties Anxiety

7. Higher Percentage of Study Sample Reported Elevated Anxiety Symptoms

8. Youth and Caregiver Reported Reintegration Challenges Fitting DP back in home routine Worrying about the next deployment Dealing with DP mood changes Getting to know DP again Figuring out who to turn to for advice 10 20 30 40 50 60 0 70 Key: Youth, Caregiver Percent (%) DP= Deployed Parent

9. Longer Periods of Parental Deployment Were Associated with More Problems • As months of parental deployment increased, so did challenges including: • Child reintegration challenges • Caregiver reported lack of community support • Total months away mattered more than number of deployments • Did not observe any differences by deployment location or military role

10. Non-Deployed Parent’s Emotional Well-Being Mattered • Children whose non-deployed parent reported better emotional well-being experienced fewer: • Challenges during and after deployment • Emotional difficulties • Caregivers who reported better emotional well-being also reported: • Fewer relationship and household hassles

11. Study 2: Examining effects of deployment on academic performance and behavioral well-being of Army children

12. Schools Face Barriers in Addressing Needs of Children Struggling with Deployment Many children and families cope well with deployment, but some struggle with a range of deployment related issues Many school staff we interviewed had no consistent information regarding military or deployment status of parents, even those close to military posts Many school staff felt disconnected with military installations

13. Children Also Face Behavioral Health Challenges and Schools Face Challenges in Addressing These Needs • Some parents appear to struggle more than their children, which may underlie many student challenges • Schools are the stable place or sanctuary for students when home life is chaotic or uncertain • Some students, particularly those whose parents are in the Reserve Component, feel isolated • Reintegration is also challenging for the family

14. What Concerns Will Face Children and Youth, And Where Should We Allocate Resources? Findings: • A significant number of youth report persistent emotional difficulties, particularly with more cumulative deployment months • Relationships between returning service member parents and children can be strained due to poor communication, developmental changes • Schools continue to struggle in providing academic and emotional support for students during moves and deployment transition periods Support Needed: • Target evidence-based behavioral health programs for youth at high end of deployment months experience; include parent and service provider education on signs and how to intervene • Expand support to families during reintegration, focusing on parent-child relationships • Ensure that schools have information on military youth transition periods and access to resources; examine current support for youth transitioning to post-secondary education/career

15. Placing Need Profile in Context Will Require Consideration of Prevention Stages Crisis Engagement Breadth of service sector engagement Number and/or severity of risk factors Low assets Cost? Training requirements Other resources? • Symptom • reduction • (Indicated/ • Tertiary Prevention) • Behavioral health treatment, long-term • Academic remediation (Indicated/Tertiary Prevention) • Early Intervention • (Targeted/Secondary Prevention) • School and community-based screening • Short course interventions • Teacher training to identify needs • Tutoring, academic support services for youth sub-population • Supporting and Maintaining Health and Well-Being • (Universal/Primary Prevention) • Addressing family basic needs • Social activities, ongoing parent and family engagement • Integrated wellness programs and policies (school, community) • Supportive school transition policies

16. What Questions Must Be Answered in Planning For Military Family Support in the Next Ten Years? • Will these social, emotional, and academic issues persist, and if so, how? How do we keep the vast majority who are doing well now healthy in the long run, and not pursuing risk behavior? • How do we help families to identify their service “match” based on their need profile and to navigate the service maze? 3. How do we ensure that any program, implemented or expanded, has evidence of effectiveness? • Implement core performance metrics • Establish common reporting system for ongoing monitoring and evaluation

17. What Questions Must Be Answered in Planning For Military Family Support in the Next Ten Years? 4. How do we ensure efficiency in program implementation, given lean economic picture? • Enforce greater centralization of program information • Ensure that new programs are supplementary or complementary to existing system of care • Target at-risk or high risk populations