https://aub.ie/MilitaryREACH-Kucera2022

Kucera, A., Koehlmoos, T., Grunwald, L., Banaag, A., Schvey, N. A., Quinlan, J., & Tanofsky-Kraff, M. (2022). Prescriptions of psychotropic medications by providers treating children of military service members. Military Medicine, Article usac048. https://doi.org/10.1093/ milmed/usac048

Children of Service members are referred to treatment through both military and civilian treatment facilities. This study captured the prevalence of mental health conditions (i.e., attention deficit-, mood-, anxiety-, or conduct-related disorder) among military-dependent children (N = 1,533,630). Among military dependents who were diagnosed with a mental health condition (n = 124,580), this study also examined whether the type of treatment facility (i.e., military or civilian) affected treatment services (i.e., received prescription medication, referred to talk therapy). Military and civilian treatment facilities appear to differ in rates of medication prescription and talk therapy referrals for military-dependent children.

https://doi.org/10.1093/milmed/usac048

Mental health
Youth
Children

Multiple branches
Army
Navy
Air Force
Marine Corps

Active Duty

Child of a service member or veteran

Childhood (birth - 12 yrs)
Adolescence (13 - 17 yrs)
School age (6 - 12 yrs)

Cross-Sectional Study

Kucera, Alexandria, Koehlmoos, Tracey, Grunwald, Lindsay, Banaag, Amanda, Schvey, Natasha A., Quinlan, Jeffrey, Tanofsky-Kraff, Marian

There are approximately 1.5 million U.S. military-dependent children. However, little is known about mental health referrals for these youths. This study sought to examine the type of mental health treatment referrals made by primary care providers for child military-dependent beneficiaries receiving care in the direct (within Military Treatment Facilities) and private care (civilian-fee-for service facilities) sectors of the Military Health System.A between-subjects, cross-sectional study was performed on children aged 5–18 years old in fiscal years 2011–2015 and enrolled in TRICARE Prime. Study analyses examined specialty (“talk therapy”) mental health care and psychotropic medication referrals from TRICARE Prime (the Defense Health Agency-managed health care program) providers for beneficiary children diagnosed with attention-, mood-, anxiety-, or behavior-related disorders in direct versus private sector care.Of 1,533,630 children enrolled in TRICARE Prime (50.03% female), 8.6% (n = 131,393) were diagnosed with a psychological disorder during FY 2011–2015. Most were attention-related (5.2%, n = 79,770), followed by mood (1.7%, n = 25,314), anxiety (1.1%, n = 16,155), and conduct-related diagnoses (0.7%, n = 10,154). Adjusting for age, sex, and sponsor rank, children within direct care diagnosed with attention-related disorders were 1.7 times more likely to receive a prescription for psychotropic medication than those in private sector care, odds ratio (OR) = 1.72, 95% confidence interval (CI): [1.66, 1.77]. Children diagnosed with mood-related disorders in direct care were 2.1 times more likely to receive a prescription for psychotropic medication than those in private sector care, OR = 2.08, 95% CI: [1.96, 2.21]. Across disorders, children who received private sector care were more likely to have a referral specialty mental health (“talk therapy”) follow-up (ps < 0.0001).For attention- and mood-related disorders, but not anxiety- or conduct-related disorders, direct care providers were more likely than private sector care providers to prescribe psychotropic medications. Inconsistencies of provider referrals within and outside of the Military Health System should be elucidated to determine the impact on outcomes.

Oxford Academic

Article

Department of Medical and Clinical Psychology, AK