Staff Perspective: Accessing Care for Military-Connected Children - Views from Parents

Staff Perspective: Accessing Care for Military-Connected Children - Views from Parents

Christy Collette

A recently published qualitative study (Benson et al. 2023) looked at the parents’ perspective in seeking behavioral health services for their children. For military-connected families, moving is a hallmark of service that brings the need to establish all types of health care at each duty station. This study focused on the parental experience of establishing behavioral health care, and the strategies they employ to overcome any barriers they experience during the process. In total, 22 parents across five branches of services were interviewed.

The results found common barriers to receiving care, that while not surprising, can help increase access to behavioral health care for military-connected children.

The caregivers who were interviewed reported that while there are many benefits to military life, the demands associated with service do create barriers to care. More specifically, the frequent moves required of active-duty families make the initiation and establishment of care challenging. Identifying appropriate providers and establishing care is time consuming. The interviews also found that by the time care is established and relationships are developed, it is time to move again. This cycle repeats throughout the moves a family goes through.

The interviews found three primary themes related to the challenges a caregiver experiences related to initiating behavioral healthcare:

  • 50% of the interviewees indicated that stigma associated with behavioral health care created a barrier. We know that military families in general are resilient, and when behavioral health needs emerge, they may feel like they have failed. The military is a strength-based organization, and the need for care may be perceived by families as a sign of weakness.
  • A second theme was the need for parents (45% of those interviewed) to convince providers that their concerns were warranted, and that referrals to specialty providers should be made. Because of the frequent moves, parents are continually retelling providers their concerns. New providers were likely to give it time before specialty referrals were made, and to minimize parents’ concerns, oftentime stating it was just normal behavior.
  • Once engaged in treatment, military families reported struggles navigating the logistics of treatment. Due to demanding schedules of service members and lack of social support, it may be difficult for both parents (especially the service member) to engage in treatment with their children.

When looking at characteristics that facilitated behavioral health care, 86% of those interviewees credited their advocacy skills as a key in establishing care. A majority (68%) also credited engagement with pediatricians who suggested care, and followed up with referrals in a timely manner.

These themes provide direction for increased access to care. In the discussion section, the authors note the importance of providers gaining a greater understanding of how military service impacts care. They call upon the shared responsibility of both military and civilian providers to address these barriers and work towards minimizing their impact. They call upon military providers to educate themselves on civilian resources and make referrals quickly when appropriate. For civilian providers, gaining knowledge about military culture and military-specific resources is critical. For civilian providers, understanding the unique demands of military service, and the frequent relocations, can help them to develop policies that ensure military-connected families receive timely care.

The findings also provide a path to help family members. Because advocacy was identified as a facilitator to care, we can develop programming and provide support to families, so they can be their own best advocates. Empowering parents with skills that will help them address concerns with providers may decrease the amount of time between a concern being identified, and a specialty referral being made.

While there is still progress to be made, this study does give hope that we are on the path to better caring for our military-connected families. There are multiple opportunities for civilian providers to learn military culture (both here at CDP and through other channels). This increased cultural competence can help those who work with military children adjust their work to accommodate the unique needs of this population. In addition, the Defense Department (DOD) has been working on reducing stigma around accessing behavioral health care. Normalizing the need for behavioral health care can decrease the amount of time before care is initiated. It can also help families to seek social support without fear of negative consequences. Caregivers can talk about care, share experiences with specific providers and offer practical support for each other.

Policy changes can also impact care. The normalization of behavioral health care can increase the likelihood that service members request time off to participate in their child’s sessions. For those who provide play therapy, this is crucial to the work they do. Working with children always includes a family component, and having all caregivers involved is critical to success. For the military, caring for the entire family can lead to improved retention rates, and allow for service members to be able to focus on the mission.

All of these changes can lead to better outcomes for our military connected children who serve with their parents.

The opinions in CDP Staff Perspective blogs are solely those of the author and do not necessarily reflect the opinion of the Uniformed Services University of the Health Science or the Department of Defense.

Christy Collette, LMHC, is a Program Associate for the Center for Deployment Psychology at the Uniformed Services University of the Health Sciences in Bethesda, Maryland. In this capacity, she is coordinating the expansion of the Star Behavioral Health Providers into new states across the nation. SBHP trains civilian behavioral health providers to work with Service members, veterans and their families.