Staff Perspective: Military Families with Children Who Have Special Needs
As a military spouse, mother of three extraordinary military children, and researcher on military families, I know military families and children are resilient. Like many other military families, our story includes cross-country and global moves, navigating the emotional terrain of multiple deployments, making friends and moving away from them, and growing through it all. However, personally and through my research, I also know that resilience isn't an innate characteristic; it's a dynamic quality that is carefully cultivated. It hinges on the challenges we face and our ability to overcome them, the strength of our family bonds, and the physical and mental well-being of each member. Crucially, resilience is also profoundly reliant on our access to vital resources, including financial stability, robust social support networks, and dependable healthcare.
Dependable healthcare may be even more important, and challenging to military families with children who have mental health, emotional, developmental, or behavioral (MEDB) concerns. In the U.S., about 22% of children have a disorder of mental health, emotion, development, or behavior (Rethy & Chawla, 2022). More recently, half of military spouses report they have at least one child that has an impairment, disorder, or disability (not restricted to MEDB concerns; Blue Star Families, 2022). I am one of these spouses; I have kids with ADHD and autism.
If we want military families - including military service members - to remain resilient, we must ensure those support systems that undergird their resilience remain strong. One critical area ripe for improvement is the military healthcare system. The recently released Blue Star Families’ 2024 Military Family Lifestyle Survey paints a concerning picture: while healthcare benefits are a significant incentive for families to remain in the military, the struggle to access that very care is a major factor pushing families to consider leaving (Blue Star Families, 2025). In fact, nearly half (49%) of active-duty service members who planned to stay in longer than they originally intended cited healthcare benefits as a key reason they would stay (Blue Star Families, 2025). Yet, a significant portion of active-duty family respondents also identified the inability to access healthcare as a primary driver for potentially leaving the military (Blue Star Families, 2025), although military parents of children with special healthcare needs tend to serve longer than military parents of children with no chronic conditions (Perkins et al., 2023).
Access to healthcare for military families is becoming more challenging. “Healthcare access” is an escalating concern for military families, with the percentage of active-duty families ranking it as a “top concern” doubling from 11% in 2020 to 22% in 2024, though it did drop slightly from 28% in 2023 (Blue Star Families, 2025). While the military provides healthcare through TRICARE and the Defense Health System, the very nature of military life often creates significant barriers to accessing this care, particularly for families with children who have MEDB needs. Each move for these families necessitates finding new providers who accept TRICARE and have availability, navigating different state or regional regulations for special education and support services, and establishing new relationships with therapists, specialists, and support groups. Research comparing TRICARE, commercial, and public insurance found that caregivers utilizing TRICARE were more likely to report needing care coordination and experiencing greater frustration in obtaining necessary services (Hero et al., 2021). The study also highlighted that children who experienced more frequent moves and those with special healthcare needs faced the most significant difficulties in accessing care (Hero et al., 2021).
Several factors contribute to the growing challenges military families face in accessing care. We are seeing a shrinking network of qualified civilian providers, especially those willing to accept TRICARE (National Center for Health Workforce Analysis, 2023), coupled with limited pediatric specialty care availability at military treatment facilities. For families with children with MEDB concerns, this translates to significant difficulties in finding qualified specialists and accessing essential therapies. The 2024 Blue Star Families survey further illuminates the specific struggles in accessing mental health care for children. Among families with children, 20% of active-duty family respondents report their child currently receives mental health care, while 13% report wanting care for their children, but being unable to obtain it (Blue Star Families, 2025). A shocking 42% of those who want mental health care for their children, but cannot access it, cite the inability to find an available provider who will treat them. Even when families can locate a TRICARE provider within a 50-mile radius, nearly half (44%) encounter waitlists or are unable to schedule an appointment. For those placed on a waitlist for their child’s mental health care, a staggering 9 in 10 waited more than three months for care (Blue Star Families, 2025).
Complicating these ongoing issues, TRICARE beneficiaries and providers have faced significant disruptions due to the rollout of new contractors in the East and West regions in early 2025. In the East, a switch in claims processors led to widespread payment delays for healthcare providers, particularly mental health professionals, causing some to consider limiting or ceasing services for TRICARE patients (Kime, 2025). Beneficiaries in the West experienced difficulties with enrollment, payment processing, accessing customer service, and obtaining timely specialty care referrals due to the new contractor, TriWest. These transitions have caused stress, confusion, and potential delays in necessary medical care for beneficiaries, while providers have struggled with unpaid claims and administrative burdens, threatening their ability to serve military members and their families.
These statistics underscore why the work being done here at the Center for Deployment Psychology and within the DoD Child Collaboratory is so important. Through an interdisciplinary, cross-sector collaboration of stakeholders, including researchers, providers, non-profits, and government, the group works to extend and enhance care for military kids, regardless of their geographic location. By implementing strategies such as telementoring and tele-education for providers, expanding telehealth services for families, and providing digital tools and on-demand training, the project works to address the gaps in care and ensure that military children receive the right care at the right time, from the right people.
While the healthcare benefits provided to military families are often cited as a reason to recommend military service or to remain in the military longer (Blue Star Families, 2023), these benefits become meaningless when families cannot access them due to long waitlists, insurance problems, or a lack of qualified providers. That's why the work of the Collaboratory resonates so deeply with me. Our commitment to creating specialized trainings for providers to better understand our military children and their needs, building vital collaborations, and exploring innovative technologies to improve access feels like a direct response to the challenges my own family and countless others have faced.
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.
Jessica Strong, Ph.D., is a military family researcher specializing in the well-being of military and veteran families, serving as a Military Behavioral Health Child Social Worker at the Center for Deployment Psychology (CDP) at the Uniformed Services University for the Health Sciences in Bethesda, Maryland. In this role, she supports the DoD Child Collaboration Study to identify best practices for enhancing and expanding accessibility to care for military-connected children and adolescents.
References:
Rethy, J., & Chawla, E. (2022). How pediatricians can help mitigate the mental health crisis. Contemporary PEDS Journal, 39(2). https://www.contemporarypediatrics.com/view/how-pediatricians-can-help-mitigate-the-mental-health-crisis
Blue Star Families. (2022). 2021 Military Family Lifestyle Survey. https://bluestarfam.org/wp-content/uploads/2022/03/BSF_MFLS_Results2021_ComprehensiveReport_3_22.pdf
Blue Star Families. (2025). 2024 Military Family Lifestyle Survey. https://bluestarfam.org/wp-content/uploads/2025/02/BSF_MFLS24_Comp_Report_Full-v2.pdf
Perkins, E. M., Sorensen, I., Susi, A., & Hisle-Gorman, E. (2023). The Impact of Having a Child With Special Healthcare Needs on Length of Military Service. Military Medicine, 188(5-6), e1246-e1251. https://doi.org/10.1093/milmed/usab495
Hero, J. O., Gidengil, C. A., Qureshi, N., Tanielian, T., & Farmer, C. M. (2022). Access to Health Care Among TRICARE-Covered Children. Rand health quarterly, 9(4), 18.
National Center for Health Workforce Analysis. (2023). Behavioral health workforce, 2023. https://bhw.hrsa.gov/sites/default/files/bureau-health-workforce/Behavioral-Health-Workforce-Brief-2023.pdf
Kime, P. (2025, February 4). Mental health providers in Tricare East go unpaid after claims processor switch. Military.com. https://www.military.com/daily-news/2025/02/04/mental-health-providers-tricare-east-go-unpaid-after-claims-processor-switch.html
Blue Star Families. (2023). 2022 Military Family Lifestyle Survey. https://bluestarfam.org/wp-content/uploads/2023/03/BSF_MFLS_Spring23_Full_Report_Digital.pdf
As a military spouse, mother of three extraordinary military children, and researcher on military families, I know military families and children are resilient. Like many other military families, our story includes cross-country and global moves, navigating the emotional terrain of multiple deployments, making friends and moving away from them, and growing through it all. However, personally and through my research, I also know that resilience isn't an innate characteristic; it's a dynamic quality that is carefully cultivated. It hinges on the challenges we face and our ability to overcome them, the strength of our family bonds, and the physical and mental well-being of each member. Crucially, resilience is also profoundly reliant on our access to vital resources, including financial stability, robust social support networks, and dependable healthcare.
Dependable healthcare may be even more important, and challenging to military families with children who have mental health, emotional, developmental, or behavioral (MEDB) concerns. In the U.S., about 22% of children have a disorder of mental health, emotion, development, or behavior (Rethy & Chawla, 2022). More recently, half of military spouses report they have at least one child that has an impairment, disorder, or disability (not restricted to MEDB concerns; Blue Star Families, 2022). I am one of these spouses; I have kids with ADHD and autism.
If we want military families - including military service members - to remain resilient, we must ensure those support systems that undergird their resilience remain strong. One critical area ripe for improvement is the military healthcare system. The recently released Blue Star Families’ 2024 Military Family Lifestyle Survey paints a concerning picture: while healthcare benefits are a significant incentive for families to remain in the military, the struggle to access that very care is a major factor pushing families to consider leaving (Blue Star Families, 2025). In fact, nearly half (49%) of active-duty service members who planned to stay in longer than they originally intended cited healthcare benefits as a key reason they would stay (Blue Star Families, 2025). Yet, a significant portion of active-duty family respondents also identified the inability to access healthcare as a primary driver for potentially leaving the military (Blue Star Families, 2025), although military parents of children with special healthcare needs tend to serve longer than military parents of children with no chronic conditions (Perkins et al., 2023).
Access to healthcare for military families is becoming more challenging. “Healthcare access” is an escalating concern for military families, with the percentage of active-duty families ranking it as a “top concern” doubling from 11% in 2020 to 22% in 2024, though it did drop slightly from 28% in 2023 (Blue Star Families, 2025). While the military provides healthcare through TRICARE and the Defense Health System, the very nature of military life often creates significant barriers to accessing this care, particularly for families with children who have MEDB needs. Each move for these families necessitates finding new providers who accept TRICARE and have availability, navigating different state or regional regulations for special education and support services, and establishing new relationships with therapists, specialists, and support groups. Research comparing TRICARE, commercial, and public insurance found that caregivers utilizing TRICARE were more likely to report needing care coordination and experiencing greater frustration in obtaining necessary services (Hero et al., 2021). The study also highlighted that children who experienced more frequent moves and those with special healthcare needs faced the most significant difficulties in accessing care (Hero et al., 2021).
Several factors contribute to the growing challenges military families face in accessing care. We are seeing a shrinking network of qualified civilian providers, especially those willing to accept TRICARE (National Center for Health Workforce Analysis, 2023), coupled with limited pediatric specialty care availability at military treatment facilities. For families with children with MEDB concerns, this translates to significant difficulties in finding qualified specialists and accessing essential therapies. The 2024 Blue Star Families survey further illuminates the specific struggles in accessing mental health care for children. Among families with children, 20% of active-duty family respondents report their child currently receives mental health care, while 13% report wanting care for their children, but being unable to obtain it (Blue Star Families, 2025). A shocking 42% of those who want mental health care for their children, but cannot access it, cite the inability to find an available provider who will treat them. Even when families can locate a TRICARE provider within a 50-mile radius, nearly half (44%) encounter waitlists or are unable to schedule an appointment. For those placed on a waitlist for their child’s mental health care, a staggering 9 in 10 waited more than three months for care (Blue Star Families, 2025).
Complicating these ongoing issues, TRICARE beneficiaries and providers have faced significant disruptions due to the rollout of new contractors in the East and West regions in early 2025. In the East, a switch in claims processors led to widespread payment delays for healthcare providers, particularly mental health professionals, causing some to consider limiting or ceasing services for TRICARE patients (Kime, 2025). Beneficiaries in the West experienced difficulties with enrollment, payment processing, accessing customer service, and obtaining timely specialty care referrals due to the new contractor, TriWest. These transitions have caused stress, confusion, and potential delays in necessary medical care for beneficiaries, while providers have struggled with unpaid claims and administrative burdens, threatening their ability to serve military members and their families.
These statistics underscore why the work being done here at the Center for Deployment Psychology and within the DoD Child Collaboratory is so important. Through an interdisciplinary, cross-sector collaboration of stakeholders, including researchers, providers, non-profits, and government, the group works to extend and enhance care for military kids, regardless of their geographic location. By implementing strategies such as telementoring and tele-education for providers, expanding telehealth services for families, and providing digital tools and on-demand training, the project works to address the gaps in care and ensure that military children receive the right care at the right time, from the right people.
While the healthcare benefits provided to military families are often cited as a reason to recommend military service or to remain in the military longer (Blue Star Families, 2023), these benefits become meaningless when families cannot access them due to long waitlists, insurance problems, or a lack of qualified providers. That's why the work of the Collaboratory resonates so deeply with me. Our commitment to creating specialized trainings for providers to better understand our military children and their needs, building vital collaborations, and exploring innovative technologies to improve access feels like a direct response to the challenges my own family and countless others have faced.
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.
Jessica Strong, Ph.D., is a military family researcher specializing in the well-being of military and veteran families, serving as a Military Behavioral Health Child Social Worker at the Center for Deployment Psychology (CDP) at the Uniformed Services University for the Health Sciences in Bethesda, Maryland. In this role, she supports the DoD Child Collaboration Study to identify best practices for enhancing and expanding accessibility to care for military-connected children and adolescents.
References:
Rethy, J., & Chawla, E. (2022). How pediatricians can help mitigate the mental health crisis. Contemporary PEDS Journal, 39(2). https://www.contemporarypediatrics.com/view/how-pediatricians-can-help-mitigate-the-mental-health-crisis
Blue Star Families. (2022). 2021 Military Family Lifestyle Survey. https://bluestarfam.org/wp-content/uploads/2022/03/BSF_MFLS_Results2021_ComprehensiveReport_3_22.pdf
Blue Star Families. (2025). 2024 Military Family Lifestyle Survey. https://bluestarfam.org/wp-content/uploads/2025/02/BSF_MFLS24_Comp_Report_Full-v2.pdf
Perkins, E. M., Sorensen, I., Susi, A., & Hisle-Gorman, E. (2023). The Impact of Having a Child With Special Healthcare Needs on Length of Military Service. Military Medicine, 188(5-6), e1246-e1251. https://doi.org/10.1093/milmed/usab495
Hero, J. O., Gidengil, C. A., Qureshi, N., Tanielian, T., & Farmer, C. M. (2022). Access to Health Care Among TRICARE-Covered Children. Rand health quarterly, 9(4), 18.
National Center for Health Workforce Analysis. (2023). Behavioral health workforce, 2023. https://bhw.hrsa.gov/sites/default/files/bureau-health-workforce/Behavioral-Health-Workforce-Brief-2023.pdf
Kime, P. (2025, February 4). Mental health providers in Tricare East go unpaid after claims processor switch. Military.com. https://www.military.com/daily-news/2025/02/04/mental-health-providers-tricare-east-go-unpaid-after-claims-processor-switch.html
Blue Star Families. (2023). 2022 Military Family Lifestyle Survey. https://bluestarfam.org/wp-content/uploads/2023/03/BSF_MFLS_Spring23_Full_Report_Digital.pdf