By Elaine Wilson
American Forces Press Service
Jan. 29, 2010 - Army wives whose husbands deploy seek mental health services at a higher rate than others, and the longer the deployment, the greater the impact, according to a new study. Researchers from the Uniformed Services University of the Health Sciences, RTI International and the University of North Carolina at Chapel Hill conducted the study, which was published this month in the New England Journal of Medicine.
Study investigators compared the rates of mental health diagnoses and use of mental health services between wives whose husbands had deployed with those whose husbands hadn't deployed, using a sampling of about 250,000 active-duty Army wives, ages 18 to 48.
"We found a distinct pattern," said Army Col. (Dr.) Charles Engel, a study co-investigator and associate chair of psychiatry at the Uniformed Services University of the Health Sciences. "The wives of servicemembers who deployed ... used more services when they had a diagnosis and more frequently received mental health diagnoses than those wives whose husbands didn't deploy."
The wives also were categorized by the total length of their spouses' deployments. Investigators compared wives whose spouses hadn't deployed, those who had deployed for less than a year and those who had deployed for more than a year. "The longer the husband had been deployed, the more we saw an excess of disorders," Engel noted.
The mental health diagnoses that were elevated were, for the most part, those related to stress, Engel explained, such as depression, anxiety and adjustment disorders. Investigators also found an increase in alcohol use. They didn't, however, find an excess of post-traumatic stress disorder.
"The stress of deployment [for spouses] really isn't the same as the kind of stress that causes PTSD," Engel said. Rather than the types of traumatic events that trigger post-traumatic stress, wives encounter stressors such as overwhelming demands at home and the uncertainty of having a loved one deployed, he explained.
The study used anonymous data from a military health system database, which captures care from the military health system and through Tricare military health care program networks.
"It was a very important use of the health tracking systems at our disposal in the military," Engel said. "These systems increasingly put us in a position to be able to look, in ways the civilian sector really just can't, at the health impact of various things."
But use of the database limited the study to active-duty wives, Engel acknowledged. "One of the limitations of the findings is that we weren't able to include National Guard or Reserve wives; we can't be sure their health care is captured by the military system when their husband is demobilized," he said. "They may be getting care from other sources primarily."
The study also restricted its analysis to spouses whose husbands had been in active-duty service for a minimum of five years, Engel said, to ensure they captured a history of active health service use and mental health background.
The net effect of that, Engel pointed out, was an older sampling of wives who may be better equipped at coping with military life. Since younger wives may be more vulnerable to the stressors of military life in general, the findings may underestimate the impact of deployments, he added.
"We say at the end, the differences we see between these two groups, if you were to include all wives, would probably be greater," he said. "This is a conservative estimate of the ... impact of deployment on the mental health of these wives."
Limitations aside, the study reaped results that can be used as an impetus for change, Engel said. Experts know anecdotally that deployments have an impact on military families, but real findings help provide the thrust to change and improve support programs, he added.
"We assume [deployment] has an impact, but in some fashion we don't really know, until we have a chance to see it in terms of real findings from a scientific study," he said.
Engel noted that he found one aspect of the findings reassuring: Army spouses are taking advantage of available mental health services.
"We now have some fairly definitive scientific data to demonstrate that the wives of soldiers who deploy have some special needs," he said. "This is bound to lead to greater discussion of what those needs are and new programs to meet those needs. And that can only be a positive thing."
While this study was limited to the Army, future studies are sure to look at deployments' impacts on spouses from other services, Engel said.
"Our group and other groups will want to analyze these data in ways that bring in the other services, particularly ... the Marine Corps," he said. "There's every reason to think that the wives of Marines may be experiencing similar kinds of challenges."