June 3, 2008 – Emi Geye likely knows at least as much about how combat deployments affect soldiers’ children as the psychiatrists, school counselors and pediatricians who filled the room around her Monday.
Her Army dad has been deployed three times since 2002 – twice for 15 months, and once for 12 – and he just left their DuPont home Monday morning for another three-week assignment in Iraq.
So the experts who gathered at McChord Air Force Base for a three-day summit on behavioral health issues for military children and teens hung on the 16-year-old’s every word.
When a parent is sent off to war, Emi said, the remaining parent and the kids need separate places to go when they’re driving each other crazy.
“And afterwards, there has to be a mandatory rehabilitation cycle,” she said.
“Deployment is a handicap that needs to be rehabilitated. An appendage of your family has been lost, and now you have to figure out how to work with it again,” she said.
Just the kind of “concrete, specific, actionable items” that Col. Elspeth Ritchie, the Army’s top psychiatrist, said she and the service’s medical leadership are looking for out of the McChord summit. About 150 people from across the Army and other services as well as academics and civilian counselors and school officials are attending.
In the last year, the American Psychological Association, the American Academy of Pediatrics, the Department of Defense Task Force on Mental Health and others have all called for increased attention to the behavioral health needs of military children.
“I think we all know that this is such an important subject,” Ritchie said. “We need to really move out on it and stick to it.”
This week’s meetings, sponsored by Madigan Army Medical Center, follow a statewide conference last November aimed at increasing public awareness of military children’s issues.
The audience this week is much more specific: Ritchie said Army leaders want the summit to draw from practices at installations around the country to come up with plans for a comprehensive, service-wide behavioral health program for children.
Madigan will play a leading part in developing that program. Officials said Monday that the Army surgeon general approved the Fort Lewis hospital’s request for $2.5 million over the next 18 months to set up a “military child and adolescent center of excellence.”
Maj. Keith Lemmon, a Madigan pediatrician, said the center can pull together prevention and treatment programs, with a focus on children whose parents are deployed.
On Monday, experts said there are several good prevention programs in place across the military – in schools, in the family readiness groups and in other settings – that teach kids what to expect during deployments, and some skills for dealing with their problems.
They said more research is needed on the effects on families dealing with multiple deployments, and on the effects that soldiers’ war-related stress and injuries have on families.
Ritchie said the Army is looking for programs that can be standardized across the service to intervene when kids have more serious problems.
She said the service also needs to press the Army’s health insurance system, TRICARE, to increase its reimbursement rates for mental health care providers. There are complaints that low rates make it difficult to accept many military family members as patients.
One idea that got support from military children Monday was pushing pediatricians to ask more about whether their patients were experiencing a deployment, and how that was going for them.
It’s an approach that Army doctors have used in dealing with post-traumatic stress disorder and mild traumatic brain injury. Soldiers’ primary care doctors are being trained to ask their patients about their experiences, rather than leaving that to mental health specialists.
Geye and three other military children who talked to the group Monday – brothers Matthew and William Rambin, ages 13 and 11, and Brittani Moser, 18 – said their pediatricians didn’t ask if they had a parent deployed.
All said they think being a child with a military parent has placed special demands on them: to grow up quicker and to learn to adapt to changing situations and to make new friends.
“You are bigger than what you are up against, you are bigger than what you are going through, because you have to be,” Geye said. “There’s no other choice. …You have to be strong at home because there is no other option. We have to keep going.”
Lemmon noted that two of the four youths on Monday’s panel planned to pursue careers in the Army, while the others said they wanted to become a dentist and a chef.
“This is what our military culture breeds, future leaders and people dedicated to serving others,” Lemmon said. “We can’t afford to get this wrong. We’ve got to take care of our military children and adolescents.”