MEDICAL NEWS (CNN) — More than 2 million children have been affected by the military deployment of at least one parent within the past decade, and thousands have had to cope with a parent's death or traumatic injury, experts say.
Therefore, it's imperative that pediatricians and other health care providers address the mental health and well-being of children from U.S. military families, according to the American Academy of Pediatrics.
"This is guidance (for the providers), but it is the first of its kind," said co-author Dr. Beth Ellen Davis, a pediatrician and retired U.S. Army colonel. "I could think of no better way to honor our service members than to help providers take care of their children."
The authors looked at previous studies from the past decade about children and parents' wartime deployment to Iraq and Afghanistan.
"When a parent goes away to war, the common typical response is that all children experience stress around that," Davis said. "Most children adjust after a short period of time."
Further help may be needed if the stress becomes excessive. Without treatment, children are at risk for behavioral, social and emotional problems. Early childhood distress can even affect brain development, David said. "We want to get them help, support and resources as soon as possible if it appears that a child is not handling the stress as a child commonly would."
The studies found sadness and worry are common among children when a parent is deployed. One in four children experienced symptoms of depression, and more than half reported trouble sleeping.
Both military and civilian pediatricians should be alert for stressors such as deployment on families, according to the report's authors, and should ask if anyone in the family or close community has been involved in wartime experiences, and how the family is coping. Non-military pediatricians care for more than half of military children, experts said.
While the research focused on parental deployment, "We definitely think the evidence would apply and extends to important people in that child's life," Davis said. "It could be an older brother."
Dr. Elspeth Ritchie has firsthand knowledge of the importance of treating these kids. The chief medical officer for the Washington Department of Mental Health, Ritchie is a retired Army psychiatrist and a former psychiatry consultant for the Army Surgeon General.
A pediatrician, she says, is often the "first line" of defense. "Pediatricians often are the first physician or the only physician that a child will see," she said. "So it's critically important for the pediatrician to screen for anxiety and depression, and then if the person is struggling or having difficulties, to refer them to the right person in the mental health system or to the appropriate counselor. "
In addition, following up is key, she said. "People express sorrow, fear and depression differently over time. It may be that a child, when young, seems to do OK and it's not until they are older they really realize what's happened, that they are willing or able to seek help for it, so it's critically important for the pediatrician to be following the child over the course of the child's growing up."
"Mental health experiences don't just go away or get better," she added. "They take months and they often take years to fully resolve."