Retrospective cohort study of outpatient mental health visits in children and youth in Canadian military families

Introduction: This article contrasts the risk for outpatient mental health visits between children and youth in Canadian military families and those in the general population. Methods: This retrospective cohort study linked provincial administrative databases 2008-2013 until out-of-province relocation, death, or Dec. 31, 2016. Included were children and youth aged <= 19 years, with at least one parent in the Canadian Armed Forces (CAF), who relocated to Ontario. A general population comparator group was matched 4:1 on age, sex, and residential region. The outcome was one or more outpatient visit associated with a mental-health-related diagnosis with a family physician, pediatrician, or psychiatrist in the three years after relocation. Results: The study included 5,478 children and youth in CAF families and 21,912 comparator children and youth. Children and youth in CAF families were 10% (relative risk [RR] 1.10; 95% confidence interval [CI], 1.04-1.17) more likely to have at least one outpatient mental-health-related visit than those in the general population, including a 72% higher risk of a pervasive developmental disorders visit (RR = 1.72; 95% CI, 1.39-2.12) and a 31% higher risk of a hyperkinetic syndrome visit (RR = 1.31; 95% CI, 1.22-1.52). Discussion: Children and youth with a parent in the military were more likely to have a mental-health-related outpatient physician visit than children and youth in the general population. Additional supports during stressful periods such as relocations, deployment and re-integration, parental transition to civilian life, or family distress may be needed to prevent negative effects on growth and development. LAY SUMMARY This study tried to answer the question "Do children and youth in military families have a greater risk of emotional and behavioural problems than children and youth in the general population?" The authors used routinely collected health data from children and youth in Canadian Armed Forces families who relocated to Ontario, matched to data from children and youth in non-military families. They compared outpatient mental health services use, such as physician visits, and the reasons for those visits, such as depression. They found that children and youth in military families were more likely to visit a physician for specific mental health diagnoses than children and youth in the general population. More programming and resources supporting the mental health and well-being of children and youth in military families may be needed.