Identifying psychological outcomes in families of Five Eyes alliance armed forces Veterans: A systematic review

LAY SUMMARY Military service can affect the psychological health and well-being of ex-service members and their families. Most research prioritizes active duty families or Veterans, with spouses/intimate partners and adult children of Veterans often overlooked. This study reviewed all previous research on the psychological health of Veteran families within the Five Eyes alliance countries of Australia, Canada, New Zealand, the United Kingdom, and the United States. It found spouses/intimate partners had higher rates of anxiety, depression, and posttraumatic stress disorder (PTSD) compared to national rates and were more likely to feel distress when their Veteran partner had mental health issues. Adult children were at higher risk for anxiety, depression, alcohol/substance misuse, and PTSD compared to national rates. Four themes identified were: personal feelings and internal emotions, Veteran-oriented, help and support, and acting as a unit. Due to the scarce available research, further studies are needed to address psychological outcomes among military Veteran families. Introduction: The psychological effects of military service and lifestyle are not confined to individual service members, as there are also potential consequences for the mental health and well-being of military family members. Adult children and intimate partners of ex-service members can share this risk but may be overlooked both as potential research populations and in the planning of policy and outreach/treatment programs. This systematic review aimed to identify the psychological health outcomes of partners and adult children of ex-service members in Five Eyes alliance countries: Australia, Canada, New Zealand, United Kingdom, and the United States. Methods: Search protocols were used in aggregate databases and related journals for peer-reviewed literature. A total of 24 studies met inclusion criteria (N = 18 quantitative, N = 6 qualitative). Quantitative studies were summarized by narrative synthesis and qualitative data was analyzed using a descriptive-interpretive approach. Results: Intimate partners had higher prevalence rates of anxiety, depression, and posttraumatic stress disorder (PTSD) than population norms and were more likely to suffer distress because of the Veteran's mental health issues. Adult children were at increased risk for anxiety, depression, alcohol/substance misuse, and PTSD compared to population norms. Four themes were identified from the qualitative data: personal feelings and internal emotions, Veteran-oriented, help and support, and acting as a unit. Discussion: There are substantial gaps in the literature regarding the mental health and well-being of intimate partners and adult children of ex-service members in Five Eyes alliance countries. Future research is needed to address psychological outcomes among families after leaving the military.