HomeMediaArticle Display

Deployments & mental health: Longer dwell times may increase risk

ARLINGTON, Va. -- Service members who spend more time at home between deployments may have a greater chance of being diagnosed with a mental health disorder than those with briefer dwell times, a Defense Department analysis has revealed, but officials urge further research.

The study, conducted by the Armed Forces Health Surveillance Center, revealed that the percentage of service members diagnosed with mental health disorders after repeat deployments - their second through fifth - increased as dwell times prior to the deployments lengthened, surveillance center officials said.

The report, they noted, reflects only data for service members who sought help and received a medically diagnosed mental health condition from credentialed providers.

These results, published in the Medical Surveillance Monthly Report, are based on data from the Defense Medical Surveillance System spanning an eight-year period. The study encompassed more than 1 million male and more than 150,000 female active-duty service members who deployed at least once in support of operations Enduring Freedom, Iraqi Freedom or New Dawn.

The report's authors offered some possible reasons behind the dwell time findings. Longer dwell times may offer service members the opportunity to completely readjust to being home, they suggested. It then may be more difficult to transition back to a warrior mindset on the next deployment.

In contrast, service members who are home for a brief time may not fully adjust and, as a result, are better able to psychologically handle subsequent deployments.

Another possibility for the finding, is that some service members may temporarily be unable to deploy again or may be delayed due to a medical condition, such as a mental health disorder, which can result in a longer dwell time.

In these cases, an increase in mental health disorders correlates with a longer dwell time, they noted, but one doesn't necessarily cause the other.

Col. Christopher Robinson, the deputy director of psychological health for the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury, offered his own interpretation of the data.

He suggested that the longer service members are home, the more likely they are to seek services or that a spouse or friend will encourage them to seek help.

Service members who have relatively short dwell times tend to keep their guard up, he explained, and may cover up symptoms or slough off suggestions to seek help knowing they're soon to deploy. But, the "longer they're home and connect with people, the greater the chance someone will tell them they're drinking too much or they seem depressed, if that is indeed the case," he said.

"Rather than thinking that longer dwell times causes more mental health diagnoses, I'd rather think that longer dwell times give service members time to seek help appropriately," Robinson said. This fits in with the data, he said, since it only reflects service members who received medical diagnoses of a mental health condition from a credentialed provider.

"I still stand by the notion that longer dwell times are helpful for the health of our service members," the doctor said, citing results from the 2009 and 2011 Mental Health Assessment Tools. MHAT teams surveyed behavioral health personnel in theater, who concurred that longer dwell times could result in less mental health problems and better morale.

The study also showed an increase in the number of service members with diagnosed mental health conditions after the first deployment and through the third, and then a general decline in the number of service members with mental health disorders on subsequent deployments. This finding is interesting, the report's authors said, since people often have the impression that deployments have a cumulative effect, meaning the more service members deploy, the more problems they're likely to have.

Robinson said this may be due to what he calls the "resilience effect." The more service members deploy, he explained, the more they know what to expect and are better able to weather adversity.

The data also may be reflecting the fact that people who stay in the service and take on repeat deployments already have the resilience to weather challenges. Others may choose to leave the service or are held back from repeat deployments due to diagnosed mental health conditions.

Other results included higher percentages of service members in health care careers being diagnosed with post-traumatic stress disorder. The proportion of health care workers with PTSD increased more sharply than those in combat occupations, the report revealed. In some cases, officials suggested, medical workers may be exposed to death and injury on a more constant basis than those in combat occupations, and, as a result, are more susceptible to mental health issues.

Additionally, younger service members and female service members were diagnosed with a mental health condition more frequently than their older counterparts.

This may be due to the fact that, as people age, they have better coping mechanisms, Robinson said. "As we age and mature, there is more of a chance that bad things can happen," he explained, and as a result people build resilience by making it through these challenging events.

"That's what resilience is -- facing adversity with courage and fortitude."

As for the gender-related finding, women in general are more likely to seek mental health care than men, the report said. This doesn't mean they're less resilient, Robinson said, but that females tend to seek care more often.

Overall, the findings bear a closer look, Robinson said. The fact that some of the results were unexpected, such as the dwell time issue, only underscores that need. Other findings, such as the increasing rates of mental health issues among health care providers, can help the Defense Department better tailor programs and address a growing need.

The analysis, Robinson said, also points to the importance of seeking mental health care without fear of repercussion.

Perhaps one of the reasons the data is showing an increase in mental health disorders, he suggested, is that more people are seeking help without fear of career repercussion. Officials will continue to work to combat the stigma of seeking help, he added, through education and awareness.

"We know that combat exposure is a risk factor for some of these problems," Robinson said. "We need to recognize that and make sure to provide services for these service members and these families, and put out a consistent message of the importance of seeking help.

"The earlier we get help the better," he added. "The longer we wait, the worse things typically become."

Service members and their family members who need mental health care can access many online resources to help identify and address issues, Robinson said, such as Afterdeployment.org, and the Real Warriors Campaign. They also can contact a chaplain, health care provider or a supervisor.

"Suffering in silence is not the way to go," he said.

Original article found here
USAF Comments Policy
If you wish to comment, use the text box below. AF reserves the right to modify this policy at any time.

This is a moderated forum. That means all comments will be reviewed before posting. In addition, we expect that participants will treat each other, as well as our agency and our employees, with respect. We will not post comments that contain abusive or vulgar language, spam, hate speech, personal attacks, violate EEO policy, are offensive to other or similar content. We will not post comments that are spam, are clearly "off topic", promote services or products, infringe copyright protected material, or contain any links that don't contribute to the discussion. Comments that make unsupported accusations will also not be posted. The AF and the AF alone will make a determination as to which comments will be posted. Any references to commercial entities, products, services, or other non-governmental organizations or individuals that remain on the site are provided solely for the information of individuals using this page. These references are not intended to reflect the opinion of the AF, DoD, the United States, or its officers or employees concerning the significance, priority, or importance to be given the referenced entity, product, service, or organization. Such references are not an official or personal endorsement of any product, person, or service, and may not be quoted or reproduced for the purpose of stating or implying AF endorsement or approval of any product, person, or service.

Any comments that report criminal activity including: suicidal behaviour or sexual assault will be reported to appropriate authorities including OSI. This forum is not:

  • This forum is not to be used to report criminal activity. If you have information for law enforcement, please contact OSI or your local police agency.
  • Do not submit unsolicited proposals, or other business ideas or inquiries to this forum. This site is not to be used for contracting or commercial business.
  • This forum may not be used for the submission of any claim, demand, informal or formal complaint, or any other form of legal and/or administrative notice or process, or for the exhaustion of any legal and/or administrative remedy.

AF does not guarantee or warrant that any information posted by individuals on this forum is correct, and disclaims any liability for any loss or damage resulting from reliance on any such information. AF may not be able to verify, does not warrant or guarantee, and assumes no liability for anything posted on this website by any other person. AF does not endorse, support or otherwise promote any private or commercial entity or the information, products or services contained on those websites that may be reached through links on our website.

Members of the media are asked to send questions to the public affairs through their normal channels and to refrain from submitting questions here as comments. Reporter questions will not be posted. We recognize that the Web is a 24/7 medium, and your comments are welcome at any time. However, given the need to manage federal resources, moderating and posting of comments will occur during regular business hours Monday through Friday. Comments submitted after hours or on weekends will be read and posted as early as possible; in most cases, this means the next business day.

For the benefit of robust discussion, we ask that comments remain "on-topic." This means that comments will be posted only as it relates to the topic that is being discussed within the blog post. The views expressed on the site by non-federal commentators do not necessarily reflect the official views of the AF or the Federal Government.

To protect your own privacy and the privacy of others, please do not include personally identifiable information, such as name, Social Security number, DoD ID number, OSI Case number, phone numbers or email addresses in the body of your comment. If you do voluntarily include personally identifiable information in your comment, such as your name, that comment may or may not be posted on the page. If your comment is posted, your name will not be redacted or removed. In no circumstances will comments be posted that contain Social Security numbers, DoD ID numbers, OSI case numbers, addresses, email address or phone numbers. The default for the posting of comments is "anonymous", but if you opt not to, any information, including your login name, may be displayed on our site.

Thank you for taking the time to read this comment policy. We encourage your participation in our discussion and look forward to an active exchange of ideas.

Department of the Air Force does not exercise any responsibility or oversight of the content at external link destination.

The appearance of external hyperlinks does not constitute endorsement by the United States Department of Defense of linked web sites or the information, products, or services contained therein. For other than authorized activities such as military exchanges and morale, welfare and recreation sites, the United States Department of Defense does not exercise any editorial control over the information you may find at these locations. All links are provided consistent with the mission of this web site.