A temporal analysis of mental health symptoms relative to separation from the military

Porter, Ben; Carey, Felicia R.; Roenfeldt, Kimberly A.; Rull, Rudolph P.; Castro, Carl A.

doi:10.1002/da.23246

Cited by 3 publications

(1 citation statement)

References 34 publications

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“…To the authors' knowledge, this is the first qualitative study to describe military‐to‐civilian transition experiences among Service members undergoing medical disability evaluation. In prior studies, disability discharges were excluded or ancillary to the study objectives (Brignone et al, 2017; Hoffmire et al, 2019; Porter et al, 2022). Another notable strength is inherent to the hard‐to‐reach, highly specialized nature of our study population.…”

Section: Discussionmentioning

confidence: 99%

A qualitative study of military service members undergoing medical separation

Lee‐Tauler,

LaCroix,

Huppert

et al. 2024

J Clin Psychol

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ObjectiveLittle research explores military perspectives on medical disability‐related transition. A qualitative study sought to understand transition experiences of United States military Service members found unfit for duty following medical and physical evaluation boards (MEBs and PEBs).MethodsConfidential telephone interviews were conducted with 25 current and prior Service members. Participants were asked to share their experiences before, during, and after the MEB and PEB processes. Interview questions explored (1) health conditions that prompted the medical disability evaluation, (2) reactions to being recommended for separation, (3) transition‐related stress and challenges, and (4) coping strategies. Salient themes were identified across chronological narratives.ResultsParticipants expressed that debilitating physical (e.g., injury) and/or mental (e.g., post‐traumatic stress disorder) illnesses prompted their medical evaluation. In response to the unfit for duty notice, some participants reported emotional distress (e.g., anxiety, anger) connected to uncertainty about the future. Other participants reported relief connected to a sense of progression toward their medical disability claim status. Transition stress included the length of the MEB/PEB process, impact of the COVID‐19 pandemic on the process, financial stress, impact on family life, and compounded effect of these stressors on emotional distress, including depression and suicidal thoughts. Participants reported using adaptive (e.g., psychotherapy) and maladaptive (e.g., excessive drinking) strategies to cope with stress.ConclusionPreliminary reports of emotional distress and transition stress following unfit for duty notices highlight the need for increased support and interventions to facilitate adaptive coping strategies during this vulnerable period.

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Section: Discussionmentioning

confidence: 99%

A qualitative study of military service members undergoing medical separation

Lee‐Tauler,

LaCroix,

Huppert

et al. 2024

J Clin Psychol

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All-cause mortality among United States military personnel: Findings from the Millennium Cohort Study, 2001–2021

Carey,

Harbertson,

Sharifian

et al. 2024

Annals of Epidemiology

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Prospective Associations of Military Discharge Characterization with Post-active Duty Suicide Attempts and Homelessness: Results from the Study to Assess Risk and Resilience in Servicemembers—Longitudinal Study (STARRS-LS)

et al. 2022

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Introduction Active duty service members transitioning to civilian life can experience significant readjustment stressors. Over the past two decades of the United States’ longest sustained conflict, reducing transitioning veterans’ suicidal behavior and homelessness became national priorities. However, it remains a significant challenge to identify which service members are at greatest risk of these post-active duty outcomes. Discharge characterization, which indicates the quality of an individual’s military service and affects eligibility for benefits and services at the Department of Veterans Affairs, is a potentially important indicator of risk. Materials and Methods This study used data from two self-report panel surveys of the Study to Assess Risk and Resilience in Servicemembers-Longitudinal Study (STARRS-LS) (LS1: 2016-2018, n = 14,508; and LS2: 2018-2019, n = 12,156), which were administered to respondents who previously participated while on active duty in one of the three Army STARRS baseline self-report surveys (2011-2014): the New Soldier Study (NSS), a survey of soldiers entering basic training; All Army Study, a survey of active duty soldiers around the world; and the Pre-Post Deployment Study, a survey of soldiers before and after combat deployment. Human Subjects Committees of the participating institutions approved all recruitment, informed consent, and data collection protocols. We used modified Poisson regression models to prospectively examine the association of discharge characterization (honorable, general, “bad paper” [other than honorable, bad conduct, dishonorable], and uncharacterized [due to separation within the first 180 days of service]) with suicide attempt (subsample of n = 4334 observations) and homelessness (subsample of n = 6837 observations) among those no longer on active duty (i.e., separated or deactivated). Analyses controlled for other suicide attempt and homelessness risk factors using standardized risk indices that were previously developed using the LS survey data. Results Twelve-month prevalence rates of self-reported suicide attempts and homelessness in the total pooled LS sample were 1.0% and 2.9%, respectively. While not associated with suicide attempt risk, discharge characterization was associated with homelessness after controlling for other risk factors. Compared to soldiers with an honorable discharge, those with a bad paper discharge had an increased risk of homelessness in the total sample (relative risk [RR] = 4.4 [95% CI = 2.3-8.4]), as well as within subsamples defined by which baseline survey respondents completed (NSS vs. All Army Study/Pre-Post Deployment Study), whether respondents had been separated (vs. deactivated), and how much time had elapsed since respondents were last on active duty. Conclusions There is a robust association between receiving a bad paper discharge and post-separation/deactivation homelessness. Policies that enhance transition assistance and access to mental healthcare for high-risk soldiers may aid in reducing post-separation/deactivation homelessness among those who do not receive an honorable discharge.

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A temporal analysis of mental health symptoms relative to separation from the military

Cited by 3 publications

References 34 publications

A qualitative study of military service members undergoing medical separation

A qualitative study of military service members undergoing medical separation

All-cause mortality among United States military personnel: Findings from the Millennium Cohort Study, 2001–2021

Prospective Associations of Military Discharge Characterization with Post-active Duty Suicide Attempts and Homelessness: Results from the Study to Assess Risk and Resilience in Servicemembers—Longitudinal Study (STARRS-LS)

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