Family Problems Among Recently Returned Military Veterans Referred for a Mental Health Evaluation

Context: Existing evidence suggests, that military veterans with mental health disorders have poorer Family functioning, although little research has focused on this topic. Objective: To test whether psychiatric symptoms are associated with family reintegration problems in recently returned military veterans. Design: Cross-sectional survey of a clinical population. Respondents who were referred to behavioral health evaluation from April 2006 through August 2007 were considered for the survey. Setting: Philadelphia Veterans Affairs Medical Center, Pa. Participants: 199 military veterans who served in Iraq or Afghanistan after 2001 and were referred for behavioral health evaluation from primary care (mean age = 32.7 years, SD = 9.1). Main Outcome Measures: Measures included the Mini-International Neuropsychiatric Interview for psychiatric diagnoses, the 9-item Patient Health Questionnaire for depression diagnosis and severity, and screening measures of alcohol abuse and illicit substance use. A measure of military family readjustment problems and a screening measure of domestic abuse were developed for this study. Results: Three fourths of the married/cohabiting veterans reported some type of family problem in the past week, such as feeling like a guest in their household (40.7%), reporting their children acting afraid or not being warm toward them (25.0%), or being unsure about their family role (37.2%). Among veterans with current or recently separated partners, 53.7% reported conflicts involving shouting, pushing, or shoving, and 27.6% reported that this partner was afraid of them. Depression and posttraumatic stress disorder symptoms were both associated with higher rates of family reintegration problems. Conclusions: Mental health problems may complicate veterans' readjustment and reintegration into family life. The findings suggest an opportunity to improve the treatment of psychiatric disorders by addressing family problems.