Military Families and Mental Health

The country of Japan hosts just under 54,000 U.S. military troops at bases and facilities throughout mainland Japan, Kyushu, and Okinawa and approximately 40,000 military dependents (spouses and families). TELL receives many referrals for the spouses and children of the active duty troops and, on occasion, for active duty members as well. The U.S. military has a culture of its own that often separates them from the mainstream population, as their lifestyles and challenges differ greatly from the majority of their non-military peers. These challenges impact the entire military family including the active duty member, the spouses, and the children and can lead to mental health issues. May is Military Appreciation Month, and we want to take the time to honor military members and their families and recognize the challenges they experience. 

Military members are often separated from their loved ones and support systems. Decisions about their daily lives are made by the military including where they live, and they sometimes have to follow restrictions non-existent for civilians. All of these things can impact their sense of identity which can impact wellbeing. Some military jobs can be in high stress situations or even lead to life and death risks (such as combat); but even if the job itself is in a safe environment, military members are often more exposed to potentially stress-inducing knowledge such as national security matters, and due to its confidential nature they also have few outlets to process their thoughts about this information.

Though the military has made efforts to decrease the stigma of mental health in the military, actual change can be a slow process and there are still issues related to this in the military. A 2021 meta-analysis by BMC Psychiatry indicated that 23% of active duty military members and veterans experienced Depression (higher than the estimated 13% to 15% of the general population). According to Health.mil, the official website of the military health system, 60-70% of military members with mental health symptoms do not seek treatment. The stigma is often related to fears that mental health symptoms can be viewed as a sign of weakness. Some fear that their careers could be at risk. All military members have to maintain good physical health and be up to date on medical check ups for “military readiness”, and there is fear that admitting to mental health challenges may impact this or the types of jobs they’ll be permitted to work in the military. 

The dependents of active duty military members also experience many challenges (including separation from loved ones and support systems) that can lead to mental health issues. In cases of these military families in Japan, it is not uncommon for the active duty member to be deployed after the family is moved to Japan which leaves the spouse in charge of caring for the children and household on their own while also adjusting to living in a new country. Additionally, when overseas, the active duty member acts as the “sponsor” for their spouse which can leave the dependent spouse powerless in some situations; for instance, in Japan, spouses must have a “power of attorney” when their active duty spouse is deployed to make some household decisions that they would, otherwise, have the right to make when living stateside. Military spouses often also have difficulty maintaining their own employment (or completing schooling) due to having to move every 2-3 years.

Often, the ability to maintain their own identity is also difficult due to having to make their life decisions based on their spouse’s military careers and feeling like their needs are secondary to their spouses and the mission of the military. In a 2021 Military Family Lifestyle Survey, 25% of military spouse respondents self reported having a diagnosis of Generalized Anxiety Disorder. This is in comparison to the 3% of the general population with this diagnosis. 

According to a study by the Substance Abuse and Mental Health Services Administration (SAMHSA), over 16% of military children aged 12-17 experienced a major depressive episode in the year prior to their study, and over 12% experienced a major depressive episode with severe impairment. All military family members experience frequent moves, but this lack of stability can be especially impactful for children who are growing and developing social and emotional skills and finding their place in the world. While moving frequently sometimes impacts the adults in the family from making secure social connections as well, this can be especially harmful for children for whom this social development is a necessary developmental milestone.

Deployment of a parent in military families also has been shown to have a significant impact on children’s mental health. The American Academy of Pediatrics cited studies that showed that 1 in 4 children with a deployed parent experienced emotional-behavioral challenges and another study that showed an “11% increase in mental and behavioral health outpatient visits in children 3 to 8 years of age during parental deployment”. 

There is a high level of resilience necessary for military members and their families to experience the challenges they do. Even those with this resilience experience a higher rate of mental health symptoms than the rates of the general population, but the bases overseas and in Japan often have limited resources. In an effort to alleviate these noted issues, TELL has committed to assisting the U.S. military families in Japan through provision of therapy and continued efforts at increasing and improving these services. Since 2018, TELL has increased the number of therapy sessions provided to military families from less than 100 sessions in 2018 to approximately 6,000 sessions in 2023. In providing these services and working closely with the U.S. bases, TELL has helped to alleviate some of the challenges of finding resources which has allowed more families to come to Japan with their active duty service member spouse/ parent. During this Military Appreciation Month of May, we want to thank our military members and their families for their daily sacrifices, acknowledge our appreciation, and reaffirm our dedication to continue providing quality mental health care to the military families stationed in Japan.