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Staying Healthy: Mental Health Needs

Children and families often deal with stressful situations that put their mental health at risk. Deployment is a reality for many military families. It affects the well-being and mental health of children and families. This lesson helps support children and families dealing with stressful life events.

Objectives
  • Describe the emotional effects of stressful events, such as deployment, on children and families.
  • Describe strategies you can use before, during, and after deployment to support children and families.
  • Provide support to children and families who experience stressful life events.

Learn

Know

It is likely that some children and families in your care will face challenging life events that can put their mental health and overall well-being at risk. Such events might include death, divorce, job loss, relocation, violence in the home, or separation. As a child-development professional on or near a military installation, you will also likely work with children who experience deployment, or you may experience deployment in your own family. Deployment is a difficult time in the lives of children and families. Each family handles these challenges differently, and each child will have unique needs. The findings of studies comparing children from military families to those from civilian families seem to indicate a greater likelihood of mental health and behavioral concerns among children in military families (Cramm et al., 2019). Nevertheless, there are typical changes you can expect as children experience challenging and stressful transitions and life events.

This lesson describes the effects of stressful events on children's lives while highlighting ways you can support children and their families during times of crisis. You will learn the typical emotional and behavioral experiences of children and youth before, during, and after deployment, and ways you can support children and their families at each stage of deployment.

Stress in Young Children's Lives

Unlike younger children, older children are typically able to verbally express what they are feeling, whether it is fear, anxiety, confusion, anger, sadness, or helplessness (Zero to Six Collaborative Group, National Child Traumatic Stress Network, 2010). Older children and youth may even be able to express the reasons behind their feelings. That being said, the level of self-awareness and verbal expression of emotions can vary from child to child. Children and youth may not always use their words, or even have the right words for the complex emotions they may feel (e.g., pride in their parents' military service, but also fear for their safety during deployment). Children's feelings can sometimes still be manifested in their behaviors, and this is especially true for young school-agers. School-age staff members can look to these behaviors as clues to what children are experiencing inside. When dealing with stressful events, children may: become clingy or fearful of new situations; demonstrate aggression; experience difficulty sleeping; or even appear to lose recently acquired skills. Let's consider deployment and how it can affect children and families.

Emotional Characteristics of Deployment

Deployment is a challenge for any family. For families faced with repeated or multiple deployments, the following seven-stage emotional cycle describes their typical experiences. 

Seven-Stage Cycle

  1. Stage 1 Anticipation of Departure
  2. Stage 2 Detachment and Withdrawal
  3. Stage 3 Emotional Disorganization
  4. Stage 4 Recovery and Stabilization
  5. Stage 5 Anticipation of Return
  6. Stage 6 Return Adjustment and Renegotiation
  7. Stage 7 Reintegration and Stabilization

Figure 1. Emotional Cycles of Deployment. Adapted from Pincus, S. H., House, R., Christenson, J., & Adler, L. E. (2001). The emotional cycle of deployment: A military family perspective. US Army Medical Department Journal, 4(5), 6.

When families learn about the deployment, they are faced with preparing themselves financially, emotionally, and physically. The deploying parent may need to spend extra time at work prior to the departure. Both parents may spend a great deal of time getting ready for the deployment, packing, filling out paperwork, performing routine home or auto maintenance, finding babysitters or making extra childcare arrangements.

Before Deployment

For many families, especially those who have been deployed before, there may be a period of detachment or withdrawal prior to deployment. Family members might emotionally prepare themselves for the pain of separation by isolating themselves. During this period, there might be fights or anger.

Children experience a variety of emotions prior to a deployment. They may not always understand why their mother, father, or other family member has to leave. It is common for young children to feel that it is their "fault" that their parent is leaving. This happens often when children have unanswered questions about the deployment. Because young school-age children are still developing a sense of time, they may feel anxious or confused about when a family member is leaving. They may not understand how long the separation will last or even that the separation is temporary. They may be confused by the changes they see in their household. Older children, especially those who have experienced deployment before may be angry, sad, or scared about their parent leaving. They may feel frustrated about additional household tasks they have been asked to take on (e.g., more chores than usual). The deploying parent may need to spend extra hours at work in preparation for deployment, and the spouse may be making arrangements for life as a single parent by attending to necessary legal, medical, or financial matters.

All of these emotions can show themselves in different ways. During this stage, the child may act withdrawn, sad, or quiet. Changes in routines may make the child more likely to act out. You might see more aggressive behaviors, tantrums, crying, or regressing (e.g., problems with self-care routines the child had previously mastered, like packing their own lunch).

During Deployment

When a family member begins their deployment, the at-home family members go through a period of disorganization. They may be sad and anxious about how the family will function. The at-home caregiver may feel overwhelmed by responsibility. It takes some time to settle into a new routine. Eventually the family recovers and develops routines that work for them; they have a new "normal."

Once the parent has deployed, children will go through a range of emotions. They may be sad, lonely, confused, angry, or scared. Fear of separation is one of the major concerns of school-age children. They may be afraid that the remaining parent will also leave. They may need constant reassurance that their parent or guardian is close by or will pick them up from your school-age program. They may be afraid that the deployed parent is in danger.

With all these changes, you may sometimes see children behaving more aggressively. You may also see children become clingy, shy, quiet, or fearful. Fears are common for all children, and deployment may increase their fears. They may be drawn to adults for comfort, or, for older children and youth, they may sometimes withdraw from adults. It is important to keep lines of communication open, and assure children and youth know you are there to listen and help them throughout this complex time.

You can help the child to feel connected to the deployed family member by offering ways to the family to help the child to cope and foster resilience (Siegel, B. S., 2013).  Many of these can be done at home with the caregiver but can also occur in your classroom to build that connection between home and school:
 

  1. Continue the discussion about the deployed parent on a regular basis.
  2. Communicate to the deployed parent frequently and regularly: write letters, draw pictures, put together goodie packages.
  3. Keep a calendar for each child so he or she can see when the deployed family member is coming home.
  4. Have a picture of the deployed parent with the children or with the family. Pictures can be hung up or put in prominent places. This is especially important for the preschool-age child.
  5. Protect younger children from seeing or hearing about the war effort or violence on television or in the newspapers.
  6. Have deployed parent audio or video record a favorite bedtime story before leaving, especially if reading was a normal routine before leaving.
  7. Seek support from extended family or a trusted adult (mentor, for school-age child) who can be available for the children.
  8. Ask family and friends not to talk about the painful or scary aspects of deployment.
  9. Keep up the family routine.
  10. Try to spend extra time with the child or children, if possible and respond empathically to the needs for more attention.
  11. Encourage ways for children to express their feelings. For younger children, it may be drawing or playing with dolls, and for older children, it may be telling stories or keeping a journal and possibly sharing the journal, especially at bedtime.
  12. Appreciate that young children will act out scary and fearful feelings through play. 勛圖厙 and understand this process and monitor the behaviors and feelings during times of family or school activities.
  13. Request the free Sesame Street video Talk, Listen, Connect (). Request free Military Child or Youth videos, Mr. Poe and Friends Discuss Reunion After Deployment () for younger children.
  14. Communicate to teachers about the deployment and continue to check in on their school performance and behaviors.
  15. Develop a scrapbook of childrens activities and accomplishments to be shared when there is reunion. This will allow the child to show and tell.

After Deployment

As the day for the return draws closer, the family prepares for more changes. They may be excited about the family member's return. They may feel a little nervous about whether their relationship with the deployed family member has changed. When the deployed family member returns, the family goes through another transition. The non-deployed caregiver might have mixed emotions about their changing role; this person has "done it alone" for quite some time and must renegotiate roles and expectations. Children may also have a hard time bringing the deployed family member back into daily routines, their roles and responsibilities may also need to shift. The deployed person may have doubts about where they fit into the family. Over time, the family stabilizes.

Immediately before and after the parent returns, the child may be excited and energetic. The child may also feel a little nervous and shy about the parent returning. Depending on their age and experiences with previous deployments, children may be scared that they won't recognize their parent. They may also be afraid that the parent will leave again. They may be confused by the changes happening in their home as family members visit and their parents negotiate new roles.

See

How can programs support children who may be facing challenging life situations? Listen as this manager discusses how she and her program support children and families who experience deployment.

Connecting During Deployment

Watch to learn strategies on how to support families dealing with stressful events.

Do

Protective Factors: Fostering Resilience in Young Children and Families

There are characteristics of children and families that can protect them as they go through stressful events. Research on resilience in children demonstrates that a significant protective factor for children is the consistent presence of a caring, positive, and protective caregiver (Zero to Six Collaborative Group, National Child Traumatic Stress Network, 2010). This person can be an ongoing resource for the particular child, and can encourage them to talk about their experience, and provide reassurance that adults in the child's life are working to keep them safe.

According to the Centers for Disease Control and Prevention and the National Center for Injury Prevention and Control, you can support children facing stressful challenges when you:

  • Maintain consistent program routines as much as possible. This provides children with a much-needed sense of stability and safety.
  • Provide opportunities for children to talk about what is going on, but do not force them to talk if they don't want to. Encouraging children to talk about their feelings and validating them strengthens children's coping skills as they hear that all their feelings are OK.
  • Be watchful of changes in children's behaviors over time. Changes in behaviors, for example acting out or withdrawing from friends, may indicate that a child needs extra support.
  • Encourage families to connect with other families who may be dealing with similar stressors. Connecting with others allows families to share experiences and coping strategies.

The remainder of this lesson focuses on how you can support children and families before, during, and after deployment.

勛圖厙 Before Deployment

Most importantly, you can help families find the resources they need, such as Military One Source () or other resources available in their particular Service. Pre-deployment counseling can help families learn ways to prepare children for the deployment.

Encourage families to talk with their children honestly about the deployment. It is important for families to help children understand:

  • Why the parent is leaving: The deploying parent has an important job to do and they know how to do the job well; they are not going alone.
  • When the deploying parent is leaving.
  • What the family will do together before the parent leaves.
  • How the child will communicate with the parent while they are deployed.
  • What will stay the same when the parent leaves: for example, one parent will still be here for breakfast and dinner, the child will still go to the same school and school-age care program, the family will still have fun together, etc.

Also encourage families to start thinking about ways to help the child feel close to the deployed parent. Are there personal items the parent and child can exchange before the deployment (e.g., a picture or favorite t-shirt)?

勛圖厙 During Deployment

During periods of deployment, it is especially important that you help the child and family maintain normal routines. Early in the deployment is not the time to transition a child to a new program or caregiver. Reassure the child that their parent or guardian will pick the child up as usual. Provide comfort. Answer the child's questions as simply and matter-of-factly as possible.

Integrate emotional literacy and problem-solving into your curriculum. Help children learn to recognize and deal with emotions. Talk about emotions every day. Look at pictures of children with different emotions, read stories about feelings and deployment, do activities that let the child identify and talk about their feelings. Help the child develop strategies for calming down and dealing with anger or fear.

Be prepared to help the parent with problems that arise. Parents may be confused by changes in their child's behavior. A parent may feel alone and unsure of how to provide discipline or guidance. The parent may feel frustrated by challenges--such as the child or youth "talking back," or not "paying attention" at school. The parent may go through periods of self-doubt, depression, or helplessness. Remember that it is important for parents to take care of their own mental and physical health. Help them connect with a Family Readiness Group, behavioral health counseling, or clergy. You can provide resources, training, and support around positive guidance and discipline. You can also help families think of ways to make life easier during the deployment. Use conversations, newsletters, and family nights to help families share ideas like:

  • Keeping track of time by putting a coin in a jar each day of the deployment; the child can buy the parent a homecoming gift upon their return.
  • Going on family hikes.
  • Have a family movie night.
  • Draw pictures or write letters to the deployed family member.
  • Have a family camp-out in the yard.
  • Schedule "date nights" (or days) with each child individually.
  • Create a family calendar.
  • Figure out a special way to say goodnight to the deployed family member each night.
  • Revisit photo books of the family together and of the deployed family member at work.
  • Create an emotions book and discuss with the child how they are feeling in that particular moment and what they can do to help regulate their emotions if needed.
     

勛圖厙 After Deployment

Celebrate with the family and the child. Answer questions and let the child talk. Acknowledge the child's feelings, and help the child find words or pictures to describe those feelings. Make sure they know all feelings are OK. It is normal to feel shy or nervous when you haven't seen someone for a while. Recognize that this is a major transition for the family, and they will likely need to be connected with resources and supports. Work with your program to identify resources you can share.

Case Example

Read the following scenario and think about the suggestions provided to support children in your care during the different phases of deployment.

Wayne and Natalia, parents of a child in your program, both serve in the military. They met while on assignment in Asia and have been serving together around the world ever since. They love travel and living in new places. In their eight year marriage, they have had two international assignments. They had their first child, Ximena, six years ago, and she is now a child in your school-age program. Although they have moved frequently, they have never been deployed at the same time-- until now. Wayne and Natalia have both been assigned six month tours of duty. In some regards, Wayne and Natalia feel well prepared for the trip: they know Natalia's mother will care for Ximena, and they have completed all the pre-deployment paperwork for Ximena's insurance and care. They feel less prepared for the emotional toll of such a long separation. What can you and your program do to help this family, and particularly Ximena, before, during, and after the dual deployment?

You may consider the following:

  • Encourage the family to begin talking with Ximena about the upcoming deployment.
  • Talk about where the parents are going and why.
  • Prepare Ximena for what will stay the same: she'll sleep at grandma's like she does sometimes now, she'll still go to her school and your school-age program before and after school, she'll still play her favorite games, eat her favorite foods, and have her special dolls and toys.
  • Create personalized stories about her parents and what is going on while they are away for Ximena to read while she is at school.
  • Create special items that could comfort Ximena during difficult times in the program (e.g., make a pillow out of one of mom or dad's shirts for Ximena to snuggle in the reading area during quiet time).
  • Provide Ximena with a consistent routine and predictable rituals at school.
  • Include reminders at school about routines that seem difficult for Ximena. You can do the same about routines that have been challenging at home as well.
  • Talk with Ximena about emotions and encourage her to share her emotions by writing notes to her parents. Comfort her when she needs extra support.
  • Share messages or notes that the parents sent to the school-age program to be shared with Ximena.
  • Provide honest responses to Ximena's questions or comments about her parents. For example, if she shares that she is scared, you can say, "I am scared sometimes too," or you can address a question about her parents by saying, "Your mom and dad are doing everything they can to be safe." Avoid elaborate responses which can be overwhelming to her.
  • When Ximena's parents return home, help Ximena talk about her emotions: anxiety, shyness, excitement. Make sure she knows all emotions are OK.
  • Organize a special activity that involves Ximena and her parents once they are back from deployment. For example, a parent-child breakfast, snack or picnic.
  • Encourage Ximena to express her feelings and share how she feels.
  • Have open and honest communication with Ximenas grandmother; she will be experiencing many changes as well and this will affect Ximena while she is in your care.

Take Care of Yourself

You provide crucial support for children and families. You cannot do that, however, if you don't take care of yourself. Helping children through difficult and sometimes tragic times can be incredibly challenging. You might find that your own mental health mirrors that of the people around you. Make sure you take time to reflect on your own needs. Talk to people around you about your feelings. Talk to your administrator about resources in your community for families experiencing deployment or loss. Taking care of yourself will make you better able to care for children. You can also learn more about your own self-care in the Social & Emotional Learning for Teachers (SELF-T) and the Self & Cultural Understanding courses.

Explore

The odds are likely that you will work with a child who is affected by deployment. Therefore, it's important to think about how you will support these children and their families. Read the scenarios in the 勛圖厙ing Children of Deployed Families activity, and answer the questions. Share your responses with a trainer, coach, or administrator. Then compare your answers to the suggested responses.

 You can also consider how this activity could be used to support children in families experiencing other kinds of separation such as long-term illness, incarceration, or frequent travel.

Apply

The death of a parent is perhaps the most emotionally challenging event that can happen to a child. Use the resources listed in Helping Children Deal with Grief to help you support the mental health of school-age children as they process their grief.

The Resources for Military Children Affected by Deployment compiled by the U.S. Army Family and Morale, Welfare, and Recreation Command, Child and Youth Services provide a list of books and websites that can help school-age children prepare for and handle the deployment of their parent or close family member.

Child Welfare Information Gateway provides a list of helpful resources that could be shared with families. The listed resources focus on helping children and families manage the deployment process, including preparing for deployment and family reunification following deployment. Child Welfare Information  Gateway: . 

Glossary

Deployment:
The relocation of forces or materials to desired operational areas. Military family members may be relocated to war zones or other areas as needed.
Mental health:
Mental health is a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community (World Health Organization, 2012).

Demonstrate

The most important time to provide support when a child and their family are preparing for a deployment is
Which of the following are ways you can support children who face stressful challenges?
Eight-year-old Carlita is afraid her mom wont recognize her when she comes home from deployment. The nature of Carlitas moms assignment has made video conference calls and Skype calls impossible. What can you recommend to Carlitas dad to help ease Carlitas fears?
References & Resources

Centers for Disease Control and Prevention, National Center for Injury Prevention and Control: Coping With Stress. 

Child Welfare Information Gateway. (2018). Deployment Resources for Families.

Ginburg, K., & Jarlow, M. M. (2014). Building resilience in children and teens: Giving kids roots and wings (4th edition). American Academy of Pediatrics.

Huebner C.R. (2019). Health and Mental Health Needs of Children in US Military Families. AAP Section on Uniformed Services, AAP Committee on Psychosocial Aspects Of Child And Family Health. Pediatrics. 143(1).

Morse, M. D. (n.d.). A Closer Look for Current Conditions: A Fresh Glance at the Emotional Cycles of Deployment.

National Academies of Sciences, Engineering, and Medicine. (2021). School-based strategies for addressing the mental health and well-being of youth in the wake of COVID-19. Washington, DC: The National Academies Press.

The National Child Traumatic Stress Network (NCTSN). (2016).  What is a Trauma-Informed Child and Family Service System? 

The National Child Traumatic Stress Network (NCTSN).  (2019).  Video 1:  The Impact of Interpersonal Trauma in Early Childhood. 

The National Child Traumatic Stress Network (NCTSN). (2019). Video 2: The Ways We Can Help Children with Early Childhood Trauma. 

Pincus, S. H., House, R., Christenson, J., & Adler, L. E. (2004). The Emotional Cycles of Deployment: A Military Family Perspective.

Sesame Workshop. (n.d.). Helping Kids Grieve.

Siegel, B. S., Davis, B. E., & Committee on Psychosocial Aspects of Child and Family Health and Section on Uniformed Services (2013). Health and mental health needs of children in US military families. Pediatrics131(6).

Zero to Six Collaborative Group, National Child Traumatic Stress Network. (2010). Early childhood trauma. Los Angeles, CA & Durham, NC: National Center for Child Traumatic Stress.