ICES Central (Mahar, Chen, Kurdyak), Toronto, Ont.; Department of Community Health Sciences (Mahar, Zhang), University of Manitoba, Winnipeg, Man.; School of Rehabilitation Therapy (Cramm), Queen's University, Kingston, Ont.; Faculty of Health (Aiken), Dalhousie University, Halifax, NS; Canadian Forces Morale and Welfare Services (Ouellette, Manser), Ottawa, Ont.; Department of Psychiatry (Kurdyak), University of Toronto, Toronto, Ont.
CMAJ Open. 2022 Feb 15;10(1):E119-E125. doi: 10.9778/cmajo.20200312. Print 2022 Jan-Mar.
In Canada, more than 64 000 children are growing up with 1 or both parents in the military. We compared mental health service use by children and youth in military families versus the general population, to understand potential mental health service gaps.
This was a matched retrospective cohort study of children and youth (aged < 20 yr) of members of the Canadian Armed Forces posted to Ontario between Apr. 1, 2008, and Mar. 31, 2013, with follow-up to Mar. 31, 2017, using provincial administrative health data at ICES. We created a comparison group of children and youth in the general population, matched 4:1 by age, sex and geography. We compared the use and frequency of mental health-related physician visits, emergency department visits and hospital admissions, and the time to first service use, using regression models.
This study included 5478 children and youth in military families and a matched cohort of 21 912 children and youth in the general population. For visits and admissions for mental health reasons, children and youth in military families were more likely to see a family physician (adjusted relative risk [RR] 1.25, 95% confidence interval [CI] 1.17 to 1.34), less likely to see a pediatrician (adjusted RR 0.87, 95% CI 0.79 to 0.96), equally likely to see a psychiatrist, and as likely to visit an emergency department or be admitted to hospital as the matched cohort. Children and youth in military families had the same frequency of use of outpatient mental health services. The time to first visit for mental health reasons was shorter to see a family physician (adjusted days difference [DD] -57, 95% CI -80 to -33) and longer to see a psychiatrist (adjusted DD 103, 95% CI 43 to 163) for children and youth in military families.
Children and youth in military families use mental health services differently from those in the general population. Provincial policies aimed at increasing access to mental health specialists for children and youth in military families, alongside targeted federal services and programming through military organizations, are needed.
在加拿大，有超过 64000 名儿童的父母一方或双方在军队服役。我们比较了军队家庭儿童和青少年与普通人群的心理健康服务使用情况，以了解潜在的心理健康服务差距。
这是一项针对加拿大武装部队成员（20 岁以下）的匹配回顾性队列研究，这些成员在 2008 年 4 月 1 日至 2013 年 3 月 31 日期间被派往安大略省，随访至 2017 年 3 月 31 日，使用 ICES 的省级行政健康数据。我们创建了一个普通人群中儿童和青少年的对照组，按年龄、性别和地理位置 4:1 匹配。我们使用回归模型比较了心理健康相关医生就诊、急诊就诊和住院的使用情况和频率，以及首次就诊的时间。
这项研究包括 5478 名军队家庭的儿童和青少年以及一个普通人群的 21912 名儿童和青少年的匹配队列。对于心理健康相关的就诊和住院，军队家庭的儿童和青少年更有可能看家庭医生（调整后的相对风险 [RR]1.25，95%置信区间 [CI]1.17 至 1.34），不太可能看儿科医生（调整后的 RR 0.87，95%CI0.79 至 0.96），看精神科医生的可能性相同，急诊就诊或住院的可能性与匹配队列相同。军队家庭的儿童和青少年接受门诊心理健康服务的频率相同。军队家庭的儿童和青少年首次因心理健康原因就诊看家庭医生的时间更短（调整后的天数差 [DD]-57，95%CI-80 至-33），而看精神科医生的时间更长（调整后的 DD103，95%CI43 至 163）。
军队家庭的儿童和青少年使用心理健康服务的方式与普通人群不同。需要制定省级政策，增加儿童和青少年获得心理健康专家服务的机会，同时通过军事组织提供有针对性的联邦服务和方案。
