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U.S. National Guard (NG) military personnel experience many barriers to care such as limited access to health-care services and geographic separation from service providers. Although stigma and barriers to mental health care have been examined in the military, little is known about how different facets of stigma and barriers to care might impact different military subgroups. In a sample of 965 NG personnel, latent class analysis was used to identify distinct subgroups of stigma and barriers to care. Four groups were identified: no stigma or barriers (31%), mild stigma and barriers (30%), high stigma and career concerns (20%), and moderate stigma and barriers (20%). Classes significantly differed with respect to several demographic characteristics, rates of mental health conditions, and rates of previous suicidal thoughts and behaviors. Results suggest that different subgroups of NG personnel vary with respect to levels of perceived stigma, barriers to care, and mental health needs. [ABSTRACT FROM AUTHOR]

Although inclusion into the National Guard brought uniformity, professionalism, and better equipment to state militia, it weakened the vital bonds of some militia companies with their communities. In the nineteenth century, the Richardson Light Guard of Wakefield, Massachusetts, thrived under generous patrons, a supportive town, and a relatively wealthy state government, but after it became part of the National Guard in 1916, the deep links with its home community steadily weakened, then broke. What had once been an institution of the town passed to the state, then to the federal government. Increased federal involvement helped an elite militia company become an average National Guard company. [ABSTRACT FROM AUTHOR]

We developed and tested a model in which supervisors' procedural justice perceptions lead to supervisors' organizational citizenship behavior (OCB), supervisors' OCB leads to subordinates' procedural justice perceptions, and in turn, subordinates' procedural justice perceptions directly influence subordinates' OCB. Using data collected from 373 National Guard members and their military supervisors, we found support for the mediation framework as well as for the prediction that individuals' OCB role definitions (that is, the extent to which they define OCB as extrarole) moderate the relationships between justice perceptions and OCB performance. [ABSTRACT FROM AUTHOR]

This study assessed the risk of suicide by time since separation from the military for US veterans who served in Iraq or Afghanistan. Suicide risk was assessed by comparing the number of suicides among veterans, when stratified by active vs. reserve/National Guard status to the expected number based on rates of suicide in the US general population. Hazard rates were used to assess suicide risk since the time each veteran separated/deactivated from active duty service. Compared to the US general population, active duty veterans had a 56% increased risk of suicide and reserve/National Guard veterans had a 29% increased risk. Suicide risk decreased as time since separation/deactivation increased for both groups. The risk of suicide for both groups was greatest during the first year of follow-up. [ABSTRACT FROM AUTHOR]

With President Trump considering use of state National Guard troops to deport illegal immigrants, it is essential to understand which rules-federal or state-govern the National Guard. While a president can "federalize" National Guard service members, bringing them under his command, the plan under consideration calls for Guard personnel to remain in a state status. This scenario raises the specter of a conflict of law situation. Would the Guard troops have to follow President Trump's and federal military officials' orders? What if a governor issues contrary instructions? Because Guard members can serve in two statuses, state and federal, it is not obvious which jurisdiction's rules are binding at any particular time. Nor is clarity found in the legal literature, a by-product of the sparse scholarly treatment the National Guard has received generally. As a clear chain of command is essential to military effectiveness, this is no trivial matter. This Article explains why it is state-rather than federal-officials who decide which rules bind state National Guard personnel. In doing so, it describes the complex power-sharing arrangement the Framers created regarding state militias, i.e., National Guard forces. Under the framework contained in the Constitution's Second Militia Clause, states govern National Guard troops assigned to them. The president's role is strictly normative, limited to setting administrative standards and providing equipment. The president's rule-making authority is concurrent with the states', which also can promulgate regulations for their forces. While both can make rules, only state officials possess the power to govern, a power which subsumes the power to decide which rules apply. Accordingly, federally promulgated rules and orders-even presidential orders-are legally binding only if state officials make them so. [ABSTRACT FROM AUTHOR]

Objective: To determine associations between need, enabling, and predisposing factors with mental health service use among National Guard soldiers in the first year following a combat deployment to Iraq or Afghanistan.Data Sources/study Setting: Primary data were collected between 2011 and 2013 from 1,426 Guard soldiers representing 36 units.Study Design: Associations between Guard soldier factors and any mental health service use were assessed using multivariable logistic regression models in a cross-sectional study. Further analysis among service users (N = 405) assessed VA treatment versus treatment in other settings.Principal Findings: Fifty-six percent of Guard soldiers meeting cutoffs on symptom scales received mental health services with 81 percent of those reporting care from the VA. Mental health service use was associated with need (mental health screens and physical health) and residing in micropolitan communities. Among service users, predisposing factors (middle age range and female gender) and enabling factors (employment, income above $50,000, and private insurance) were associated with greater non-VA services use.Conclusion: Overall service use was strongly associated with need, whereas sector of use (non-VA vs. VA) was insignificantly associated with need but strongly associated with enabling factors. These findings have implications for the recent extension of veteran health coverage to non-VA providers. [ABSTRACT FROM AUTHOR]

Background: The study of military-related mental health has been disproportionately focused on current symptomology rather than potentially more informative life course mental health. Indeed, no study has assessed age-of-onset and projected lifetime prevalence of disorders among reservists.Methods: Age-of-onset and projected lifetime DSM-IV anxiety, mood, and substance use disorders were assessed in 671 Ohio Army National Guard soldiers aged 17-60 years. Between 2008 and 2012, face-to-face clinical assessments and surveys were conducted using the Structured Clinical Interview for DSM-IV and Clinician-Administered PTSD Scale.Results: Lifetime prevalence of psychiatric disorders was 61%. Alcohol abuse/dependence (44%) and major depressive disorder (23%) were the most common disorders. The majority (64%) of participants reported disorders antedating enlistment. Median age-of-onset varied with anxiety disorders - particularly phobias and OCD - having the earliest (median=15 years) and mood disorders the latest median age-of-onset (median=21 years).Limitations: The study was limited by both the retrospective investigation of age-of-onset and the location of our sample. As our sample may not represent the general military population, our findings need to be confirmed in additional samples.Conclusions: Each psychiatric disorder exhibited a distinct age-of-onset pattern, such that phobias and OCD onset earliest, substance use disorders onset during a short interval from late-adolescence to early-adulthood, and mood disorders onset the latest. Our finding that the majority of participants reported disorders antedating enlistment suggests that an assessment of lifetime psychopathology is essential to understanding the mental health burden of both current and former military personnel. [ABSTRACT FROM AUTHOR]

The article history of the use of the National Guard on the U.S.-Mexico border, starting with Operation Jump Start, then Operation Phalanx, and Operation Strong Safety. Topics discussed include authority by which the President or governors acted under when deploying the National Guard; legal considerations surrounding the deployment of National Guard troops to the border by a state governor; and laws related to over-militarization of the border.

An injury during deployment disrupts family and life functioning. The purpose of the present study was to provide an in-depth examination of three injured National Guard soldiers showing how differential experiences of navigating multiple systems to obtain treatment for injury resulted in different adjustment trajectories for these soldiers and their families. A comparative case study examined three families where a soldier's injury was a central theme of family adjustment. Qualitative data were drawn from interviews conducted conjointly with both the soldier and spouse to provide an in-depth perspective of adjustment, meaning, and resource utilization patterns. In addition, survey data were collected at three time points in the deployment cycle (predeployment, 90 days post, and 1 year). These data were integrated into the case analysis, including mental health, marital relationship, treatment history, and characteristics of resilience. Study findings suggest that a delay in diagnosis, wait time for treatment, and the lack of comprehensive formal and financial support for a soldier following nonhostile injury lead to a pileup of stressors that are detrimental to the soldier's physical and mental health, financial stability, and family well-being. Further study is needed to understand how these system level issues impede resilience among National Guard families. [ABSTRACT FROM AUTHOR]

Purpose: Low social support and small social network size have been associated with a variety of negative mental health outcomes, while their impact on mental health services use is less clear. To date, few studies have examined these associations in National Guard service members, where frequency of mental health problems is high, social support may come from military as well as other sources, and services use may be suboptimal.Methods: Surveys were administered to 1448 recently returned National Guard members. Multivariable regression models assessed the associations between social support characteristics, probable mental health conditions, and service utilization.Results: In bivariate analyses, large social network size, high social network diversity, high perceived social support, and high military unit support were each associated with lower likelihood of having a probable mental health condition (p < .001). In adjusted analyses, high perceived social support (OR .90, CI .88-.92) and high unit support (OR .96, CI .94-.97) continued to be significantly associated with lower likelihood of mental health conditions. Two social support measures were associated with lower likelihood of receiving mental health services in bivariate analyses, but were not significant in adjusted models.Conclusions: General social support and military-specific support were robustly associated with reduced mental health symptoms in National Guard members. Policy makers, military leaders, and clinicians should attend to service members' level of support from both the community and their units and continue efforts to bolster these supports. Other strategies, such as focused outreach, may be needed to bring National Guard members with need into mental health care. [ABSTRACT FROM AUTHOR]

Objective: Convergent evidence suggests that low socioeconomic status (SES) may be related to reduced mental health service use. However, this relationship has not been tested in the National Guard (NG) population, in which the prevalence of mental health symptoms is high. Methods: Surveys were completed by 1,262 NG soldiers. SES was measured by education and income. Adjusted multivariable regression models assessed associations between SES, overall service use, and use of specific types of services. Results: SES was not associated with overall use but was associated with use of certain types of services. Higher SES was associated with lower likelihood of psychotropic medication use (odds ratio=.83, 95% confidence interval=.72-.96), and higher SES strengthened the positive relationship between PTSD and use of individual therapy. Conclusions: Higher SES may increase the use of individual therapy among soldiers with PTSD. Barriers to care among individuals with low SES merit continued attention and outreach efforts. [ABSTRACT FROM AUTHOR]

An essay is presented which explores the U.S. dependency on National Guard and Reserve members for protecting civilian employment and to provide healthcare to citizen soldiers. Topics discussed include obstacles for the National Guard and Reserve members in finding the employment, need to emphasize on the needs of National Guard and Reserve members by the U.S. Congress and implications regarding the National Guard and Reserve members.

The article discusses the role of the U.S. National Guard State Partnership Program (SPP) in achieving the goals of the foreign area officer (FAO) program. It emphasizes the mission of the SPP to support the security cooperation goals of the Combatant Command. It mentions the use of the SPP to fill the gap of the Army Reserve FAO in meeting the nations' national security goals. It also notes the platform provided by the SPP to address identified deficiencies in partnership.

The article focuses on the role played by the U.S. National Guard in addressing security threats and risks across the U.S. Southwest border. Topics discussed include the security controls and policies in the state which enabled people to facilitate legal commerce transactions, the policing crimes taking place in the traditional customs such alien smuggling, illegal immigration, and narcotics trafficking, and the increasing incidence of drug trafficking involving gangs in the Southwest Region.

Given the cost and burden associated with training and recruitment of military members, identifying predictors of military retention remains an important goal. The aim of the current study was to examine predictors of male and female service members' likelihood of remaining in the National Guard following combat deployment in support of Operation Iraqi Freedom. Using a prospective, longitudinal design, this study assessed a wide range of predictors including mental health functioning, personality variables, deployment stressors, and various domains of quality of life. Results indicated perceived unit support was the strongest predictor of intention to re-enlist for both male and female participants. However, significant gender differences emerged as predeployment depression and a trend toward perceived life threat during deployment were predictors of men's intention to re-enlist, whereas the predeployment personality dimension of introversion (low positive emotionality) and postdeployment life stressors were predictors of women's intention to re-enlist. Surprisingly, no postdeployment mental health variables predicted National Guard soldiers' intention to re-enlist. Findings from this study suggest factors associated with National Guard service members' retention or attrition from the military may be amenable to intervention. [ABSTRACT FROM AUTHOR]

National Guard service members and their families face unique circumstances that distinguish them from other branches of the military. In this article, we highlight unique National Guard needs and argue that more can be done by policy makers to help this population. We present the findings from a representative survey of Michigan citizens showing that public support exists for increased assistance for these service members. Using the multiple streams framework, we propose that policy makers currently have the opportunity to facilitate increased support for National Guard members and families. Specifically we suggest policy implications that feature the important role of state and local resources. [ABSTRACT FROM AUTHOR]

Objectives: Readjustment stressors are commonly encountered by veterans returning from combat operations and may help motivate treatment seeking for posttraumatic stress disorder (PTSD). The study examined rates of readjustment stressors (marital, family, and employment) and their relationship to early mental health treatment seeking among returning National Guard soldiers with PTSD. Methods: Participants were 157 soldiers who were surveyed approximately three months after returning from combat operations in Iraq and scored positive on the PTSD Checklist (PCL). The survey asked soldiers about their experience with nine readjustment stressors as well as their use of mental health care in the three months after returning. Results: Many readjustment stressors were common in this cohort, and most soldiers experienced at least one stressor (72%). Univariate analyses showed that readjustment stressors were related to higher rates of treatment seeking. These findings remained significant after multivariate analyses adjusted for depression and PTSD severity but were no longer significant after adjustment for age and marital status. Conclusions: Readjustment stressors are common among soldiers returning from duty with PTSD and may be more predictive than PTSD symptom levels in treatment seeking. These effects appeared to be at least partially accounted for by demographic variables and the role of greater familial and occupational responsibilities among older veterans. Treatment seeking may be motivated by social encouragement or social interference and less by symptom severity. [ABSTRACT FROM AUTHOR]

This article examines the requirements for ethical press apologias, defined as attempts to defend credibility when accused of ethical failure. Facing changing transparency expectations, apologists may fail to fully respond to injured stakeholders. Criticisms of CBS News' flawed report on President Bush's National Guard service illustrated this problem. Hearit's (2005b) paradigm for ethical apologias is applied to “RatherGate” to see if and where the paradigmatic criteria fell short. A revised paradigm is proposed. [ABSTRACT FROM AUTHOR]