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Background: Little is known about longer term military work outcomes in UK military personnel who develop mental health problems when operationally deployed. Deployed Field Mental Health Teams (FMHTs) who support them follow the principles of 'Forward Psychiatry,' aiming to treat psychiatric casualties close to the front line to maximize operational effectiveness and occupational retention. Aim: To examine the short- and long-term military work outcomes in soldiers deployed to Iraq between 2003 and 2007 who were referred to the FMHT. Method: FMHT clinical records were linked to occupational records with 825 resulting matches. Results: 71.6% of the referred soldiers with a documented short-term military work outcome returned to their operational unit, and 73.5% of those who had a documented long-term military work outcome served on for a period in excess of two years. Adjusting for potential confounders, a shorter service length and removal from the operational theatre were both strongly associated with premature discharge; however, it was not possible to determine the severity of the presenting mental health problem and assess whether this impacted outcome. Conclusions: The results of this study support the use of the Forward Psychiatry principles in achieving good short-term military work outcomes. Utilizing these principles, three-quarters of those referred to the FMHT were returned to their deployed unit and approximately three-quarters of those assessed by the FMHT remained in service two years after referral. We suggest that these are positive work outcomes; however, being evacuated out of the operational environment and having a short service length were both associated with premature discharge, though we were unable to examine the role of illness severity.

Young children (birth through 5 years of age) are disproportionately represented in U.S. military families with a deployed parent. Because of their developmental capacity to deal with prolonged separation, young children can be especially vulnerable to stressors of parental deployment. Despite the resiliency of many military families, this type of separation can constitute a developmental crisis for a young child. Thus, the experience may compromise optimal child growth and development. This article reviews what is known about the effects of the military deployment cycle on young children, including attachment patterns, intense emotions, and behavioral changes and suggests an ecological approach for supporting military families with infants, toddlers, and preschoolers. Specifically, home-based family focused interventions seem to warrant the most serious consideration. DOI: 10.111l/j.1939-0025.2010.01066.x

Several recent articles have explored the effects of military deployment on U.S. service members' mental health outcomes. Although increased attention has also begun to focus on the effects of deployment on military families, providing a conceptualization for the mechanisms of this process can help organize existing information and inform future efforts. In this article we seek to draw greater attention to the effects of deployment on service members and to provide an overview of recent literature on the impact of deployment on service members and military families. A further goal is then to provide one conceptual perspective--a model of family stability--that may help inform our understanding of the impact of military deployment on families. Beyond informing research, the issues presented in this article have far-reaching consequences not only for American military families and their current mental health and primary care providers but also for practitioners in the broader mental health community who will be increasingly called upon to provide services to this population. Keywords: military deployment, family stability, child outcomes, family outcomes DOI: 10.1037/a0020332

The effects of combat deployment to Iraq or Afghanistan of US Army or Marine Corps personnel on their children and spouses are studied. Parental combat deployment has a cumulative effect on children, including child depression and externalizing symptoms, that remains after the parent returns from deployment.

During the Second World War, controversy surrounded not the inevitability of psychiatric casualties but the extent to which they could be minimized by selection, training, morale, and leadership. By early 1944, when planning for the D-Day landings was advanced, the problem of the psychiatric battle casualty was considered manageable by careful preparation and clinical understanding. The campaign to liberate Europe offered the newly formed Directorate of Army Psychiatry an opportunity to demonstrate its effectiveness. Psychiatric services were deployed to Normandy to maximize the return of front-line troops to duty. Commanders, however, entertained doubts about the value of military psychiatrists. By offering a sanctioned escape route from battle, some believed that their mere presence undermined the fighting spirit of combat troops. The records of 32 General (Psychiatric) Hospital have been analysed to discover categories of troops most vulnerable to breakdown and to assess the impact of front-line treatments. Infantry soldiers, those most likely to be killed, were disproportionately represented amongst admissions. Senior non-commissioned officers were also at elevated risk of breakdown, some being war weary from earlier campaigns. Probably 36 per cent of admissions returned to combatant duty, and 53 per cent were evacuated to the UK. The scale of psychiatric casualties revealed failures in pre-deployment screening. doi:10.1017/S0018246X09990495

Media coverage highlighting service delivery problems at Walter Reed Army Medical Center has led to heightened public scrutiny and congressional oversight regarding the care provided to returning Operation Enduring Freedom [...], This article discusses social work practice areas for civilian social workers who provide services to military service members, veterans, and their families. These practice areas include education, child welfare, domestic violence, mental health, health care, substance abuse, and criminal justice. The authors examine the impact of the contemporary military lifestyle and current military operations on service members and their families in the context of these practice areas, with the goal of compelling civilian social workers to acknowledge their responsibility to competently serve military and veteran clients. KEY WORDS: deployment cycle; mental health; military; social work; veterans

A comprehensive understanding of the stressors of the Iraq War is needed to ensure appropriate postdeployment assessments and to inform empirical inquiries. Yet we are unaware of any published studies that address the range of stressors experienced by this cohort. Thus, in the present study, we report the results of an interpretive literature review of mainstream media reports published from the beginning of the Iraq War in March 2003 to March 2005. This literature revealed a combination of stressors associated with traditional combat, insurgency warfare, and peacekeeping operations. The increasing deployment of National Guard/Reservist personnel, older soldiers, and women highlights additional stressors associated with sexual harassment and assault, preparedness and training, and life and family disruptions. This is a cause for concern as war-zone stressors have been implicated in postdeployment health outcomes, including intimate partner violence and child maltreatment, immediate physical and mental health, and long-term adjustment. Keywords: stressors; media; war; deployment; Iraq; review

Objective neuropsychological outcomes of Iraq War deployment in a large military cohort are examined. Results suggest that deployment to Iraq is associated at least transiently with subtle alterations in neural functioning, as indicated by reduced proficiency in sustained attention and memory, heightened negative state affect reflecting increased feelings of confusion and tension and an advantage in reaction time, with further investigation of deployment on neural function needed.

During overseas deployments, many spouses and families move away from their initial military installation, usually to live with or near relatives. Relatively little has been known about those who move away even though the issue is of importance to the military because its support systems are designed on the assumption that family members are living in proximity to those support systems. The purpose of this research was to describe the characteristics of those who actually moved away during a deployment compared to those who stayed but wanted to leave and to those who stayed. Results generally fit a social exchange model of reasons for moving, staying, or wanting to move but staying. High stress appears to lead to a desire to move but other factors act as barriers or facilitators to actually moving. Military family support did not predict moving away or staying. Implications for military support services are discussed.

Nearly 500 wives, married to enlisted soldiers who deployed to Somalia for Operation Restore Hope, participated in a postdeployment study in the summer of 1993. About 10% of their husbands had returned early from Somalia for family reasons. Analysis of their wives' reports suggests that early returns were associated most often with childbirth or problematic pregnancies rather than other factors such as inexperience with deployments, negative attitudes towards the military, a lack of support services, or lower coping abilities. However, in hindsight, our results probably reflect compliance with military policy at that time for that deployment, under which pregnancy-related concerns were one of the most legitimate reasons for permitting an early return. The results support sociological theories that highlight the importance of macrosocial factors in influencing the lives of individual families somewhat independently of the microsocial environment of the families.

The U.S. Department of Defense has announced that it will use Reserve component units more frequently for overseas deployments, for humanitarian and peacekeeping missions. Approximately one thousand Reserve component veterans, most from Ohio, were surveyed regarding their perceptions of the effects of increased overseas deployment requirements for Reserve servicemembers. Approximately half of those surveyed reported that the new requirements would pose substantial difficulties for civilian employment and family life, with reduced intentions to remain in the military or to stay long enough to retire from the military. Difficulties seemed to be more severe for family life than for civilian employment. Persian Gulf War veterans were more pessimistic about the effects of the new requirements on family life and recruiting; however, those who had remained in the military were less pessimistic about the effects of increased deployments.

Results of a study to evaluate the development of mental health problems among U.S. Army wives of military personnel deployed in Iraq and Afghanistan have revealed that such problems do exist. The research highlights the need for developing more programs to promote health and wellbeing among spouses and children.

JANICE GROSS STEIN explores strategies of reassurance than can contribute to the prevention of the use of force among adversaries. The assesses their strengths and weaknesses and identifies the conditions under which strategies of reassurance can complement or supplement the threats that underlie deterrence.

The actions of our enemies in the global war on terrorism indicated one of their principle targets is our morale and fighting spirit. This study provides a supposition which can be implemented to model the morale of troops in combat. By investigating the troop's morale and combat spirit, the impact to their combat effectiveness can be better investigated. An operational description of average morale is provided. Previous models of morale are then reviewed. A theoretical modelling framework of combat spirit is then introduced. The research concludes with an application of the modelling framework to a notional example based on US deployments into Iraq. A notional excursion based on the impact of multiple deployments is also presented.

Changes in self-reported soldier marital satisfaction and marital quality were assessed at three points in time, 1994-1997, before, during, and after a 1995 peacekeeping deployment of approximately 100 married soldiers to the Sinai peninsula. Analysis shows a moderate decline in marital satisfaction during the deployment (effect size of 0.27-0.29) but no overall change in the long term. Marital quality did not change significantly over time. Marital stability rates were especially low for soldiers who reported that their marriage was in trouble prior to the deployment. It appears that stable marriages can survive 6-mo. deployments without long-term decrements in satisfaction or quality. How many couples will continue to accept voluntarily a military lifestyle that requires frequent sacrifices of marital satisfaction as may occur during separations and deployments remains an open question, even though intentions for retention did not appear correlated with marital satisfaction or changes in marital satisfaction over the deployment in this study.

The importance of establishing a program to deal with symptoms of substance abuse, posttraumatic stress disorder (PSTD) and traumatic brain injury (TBI) among previously deployed military personnel is discussed.