Retrospective cohort study of outpatient mental health visits in children and youth in Canadian military families

Abstract: Introduction: This article contrasts the risk for outpatient mental health visits between children and youth in Canadian military families and those in the general population. Methods: This retrospective cohort study linked provincial administrative databases 2008-2013 until out-of-province relocation, death, or Dec. 31, 2016. Included were children and youth aged ≤ 19 years, with at least one parent in the Canadian Armed Forces (CAF), who relocated to Ontario. A general population comparator group was matched 4:1 on age, sex, and residential region. The outcome was one or more outpatient visit associated with a mental-health-related diagnosis with a family physician, pediatrician, or psychiatrist in the three years after relocation. Results: The study included 5,478 children and youth in CAF families and 21,912 comparator children and youth. Children and youth in CAF families were 10% (relative risk [RR] 1.10; 95% confidence interval [CI], 1.04-1.17) more likely to have at least one outpatient mental-health-related visit than those in the general population, including a 72% higher risk of a pervasive developmental disorders visit (RR = 1.72; 95% CI, 1.39-2.12) and a 31% higher risk of a hyperkinetic syndrome visit (RR = 1.31; 95% CI, 1.22-1.52). Discussion: Children and youth with a parent in the military were more likely to have a mental-health-related outpatient physician visit than children and youth in the general population. Additional supports during stressful periods such as relocations, deployment, and re-integration, parental transition to civilian life, or family distress may be needed to prevent negative effects on growth and development.