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WASHINGTON Two million children with parents in the military sought outpatient mental health care last year, twice the number from the start of the Iraq war, internal Pentagon documents show.
The documents, obtained by The Associated Press, also reveal an alarming spike in the number of military children hospitalized for mental health reasons.
From 2007 to 2008, 20 percent more children of active duty troops used inpatient mental health services, many of them under age 14, the documents show. Since the 2003 invasion of Iraq, inpatient visits among military children have increased 50 percent.
The total number of outpatient mental health visits for children of those on active duty doubled from 1 million in 2003 to 2 million in 2008. During the same period, the total yearly bed days for children of active duty personnel 14 and under increased from 35,000 in 2003 to 55,000 in 2008, the documents show.
Overall, the number of children and spouses of active duty personnel and National Guard and Reserve troops seeking mental health care has been increasing steadily.
The increases come as the military struggles with wars in Iraq and Afghanistan and a shortage of therapists.
Last year's spike in child hospitalizations coincided with the "surge" of tens of thousands of additional U.S. troops into Iraq to try to stabilize the country.
However, it was not clear from the documents if there was a direct correlation between troop escalation and the number of military children seeking mental health help, or if the increase illustrated a cumulative effect of nearly eight years of war since the Sept. 11, 2001, terror attacks.
Other factors could include efforts to encourage more family members to seek mental health help and sensitivity among military families to the ailing economy and housing downturn.
The military plans additional research.
The statistics, however, reinforce the worries of military leaders and private military family organizations about the strains of the wars. An estimated 2 million children have been affected by deployments to the recent wars. Along with issues of separation, some must deal with the injury or death of a loved one.
Military families move almost every three years on average, which adds additional stress.
"Army families are stretched, and they are stressed," Sheila Casey, wife of Gen. George W. Casey Jr., the U.S. Army chief of staff, told a congressional panel last month. "And I have often referred to them as the most brittle part of the force."
Evidence of domestic violence and child neglect among military families, as well as an increase in suicide, alcohol abuse and cases of post-traumatic stress, are troubling signs, Mrs. Casey told a Senate Armed Services subcommittee. She and other military spouses testified that accessing mental health care is a problem.
At summer camps organized during the warm midyear months by the National Military Family Association for about 10,000 children of mostly deployed soldiers, there are more anecdotal reports this year of children taking medication and showing signs of severe homesickness, anxiety or depression, said Patricia Barron, who runs the association's youth initiatives.
Barron, a military spouse, said her organization is participating in a study on deployments and the family. She said much is still unknown about the affects of deployment on families.
"If it continues to happen, you have to wonder how this is affecting them," Barron said. "In the long run, you have to wonder if there isn't going to be detrimental affects that might hang on for a long period of time."
The shortage of mental health professionals is not just isolated within the military. The problem is more pronounced there, however, because of the increase in demand in both the home front and in war zones.
About 20 to 30 percent of service members returning from war report some form of psychological distress.
Efforts are under way to encourage the military, the Department of Veterans Affairs, as well as state and local agencies, to share mental health resources. Also, there have been incentives offered to encourage military spouses to enter easily transferable fields such as health care.
In recent years, more money has gone into areas such as education, housing and child care devoted to improving the quality of life of military families. First Lady Michelle Obama has said helping military families is a priority.