{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T20:47:36Z","timestamp":1740170856427,"version":"3.37.3"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"3-4","license":[{"start":{"date-parts":[[2022,3,8]],"date-time":"2022-03-08T00:00:00Z","timestamp":1646697600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009898","name":"Defense Health Agency","doi-asserted-by":"publisher","award":["HU0001-11-1-0023"],"award-info":[{"award-number":["HU0001-11-1-0023"]}],"id":[{"id":"10.13039\/100009898","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,3,20]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>There are approximately 1.5 million U.S. military-dependent children. However, little is known about mental health referrals for these youths. This study sought to examine the type of mental health treatment referrals made by primary care providers for child military-dependent beneficiaries receiving care in the direct (within Military Treatment Facilities) and private care (civilian-fee-for service facilities) sectors of the Military Health System.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>A between-subjects, cross-sectional study was performed on children aged 5\u201318\u2009years old in fiscal years 2011\u20132015 and enrolled in TRICARE Prime. Study analyses examined specialty (\u201ctalk therapy\u201d) mental health care and psychotropic medication referrals from TRICARE Prime (the Defense Health Agency-managed health care program) providers for beneficiary children diagnosed with attention-, mood-, anxiety-, or behavior-related disorders in direct versus private sector care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 1,533,630 children enrolled in TRICARE Prime (50.03% female), 8.6% (n\u2009=\u2009131,393) were diagnosed with a psychological disorder during FY 2011\u20132015. Most were attention-related (5.2%, n\u2009=\u200979,770), followed by mood (1.7%, n\u2009=\u200925,314), anxiety (1.1%, n\u2009=\u200916,155), and conduct-related diagnoses (0.7%, n\u2009=\u200910,154). Adjusting for age, sex, and sponsor rank, children within direct care diagnosed with attention-related disorders were 1.7 times more likely to receive a prescription for psychotropic medication than those in private sector care, odds ratio (OR)\u2009=\u20091.72, 95% confidence interval (CI): [1.66, 1.77]. Children diagnosed with mood-related disorders in direct care were 2.1 times more likely to receive a prescription for psychotropic medication than those in private sector care, OR\u2009=\u20092.08, 95% CI: [1.96, 2.21]. Across disorders, children who received private sector care were more likely to have a referral specialty mental health (\u201ctalk therapy\u201d) follow-up (ps\u2009&amp;lt;\u20090.0001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>For attention- and mood-related disorders, but not anxiety- or conduct-related disorders, direct care providers were more likely than private sector care providers to prescribe psychotropic medications. Inconsistencies of provider referrals within and outside of the Military Health System should be elucidated to determine the impact on outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1093\/milmed\/usac048","type":"journal-article","created":{"date-parts":[[2022,3,8]],"date-time":"2022-03-08T08:20:17Z","timestamp":1646727617000},"page":"615-620","source":"Crossref","is-referenced-by-count":0,"title":["Prescriptions of Psychotropic Medications by Providers Treating Children of Military Service Members"],"prefix":"10.1093","volume":"188","author":[{"given":"Alexandria","family":"Kucera","sequence":"first","affiliation":[{"name":"Department of Medical and Clinical Psychology, USU , Bethesda, MD 20814, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1377-8615","authenticated-orcid":false,"given":"Tracey","family":"Koehlmoos","sequence":"additional","affiliation":[{"name":"Health Services Research Program, Department of Preventive Medicine and Biostatistics, USU , Bethesda, MD 20814, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lindsay","family":"Grunwald","sequence":"additional","affiliation":[{"name":"Health Services Research Program, Department of Preventive Medicine and Biostatistics, USU , Bethesda, MD 20814, USA"},{"name":"Henry M. 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Jackson Foundation for the Advancement of Military Medicine , Inc., Bethesda, MD 20817, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3136-6713","authenticated-orcid":false,"given":"Natasha A","family":"Schvey","sequence":"additional","affiliation":[{"name":"Department of Medical and Clinical Psychology, USU , Bethesda, MD 20814, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9335-6820","authenticated-orcid":false,"given":"Jeffrey","family":"Quinlan","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, University of Iowa Carver College of Medicine , Iowa City, IA 52317, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3871-2233","authenticated-orcid":false,"given":"Marian","family":"Tanofsky-Kraff","sequence":"additional","affiliation":[{"name":"Department of Medical and Clinical Psychology, USU , 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