Abstract
“Objective: To determine if deployment to recent military operations or other health, demographic, or military-related characteristics were associated with employment after military service.
Methods: Former US active duty military service members participating in the Millennium Cohort Study, a population-based sample of US military personnel that began in July of 2001, were prospectively followed from the time of baseline health reporting to self-reported employment status after military separation.
Results: Of the 9099 separated personnel meeting inclusion criteria, 17% reported unemployment after military service. In multivariable modeling, prior deployment experiences, with or without reported combat, and post-traumatic stress disorder (PTSD) were not significantly associated with employment status post-service. Among those who routinely retired from service with a pension, positive screens for depression (OR, 1.67; 95% Cl, 1.05 to 2.63) and panic/anxiety (OR, 1.63; 95% Cl, 1.10 to 2.43 were significantly associated with subsequent unemployment. Poor physical health, female sex, black race, lower education and disabling illnesses/injuries were also predictive of post-service unemployment.
Conclusions: After stratifying for reason for military separation, mental disorders like depression or panic/ anxiety and poor physical health may have greater impact than prior deployment experiences or PTSD on the ability to find or maintain employment post-service. These findings may guide support for veterans most in need of job placement services after military service.”
Implications
For Practice
Military healthcare professionals should continue addressing any mental health concerns and physical disability issues service members might have prior to their discharge. Addressing mental health and physical disability concerns prior to discharge might assist the service members with acquiring post-service employment. Discharging service members with a mental health concern or a physical disability issue should seek clinical help from military healthcare professionals. In addition to learning how to manage and treat a mental health concern or physical disability, discharging service members should consider learning more about work environments that will emphasize their strengths. The VA and several other organizations offer resources to veterans to assist them in gaining post-service employment. Veterans with mental health concerns or physical disabilities should consider taking advantage of the employment resources geared at gaining post-service employment. Local VA hospitals and clinics offer resources that address common concerns employers might have about hiring a veteran with a mental illness or a physical disability. Employers interested in hiring veterans and employers who currently employ veterans with a mental illness or a physical disability should familiarize themselves with these resources. Education on mental health as different than PTSD may benefit veteran job seekers and employers.
For Policy
The U.S. Department of Defense might consider creating a more formalized process for educating service members on how to both apply their military skills in the civilian workforce while addressing potential mental and physical health concerns that may obstruct successful pursuit of civilian employment in the future. Taking into account the diverse sub-group populations who appeared to have higher associations of unemployment and mental or physical disabilities, VA centers might better target treatment and employment assistance by determining which resources would best suit the individual needs of veterans. This targeting might be in the form of workshops, preparatory classes, or one-on-one counseling. Policymakers at the state, local, and federal level may provide the necessary financial resources to support training for VA workers who work with veterans to facilitate the transition of separating from military service to re-entering the civilian workforce, taking note to account for the sensitivities of potential mental health disorders. Policymakers might also further implement legislation that provides specialized employment search assistance to veterans to better suit the unique needs of returning veterans with mental health concerns or physical disabilities.
For Future Research
This study was limited because it could not discern individuals actively looking for employment from the total number of participants classifying themselves as unemployed in the Millennium Cohort Study population. Future researchers should assess how injuries sustained during military service affect unemployment statistics, as two-thirds of the testing groups reported disabling illness, injury or poor health in association with unemployment rates. To further understand the association between unemployment, mental health, prior deployment experience, and employment, future researchers should account for people who frequently leave and acquire jobs. Furthermore, because mental health disorders were self-reported the results may have been skewed due to misclassification or intentional misreporting. Future research should include clinical assessments of veterans to minimize misclassification, but should be aware that they may be unable to gather a comparably robust and representative sample size. Future researchers should study additional factors that might contribute to high unemployment levels for veterans, such as education, race and gender.