Mental health and functional impacts in military-connected youth living with an ill or injured Veteran parent

Introduction: A growing body of research has highlighted the unique challenges and support needs of Hidden Helpers, the over 2.3 million children living with an ill or injured Veteran in the United States. This paper explores demographic, diagnostic, and functional impairment data of Hidden Helpers seeking mental health treatment within a large behavioural health network serving United States military and Veteran families. Methods: The authors conducted a secondary analysis of electronic health record data from 3,367 child and adolescent clients (ages 5-17 years) receiving care across a national network of outpatient mental health clinics serving military and Veteran families. Hidden Helper status was identified via caregiver-related screening at intake. Functional impairment was assessed using the Columbia Impairment Scale (CIS). Group differences in diagnoses and CIS scores were examined using descriptive statistics and t -tests. Results: Of the sample, 178 (5.6%) were identified as Hidden Helpers. Both groups presented similar diagnostic profiles, with the most common diagnoses being adjustment disorders, anxiety, and depression. Mean CIS scores for Hidden Helpers (self-report: mean = 10.88; parent-report: mean = 12.64) and non-helper peers (self-report: mean = 11.80; parent-report: mean = 13.47) fell below clinical thresholds and did not significantly differ between groups (p > 0.05). Discussion: These findings suggest that standard clinical assessments may not fully capture the unique experiences of caregiving youth. Future research should explore item-level impairments as well as protective factors to better support this vulnerable population. Continued efforts are needed to address the unique needs of Hidden Helpers both within and outside of health care settings.