WASHINGTON --- Children of U.S. military troops sought outpatient mental health care 2 million times last year, double the number at the start of the Iraq war, and there was also an alarming spike in the number of military kids hospitalized for mental health reasons.

Internal Pentagon documents show the increases. From 2007 to 2008, 20 percent more children of active-duty troops were hospitalized for mental health services. 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 men and women on active duty doubled from 1 million in 2003 to 2 million in 2008. During the same period, the yearly bed days for military children 14 and younger increased from 35,000 to 55,000, the documents show.

Overall, the number of children and spouses of active-duty personnel and Guard and Reserve troops seeking mental health care has been steadily increasing as the military struggles with wars in Iraq and Afghanistan. Last year's increase in child hospitalizations coincided with the "surge" of tens of thousands of additional U.S. troops into Iraq to stabilize the country.

Reasons for the treatment increases are not clear. Besides the impact of service members' repeated tours in overseas war zones -- and the severe economic recession -- the military has been encouraging troops' family members to seek mental health help when needed.

The military plans additional research.

Along with issues of separation, some military families must deal with injuries or the deaths of loved ones. Military families move, on average, nearly every three years, which adds 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, along with increases in suicide, alcohol abuse and cases of post-traumatic stress, are all troubling signs, Mrs. Casey told a Senate Armed Services subcommittee. She and other military spouses testified that gaining access to mental health care is a problem.

The shortage of mental health professionals isn't isolated to the military. But the problem is more pronounced because of the increase in demand, both on the home front and in the war zones.

About 20 percent to 30 percent of service members returning from war report some form of psychological distress.