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Agenda
Veteran Population
What is PTSD
Symptoms of PTSD
Risk Factors
Positive Aspects of Culture
Negative Aspects of Culture
Existential Aspects of Culture
American Military Veterans (2010)
21.8 million veterans
1.6 million women veterans
17.5 million White veterans
2.4 million Black veterans
203,000 Asian American veterans
156,000 American Indian or Alaska Natives
9 million veterans 65 or older
1.7 million were age 35 or younger
Where Did They Serve?
7.6 million Vietnam veterans
4.8 million Gulf War veterans
2.1 million World War II veterans
2.6 million Korean War veterans
5.5 million veterans served during peacetime only
Since 2001, over 1.5 million service members have served in Iraq or Afghanistan
What is PTSD?
Psychiatric disorder than can occur following the experience of witnessing of life threatening events
Military combat
Natural disasters
Terrorist incidents
Serious accidents
Violent personal attacks
Combat PTSD
Following war, many veterans return home significantly altered
Have a changed view of the world and themselves
Reactions may be short lived (only a few months)
For others, healing may require long term vigilance
Typical Symptoms
Survivor guilt
Fear
Flashbacks
Loneliness
Revenge fantasies
Emotionally numb
Depression
Frustration
Nightmares
Distrust
Suicidal
Addiction
Hyper arousal
Difficulty sleeping
Effects of PTSD
Symptoms may not appear until months or years after combat
Can significantly impair a person’s daily life
Difficulties in social or family life
Occupational instability
Marital problems
Family discord
Difficulties in parenting
Prevalence Rates of PTSD
Vietnam: 15% to 31% of veterans
Iraq and Afghanistan: 10% to 18% of veterans
Mental health illness is 2nd largest category for which veterans from Iraq and Afghanistan seek treatment
Between 2006-2007, 70% increase in veterans seeking treatment for PTSD
Risk Factors
Longer deployments
More severe combat exposure
More severe physical injury
Traumatic Brain Injury
Lower rank
Lower level of schooling
Low unit morale
Not married
Family problems
Member of National Guard or Reserves
Prior trauma exposure
Female (twice as likely)
Hispanic ethnic group
Positive Cultural Factors
Improvements in access to health care
Physical exercise
Selfless service
Personal courage
Moving/relocating
Discipline
Social Support
Positive Cultural Factors
Improvements in health care Iraq and Afghanistan veterans eligible for 5 years
of free health care for condition related to combat after discharge
Increased staffing
Physical exercise Importance of exercise instilled in military
Used to reduce stress or tension
Distraction from difficult emotions or painful memories
Positive Cultural Factors
Moving/Relocating Veterans are used to changing duty stations
May find it necessary to move to feel safe
Living in high crime areas increases PTSD
Discipline Basic foundation of the military lifestyle
Veterans more likely to participate in treatment program and aftercare
More likely to take prescribed medications
Positive Cultural Factors
Selfless service
Put welfare of others before own
Veterans likely to volunteer; feel as though they can contribute
Personal courage
Ability to face, fear, danger, adversity
Requires courage to face own mental health issues
Positive Cultural Factors
Role of social support
Learn importance during deployments
Helps to cope with PTSD
Emotional support important to make veteran feel safe and changes habits and behaviors
Negative Cultural Factors
Military structure encourages camaraderie and peer support
Double-edged sword; creates hidden barriers to seeking care
Stigma of mental illness is largest obstacle to overcome
Perception of being weak; treated differently
Members of unit may lose confidence in their abilities
50% of veterans in one study showed signs of mental illness, but refused to seek treatment due to stigma
Media portrayal of PTSD sufferers as monsters
Negative Cultural Factors
Alcohol use widely accepted in the military
20% with PTSD also have substance abuse disorder (SUD)
PTSD and SUD; likely to have other health complications
Using drugs and alcohol can make PTSD worse
Tobacco use rates higher than general population
Number of veterans who smoke is double for PTSD (about 6 in 10)
Tobacco use creates other health concerns
Negative Cultural Factors
Poverty
More than 968,000 veterans in poverty
1 in 7 homeless adults are veterans
1.5 million veterans at risk of homelessness to due to poverty
Poor diets
May not have access to mental health care
Negative Cultural Factors
Distrust in VA medical system
Vietnam veterans treated poorly upon return
Vietnam veterans – PTSD was not acknowledged as a disorder until 1980
Long waits for appointments
Many mental health professionals in VA system are not veterans
Existential Cultural Factors
Communication
Veterans have a unique language carried over from military service
Military slang and acronyms used