Wounded Warriors: Issues, Context, Accommodation

Edward A. Martinelli, Jr., Ph.D., Utah Valley University

Impacts and Prevalence Intake Issues Qualification Issues Accommodation Issues Local Issues

Since October 2001 Approx. 1.64 million troops have deployed as

part of Operation Enduring Freedom (OEF; Afghanistan) and Operation Iraqi Freedom (OIF; Iraq).

As compared to past deployments Higher proportion deployed Deployments have been longer Breaks between deployments have been infrequent Redeployment to combat has been more common

Nevertheless--- Operations have employed smaller forces Casualty rates (killed or wounded) are

lower Technology has led to more surviving…. But “invisible wounds” are beginning to

emerge

RAND Study focused on 3 major conditions: Post-Traumatic Stress Disorder (PTSD) Major Depressive Disorder and associated

symptoms, and Traumatic Brain Injury (TBI)

All three affect mood, thoughts, and behavior

1,965 servicemembers were surveyed 24 Geographic Areas

Mental Health Issue Rates in the Past 30 Days 14% screened positive for PTSD 14% screened positive for Depression 19% reported a probable TBI

Depression is not considered a combat-related injury, but it is highly associated with combat exposure

Not possible to know the severity of TBI issues

About 1/3 of those previously deployed have at least one of these three conditions

About 5% report symptoms of all three Some groups (Reserve Components

and those who’ve left the service) may be at higher risk

Of those reporting a probable TBI 57% had not been evaluated by a

physician Rates for TX of Depression or PTSD

Comparable to general population (53%)

Like most issues, we can expect these issues to emerge in three or four major ways Intake Eligibility Determination Accommodation Provision Specific Institutional Issues

Label stigma Self-Identity Knowledge of services and location Differences between VA and School

services

Invisible disabilities more difficult for us to quantify TBI issues may present much later

Dynamic nature of some diagnoses May be situational Course content related Time of year related

Individual may not have much experience with academic setting Their experience so far may be simply with

non-academic tasks Memorization, short/long term memory,

etc. Documentation may be atypical

Military looks at disability sometimes from a compensation not a limitation standpoint

In summary, functional impacts may be hard to identify Relationship important to returning for

additional help Adjustments may be needed mid-term

What are you doing with other psychiatric issues?

Watch for anniversaries, holidays, etc.

Anxiety Issues Issues around sights, smells, locations,

context Testing issues Classroom environment Interactions with others More often than not the individual simply

wants to remove themselves from the situation

Not surprising to see Memory issues Concentration issues Comparison to past performance Old versus new learning and skills

May be emotional issues Impulse control Mood swings