Guiding Vets and Active Military to Supportive ServicesJoe Qualls, US Army Veteran/OIF3
Kendra Brandstein, PH.D., MPH, MSW
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with the American Recovery and Reinvestment Act (ARRA) funding for the Retention and Evaluation Activities (REA) Initiative.
This webinar is being offered by the San Francisco Community Clinic Consortium and the California Statewide AHEC program in partnership with
the Office of Statewide Health Planning and Development (OSHPD), designated as the California Primary Care Office (PCO).
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Guiding Veterans to Supportive Services
Kendra Brandstein, PH.D., MPH, MSWJoe Qualls, US Army Veteran/OIF3
Background
• 2.2 million have served in Iraq & Afghanistan
• 50% percent of eligible vets report having mental health problems
• Family members are dealing w/ deployment related issues
U.S. Department of Veterans Affairs
The IssueVeterans and mental health
services
Approximately 23 veterans a day take their lives.
One active duty service member commits suicide a day. That is 8,395 of our heroes.
Of the veteran’s eligible for services approximately only 51% use the eligible services and benefits.
Mental Health Diagnosis Data
High incidence of the following in our 625,384 Eligible OEF/OIF Veterans at the VA:•PTSD•Depressive and neurotic disorders•Affective Psychoses•Substance abuse•Suicide
U.S. Department of Veterans Affairs
The Affects of Mental Health• The challenges are enormous and the
consequences of non-performance are significant. – Reported psychological symptoms:
• 38% of Soldiers• 31% of Marines • 49% National Guard
– Furthermore, psychological concerns are significantly higher among those with repeated deployments, a rapidly growing cohort.
– These Figures only include self reported. Many more undiagnosed and untreated!
(Report of the DoD Task Force on Mental Hlth June 2007)
Our Purpose
Learn about mental and behavioral health Recognize signs and symptoms
Identify local resource
The Issue
• One suicide a day for the past year
• 23 suicides a day (national)
Experience 2007 2012Death of unit member 48.6% 73.4%Shooting at enemy 29.6% 78.5%IED exploded near them 32.8% 62.4%Responsible for death of 8.3% 48.4% combatant
Military Culture 101
• The military is a distinct sub-culture in the United States with its own:
•Rituals•Traditions•Oaths and Pledges•Hierarchy
Military 101
• Branches–Air Force–Army–Coast
Guard–Marines–Navy
• Status–Active
Duty–Nat. Guard–Reserve–Retired–Veteran
• Core Values
Post Traumatic Stress Disorder
What is PTSD?
• Anxiety disorder that changes the body's response to stress
• Can occur after a traumatic event
• Psychological, genetic, physical, and social factors are involved
• The cause is unknown
U.S. Department of Veterans Affairs
Events that lead to PTSD
• Multi-casualty incidents – (Suicide Bombers, VB/IEDs,
ambushes)• Aftermath of battle• Handling human remains • Witnessed or committed
atrocities (Societal Constructs)• Feeling/being helpless to defend
or counter-attack• Moral Injury
Signs and Symptoms of PTSD
• Re-experiencing the traumatic event• Avoiding reminders of the trauma• Increased anxiety and emotional
arousal• Nightmares• Numbing• Isolation
Treatment of PTSD• Treatments
include:– Cognitive
therapy– Exposure
therapy– EMDR– Medication– Group
therapy– Family
therapy
• Treatment lasts 3-6 months
• If multiple disorders can last up to one year
Barriers to Care• 1 out of 5 people say
they might not get help because of what other people might think
• 1 out of 3 people say they would not want anyone else to know they were in therapy
• VA System• Insurance• Military Culture
US Department of Veterans Affairs
Resources for PTSD Help
• http://www.ptsd.va.gov/index.asp• http://www.ptsd.va.gov/public/whe
re-to-get-help.asp
Traumatic Brain Injury
What is TBI?• Traumatic
Brain Injury (TBI) is a complex injury with a broad spectrum of symptoms and disabilities.
• Does not heal like other injuries. Recovery is a functional recovery, based on mechanisms that remain uncertain.
US Department of Veterans Affairs
What is TBI?
• Individuals with severe injuries can be left in long-term unresponsive states.
• Change in brain
function can have a dramatic impact on family, job, social and community interaction.
Classifications of TBI Symptoms
Mild • Loss of
consciousness and/or confusion and disorientation is shorter than 30 minutes
• MRI and CAT scans normal
• Headache, difficulty thinking, memory problems, attention deficits, mood swings and frustration
Severe• Loss of
consciousness for more than 30 minutes
• Memory loss after the injury or penetrating skull injury longer than 24 hours.
• Limited function of arms or legs, abnormal speech or language, loss of thinking ability or emotional problems
American Speech-Language Hearing Association
Treatment for TBI• Imaging tests• Rehabilitation• Making sure enough oxygen
is going to the brain• Little can be done to reverse
the trauma to the brain.• Require immediate medical
attention (unlikely)
Resources for TBI Help
• http://www.cdc.gov/traumaticbraininjury/
• www.facebook.com/cdcheadsup– This website focuses on sharing
brain injuries with others.
How are PTSD and TBI Alike?
• The affects of PTSD and TBI are very similar – Increased anxiety and
emotional arousal– Difficulty sleeping
• TBI doubles the risk of a solider experiencing PTSD.
• There is no cure for PTSD or TBI, but TREATMENT is a MUST
Depression In the Military
What is Depression?
• Medical condition that affects physical and emotional health
• Can be a result of biological or cognitive factors– Result of substance misuse– Other physical and psychological issues– Combat experience– Trauma
US Department of Veterans Affairs
Signs and Symptoms
• Experiencing the following:
– Sadness, restlessness
– Lack of interest, energy
– Difficulty sleeping or oversleeping
– Extreme fluctuations in appetite
– Weight gain/loss
– Problems concentrating, remembering or making decisions
– Having thoughts of death or hurting oneself
What to do
• Help guide them towards seeking treatment
• Provide Support• Take care of themselves
• Can include:– Medication– Psychotherapy– Combination of medication and
therapy
Resources
• DoD at http://www.militarymentalhealth.org or telephone 877-877-3647.
• Department of Veterans Affairs at http://www.mentalhealth.va.gov/depression.asp
• Military Pathways at http://www.mentalhealthscreening.org/programs/military/.
Self-medicating alcohol and drug use
What is Self-medication?
• Drugs or alcohol as treatment for disorders/traumas that may otherwise be treated by established medical methods
• Temporary relief from issues but results in further development of the underlying problem
US Department of Veterans Affairs
What can you do?
• Educate yourself about the various mental health disorders
• Listen• Understand
• Encourage those affected to seek help
• Be Supportive!
• Local Community Clinics• Veterans Village of San Diego• Vet Center (specifically for
combat vets with MST and PTSD ONLY)– Locations
• Chula Vista• Liberty Station/Point Loma• San Marcos
• 211 Information Line• VA
Resources
References • American Speech-Language-Hearing Association
– http://www.asha.org/public/speech/disorders/TBI.htm• County of SD HHS: Overview of Services for Military, Veterans, and
Families – http://www.sdcounty.ca.gov/hhsa/programs/bhs/documents/VetsServ.
pdf• Global Security
– http://www.globalsecurity.org/military/facility/san_diego.htm• Report of the Department of Defense Task Force on Mental Hlth June
2007– http://www.health.mil/dhb/mhtf/MHTF-Report-Final.pdf
• U.S. Department of Veterans Affairs– http://www.mentalhealth.va.gov/communityproviders/docs/VA_Suici
de_RMT.pdf– http://www.mentalhealth.va.gov/index.asp– http://www.mentalhealth.va.gov/PTSD.asp– http://www.mentalhealth.va.gov/mentalhealth/featurearticle_mar.as
p– http://www.mentalhealth.va.gov/depression.asp– http://www.mentalhealth.va.gov/substanceabuse.asp– VA Forum:
http://www.hsrd.research.va.gov/publications/forum/may11/may11-2.cfm#.UUdO1BdaxLc