Guiding Vets and Active Military to Supportive Services

Guiding Vets and Active Military to Supportive Services

Joe Qualls, US Army Veteran/OIF3Kendra Brandstein, PH.D., MPH, MSW

The presentation will begin shortlyThis webinar is being recorded for future use.

Funds for this webinar were provided by the U.S. Department of Health and Human Services (HHS), Health Resources and Services Administration (HRSA) 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 ServicesKendra Brandstein, PH.D., MPH, MSWJoe Qualls, US Army Veteran/OIF3

Background2.2 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

U.S. Department of VAhttp://www.mentalhealth.va.gov/index.aspThe 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 veterans eligible for services approximately only 51% use the eligible services and benefits.

Mental Health Diagnosis DataHigh incidence of the following in our 625,384 Eligible OEF/OIF Veterans at the VA:PTSDDepressive and neurotic disordersAffective PsychosesSubstance abuseSuicide

U.S. Department of Veterans Affairs U.S. Department of Veterans Affairshttp://www.mentalhealth.va.gov/communityproviders/docs/VA_Suicide_RMT.pdfhttp://www.hsrd.research.va.gov/publications/forum/may11/may11-2.cfm#.UUdO1BdaxLc

The Affects of Mental HealthThe challenges are enormous and the consequences of non-performance are significant. Reported psychological symptoms:38% of Soldiers31% of Marines 49% National GuardFurthermore, 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)Report of the Department of Defense Task Force on Mental Hlth June 2007http://www.health.mil/dhb/mhtf/MHTF-Report-Final.pdfOur PurposeLearn about mental and behavioral health Recognize signs and symptoms Identify local resourceThe IssueOne suicide a day for the past year23 suicides a day (national)Experience 20072012Death 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 101The military is a distinct sub-culture in the United States with its own:RitualsTraditionsOaths and PledgesHierarchy

Military 101BranchesAir ForceArmyCoast GuardMarinesNavy

StatusActive DutyNat. GuardReserveRetiredVeteranCore Values

Post Traumatic Stress DisorderWhat 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

U.S. Department of Veterans Affairshttp://www.mentalhealth.va.gov/PTSD.aspEvents that lead to PTSDMulti-casualty incidents (Suicide Bombers, VB/IEDs, ambushes)Aftermath of battleHandling human remains Witnessed or committed atrocities (Societal Constructs)Feeling/being helpless to defend or counter-attackMoral Injury

http://www.ptsd.va.gov/Signs and Symptoms of PTSDRe-experiencing the traumatic eventAvoiding reminders of the traumaIncreased anxiety and emotional arousalNightmaresNumbingIsolation

http://www.ptsd.va.gov/public/understanding_ptsd/booklet.pdfTreatment of PTSDTreatments include:Cognitive therapyExposure therapyEMDRMedicationGroup therapyFamily therapyTreatment lasts 3-6 monthsIf multiple disorders can last up to one year

http://www.ptsd.va.gov/public/understanding_ptsd/booklet.pdfBarriers to Care1 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 therapyVA SystemInsuranceMilitary Culture

US Department of Veterans AffairsUS Department of VAhttp://www.mentalhealth.va.gov/PTSD.aspResources for PTSD Helphttp://www.ptsd.va.gov/index.asphttp://www.ptsd.va.gov/public/where-to-get-help.asp

Traumatic Brain InjuryWhat 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

US Dept of VAhttp://www.mentalhealth.va.gov/mentalhealth/featurearticle_mar.aspWhat 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 SymptomsMild Loss of consciousness and/or confusion and disorientation is shorter than30 minutes

MRI and CAT scans normal

Headache, difficulty thinking, memory problems, attention deficits,mood swings and frustration

SevereLoss of consciousness for morethan30 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 ofthinking abilityor emotional problems

American Speech-Language Hearing Association American Speech-Language-Hearing Associationhttp://www.asha.org/public/speech/disorders/TBI.htmhttp://www.cdc.gov/concussion/signs_symptoms.htmlTreatment for TBIImaging testsRehabilitationMaking sure enough oxygen is going to the brainLittle can be done to reverse the trauma to the brain.Require immediate medical attention (unlikely)

Resources for TBI Helphttp://www.cdc.gov/traumaticbraininjury/

www.facebook.com/cdcheadsupThis 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 arousalDifficulty sleepingTBI doubles the risk of a solider experiencing PTSD. There is no cure for PTSD or TBI, but TREATMENT is a MUST

http://www.ptsd.va.gov/professional/pages/traumatic-brain-injury-ptsd.aspDepression In the MilitaryWhat is Depression?Medical condition that affects physical and emotional healthCan be a result of biological or cognitive factorsResult of substance misuseOther physical and psychological issuesCombat experienceTrauma

US Department of Veterans Affairs

US Department of VAhttp://www.mentalhealth.va.gov/depression.aspSigns and SymptomsExperiencing the following:

Sadness, restlessness

Lack of interest, energyDifficulty sleeping or oversleeping

Extreme fluctuations in appetite Weight gain/loss

Problems concentrating, remembering or making decisions

Having thoughts of death or hurting oneself

-*Must experience signs and symptoms for at least two weekshttp://www.mentalhealth.va.gov/depression.aspWhat to doHelp guide them towards seeking treatmentProvide SupportTake care of themselves

Can include:MedicationPsychotherapyCombination of medication and therapy

http://www.mirecc.va.gov/visn22/depression_education.pdfResources DoD at http://www.militarymentalhealth.org or telephone 877-877-3647. Department of Veterans Affairs at http://www.mentalhealth.va.gov/depression.aspMilitary Pathways at http://www.mentalhealthscreening.org/programs/military/.Self-medicating alcohol and drug useWhat 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 problemUS Department of Veterans Affairs US Department of Vahttp://www.mentalhealth.va.gov/substanceabuse.aspWhat can you do?Educate yourself about the various mental health disordersListenUnderstand

Encourage those affected to seek helpBe Supportive!

Local Community ClinicsVeterans Village of San DiegoVet Center (specifically for combat vets with MST and PTSD ONLY)LocationsChula VistaLiberty Station/Point LomaSan Marcos211 Information LineVA

ResourcesReferences American Speech-Language-Hearing Associationhttp://www.asha.org/public/speech/disorders/TBI.htmCounty of SD HHS: Overview of Services for Military, Veterans, and Families http://www.sdcounty.ca.gov/hhsa/programs/bhs/documents/VetsServ.pdfGlobal Securityhttp://www.globalsecurity.org/military/facility/san_diego.htmReport of the Department of Defense Task Force on Mental Hlth June 2007http://www.health.mil/dhb/mhtf/MHTF-Report-Final.pdfU.S. Department of Veterans Affairshttp://www.mentalhealth.va.gov/communityproviders/docs/VA_Suicide_RMT.pdfhttp://www.mentalhealth.va.gov/index.asphttp://www.mentalhealth.va.gov/PTSD.asphttp://www.mentalhealth.va.gov/mentalhealth/featurearticle_mar.asphttp://www.mentalhealth.va.gov/depression.asphttp://www.mentalhealth.va.gov/substanceabuse.aspVA Forum: http://www.hsrd.research.va.gov/publications/forum/may11/may11-2.cfm#.UUdO1BdaxLcContact InformationKendra Brandstein619 862-6601 and brandstein.kendra@scrippshealth.org

Joe Quallsjoeandkami@gmail.com