Tools to Connect with Veterans in Treatment

1. Tools to Connect with Veterans in Treatment Kiara Bembry, BSPH, ASPIN

2. Purpose • The Military Culture is as unique a culture as any other • Establish a functional understanding of Military Culture and Terminology • To gain tactful ways to interact with our Military Population

3. Indiana Veteran Statistics • US Census Bureau: 2008-2012 -468,000 Veterans • 20,275 service members currently on active duty are residents of Indiana. • Of the 21,000 + reserve component service members in Indiana, 14,406 (69%) are members of the Indiana National Guard— the nation’s fourthlargest National Guard component.

4. Indiana Veteran Statistics • Of the 32,000 + members of the total reserve component in Indiana who have deployed since 9-11, 17,748 (55%) have come from the Indiana National Guard. • The latter numbers reflect that some members of the reserve components have been deployed multiple times.

5. What exactly is the military? • Primary mission: Defend the United States and United States interests. • Rescue operations • Medical assistance in impoverished areas • Food & humanitarian relief • Natural disaster relief • Law enforcement • Piracy and drug interdiction • …and more

6. What exactly is the military? • Seven federally established Uniformed Services of the United States • Two non-combatant uniformed services • Department of Health and Human Services • Government’s principle agency for protecting health of all Americans and providing essential human services • Department of Commerce • Promotes job creation, economic growth, sustainable development and improved standards of living through various partnerships

7. Armed Forces • Army – As the oldest branch of the Military, the Army protects the security of the United States and its resources. • Navy – The Navy defends the right to travel and trade freely on the world’s oceans and protects national interests overseas. • Marine Corps – Working closely with the Navy, the Marine Corps is often first on the ground in combat situations. • Air Force – The Air Force protects American interests at home and abroad with a focus on air power. • Coast Guard – The Coast Guard is a military, multi-mission, maritime service within the Department of Homeland Security. Its core roles are to protect the public, the environment and U.S. economic and security interests in any maritime region, including international waters and America’s coasts, ports and inland waterways.

8. Military Branches – Personnel • Army= ? • Air Force = ? • Navy= ? • Marine Corps = ? • Coast Guard = ?

9. Military Branches – Personnel • Army = Soldier • Air Force = Airman • Navy = Sailor • Marine Corps = Marine • Coast Guard = Guardian/Coastie

10. Military Status ACTIVE DUTY • Considered full-time employees • During deployments of 6-15 months; may have periods of working nearly 24 hours/day, 7 days/week • During wartime, may be separated from family for long periods even when not deployed due to long training cycles

11. Military Status NATIONAL GUARD AND RESERVES • Considered part-time employees • ~39 days/year • Typically monthly drills /two-week annual trainings • May be called very suddenly to Active Duty (full time) for deployments • Leave family, regular job, community • Transition from Active Duty back to part-time status can be difficult because of lack of support system

12. Military Language Some Common Acronyms and Phrases You Should Know: • Conus/Oconus – Continental U.S., Outside Continental U.S. • Post – Army Installation • Base – Air Force or Navy Installation • Camp – MarineCorps Installation • PCS – Permanent Change of Station • TDY – Temporary Duty • Leave – Off Duty (usually vacation) • AWOL – Absent without leave; i.e. unauthorized absence

13. Military Language Some Common Acronyms and Phrases You Should Know • IED – Improvised Explosive Device • VBED – Vehicle Borne Explosive Device • DFAC – Dining Facility, Mess Hall • HUMVEE – High Mobility Multi-Purpose Wheeled Vehicle • Kevlar – Typically the Helmet Made of the Material Kevlar • MRE – Meals Ready to Eat • FOB – Forward Operating Base • CHU – Containerized Housing Unit • BOG – Boots on the Ground

14. Military Language Some Common Acronyms and Phrases You Should Know • MOB/DEMOB – Mobilization, Demobilization • OIF/OEF/OND – Operation Iraqi Freedom, Operation Enduring Freedom, Operation New Dawn • OPTEMPO – Operations Tempo • COSC – Combat Operational Stress Control • COSR – Combat Operational Stress Response • Outside the Wire – Off the Base • Inside the Wire – On the Base • Down Range - Deployed

15. Military Language Some Common Acronyms and Phrases You Should Know: • Battle Buddy – another service member whom you count on • Battle Rattle – Body Armor • Gunner – “My Gunner” • Driver • “11 Bravo” – Infantryman • MEDEVAC – Medical Evacuation • MEB – Medical Evaluation Board • WTB/WTU – Warrior Transition Battalion/ Warrior Transition Unit

16. Key Cultural Elements • Cohesion – sticking together or forming as a whole • Camaraderie – friendship and trust among a group of individuals • Esprit de Corps- sense of unity, loyalty, enthusiasm, and dedication to a group

17. Military Culture vs. Civilian Culture Military • Intolerance is the order of the day • Respect is an expectation • Free will is not encouraged Civilian • Tolerance is an ambitious goal • Respect is optional • Free will is an expectation

18. Military Culture vs. Civilian Culture Military • Lawful orders are to be followed without question • Anger/violence is trained and is essential Civilian • Questioning authority is a valued freedom • Violence is not lawful

19. Military Culture vs. Civilian Culture Military • Individuality is not valued, team is the constant goal • Largely male dominant and sexism is an underlying tension Civilian • Individuality is a goal, team is a concept • Gender equality is a stated goal

20. Military Culture vs. Civilian Culture Military • Vulgarity is a common part of communication • Sarcasm is a predominate communication tool Civilian • Vulgarity is confined to certain places • Sarcasm is used primarily for humor

21. Who joins the military? • Across all uniformed services, combining both enlisted and officers, average trends: • The majority come from middle income families • The majority have graduated from high school • Minorities are NOT overrepresented in the military

22. And why do they join? • Family tradition • Transition to man/womanhood • To serve country • Support family • Friend did it • Get out of trouble with the law • Do something noble with life

23. And why do they join? • Give life (death) a purpose • Protect people, country and way of life • Be a part of a team – something bigger than self • Inherent sense of selflessness • College money • Free medical care • Travel • Get out of poverty

24. Issues Facing Returning Veterans • The signature wounds of the Iraqi and Afghanistan wars are Traumatic Brain Injury (TBI) and PTSD. • PTSD is a lingering psychological condition produced by experiences that overwhelm the person’s mind and brain capacities for processing and understanding what has happened. • Untreated PTSD lives on inter-generationally and renders the next generations more vulnerable to subsequent traumatization. • Some soldiers suffer from both conditions. • Source: American Psychoanalytic Association

25. Issues Facing Returning Veterans • Traumatic Brain Injury (TBI), while one of the most common types of trauma suffered by service members in Iraq and Afghanistan, is also one of the most difficult to diagnose. • Source: American Psychoanalytic Association • Deployments can cause higher level of child abuse/neglect in families left at home (42%) and higher divorce rates. • Homelessness

26. Military Culture – Some Opening Questions • Ice breakers? Ask about: • Length in service and deployment history • Other adversities • Education / treatment while on active duty • Discharge type • Military / Veteran identity

27. Military Culture – Some Opening Questions • What branch of service were you in? • Soldier, Sailor, Airman, Marine, Guardian • What was your MOS, NEC, or AFSC? • Military Occupational Specialty (MOS – Army and Marines), • Navy Enlisted Classification (NEC (rate) – Navy), • or Air Force Specialty Code (AFSC – Air Force) • What did you actually do while deployed?

28. Activity • Practicing Open-ended Questions • Get into pairs/roles – One veteran & one Non-veteran • You are in a setting where the non-veteran is wanting to learn more about the veteran. Ask him or her some open ended questions. • Key words/phrases you may want to use – deployment, MOS, length of service, education • Switch!

29. Military Culture Values Beliefs Traditions Norms Perceptions Behaviors

30. Military Culture Honor: “I will bear true faith and allegiance…” Courage: “I will support and defend…” Loyalty: “Semper Fidelis” (“Always Faithful”) Integrity: Demonstrate uncompromising ethical conduct Commitment: “I will obey my orders…”

31. Resources • Indiana Department of Veteran Affairs • Hoosier Veteran Assistance Foundation (HVAF) • Veteran Resource Center – Indianapolis • Indiana University- Veteran Support Services • Bloomington VA Outpatient Clinic • VA Vocational Rehab & Employment Program • Additional on-campus services • IPCN – Indiana Pathways to College Network • Guidebook for Incarcerated Veterans • Resources for Women Veterans • Workforce Development Resources

32. http://www.ivbhn.org/site/ • Free Trainings available • Earn CEUs

33. Contact Information Kiara Bembry kbembry@aspin.org 317-536-4684

34. THANK YOU!

35. Resources - Links • A Snapshot of Our Nation’s Veterans. (n.d.). BillMoyerscom. Retrieved May 1, 2014, from http://billmoyers.com/2012/07/27/a-snapshot-of-our-nations-veterans/ • About the Army. (n.d.). goarmy.com. Retrieved May 1, 2014, from http://www.goarmy.com/about.html • About the Department of Commerce. (n.d.). Retrieved May 1, 2014, from http://www.commerce.gov/about-department-commerce • About Us. (n.d.). USCG:. Retrieved May 1, 2014, from http://www.uscg.mil/top/about/ • Air Force Personnel Center - Air Force Personnel Demographics. (n.d.). Air Force Personnel Center - Air Force Personnel Demographics. Retrieved May 1, 2014, from http://www.afpc.af.mil/library/airforcepersonneldemographics.asp • America's Navy. (n.d.). Frequently Asked Questions : Navy.com. Retrieved May 1, 2014, from http://www.navy.com/faq.html • America's Navy. (n.d.). Mission & History : About the Navy : Navy.com. Retrieved May 1, 2014, from http://www.navy.com/about/mission.html • Baumann, D.K. (n.d.) Strategies for engaging returning veterans [PowerPoint slides] • HVAF of Indiana. (n.d.). HVAF RSS. Retrieved April 30, 2014, from http://www.hvafofindiana.org/ • Indiana Department of Veterans' Affairs. (n.d.). DVA: Indiana Benefits. Retrieved April 29, 2014, from http://www.in.gov/dva/2343.htm • Indiana University Bloomington. (n.d.). Resources: Veterans Support Services:. Retrieved May 1, 2014, from http://veterans.indiana.edu/resources/index.shtml • . (n.d.). . Retrieved May 1, 2014, from http://www.inpathways.net/vet_resources.pdf • . (n.d.). . Retrieved May 1, 2014, from http://www.military.com/join-armed-forces/military-missions-overview.html

36. Resources - Links • The Official Website of the City of Indianapolis and Marion County. (n.d.). Veteran Resource Center. Retrieved April 29, 2014, from http://www.indy.gov/eGov/Mayor/programs/VeteranServices/Pages/VeteranResourceCenter.aspx • United States Air Force - airforce.com. (n.d.). United States Air Force - airforce.com. Retrieved April 30, 2014, from http://www.airforce.com/ • HVAF of Indiana. (n.d.). HVAF RSS. Retrieved April 30, 2014, from http://www.hvafofindiana.org/ • Indiana Department of Veterans' Affairs. (n.d.). DVA: Indiana Benefits. Retrieved April 29, 2014, from http://www.in.gov/dva/2343.htm • Indiana University Bloomington. (n.d.). Resources: Veterans Support Services:. Retrieved May 1, 2014, from http://veterans.indiana.edu/resources/index.shtml • . (n.d.). . Retrieved May 1, 2014, from http://www.inpathways.net/vet_resources.pdf • . (n.d.). . Retrieved May 1, 2014, from http://www.military.com/join-armed-forces/military-missions-overview.html • The Official Website of the City of Indianapolis and Marion County. (n.d.). Veteran Resource Center. Retrieved April 29, 2014, from http://www.indy.gov/eGov/Mayor/programs/VeteranServices/Pages/VeteranResourceCenter.aspx • United States Air Force - airforce.com. (n.d.). United States Air Force - airforce.com. Retrieved April 30, 2014, from http://www.airforce.com/