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Military Presentation. James Martin, LMSW, MAC, SAP, EMDR, CISD. The Casualties of War. History Americans at War Military Culture Deployment/Redeployment Reintegration PTSD Causes Symptoms Suicide Treatment. The Veterans Commission Reported.
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Military Presentation James Martin, LMSW, MAC, SAP, EMDR, CISD
The Casualties of War • History Americans at War • Military Culture • Deployment/Redeployment • Reintegration • PTSD Causes • Symptoms • Suicide • Treatment
The Veterans Commission Reported • America has 23.5 million veterans in 2007 • WWII Vets dying off • Average of 500,000 per year are dying off about 1400 per day. • By the end of 2006 Vietnam Veterans were the largest group in the veteran population. • Curently over 2 million war veterans .
The Veterans Commission Reported • The effects of the current war are beginning to show • 2 million had service related disabilities at the end of 2007 and this number is rising. • The VA is not geared up to handle these numbers so vets needing help sometimes don’t receive it
Who are our Military Personnel • Active Duty • 1.4 Million (48%) • Reserves • 1.1 million (31%) • DoD Civilian Personnel • 800,000 (23%)
Who Are Our Military • Regular Army • Regular Navy • Regular Air force • Regular Marines National Guard • Reserves
Who Are Our Military PersonnelAge: • Active Duty (general) 56% are under 26 years old • Active Duty (Married) Average age 31.8 years • Reserves: 40% are 36 + years old
Who are our Military Personnel • Married • Active Duty : 56% • Reservists : 44% • Active duty with dependents: 56.8 % • Reservists with dependents: 56.3% • 1.2 Million dependent children of active duty service members
Dual Income Families • Require Second Income 77% • Spouses of active duty personnel employed/ seeking employment 59%
The Vary Nature Of Military • Trained to Kill • Trained to kill almost without hesitation • Make life and death decisions under stress • Do things that are horrible and upsetting for any human being • Their training and war experience can have a life altering impact on their lives (young)
Battle Conditions • Fear . • Guilt • Extreme weather conditions, hot or cold • Under constant enemy fire • Extreme fatigue • Perhaps four hours sleep a night • Extended time
BattleConditions • One third of 10 to 21 year olds killed. • Beginning 2006 weapons of choice I.E.Ds. • 140,000 suffered brain injury. • Almost 10,000 have accrued in 2011. • June, 2011 deadliest month since 2008 - 14 attacks per day.
Deployment • Deployed • Home • Redeployed up to 5 times and more • Reintegration • Problems adjusting. • Deployed again
Deployment Family • Difficulty adjusting • Made decisions • Finances • Children (behavioral problems) • Social support • High rate of divorce (young)
Deployed Military Personnel • Separated from family and friends • Disrupted career • Stress of combat • Lonely, scared, angry, sad • Expanded world experience and possible changes in world view
Experience of Deployment Spouse at Home • Expanded responsibilities • Single parenting • Handling finances • Anxiety, anger, stress • Loneliness • Growth, change, self confidence
Reintegration • Once over and leaves his/ her combat unit, those who served will inevitably rethink their experience. • That’s when they and their families will begin to experience the long term consequences of the psychological damage of the war.
Reintegration • Home coming party or quiet time • Children react in different ways to return • Mixed emotions • Problems connecting • Life again becomes disrupted • Return parent has to be updated • Family has to adjust to a new normal
Reintegration • Stability for the family, roles and responsibilities • Discipline now goes back to both parents • Non deployed parent may have changed • Tension and anger can increase (marital ) • Commitment to two families • Physical and psychological needs (PTSD) • CAN BE DEPLOYED AGAIN
History of PTSD and TBI • History of Wars , PTSD and TBI • Civil War Melancholy • WW I Shell Shock • WW II and Korea Combat Fatigue • Vietnam War PTSD
State of Denial • I don’t have a problem - I can handle it • A cultural thing , supposed to be tough • Don’t want to admit their fear so they repress it • Bond with members of unit, don’t want to leave them • Paying job don’t - want to lose it
Combat-Related Stress Reactions In Denial • Isolation from friends and loved ones • Major psychiatric problems • Marital and family discord • Work and career problems • Alcohol and drug problems • Suicide
PTSD • Personality Disorder, • Discharged Under Chapter 11 • 1980 Vietnam PTSD
PTSD Combat Reaction to A Civilian Provocation • 1981 - 1,000 Vietnam Vets, one quarter arrested since returning home . • VA reports 150,000 or more homeless. • January, 2008 N.Y. Times investigation came up with 121 cases in which combat vets committed a killing or were charged with one after returning from war in Iraq or Afghanistan .
Symptoms Of Combat PTSD and TBIDealing With the Unseen Scars Of War • Military culture - mental toughness • Life time occurrence 10%-30% • Currently the cases have jumped 50% • Studies estimate that one in every five military returning from combat has PTSD
PTSD • DoD stated on the rise from 40 to 50 present • PTSD is a cumulative disorder • Worsens with increased exposure to combat • Many troops have been deployed numerous times and their times have been involuntarily extended. • Conducting combat 10 to 12 hours per day for months on end.
PTSD - I Why PTSD REGONIZED MORE TODAY Better medical records, Lives saved Due to better technology Modern technology - live longer Better medical response teams Body armor, armored Humvees, can’t protect - arms and legs, amputation increased dramatically TBI increased from impact
PTSDII • World War I and WW II – fewer that 2 soldiers wounded for each killed • Korea, Vietnam up slightly – 3 wounded for each fatality • PTSD rate in Vietnam was artificially low – little knowledge 40 yrs. Ago • Unpopular coming home, homelessness, spit on, baby killers – didn’t want attention • Counselors stated that Vietnam vets were traumatized by news media – current vets starting to seek treatment
PTSDIII • More women in combat for first time in a major combat • Higher for women than men, more sensitive • Nationally there are about 1.7 million female vets, 235,000 receiving help - expect numbers to double in next 4 years • Some hit with a double whammy with sexual abuse, won’t tell due to nature of culture • Condition called personality disorder discharged under chapter 11 saved government up to 8 billion in medical benefits • Over 3,000 vets sought help in 2008 - Tri Care not accepted by some providers
Suicide • Veterans Association reports seeing 18 suicides per day among 25 million veterans • DoD taking action • Reported 150,000 homeless veterans, most from the Vietnam War • Expect numbers to increase
Suicide • Higher rate than any other War where records were kept • More died from suicide than military action • Rate before 9/11 - 9.1 per 1,000,000, by 2007 twice that - 24 per Per 1,000,000 • Reported that 1,000 attempts per month seen in medical facilities
Suicide • First seven months of 2011 - 109 suicides • July, 2011 - suicides hit a record • Staff Sergeant shot himself to avoid his ninth deployment • A full scale crisis • Trained peers • DoD investigating
Treatment Modalities • Get solider to talk • Reality Therapy • Flooding • Debriefing • Virtual Reality • EMDR
Other Treatment Modalities • MHN, Military One 12 sessions • Mental Health on base • Met plan • Blue ribbon/weekend-workshops/reintegration/families/children/ Dear John 9 (letters)