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Guiding Vets and Active Military to Supportive Services Joe Qualls, US Army Veteran/OIF3 Kendra Brandstein , PH.D., MPH, MSW. The presentation will begin shortly This webinar is being recorded for future use .

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  1. Guiding Vets and Active Military to Supportive ServicesJoe Qualls, US Army Veteran/OIF3Kendra Brandstein, PH.D., MPH, MSW The presentation will begin shortly This 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).

  2. WELCOME EVERYONE!Thank you for joining us today

  3. Raising your hand to ask a question

  4. Sending Notes

  5. Muting your phone

  6. Guiding Veterans to Supportive Services Kendra Brandstein, PH.D., MPH, MSW Joe Qualls, US Army Veteran/OIF3

  7. 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

  8. Veterans 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. The Issue

  9. 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

  10. 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)

  11. Our Purpose Learn about mental and behavioral health Recognize signs and symptoms Identify local resource

  12. The Issue • One suicide a day for the past year • 23 suicides a day (national) Experience20072012 Death 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

  13. Military Culture 101 • The military is a distinct sub-culture in the United States with its own: • Rituals • Traditions • Oaths and Pledges • Hierarchy

  14. Branches Air Force Army Coast Guard Marines Navy Status Active Duty Nat. Guard Reserve Retired Veteran Core Values Military 101

  15. Post Traumatic Stress Disorder

  16. 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

  17. 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

  18. Signs and Symptoms of PTSD • Re-experiencing the traumatic event • Avoiding reminders of the trauma • Increased anxiety and emotional arousal • Nightmares • Numbing • Isolation

  19. 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 Treatment of PTSD

  20. 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

  21. Resources for PTSD Help • http://www.ptsd.va.gov/index.asp • http://www.ptsd.va.gov/public/where-to-get-help.asp

  22. Traumatic Brain Injury

  23. 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?

  24. 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.

  25. 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 Classifications of TBI Symptoms

  26. 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)

  27. Resources for TBI Help • http://www.cdc.gov/traumaticbraininjury/ • www.facebook.com/cdcheadsup • This website focuses on sharing brain injuries with others.

  28. 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

  29. Depression In the Military

  30. 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

  31. 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

  32. What to do • Help guide them towards seeking treatment • Provide Support • Take care of themselves • Can include: • Medication • Psychotherapy • Combination of medication and therapy

  33. 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/.

  34. Self-medicating alcohol and drug use

  35. 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

  36. What can you do? • Educate yourself about the various mental health disorders • Listen • Understand • Encourage those affected to seek help • Be Supportive!

  37. Resources • 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

  38. 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_Suicide_RMT.pdf • http://www.mentalhealth.va.gov/index.asp • http://www.mentalhealth.va.gov/PTSD.asp • http://www.mentalhealth.va.gov/mentalhealth/featurearticle_mar.asp • 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

  39. Contact Information Kendra Brandstein 619 862-6601 and brandstein.kendra@scrippshealth.org Joe Qualls joeandkami@gmail.com

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