Challenges Facing Returning Veterans

1. Challenges Facing Returning Veterans Karen Kelly, Ph.D., LPC, NCC, MAC, CCS, CRPS,SAP,CAMF,CDD,CPS,CDC

2. Challenges Facing Returning Veterans • Overview: Active duty military life affects a person’s relationships, work, health and other parts of daily living. As individuals are leaving the military they are bringing their experiences into an unsuspecting community. As these individuals begin to show up in offices, programs and emergency rooms they may go undiagnosed or be improperly diagnosed. As providers of mental health and substance abuse services we need to be competent in at least the identification, assessment and referral of these individuals. This work shop will provide the audience with insight into some of the varied experiences into military life and the challenges faced upon discharge. Circle of Recovery, Inc. July 2012

3. Challenges Facing Returning Veterans • Objectives: By the end of this presentation participants will… • Gain a better understanding of military culture • Gain tools to assess who might be at risk for PTSD or other combat related stress reactions. • Explore various types of tools/therapies designed to assist these individuals. • Discuss additional community resources available • Discuss the impact of alcohol and drug use on PTSD and stress related disorders. Circle of Recovery, Inc. July 2012

4. Challenges Facing Returning Veterans • Introductions: Circle of Recovery, Inc. July 2012

5. Challenges Facing Returning Veterans Nearly 1 in 5, or 30,000 soldiers who have served in Iraq or Afghanistan have PTSD or depression while only about half of that number actually have sought treatment. Circle of Recovery, Inc. July 2012

6. Challenges Facing Returning Veterans • What is Culture Circle of Recovery, Inc. July 2012

7. Challenges Facing Returning Veterans • ACTIVITY: • Identify Your Culture: • Discuss goals, values, visions, slogans, or pledges That are particular to your setting Circle of Recovery, Inc. July 2012

8. Challenges Facing Returning Veterans • Identifying culture: • Why might these values, goals, slogans, etc. be important to an organization? Circle of Recovery, Inc. July 2012

9. Challenges Facing Returning Veterans • Culture: • Culture can be defined as the knowledge, experience, values, ideas, attitudes, skills, taste, and techniques that are passed on from more experienced members of a group to new members. • Elements of culture include: symbols, signs, ceremony, rituals, ethics, health, gender, myths, gender roles, gestures, kinetics, presence, ownership,recreation,relationships,privilages and rewards. Circle of Recovery, Inc. July 2012

10. Challenges Facing Returning Veterans • Understanding Military Culture? Circle of Recovery, Inc. July 2012

11. Challenges Facing Returning Veterans • Military Language and Phrases Circle of Recovery, Inc. July 2012

12. Challenges Facing Returning Veterans • Training and Indoctrination: • Training as a way to accomplish the mission • Military training: Has been defined in previous years as “the inculcation of skills aimed at achieving maximum efficiency in the battlefield, hence Basic training. • Basic training: “The preparation of individuals from civilian life for the demands of military life. • Battlemind Circle of Recovery, Inc. July 2012

13. Challenges Facing Returning Veterans • This basic training requires fitness, discipline, and the ability to live, and work in a highly structure environment. • In addition emphasis is placed on rules, discipline, social conduct, physical conditioning, self-confidence, and pride in being a member of the military. Circle of Recovery, Inc. July 2012

14. Challenges Facing Returning Veterans • Elements of Military Culture: Circle of Recovery, Inc. July 2012

15. Challenges Facing Returning Veterans • Elements of Military Culture include by are not limited to: • Expectations • Terms • Chain of Command • Protocol • Customs • Transition Circle of Recovery, Inc. July 2012

16. Challenges Facing Returning Veterans • Military Terms: • AWOL Absent without leave • AD Active Duty • BCT Basic Training • BDE Brigade • BN Battalion • CDR Commander • CG Commanding General • DOD Department of Defense • TDY Temporary Duty • NCO Non commissioned Officer • PCS Permanent change of station Circle of Recovery, Inc. July 2012

17. Challenges Facing Returning Veterans • Military culture is shaped by national culture as well as geographical and historical factors. • Because of the constant change in leadership, professional military education, technology, and the impact of war. • Members become weary, tired and disenfranchised to what is unknown. • The end result challenges and a breakdown in their mental and physical well being. Circle of Recovery, Inc. July 2012

18. Challenges Facing Returning Veterans Veterans who are trained to “be warriors, suck it up, and perform the mission” are often afraid to seek help for mental health and addictions issues because they don’t want to be seen as weak. Circle of Recovery, Inc. July 2012

19. Challenges Facing Returning Veterans Circle of Recovery, Inc. July 2012

20. Challenges Facing Returning Veterans • Deployment and Reintegration Issues: • What is deployment? • What happens after deployment? • Adapting to normalcy after deployment . • Transitioning to home life after discharge. Circle of Recovery, Inc. July 2012

21. Challenges Facing Returning Veterans • The transitioning military member: • What to expect • Physical Health • Emotional Health • Taking care of self • Talking about the experiences • Identifying signs and symptoms • Resources Circle of Recovery, Inc. July 2012

22. Challenges Facing Returning Veterans • Military training and stress reactions have one thing in common- survival • Military education exercises, training, drilling, discipline, focuses on building a cohesive unit and increased unit performance. • Certain circumstances, however, threatens both the physical and mental well being of military personnel. • The end result a breakdown in the physical and mental health of the individual Circle of Recovery, Inc. July 2012

23. Challenges Facing Returning Veterans • Impacting physical and mental health concerns: • Injury • Developmental problems • Physical strains • Diseases of the brain • Viruses • Aging issues • Extreme grief • Prolonged stress Circle of Recovery, Inc. July 2012

24. Challenges Facing Returning Veterans Combat Operational Stress (COS) and COS-Reactions (COSRs) are Much More Common Than PTSD All can be Managed or Treated Effectively Circle of Recovery, Inc. July 2012

25. Challenges Facing Returning Veterans Circle of Recovery, Inc. July 2012

26. Challenges Facing Returning Veterans • Not all members were traumatized by Deployment and Combat. • Around 70% will experience Combat and Operational Stress Reactions • Research suggests that approximately 20% of returning Veteransmeet the criteria for Major Depression, Acute Anxiety orPTSD Circle of Recovery, Inc. July 2012

27. Challenges Facing Returning Veterans • Identifying Post Traumatic Stress Disorder Circle of Recovery, Inc. July 2012

28. Challenges Facing Returning Veterans • What is Post Traumatic Stress Disorder • PTSD is an emotional and behavioral disturbance that may occur after exposure to an exceptionally stressful, threatening or catastrophic event. • Some events are: • Combat • Disaster • Life threatening events • Witnessing violent death • Sexual assault • Violent Crimes • Threats of serious injury or death • Diagnosis emerges in 5% men, 10% women some variance depending on specific sub-populations Circle of Recovery, Inc. July 2012

29. Challenges Facing Returning Veterans • Symptoms: • Arousal symptoms, restlessness, sleeplessness, hyper alert, inability to relax or get comfortable • Intrusive symptoms, mental "replays” and dreams in which the person sees, hears, feels, smell, tastes aspects of the event • Avoidance, lack of emotion, avoiding others, reminders such as people, places, and conversations can set off a reaction • Symptoms typically last beyond a month and can occur long after the original traumatic event Circle of Recovery, Inc. July 2012

30. Challenges Facing Returning Veterans • Challenges in managing PTSD • Multiple combat experiences • Combined military and personal traumatic events • Alcohol and Drug use/abuse • Grief • Emotional depression • Disability due to injury • Memory and thinking problems • Other mental and physical problems Circle of Recovery, Inc. July 2012

31. Challenges Facing Returning Veterans • Treating PTSD: • Positive Motivation • Trained in the identification and treatment of PTSD • Behavioral therapy • Cognitive Behavior therapy • Pharmacotherapy • EMDR • Trauma Incident Reduction (TIR) • Thought Field Therapy (TFT) • Assisting family member in understanding PTSD Circle of Recovery, Inc. July 2012

32. Challenges Facing Returning Veterans • Other factors effecting the returning military member: • Heavy alcohol use • Alcohol is used to cope with stress, boredom and loneliness • Easy accessibility • One fourth of military young adults reported heavy alcohol use compared to 17.4% of civilians • Drug use for 18-25 year olds is less than ½ civilians • Mental health of military kids are impacted • Increase in incarceration of veterans Circle of Recovery, Inc. July 2012

33. Challenges Facing Returning Veterans • Major Transition challenges: • Re-connecting to a new city, community and area. • Difficulty in writing effective resumes for the job search • Family, medical, and spiritual support • How to succeed in the business/civilian world • Connecting and networking outside of the military • Difficulty in navigating through the resource network Circle of Recovery, Inc. July 2012

34. Challenges Facing Returning Veterans • Assisting the reintegrating military veteran • Education • Arming yourself with knowledge around veterans and their military experiences • Understanding the distinction between Major Depression, Acute Anxiety andPTSD • Utilize appropriate treatment strategies • Reach out to assist family members and significant others associated with the veteran • Learn what available resources are in your community Circle of Recovery, Inc. July 2012

35. Challenges Facing Returning Veterans • Warriorswho are depressed or overwhelmed areat risk forsuicide! • Our negative emotions can create negative, hopeless thinking • Trained Mental Health Providers and Specialty Counselors are well-trained to assist “at risk” Soldiers and provideeffective counseling or referrals • Some Warriors require medication for stabilization and treatment • Other Warriors falsely believe they can not be helped. They can! WhereResiliency, Thriving and Post Traumatic Growth reside,Suicide is not an option! Circle of Recovery, Inc. July 2012

36. Challenges Facing Returning Veterans CLOSING REMARKS • As a man thinketh, so is he” Proverbs 23:7 • “The mind is its own place, and in itself, can make heaven of hell and a hell of heaven” John Milton-Author • “Its not stress that kills us, it is our reaction to it” Hans Selye- Scientist who coined the term “stress” • “If we know why (we suffer) we can endure any how” • “What doesn’t break my back makes me stronger” Nietzsche- German Philosopher • “…more than that, we rejoice in our sufferings, knowing that suffering produces endurance, and endurance produces character, and character produces hope…” Romans 5:3 Circle of Recovery, Inc. July 2012

37. Challenges Facing Returning Veterans Circle of Recovery, Inc. July 2012

38. Challenges Facing Returning Veterans • RESOURCES: • Veterans Administration • Military One Source • Join Together • Alcohol Research & Health • International Society for Traumatic Stress • National Center for PTSD • PTSD Alliance • Substance Abuse and Mental Services Administration • www.TheNationalCouncil.org • Army One Source Circle of Recovery, Inc. July 2012