After They Have Served The Effects of Combat Stress amp Post Traumatic Stress on the Home Front Covered Today Situation Who was Deployed Significant Events That They Saw Magnitude ID: 577502
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Slide1
Veteran’s IssuesAfter They Have Served
The Effects of Combat Stress
& Post Traumatic Stress on the Home FrontSlide2
Covered TodaySituationWho
was
Deployed
Significant Events That They SawMagnitude of the ProblemChallenges That They FaceBattle Zone Skills That Interfere with ReadjustmentPotential TriggersSlide3
Covered Today
Good
News!
Research indicates that 75-80% of veterans who are exposed to combat and/or served in combat environments return from deployment and transition into civilian life very productively.Slide4
Healthy Transitions
Certainly
the transition from war zone to home is a unique experience for each veteran and their family. Most move through and beyond this transition with a true sense of meaning and purpose for their lives.
Family
support, education, and awareness are keys to successful homecomings.Slide5
Who was Deployed
Significant Events That They Saw
Magnitude of the Problem
The SituationSlide6
Operations in Support of the Global War on Terrorism
Operation Iraqi Freedom (OIF)
Mar 20, 2003 - Sept 1, 2010
Operation New Dawn (OND)Sept 1, 2010 – Dec 15, 2011Operation Enduring Freedom (OEF)Oct 7, 2001- Current DateSlide7Slide8
Source: Defense Manpower Data CenterSlide9
No Safe PlaceNo Safe Role
Asymmetrical WarfareSlide10
Global War on Terrorism 2001-2007
94%
- Received
small-arms fire86% - Know someone who was seriously injured or killed
77%
- Shot at or directed fire at the enemy
68%
- Saw
dead or seriously injured Americans
51%
- Handled
or uncovered human remains
48%
- Responsible
for the death of an enemy combatant
28%
- Responsible
for the death of a
noncombatant
(New England Journal of Medicine
)Slide11
New England Journal of MedicineJuly 2004
Examined mental health problems among 3671 Soldiers and Marines 3 to 4 months after their return from Afghanistan or Iraq.
They Found:Up to 17.1% screened positive for major depression, generalized anxiety and/or PTSD.Of those who screened positive for a mental disorder, as few as 23% sought treatment.Those with a mental disorder were twice as likely to report concern about stigmatization should they report their problems.
Combat veterans are at high risk for PTSD and other MH problems, but unlikely to report them.
NEJM, July 1, 2004—Vol. 351,
No.
1Slide12
Journal of the American Medical Association March 1,
2006
303,905 Army soldiers and Marines screened from 5/1/03 to 4/30/04, on return from deployments to GWOT (Iraq, Afghanistan, Other Locations)
Those who screened positive for a mental health concern were significantly more likely to leave service for any reason during the year after deployment than those who screened negativeService members are twice as likely to report mental health concerns 3 to 4 months after returning from deployment compared with reporting immediately on return
JAMA, March 1,
2006—Vol.
295, No. 9Slide13Slide14
Global War on Terrorism 2001-2007
Two thirds of the casualties in the Global War on Terrorism occurred between 2001-2007
Increased operational (OP) tempo early in the war
Mental health
issues not
formally addressed
until 2007
Changes to addressing mental health issues implemented in
2008Slide15
Turning Point: Walter Reed 2007Specialist Jeremy Duncan testifies during a hearing before the House Subcommittee of Government Reform and Oversight Committee March 5, 2007 at Walter Reed Army Medical Center in Washington, DC. The hearing was held to examine the treatment and living conditions at the medical center.
By
Alex Wong/Getty Images.Slide16
Global War on Terrorism 2008-Present
Experiencing stress from combat is viewed as “normal” rather than weak
All ranks have similar reactions to combat
Stigmatism to PTSD dramatically diminishedTreatment for combat stress and post traumatic stress is encouragedSlide17
1,724,058Is the number
of Operation: Iraqi Freedom, Enduring Freedom and New Dawn veterans who have left active duty since September 30, 2002Slide18
Frequency of Mental Disorders13
among OEF/OIF/OND Veterans since 2002
14
Disease Category (ICD-9 290-319)
Total Number of OEF/OIF/OND Veterans
15
PTSD (ICD-9 309.81)
16
299,561
Depressive Disorders (311)
239,174
Neurotic Disorders (300)
217,736
Affective Psychoses (296)
144,898
Alcohol Dependence Syndrome (303)
68,953
Nondependent Abuse of Drugs (305)
17
51,018
Special Symptoms, Not Elsewhere Classified (307)
44,159
Specific
Nonpsychotic
Mental Disorder due to Organic Brain Damage (310)
38,611
Drug Dependence (304)
32,763
Sexual Deviations and Disorders (302)
35,141
VA Health Care Utilization among OEF/OIF/OND Veterans Cumulative from 1
st
Qtr
FY 2002-4
th
Qtr
FY
2013,
Released January
2014Slide19
Effects of WarCombat Stress Post Traumatic StressSlide20
Symptoms of Post Traumatic Stress
Symptoms
of post-traumatic stress disorder (PTSD) can be terrifying and may disrupt your life.
Usually begin soon after the traumatic eventMay occur months or years laterMay come and go over many yearshttp://psychewizard.comSlide21
Symptoms of Post Traumatic Stress
Four Types of Symptoms
Avoidance symptoms
Numbing symptomsFeeling Keyed UpReliving symptoms
http://
psychewizard.comSlide22
AvoidanceYou may try to avoid situations or people that trigger memories of the traumatic event.
You
may even avoid talking or thinking about the event.
Some people may keep very busy or avoid seeking help. This keeps them from having to think or talk about the event.Slide23
Feeling NumbYou may find it hard to express your feelings. This is another way to avoid memories
You may not have positive or loving feelings toward other people and may stay away from relationships
You may not be interested in activities you used to enjoy
You may forget about parts of the traumatic event or not be able to talk about themSlide24
Feeling Keyed UpYou always may be alert and on the lookout for danger. This is known as increased emotional arousal. It can cause you to:Suddenly become angry or irritable
Have a hard time sleeping
Have trouble concentrating
Fear for your safety and always feel on guard Be very startled when someone surprises youSlide25
Reliving The EventBad memories of the traumatic event can come back at any time. You may feel the same fear and horror you did when the event took place. You may feel like you're going through the event again. This is called a flashback.
Sometimes there is a trigger: a sound or sight that causes you to relive the event.
Leatherneck Magazine. www.leatherneck.comSlide26
Reliving Traumatic Stress Injuries
Abrupt injuries to the brain and mind
Due to specific events) that cause:
Terror, horror, or helplessnessPhysiological hyper-arousalDissociation (abrupt and transient loss of mental integrity)Damage to necessary or deeply-held beliefsShame or guiltSlide27
Crisis InterventionIdentifying a crisis
The Goal of InterventionSlide28
What is a CrisisA crisis is an overwhelming reaction to a threatening situation in which a person’s usual problem solving strategies fail to resolve the situation resulting in a state of
disequilibrium.
A crisis is a perception or experiencing of an event or situation as an intolerable difficulty that exceeds the person’s current resources and coping
mechanisms.Slide29
Goal of InterventionThe goal of intervention is to restore the person to pre-crisis level of equilibrium, not of personality changes.Attempt to mobilize the veteran’s internal and external resources.
Exact nature of the intervention will depend on the veteran’s pre-existing strengths and supports and your level of creativity and flexibilitySlide30
AssessmentInterventionResources
The Crisis StateSlide31
Crisis Intervention Balancing FactorsSlide32
InterventionA
process to assist individuals in finding adaptive solutions to unsettling
events
------ SMS Text ------
From: **********
Received: Mar 9, 2011 6:50 PM
Subject: So if I have a gun in my mouth...
So if I have a gun in my mouth...does That mean I have a plan, or am I just thinking about killing myself?Slide33
DO …say things like:
DON’T …
say
things like:“You are safe now (if true).”“I’m glad you’re talking with me now.”“I am sorry it happened.”“Your reaction is not an uncommon response to such a terrible thing.”
“I can’t imagine how terrible you are feeling.”
“You are not going crazy.”
“Things may never be the same, but they can get better.”
“
I understand.”
“
I’m glad you can share those feelings.”
“You’re lucky that. . .”
“It’ll take some time but you’ll get over it.”
“I can imagine how you feel.”
“Don’t worry; it’s going to be
alright
.”
“
Calm down and try to relax
.”
Do’s and Don’tsSlide34
Battle Zone Skills That May Interfere with ReadjustmentCHALLENGESSlide35
In Combat
: Unpredictable, fast, rapid lane changes, straddling the middle line, keeping other vehicles at a distance, designed to avoid IEDs and VBIEDs.
Road Construction
Traffic Jams
Stress
Confusion
Aggressive Driving
Speeding
Erratic driving in congested areas
Triggers
ExamplesSlide36
In Combat:
Countless split-second decisions are made to apply deadly force in dangerous and highly ambiguous environments.
Bar Scene
Alcohol
Family Issues
Marital Issues
Overreactions to minor insults
Inappropriate aggressiveness
Assault
Domestic violence
Triggers
ExamplesSlide37
In Combat
: Carrying your weapon at all times was mandatory and necessary.
Feeling naked without a firearm
Traveling outside of your element
Anxiety
Stress
Armed without a reason
Firearm in vehicle
Trigger
ExamplesSlide38
In Combat:
Controlling your emotions during combat is critical for mission success
Detachment from battle buddies/Adapting to a new environment
Anniversary Dates
Holidays
Patriotic Holidays/Rally’s
“Black and White” perspective
Anger over minor issues
Avoiding crowds or public
Avoiding family/friends
Trigger
ExamplesSlide39
Keys to successful homecomingsSuccessful HomecomingsSlide40
Keys to Successful HomecomingsFamily Support
Education
Awareness
Early ActionSlide41
Getting HelpEven if you always have some symptoms, counseling can help you cope.
Your
symptoms don't have to interfere with your everyday activities, work, and relationships.
Most people who go through a traumatic event have some symptoms at the beginning but don't develop PTSD.Slide42
ResourcesSlide43Slide44
National Suicide Prevention HotlineCall the toll-free National Suicide Prevention hotline and indicate you are a veteran. You'll be immediately connected to VA suicide prevention and mental health professionals. We can help-- If you feel you are in Crisis--Call the Suicide hotline (1-800-273-TALK
).Slide45
Questions?