Building Competency to Serve Active Duty & Reserve Members, Veterans and Dependents. Re-Integration and Recovery.

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Brent Murphy
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1 Building Competency to Serve Active Duty & Reserve Members, Veterans and Dependents. Re-Integration and Recovery.

2 Shawn Dowling LCDCIII, LISW-S, ACSW HCHV COORDINATOR VAAAHS

3 Vincent Warren Management Specialist, U.S Navy PEER SUPPORT SPECIALIST VA SUPPORTED HOUSING PROGRAM VAAAHCS

4 Understanding Military Culture In order to effectively meet the needs of military members and their families we must understand the culture within the US Military. Culture is defined as: The set of shared attitudes, values, goals, and practices that characterizes an institution, organization or group

5 What is Different for Military Members compared to Being a Civilian Service is Generational Lack Control Over: Location, body, clothes, etc.. Becomes a piece of Government Property Dependents Are Not Encouraged to Ask for Help or Admit they Need it. Constant changes in regulations, expectations, and position security Freedom of speech limited Cannot Advocate for a Sober Work Culture Cannot Transfer or Quit Violence is a Fact of Every Day Life Can t call in sick or take a mental health day Confidentiality is non existent Constant reintegration 1% of population

6 Common Military Behaviors Being constantly on guard (hyper vigilant) Common practice for weapons to be present Stoic/Flat affect Recalling events repeatedly Emotional numbing/detachment Heightened response to loud noises Lack of assertiveness/speaking up Situational awareness THESE BEHAVIORS MAXIMIZED SURVIVAL DURING ENLISTMENT, BUT CAN BE CONSIDERED DISRUPTIVE IN CIVILIAN ENVIRONMENTS

7 OLD WAYS OF THINKING BY THE MEMBER AND SOCIETY Seeking help is a sign of weakness Impacts career-deployability, promotions Combat Veterans are all messed up Service members are victims of government agenda WWII, Korean, Vietnam veterans didn t need helpthey didn t have problems. If a member deploys they have PTSD, or have experienced some form of trauma When a crime has been committed by a service member- military service is disclosed

8 The Current Epidemic of Suicide 20.2 per 100,000 soldiers have completed suicidehigher than current civilian rate. 32 suicides in the month of June had been deployed, of those 10 had deployed 2-4x. Males at higher risk. Security Forces, Maintainers and Recruiting at higher risk. 155 suicides in the first 154 days of the year-2012 Undocumented attempts Inability to cope is interpreted as a loss of respect, dignity, lacks resiliency and purpose.

9 Drugs Impact Military Discipline The abuse of alcohol, prescription drugs or the use of illicit drugs are inconsistent with the Armed Forces Values, the Warrior Ethos and the standards necessary to accomplish the mission: Performance Discipline Safety Readiness

10 Substance Use Disorders Pain Medication while in the field-not prescribed when they return home. Return home, substances are used as a tool during the reintegration period Coping mechanism to assist with anxiety, depression, trauma, adjustment Sleep meds prescribed due to drastic changes in sleep patterns

11 Times are Changing

12 Lt. Col. Wayne Talcott, Air Force Psychologist stated; You maintain a jet engine so it doesn t fall out of the sky, he said. We need to begin to look at where there are risks to the human weapon system and how we can build a system that protects our people.

13 Risk Factors Significant Stress for Members Before, During, After Deployment Accelerated Deployment Impacts Operational Readiness (Individual & Unit) Impacts: Retention Accidents Mental Health & Stress Disorders Substance Abuse PTSD Co morbidity of PTSD/Substance Abuse Family Problems / Generational Impact / Community Mitigation Strategies Mitigation Significant Protective Factors can be Mobilized BEFORE hand that are PROVEN to work Prevention Education Team/Social Support Coworker Peer Referral Supervisor Responsiveness Stigma Reduction Advertising of Resources Team Moderation in Alcohol Use Wellness Lifestyle Positive Policy Attitude

14 Current Pilot Programming for Military Needs assessment/data collection and integration Data visualization and data dashboard projects (DE, IA, MD, NH) Tracking Veteran status on driver s licenses (GA, MD, UT, WA) Workforce development/military culture-informed services Hosted Operation Immersion (AZ, TN, RI) Military cultural competency training (AZ, IA, ME, NC, OH) Training with law enforcement and first responders (CT, ME, NC, OH) ESGR-Employment Support for Guard and Reserve Criminal Justice Implementation of Veterans Treatment Courts (FL, NH, ME, UT, OH) Intimate partner violence strategic action plan (CT) Veteran Dormitory Program in prisons and jails (FL)

15 Navy Capt. Robert Murphy, a medical corps officer stated that We re certainly not opposed to alcohol use, but we are trying to reduce the prevalence of alcohol abuse.

16 Then VS. Now Old Approach New Approach Goal: Eliminate the problem Cultural change Focus: Deterrence Prevention Target: Service member Circle of Influence Primary Responsibility: Service member Service member Substance Abuse: Abuse vs. Addiction Individual Issues Community Issues Approach: Punitive Intervene to prevent substance abuse and foster rehabilitation Key Message: Don t Get Caught Every Service member has a duty to intervene to prevent substance abuse and access to rehabilitative services with command support

17 Policy Academy Objectives Strengthen behavioral health systems for Service Members, Veterans, & their Families Involve Service Members, Veterans, and Families Increase access Close the gaps Build capacity Increase interagency communication/collaboration Incorporate best practices Plan for sustainability 17

18 Mental Health Adjustment disorder vs. SPMI diagnosis Allowed medications Understanding needed documentation Evaluation Diagnosis/prognosis Meds prescribed Treatment Plan Regular Summaries Acknowledge the concern they may feel that seeking treatment will impact their career.

19 Understanding the Process Member seeks help Placed on Profile: ALC-C code given: Good for 1 year Unfit Disqualifying diagnosis- MEB required. Retire or discharge Unsuitable Not a medical issue - command determines to retain or discharge

20 Unfitting Diagnoses Psychosis, unless brief and from a reversible cause Persistent impairment (> 1 year) Continuing psychiatric support (> 1 year) Recurrent impairment (>1 in 1 year) Conditions requiring use of lithium, anticonvulsants, or antipsychotics for mood stabilization

21 Unsuitable Diagnosis Personality disorders Learning disorders BUT ALSO: ADHD; if medication required, WWD and waiver request from NGB/SG required Adjustment disorders Sexual perversions Flying phobia Substance use disorders

22 Must be seen by Military MH Recurrent depression or anxiety disorders Psychiatric medication for > 1 year Hospitalized for any psychiatric condition

23 RECOVERY/RESTABILIZATION It is a PROCESS not an EVENT. Provider competency a must, without it the individual will dis-engage. Know the SYSTEM and the INDIVIDUAL Assist with Serving the Whole Person including the Dependents in a non-threatening setting that is family focused. Remember they are trained as a team work with them as such.

24 Learn the Language: Understand Rate and Rank, Medals and Awards. Learn About the Base closest to your practice/agency Deployment Structure-for active duty, reserve, guard. Understand and Respect the Traditions and Expectations of the Military Culturecustoms and courtesies and military bearings. HELPFUL HINTS

25 References ticles/blalcohol.htm

Introduction to Veteran Treatment Court

Justice for Vets Veterans Treatment Court Planning Initiative Introduction to Veteran Treatment Court Developed by: Justice for Vets Justice for Vets, 10 February 2015 The following presentation may not