MILITARY LIFESTYLE and TRANSITION CHALLENGES

1. MILITARY LIFESTYLE and TRANSITION CHALLENGES Josh Bode, LCSW Social Worker Substance Use Disorder Program Boise Veterans Administration Medical Center Created by: Nikole Gaskell, MSW Student

2. Military History "The military history of the United States spans a period of over two centuries. During the course of those years, the United States has evolved from a new nation fighting the British Empire for independence (without a professional military 1775–1783), through a monumental American Civil War (1861–65) to the world's sole remaining superpower of the late 20th and early 21st centuries" Wikipedia (Dec 2010)

3. Today’s military Since Sept 11, 2001: • More than 1.5 million troops have deployed in support of OEF/OIF. Fiscal year 2010: • There were about 2.2 million active duty and reserve component military personnel. • Reservists and National Guard members represented roughly 59% of the total military force. Dulaney, M., Illingsworth, M. & Savitsky, L. , (2009) Sections 401 & 411 of 2010 Defense Authorization Act

4. Who Serves • 50% are between 17-24y/o • 16% are women • 25% are minorities DuLaney et.al (2009)

5. Benefits of Military Life • Travel • Housing assistance • Occupational training • Health clubs • Education benefits • Competitive pay for some • Medical/Dental care • Food reimbursement

6. Military Lifestyle "Military life is characterized by mobility and an emphasis on mission readiness.“ (DuLaney et.al, 2009) For Service members: • Must be available 24/7, 365 days a year • Basic needs are met/supported by the military • Culture of high alcohol use • Strict training and discipline regimens • Physical fitness

7. Military Lifestyle For Service members: • Superiors are involved in personal life issues • Multiple deployments • High training tempo, even for those who don’t deploy • Source of pride for many • It is what you make it • Enjoyable for many

8. Military Lifestyle For military families: • Isolation • Single parenting during times of separation • Re-integration challenges • Coping with soldiers’ injuries • Financial strain for younger/lower enlisted • Repeated personal readjustment • Fear

9. Lifestyle Challenges • Challenges can lead to : domestic violence, substance abuse, child abuse/neglect. • In a 2005 study of military veterans, PTSD was associated with partner violence for one-third of the study participants. • “For those still on active duty, the process of ‘self-medicating’ [with drugs/alcohol] and resulting instances of misconduct… can have disastrous effects.” • Child abuse/neglect may be perpetrated by either or both parents due to these stressors. (DuLaney et al, 2009)

10. Deployment “Deployment describes a service member’s time spent away from his or her home base in support of a military operation and involves three phases each with its own unique set of stressors for the service member and his/her family.” (DuLaney et al., 2009)

11. Deployment • Pre-deployment- Preparation and training away from home • Deployment- Both family and service members worry about the stress of the combat zone as well as the overall well-being of their families. • Post-deployment- Stressful time of readjustment for all family members.

12. Transition to Civilian Life There are challenges for ALL service members when transitioning back to civilian life whether they served in a combat zone or not. • Perception of being able to get out of the military and get career “credit“ for being in • Coping with wounds • Psychological problems • Family changes

13. Transition to Civilian Life • Lifestyle changes • Sense of loss (comrades, mission) • Military- put aside personal life to be available 24/7 • Connecting to a new community • Things were scheduled and strictly regulated, not so in civilian life • Physical changes- no longer required to do PT

14. Transition to Civilian Life • Competitive nature of civilian sector vs. teamwork in the military • Relocation • Family/interpersonal problems are “in their face” on a daily basis • May be resentments if bad military experience • Substance abuse • Divorce- Enlisted soldiers and Marines divorced their spouses at a higher rate in fiscal 2008 than at any other time in at least 16 years.

15. Transition to Civilian Life • Homelessness- vets are 12.6% of the U.S. population, but 18.7% of homeless population. Many suffer from substance abuse, mental illness and 33% of homeless vets have served in a war zone. (DuLaney et. Al, 2009) • Unemployment rate is higher in newly returning OEF/OIF era veteran population than that of non-vets for the same period. This increases the financial stress that veterans experience.

16. Army Concept-Battlemind Battlemind skills helped them survive in combat, but may cause problems if not adapted when they get home. Buddies (cohesion) vs. Withdrawal Accountability vs. Controlling Targeted Aggression vs. Inappropriate Aggression Tactical Awareness vs. Hypervigilance Lethally Armed vs. “Locked and Loaded” at Home Emotional Control vs. Anger/Detachment Mission Operational Security (OPSEC) vs. Secretiveness Individual Responsibility vs. Guilt Non-Defensive (combat) Driving vs. Aggressive Driving Discipline and Ordering vs. Conflict

17. Battlemind ALCOHOL TRANSITION- Alcohol may be limited, but back home it is plentiful. Many service members use it as a way to cope and relax which can lead to further problems. • Battlemind skills come along with training. • This mentality also affects those who have not been in battle. • This is an Army concept. Other services have similar models.

18. Wounded Servicemembers • As of 2007, including injuries in combat and non-hostile activities, nearly 53,000 service members have been injured since the onset of Operation Enduring Freedom (Afghanistan) and Operation Iraqi Freedom (Iraq). (DuLaney et. al, 2009) • In the past many injuries were fatal, but medical advances have made survival rates much higher. HOWEVER: • Grave physical injuries due to advances; damaged brains (traumatic brain injury), spinal cords, vision, hearing loss, amputated limbs, disfigured faces and invisible injuries including psychological problems.

19. Treatment Many service members and veterans don’t seek treatment, particularly for invisible injuries, because of: • Stigma • Fear of career impact (even civilian) • Loss of peer confidence • Military culture: “suck it up” This can lead to substance abuse, suicide, violence and family problems.

20. Idaho VA Resources • To connect a veteran to the various services available, please contact your local Veterans Justice Outreach Coordinator. • VJO’s for state of Idaho • Southwest Region: Joshua Bode • (208) 422-1000 Ext 7154 • Central Region: Rhonda Strother • (509) 525-5200 Ext 22056 • Northern Region: Paul Nicolai • (509) 434-7285 • Eastern Region: Amy Earle • (801) 582-1565 Ext 6327

21. Resources Available to Veterans • Medical Centers Treating Idaho • Boise VA Medical Center • Community Based Outpatient Clinic in Salmon, Caldwell, and Twin Falls • Walla Walla Medical Center • Community Based Outpatient Clinic in Lewiston • Spokane VA Medical Center • Community Based Outpatient Clinic in Coeur d’Alene • Salt Lake City VA Medical Center • Community Based Outpatient Clinic in Pocatello

22. Behavioral Health Programs Available • White City Oregon Domiciliary Program • Up to 6 month admission • Mental Health and Substance Dependency Services. • Wide array of services available • American Lakes Domiciliary Program • Substance Dependency and Post Traumatic Stress Disorder Treatment Program • Boise Substance Abuse Residential Rehabilitation Treatment Program • Walla Walla Substance Abuse Residential Rehabilitation Treatment Program

23. Vet Centers • Boise Vet Center (208) 342-3612 • Pocatello Vet Center (208) 232-0316 • Services provided by Vet centers: • Adjustment Counseling • Military Sexual Trauma • Mobile Vet Center

24. VA Regional Offices • Boise VA Regional Office • Veterans Benefit Administration • Federal Benefits for Veterans Handbook • Veterans Service Organizations • Idaho Division of Veteran Services • 208-577-2310 • Responsible for State Veterans Homes • Assist in disability claims • Disabled American Veterans • 208-429-2140 • Numerous others available in local communities

25. Legend: Active Army Installation Army National Guard Family Assistance Center Army Reserve Family Programs Office Joint Forces Headquarters Survivor Outreach Services ROTC MEPPS Recruitment Battalion Idaho Post Falls Hayden Moscow Lewiston Caldwell Boise Idaho Falls Pocatello Twin Falls

26. Other Resources • www.gibill.gov • Education and training (1-888-442-4551) • Military OneSource • (1-800-342-9647) • Army OneSource • Sheila Schumacher (208) 660-5607 • Military Family Readiness Centers • Mountain Home AFB, Idaho • (208) 828- 2458 • Gowen Field, Idaho • (208) • Fairchild AFB, Washington • (509) 247-2246 • Hill AFB, Utah • (801) 777-4681

27. Idaho Military Resources • Mary Kelly, Transition Assistance Advisor • (208) 272-4408 • Mary.kelly3@id.ngb.army.mil • Tom Obstarczyk, National Guard Family Assistant • (208) 272-4355       • Thomas.obstarczyk@us.army.mil • Jase Theyer, IDARNG Resilience and Suicide Prevention Program Manager • 208-995-4069 • Jace.theyer@us.army.mil • Kim Cole-Washington National Guard Family Programs • 509 844-1115 • Mary Thomas, Readiness Program Manager, Fairchild Air Force Base • 509-247-7009

28. Online Training Resources • National Center for Post Traumatic Stress Disorder • Veterans Crisis Line • 1-800-273-8255 • Suicide Prevention Coordinator Available at every Medical Center • Army OneSource • Contact Sheila Schumacher for questions and support • “Treating the Invisible Wounds of War” Training

29. Caveats • Don't assume every veteran has deployed. • Clarify if the veteran that deployed saw “hard time.” • Don't assume every veteran has PTSD. • Remember that many veterans are female with many of the same issues. • Resiliency factors for people differ and some veterans may be able to handle readjustment easier than others.

30. Conclusion Lifestyle in the military is very different from that of civilians. There are numerous challenges for veterans who are discharging from the military whether they have seen combat or not. A positive relationship between military, veteran and civilian services is crucial. Memorandums of Understanding (MOU’s) are helpful.