Issues Facing Combat Veterans

1. Issues Facing Combat Veterans

2. Agenda • Virginia Wounded Warrior Program (VWWP) • Population Description • Paradox of Coming Home • Traumatic Brain Injury • Post Traumatic Stress Disorder • Suggestions for Working with Combat Veterans • Resources

3. VirginiaWoundedWarriorProgram The Virginia Wounded Warrior Program (VWWP), in cooperation with the Department of Behavioral Health and Developmental Services and the Department for Aging and Rehabilitative Services, monitors and coordinates behavioral health and rehabilitative services and support through an integrated, comprehensive and responsive system of public and private partnerships. VWWP facilitates these services for Virginia veterans, members of the Virginia National Guard and Armed Forces Reserves (not in active federal service), and their families affected by stress related conditions or traumatic brain injuries resulting from military service. Frederick Clarke Loudoun Arlington Fairfax Warren Shenandoah Alexandria Fauquier Rappa- hannock Prince William Page Rockingham Culpeper Madison Stafford Highland King George Greene Orange Spotsylvania Westmoreland Augusta Charlottesville Bath Caroline Richmond Louisa Albemarle Essex Northumberland Rockbridge Fluvanna Nelson Alleghany Hanover Goochland King William Accomack King & Queen Lancaster Henrico Amherst Buckingham Botetourt Powhatan Middlesex Cumberland Charles City Co. Richmond Matthews Craig Gloucester Lynchburg Appo- mattox New Kent Chesterfield Amelia James Giles Northampton Roanoke Buchanan Bedford Prince Edward Campbell Mont- gomery York Nottoway Prince George Bland Tazewell Dickenson Surry Newport Pulaski Dinwiddie Hampton News Charlotte Franklin Portsmouth Russell Wise Isle Of Wythe Floyd Sussex Lunenburg Wight Norfolk Pittsylvania Smyth Southampton Halifax Virginia Beach Brunswick Washington Carroll Henry Scott Patrick Suffolk Mecklenburg Chesapeake Lee Grayson Greensville

4. Our Military Population • Approx. 1.5 million Active Duty Service Members • More than half of these are 25 yrs. old or younger • More than half are married and/or have children • 100,000 are single parents • 888,000 National Guard and Reserve Members • One third are 25 yrs. old or younger • 60% are married and/or have children • 28% are single parents • 30,000 are dual military couples

5. Our Veteran Population • 21.9 million veterans in the US • 1.5 million are females • 9 million are 65 years or older • 28% of all Americans who die each year are veterans (each month 73,000 WWII, Korea and Vietnam Veterans die) • 823,348 veterans reside in Virginia

6. Current Conflicts • 30,852 U.S. service members wounded in hostile action since the beginning of U.S. military operations in OIF and over 6,300 service members have been killed in Iraq and Afghanistan • Approximately 2.3 million service members have deployed in OIF/OEF/OND since 9/11/2001 • Approximately 600,000 National Guard and Reservists have deployed since the beginning of U.S. military operations in Iraq

7. Everyone is changed by war

8. The Paradox of Coming Home • Combat Zone Responses helped the soldier remain alert, safe and ready • Challenge is to modify these responses for the transition back to civilian life

9. The process of moving from this….

10. To This:

11. Common Transition/Adjustment Responses • Feeling irritable or jumpy • Becoming easily annoyed or frustrated • Feeling numb • Feeling disconnected from friends and family • Experiencing sadness or guilt

12. Common and Normal Transition Responses • Sleeping too much or too little • Being uncomfortable with physical or emotional intimacy • Having intrusive thoughts, flashbacks, or nightmares • Having trouble concentrating or remembering

13. Traumatic Brain Injuries • 28% of all OIF/OEF Troops have been exposed to blasts • Signature wound of these conflicts • Most common- Closed- caused by changes in pressure that cause concussions and contusions. May not exhibit physical wound and therefore go unrecognized • Many overlapping symptoms between TBI and PTSD: FATIGUE IRRITABILITY INSOMNIA COGNITIVE DEFICITS MEMORY PROBLEMS ANGER FRUSTRATION DEPRESSION

14. PTSD Symptoms CriteriaStressor Criterion • Re-experiencing: flashbacks, night-mares, distressing recollections • Avoidance: anything reminding one of the past, detachment, loss of interest • Arousal: hyper-vigilance, startle response, concentration problems, sleep problems, anger

15. Common Coping Strategies for Veterans with Combat Stress, TBI, and PTSD • Alcohol abuse • Weapons as security • Isolation • Yelling, anger, outbursts • Motorcycles/Cars—speed • Overspending • Suicide • approx 6,500 Veterans / year

16. Throwing the Lifeline: Strategies for Helping Link veteran with other combat veterans *support and networking groups *VWWP, WWP, VFW, AL Help veteran think about setting new career goals (perhaps based on MOS) Help veteran connect to appropriate resources

17. Suggestions for Working with Combat Veterans If needed reassure the veteran/service memberthat they are home (particularly helpful in crisis settings) Show respect and appreciation for their military service Do not share your personal views on war or politics Connect the veteran/service member with other veterans-help them develop a peer support network

18. Suggestions (cont) Avoid use of labeling (“you must have PTSD”) Do not say you understand what they have experienced unless you have experienced combat yourself Involve the veterans primary support system Long term- recognize importance in discussing grief and survivors guilt and the impact of experiences on the veteran’s spirituality and belief system Refer to other professionals as appropriate

19. Resources • Virginia Wounded Warrior Program: www.wearevirginiaveterans.org • Center for Deployment Psychology : www.deploymentpsych.org • National Center for PTSD : www.ptsd.va.gov • Defense and Veterans Brain Injury Center: www.DVBIC.org • National Resource Directory for Wounded Warriors, Veterans and Service Members : www.nationalresourcedirectory.org

20. Our community, our strength!