“LESSONS LEARNED” NEW JERSEY VETERANS HELPLINE 1-866-VETSNJ4… YOU! (1-866-838-7654) A Partnership of UMDNJ- UBHC & NJ DMAVA
NEW JERSEY VETERANS FOR YOU HELPLINE AT UMDNJ-UBHC • Is answered 24 /7 by Veteran/Peer clinical staff & counselors with military expertise • A “Vet to Vet” experience, it is confidential, free, and available to meet your needs • New Jersey soldiers and their families receive telephone peer counseling, clinical and suicide assessments as needed, referrals to veteran mental health treatment and customized resources available through NJ Department of Military & Veterans Affairs
NEW JERSEY VETERANS HELPLINEServices Include: • “Veteran to Veteran” Peer Support • Telephone Counseling • Veteran Clinical Assessments • Triage - Veteran Service Offices Resources • Referrals to providers with military expertise • Crisis Support/Field Activity • Vietnam Veterans Support Group Meetings • Family Support & Liaison activity
New Jersey Veterans HelplineCALL HISTORY- 2005- 2008 Total calls : 5,637/8,882 Service Requests Call backs by Veteran/Peer Counselors: 3,324 Telephone Counseling /Treatment Requests: 1,564 2009 (6 MONTHS)TOTAL CALLS/CONTACTS = 7,358 FIELD/GROUP CONTACTS = 5,391 CALLS & TELEPHONE COUNSELING = 1,050 60-70% OEF/OIF Gender – 70% male; 24% female; 6% unknown
FIELD ACTIVITY SUMMARY RECONSTITUTIONS/DEPLOYMENTS • UBHC Veteran staff participated in 58 Reconstitutions - 2005 - 2008 • As a result approximately 175 veterans in therapy • Increase in 1:1 and group field activity highlighted our team in 2008 • 2009 selected to be “Lead” in NJ DMAVA PTSD Task Force • “Lead” in Welcome Home 1:1 sessions for Reconstitution of approx. 2,400 soldiers
“WELCOME HOME” RECONSTITUTION STATISTICS June 1, 2009 to June 16, 2009 • Number of Soldiers Interviewed 2,408 • Number of Volunteers 206 • Number of Veterans Needing Appointments Immediately 18 • Follow-Up Forms Completed 199
“WELCOME HOME”CLINICAL ISSUES • ANGER • ANXIETY • DEPRESSION • ANGER • READJUSTMENT ISSUES • MARRIAGE/FAMILY ISSUES • EARLY STAGES OF PTSD • MULTIPLE DEPLOYMENTS • REDEPLOYMENT ISSUES SUCH AS: FINANCES, JOB, HOME, ETC.
“WELCOME HOME”VOLUNTEER COMMENTS • It was an experience I will not soon forget. Hopefully the National Guard members got as much out of the experience as I did. • It was a wonderful experience. It was important to see the faces behind the story; those that have gone where most of us cannot imagine. • It was one of the best volunteer experiences of my life. I felt very proud to be a part of the endeavor to help the returning veterans.
“WELCOME HOME”VOLUNTEER COMMENTS • This was such a great experience for me that I would like to continue doing every chance I get. I loved the connection I made with some of the soldiers and it made me feel better knowing that I did a little to help. Some of them just needed a little time and someone to listen. I think it’s a great program that does great things for our soldiers. • It was a heart felt experience. Being one of the first few people to welcome back the veterans, to give them time to discuss their personal experience in Iraq and to be able to offer them the help/assistance they identified was very rewarding. The veterans that sat with me made me very proud of their commitment and you gave me the opportunity to tell them so • The camaraderie, professionalism was heartwarming and endearing. I had a fantastic experience. It was immensely rewarding and I wanted to extend a thank you to everyone there • LESSON LEARNED – GRATITUDE/COMPASSION
60-DAY REINTEGRATION PROGRAM Yellow Ribbon Committee 60-Day Reintegration Project SAMPLE AGENDA • 8:00 a.m. – 9:00 a.m. 500 – Registration – Logistics Team & Yellow Ribbon Staff • 9:00 a.m. – 10:15 a.m. 250 – Large Group Briefing - Dr. George Everly 250 – Breakout groups for New Jersey Veterans Administration/NJDMAVA Post Deployment Survey Distribution – Anna Kline & Team • 10:15 a.m. – 10:30 a.m. 15 Minute Break • 10:30 a.m. – 11:45 a.m. Groups switch 250/250 • 12:00 – 1:00 p.m. 500 – Lunch (12:15 p.m.) (Team Briefing – Logistics & Details) Small Group Break Out Sessions • 1:00 p.m. – 1:15 p.m. Introductions • 1:15 p.m. – 2:00 p.m. Anger Management – 15 minute didactic & 15 minute Q & A • 2:00 p.m. – 2:45 p.m. Substance Abuse – 15 minute didactic & 15 minute Q & A • 2:45 p.m. – 3:00 p.m. 15 Minute Break • 3:00 p.m. – 3:45 p.m. PTSD/Compulsive Behavioral – 15 minute didactic & 15 minute Q & A • 3:45 p.m. – 4:00 p.m. Evaluations/Certificates distribution and collection
DATES & LOCATIONS • Saturday, September 12, 2009 Team A 8:30 AM 4:00 PM • UMDNJ – 675 Hoes Lane, Piscataway • Sunday, September 13, 2009 Team B 8:30 AM 4:00 PM • East Orange VA – 385 Tremont Avenue, East Orange • Saturday, September 19, 2009 Team C 8:30 AM 4:00 PM • UMDNJ – 675 Hoes Lane, Piscataway • Sunday, September 20, 2009 Team D 8:30 AM 4:00 PM • UMDNJ - Stratford Campus
DEFINITIONS REINTEGRATION: The time when the service member eases his/her way back into a routine and returns to the day-to-day civilian life. To avoid upsetting the balance established during the service member’s absence, the veteran must slowly work his/her way back into the family. 30, 60 & 90 day events will support soldier and his/her family as a follow-up
DEFINITIONS MOS- Military Occupational Specialty OIF- Operation Iraqi Freedom OEF- Operation Enduring Freedom LOD- Line of Duty NJDMAVA-New Jersey Department of Military & Veterans Affairs FAC- Family Assistance Centers VSO- Veteran Service Organization
WHO ARE YOU SERVING?New Jersey National Guard –OIF/OEF WARRIOR SPIRIT-Acknowledge it! An intensity of life filled with energy and readiness to act when needed protecting one’s family, neighborhood, nation and world. A total willingness to stand up for what is right with a sense of duty greater than one’s own need. Charles Lewis Arnold, MS, BCPC, CTM, CTSS (ret. Master Sergeant, United States Marine Corps and New Jersey Army National Guard)
“The 60-Day Reintegration” is a Large/Small Group Experience • Goal: Focus on resiliency and normalizing experiences • Decrease stigma And increase chance Veteran will disclose any concerns • Primary team of Veterans, clinicians & peers • Encourage discussion/sharing • Engage, psycho-education, dialogue • Encourage utilization of support services • Reinforce gratitude for service
WHAT YOU ARE DOING… • Volunteering to support our troops as a member of the UBHC-UMDNJ team lead by the New Jersey Veterans Helpline Staff by genuinely sharing your gratitude for their service • Providing psycho educational information through small group didactics and discussion • Asking them how they feel as they adjust to returning home…… Thanking them whenever possible
STEPS OF THE “60-DAY REINTEGRATION” • 12:15 Team Briefing • 1:00 Begin Small Group Program • Utilize PowerPoints as “Guides” • Avoid Scripting • Provide Didactic • Prompt Discussion • Offer Resources/Follow Up
WHAT IS YOUR GOAL? • Share gratitude for service • Normalize experiences • Review materials- psycho education, discussion • Ensure service to those in need • Explain confidential resource in NEW JERSEY VETERANS HELPLINE • Reinforce resiliency and hope
WHAT YOU ARE NOT DOING • A clinical/psychosocial assessment • A crisis /acute screening assessment • An informal conversation • A rigid or scripted series of questions • Medical assessment of any kind • Referral to specific providers • An inquiry to explore military life
LESSONS LEARNED • NJ Veterans Helpline data reflects trends in service needs and caller reporting of symptoms • VA/NJDMAVA study reflects specific information regarding the troops pre-deployment • National PTSD resources and Military resources have offered solutions to meet soldiers behavioral healthcare needs
WHAT HAVE THEY TOLD US?New Jersey National Guard –OIF/OEF Veterans Helpline Callers Clinical Issues • Depression/Mood Disorder • Anxiety/Phobias • Medical/Somatic Complaints • Marital/Couples • Post Traumatic Stress Disorder • Family/Parenting Issues • Substance Abuse • Aggression/Violence • Recent Loss • Suicidal Thoughts
WHO IS OUR “HIGH RISK” CALLER? • 65% counseling requests- OIF/OEF • Anxiety, depression present in most cases • Anger was present in majority of cases. Anger varied depending on the unique situation with each soldier. Multiple deployments a theme • Sleep disturbances reported frequently • Long hours /difficult schedules a cause, others report anxiety related to fear of harm etc. • Flashbacks and reaction to loud noisescommon • 2009 Calls = Anger
Military Families & New Jersey Veterans Helpline Primary Diagnosis/Complaintwith Parenting/Family Issues Depression 93%Anxiety 91%Aggression 89%Marital/Family 68%Violence 27%
MILITARY POPULATION TREATMENT RESISTANCE • Efforts to minimize distress may be based in desire to hasten discharge, quicken return to family, avoid compromising military career or retirement and in response to realistic fears about impact on career prospects. • Lessen risk through prevention of: • Family breakdown • Social withdrawal and isolation • Employment problems • Substance abuse • Stress Confidentiality
MILITARY SUICIDE INFORMATIONStatistics 2007 (Violanti) 89 confirmed suicides in 2007 with an additional 32 deaths being investigated (U.S. Army Figures) • 2,100 suicide attempts in 2007 • 350 suicide attempts in 2002, the year before the war in Iraq began • 5 attempts per day • Multiple deployments a risk
“You are greater than you know” Mother Theresa
Overview of the Health Needs Assessment Survey of the New Jersey National Guard 2007-2009 Department of Military and Veterans Affairs VA New Jersey Health Care System Bloustein Center for Survey Research, Rutgers University
Purpose and Methods Purpose Methods • To assess the mental and physical health effects of deployment to Iraq and Afghanistan on members of the New Jersey National Guard • To use the information to assist DMAVA and the VA in planning for the health service needs of returning veterans • Anonymous, self-administered surveys distributed to Guard members before and after deployment to Iraq • Questions focus on: • mental and physical health • combat experiences • access to treatment • A total of 2,543 useable pre-deployment surveys were collected • Follow-up survey will be conducted at 60-day reintegration
History of Previous Deployments to Iraq and/or Afghanistan • First deployment: 75% • At least one previous deployment: 24.9% • More than one previous deployment: 2.9%
Mental Health Problems by Number of Previous Tours All values significant at p=.000
Proportion Treated in Last Year Among Previously Deployed Troops with Mental Health, Substance Use and Health Care Problems Note: substance use treatment was measured for those with alcohol dependence,mental health treatment for those with PTSD and medical care for those with chronic, intense pain.
Symptom Screening and Reporting Among Those with PTSD NOTE: Questions about screening and symptom reporting refer to post-deployment briefing only.
Clinical Implications Veterans with mental health problems are at higher risk for physical health problems as well as for family and financial problems Stigma is a serious barrier to veterans reporting and seeking treatment for mental health and substance abuse problems Alcohol problems are rarely treated and may require intensive outreach to impaired veterans