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FACTS AND STATISTICS REGARDING THE NEEDS OF LONG ISLAND VETERANS. VETERANS HEALTH ALLIANCE OF LONG ISLAND John A. Javis Director of Special Projects (MHA Nassau County) PHONE: (516) 489-2322 ext. 1101 E-MAIL: jjavis@mhanc.org.

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VETERANS HEALTH ALLIANCE

OF LONG ISLAND

John A. Javis

Director of Special Projects

(MHA Nassau County)

PHONE: (516) 489-2322 ext. 1101

E-MAIL: jjavis@mhanc.org

Exploratory Committee

what is your personal level of involvement
WHAT IS YOUR PERSONAL LEVEL OF INVOLVEMENT?
  • You are a veteran yourself?
  • You know someone currently serving / recently served in the military?
  • You have family ties to the military?
  • You are a concerned practitioner who sees this an important issue?

Exploratory Committee

new york state military perspective
NEW YORK STATE MILITARY PERSPECTIVE
  • 950,000+ Veterans in NYS
  • NYS has the 5th largest population of veterans in the U.S.
  • Since October 2001, approximately 85,000 troops have returned to the New York Area

Exploratory Committee

li veterans overview
LI VETERANS OVERVIEW
  • 152,000+ Veterans on Long Island
  • Suffolk slightly higher than Nassau
  • Long Island is 2nd only to San Diego in the % of veterans it has in its population.
  • About 6,000 LI residents have served in Operation Enduring Freedom (OEF) / Operation Iraqi Freedom (OIF) / Operation New Dawn (Peacekeeping Operations in Iraq)

Exploratory Committee

long island military perspective
LONG ISLAND MILITARY PERSPECTIVE
  • No Active Duty Military bases on Long Island (Therefore no access to “on base” services / No strong military “culture”)
  • Area saw a 35% increase in military enlistment following 9/11.
  • High level of Guard / Reserve members
  • Guard / Reserve Units have played a major role in OEF / OIF. (at certain points in time, Reserves total 40% of forces)
  • Guard / Reserves have sustained 50% of casualties in OIF.

Exploratory Committee

reluctance to seek help
RELUCTANCE TO SEEK HELP
  • Veterans openly admit to not being honest on post-deployment mental health surveys. (Give false answers so they “get home”.)
  • VA Committee on Post-Traumatic Stress Disorder admitted, “No one seems to expect them to answer truthfully”.

Exploratory Committee

reluctance to seek help capella study
RELUCTANCE TO SEEK HELP (Capella Study)
  • (1) Concern about negative impact on military career.
  • (2) No help was offered me.
  • (3) No one with combat experience available to help me.
  • (4) Concern loved ones would “lose respect for me”.
  • (5) Not enough access to community mental health resources.

Exploratory Committee

is this war different from others regarding ptsd
IS THIS WAR DIFFERENT FROM OTHERS REGARDING PTSD?
  • CIVIL WAR: “Soldiers Heart”
  • WORLD WAR I: “Shell Shock”
  • WORLD WAR II: “Battle Fatigue”
  • VIETNAM: “Combat Stress” / PTSD becomes diagnosis in 1980
  • Can’t compare Vietnam PTSD (some untreated 20+ years) with OEF / OIF PTSD (who may be treated within days.)

Exploratory Committee

other factors related to oef oif
Other Factors Related to OEF / OIF
  • WORLD WAR II: A long war, obviously world-wide struggle – mostly everyone involved. Large # of veterans returning. Returning by ship allows time to “decompress”. GI Bill. Growth of America
  • VIETNAM: Political unpopularity of the war, Policy of a 1 year tour, Veterans not well received upon return home, Return home by jet plane.

Exploratory Committee

other factors
Other Factors
  • GULF WAR I: War fought, for the most part, “at a distance”, technology reigns, short duration.
  • OEF / OIF:
  • > Same people (about 2 million) / Units keep being re-deployed.
  • > Insurgency
  • > Urban Warfare
  • > IEDs
  • > Instant Communication / Cell Phone / Internet

Exploratory Committee

mental health in the combat zone
MENTAL HEALTH IN THE COMBAT ZONE
  • 13 - 17% of soldiers deployed to Iraq / Afghanistan are taking some form of medication for stress, anxiety, depression or sleeplessness.
  • This would not have been done in earlier wars.
  • 2004 New England Journal of Medicine reported that 11% of recruits had a psychiatric history before entering the military.
  • Increase in “waivers” from 5% in 2004 to 11% (leading up to the surge) for issues like marijuana possession, DUI, misdemeanors and felonies.

Exploratory Committee

transition issues
TRANSITION ISSUES:
  • Generally poor preparation for transition from “combat” environment to “civilian” life.
  • No communication from state VA to local VSA that a veteran is returning home.
  • Unfortunately, due to this lack of communication, veterans can wind up “in crisis” before seeking help
  • Aforementioned multiple deployments, particularly of Guard / Reservists causes multiple transitions

Exploratory Committee

traumatic brain injury
TRAUMATIC BRAIN INJURY
  • The Iraq and Afghanistan Veterans of America estimates that between 150,000 – 300,000 OEF / OIF veterans have a Traumatic Brain Injury
  • FEB. 2007: Documentary of ABC News Anchor Bob Woodruff who suffered a Traumatic Brain Injury in Iraq
  • At Walter Reed Army Medical Center, 30% of wounded soldiers also have TBI

Exploratory Committee

considerations for treatment of tbi
CONSIDERATIONS FOR TREATMENT OF TBI
  • Dr. Maria Mouratadis (Presentation at Veterans Health Alliance January 2010)
  • Early in wars more 19 years olds were being treated, later in wars, with heavier use of Guard / Reserves, more 30 years olds being treated.
  • 3 months seems to be a critical point for recovery, symptoms getting worse, or staying the same.
  • High divorce rate 1 year after injury.
treatment of tbi
TREATMENT OF TBI
  • Suicide and TBI –Common question to ask is “Do you have a plan?” People with brain injuries often cannot plan! – Also can be impulsive.
  • Need to alter approach – Exposure Therapy and Stress Debriefing are contraindicated for TBI. – May need to alter approach – not 1 hour session, three 20 minute sessions.
  • Expectation of Recovery
  • “Of course I’m having nightmares, but they’ll get better”.
4 common factors
4 COMMON FACTORS
  • 4 issues commonly seen together:
  • TBI
  • PTSD
  • Chronic Pain
  • Alcohol Abuse
  • Sometimes as brain “heals” TBI gets worse as brain begins to process the traumatic event.

Exploratory Committee

slide20
SUICIDE RISK DOUBLE AMONG MALE U.S. VETERANS
    • NIMH Study (Dr. Mark Kaplan)
    • Study concluded that those individuals were 2.13 more likely to die of suicide over time then their non-veteran counterparts.
    • VA Admission / E-Mails indicate that 18 veterans a day nationally complete suicide.
    • VA Suicide Hotline based in upstate NY receives between 130 – 140 calls a day.

Exploratory Committee

slide21
HOMELESSNESS

Veterans Comprise 11% of the general population, yet are 26% of the homeless population.

Exploratory Committee

definition of homeless
DEFINITION OF “HOMELESS”
  • (1) Lacks a fixed, regular and adequate nighttime residence.
  • (2) Has a nighttime residence that is:
  • Temporary (Shelter, welfare hotels, transitional housing for those with a mental illness
  • Place not designed or ordinarily used as regular sleeping accommodations for human beings.

Exploratory Committee

slide23
Using this definition: about 5,500 Long Island Veterans would be considered “homeless”.

Exploratory Committee

homeless statistics
HOMELESS STATISTICS
  • About 1/3 of the homeless veterans have served in a war zone.
  • 89% were honorably discharged.
  • 76% have a mental health and / or substance abuse problem. National Coalition for Homeless Veterans
  • Women Veterans have 3.6X the risk of homelessness than their counterparts in the community.

Exploratory Committee

women veterans
WOMEN VETERANS

Higher percentage of women in the military

  • Women make up about 15% of the current force structure and are 11% of the soldiers in Iraq and Afghanistan
  • By 2020 Women Veterans will account for 20% of veterans under the age of 45.
  • 42% of Women Veterans have enrolled in the VA

Some WW II and Vietnam women veterans may not

feel, or realize, they are entitled to VA services

Exploratory Committee

military sexual trauma
MILITARY SEXUAL TRAUMA
  • A 7/08 House panel investigating military sexual assault reported that 4/10 female veterans reported sexual assault.
  • Of female veterans seen at the VA, 37% reported multiple sexual assaults
  • 71 – 90% Report being sexually harasssed.

Exploratory Committee

sexual assault harassment
SEXUAL ASSAULT / HARASSMENT
  • A 2006 DOD study on Sexual Assault reported a 73% increase in incidents from 2004 – 2006.
  • 40% of homeless female veterans report a history of sexual assault
  • 71 – 90% report being sexually harassed

Exploratory Committee

sexual issues
SEXUAL ISSUES
  • New generation of younger female veterans more aware of the issue and more inclined to report.
  • At home mix of soldiers whose wives are deployed, wives whose husbands are deployed – poor judgement of young soldiers
substance abuse
SUBSTANCE ABUSE
  • In combat zone – access to alcohol restricted – in civilian life if it plentiful

Exploratory Committee

substance abuse at ft drum ny
SUBSTANCE ABUSE AT FT. DRUM, NY
  • A 23 year old soldier at Ft. Drum, New York, interviewed by Reuters said, “The first month back, everybody got drunk, pretty much”….”You’ve been gone 15 months and that’s what everybody wants to do”.
heavy drinking
HEAVY DRINKING
  • 2005 Army Survey found that nearly 25% of soldiers described themselves as “heavy drinkers” (i.e. Having 5+ drinks at 1 sitting once a week)
  • 18 – 25 year old Soldiers and Marines are 2X as likely to be “heavy drinkers” than their civilian counterparts.
lack of substance abuse treatment
Lack of Substance Abuse Treatment
  • New Jersey National Guard
  • 37% had “problem drinking”
  • 55% for those with PTSD
  • Of those reporting both, 41% received mental health treatment – only 9% received help for substance abuse.
ny times article after the battle fighting the bottle at home july 8 2008
NY Times Article, After the Battle, Fighting the Bottle at Home (July 8, 2008)
  • “In recent years the military has worked to transform a culture that once indulged heavy drinking as part of its warrior ethos into one that discourages it and encourages service members to seek help”.
homecoming issues maj davina french samhsa conf aug 08
HOMECOMING ISSUES (MAJ. DAVINA FRENCH, SAMHSA CONF. AUG. ’08)
  • While deployed, “Can’t wait to get home and see my kids…….It will be great”. – While deployed in Iraq may have spent a lot of time being around children –
  • When home, veteran may feel “smothered” by their child and pull away – Veteran may be distracted by thoughts of their comrades who are still deployed.
homecoming cont d
HOMECOMING (Cont’d)
  • WHO IS THE “HERO”?
  • Returning veterans may be treated to parades, parties, banners etc. but may not feel “heroic”.
  • May feel that those killed are the “true” heroes.
homecoming transition dan taslitz one freedom samhsa august 08
HOMECOMING / TRANSITION (Dan Taslitz, One Freedom, SAMHSA August ’08)
  • In combat, life is “Either – Or”
  • Either “I’m Safe” OR “I’m in danger – kill”
  • Civilian world is not “Either – Or” (ex. Being insulted by someone is not a “life threatening experience”
  • Sleeping is dangerous in combat zone - how to sleep when home?
marital relational problems
MARITAL / RELATIONAL PROBLEMS
  • 20% of married troops in Iraq say they are planning a divorce.
  • 2/3 of married / cohabiting veterans report some kind of family or adjustment problem
  • 56% of divorced / separated veterans report conflicts involving “shouting, pushing or shoving”.
  • Capella Study: Only 3% of servicemembers felt the typical military family was “very prepared” to help them transition from combat duty.
  • More than 50% felt that families were “not at all prepared” to help with the transition.

Exploratory Committee

children s issues
CHILDREN’S ISSUES
  • 22% of veterans reporting that their child “did not act warmly towards them” or were “afraid of them”.
children cont d
CHILDREN (Cont’d)
  • Adolescents of Army parents deployed in Operation Iraqi Freedom showed higher levels of perceived stress, heart rates and blood pressure (Military Medicine 2007)
children cont d col george patrin samhsa august 2008
CHILDREN (Cont’d) (COL. George Patrin, SAMHSA August 2008)
  • The parent “volunteered” for the military, the child didn’t chose this.
  • Children can “lose their childhood” due to taking on many responsibilities in the home.
  • Children are the “rear detachment”
employment
EMPLOYMENT
  • The Iraq and Afghanistan Veterans of America Report “Careers After Combat”
  • Recently separated veterans earns $10,000 less than civilian counterparts.
  • Female veterans earn $10,000 less than male veterans.
  • Veterans unaware of USERRA Protections
  • Employers unaware of skills of veterans
  • Veterans struggle to translate skills to civilian workforce

Exploratory Committee

employment1
EMPLOYMENT
  • 40% of reservists lose income when they deploy
  • Impact on Veterans Small Business
  • January 2011 – OEF / OIF unemployment around 15% as general population around 9%
  • Senator Gillibrand efforts
  • VHALI Resume Training for ARNG

Exploratory Committee

new gi bill
NEW GI BILL
  • A fantastic benefit covering education, books and living expenses.
  • Covers cost of a state school
  • NYS also as Combat Veterans Tuition Award
  • Beware of recent changes in the new GI Bill which negatively impact NY Veterans using the benefit. (Re-based nationwide benefit to $17,500)

Exploratory Committee

veterans and violence
VETERANS AND VIOLENCE
  • Jan. 2008 New York Times article sensationalized the fact that 121 OEF / OIF veterans committed / charged with murder.
  • Statistically, these veterans had a murder rate of 1.34 incidents per 100,000 veterans per year.
  • For the general population the murder rate is 7.67 per 100,000

Exploratory Committee

capella study what helps
CAPELLA STUDY: What Helps
  • 77% of servicemembers seeking mental health services said the assistance was helpful – with community mental health providers receiving higher rankings than military providers.
  • 87% felt that setting a goal (Degree, new career) was helpful.

Exploratory Committee

what is the veterans health alliance of long island
WHAT IS THE VETERANS HEALTH ALLIANCE OF LONG ISLAND?
  • A collaboration of over 80 mental health and substance abuse providers, county and state mental health and substance abuse oversight bodies, the VA, VET Centers, Veterans Service Agencies, veterans organizations, elected officials, local universities and other stakeholders.
mission of veterans health alliance of long island
MISSION OF VETERANS HEALTH ALLIANCE OF LONG ISLAND:
  • To promote the health and well-being of Long Island Veterans and their families through advocacy, and a wide array of services.
3 workgroups
3 WORKGROUPS:

(1) PROGRAM AND TRAINING

(2) ADVOCACY

(3) OUTREACH

future mental health impact
FUTURE MENTAL HEALTH IMPACT?
  • The day Saigon fell was a “bad day” for Vietnam era Veterans.
  • The day the Berlin Wall fell as a “good day” for veterans.
  • Concern for mental health impact on OEF / OIF veterans if Iraq / Afghanistan “collapses”.
next steps
NEXT STEPS?
  • Are you aware of how many veterans you / your agency are currently serving?
  • What can you do to increase awareness of veterans issues in your agency?
who has my back
“Who has my back”?
  • In Combat, warriors “watch each others back” – when they return to civilian life some wonder, “Who has my back now”?
  • As a community we need to make the veterans aware that “we have their back”!