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Guiding Vets and Active Military to Supportive Services Joe Qualls, US Army Veteran/OIF3 Kendra Brandstein , PH.D., MPH, MSW. The presentation will begin shortly This webinar is being recorded for future use .

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Guiding Vets and Active Military to Supportive ServicesJoe Qualls, US Army Veteran/OIF3Kendra Brandstein, PH.D., MPH, MSW

The presentation will begin shortly

This webinar is being recorded for future use.

Funds for this webinar were provided by the U.S. Department of Health and Human Services (HHS), Health Resources and Services Administration (HRSA) with the American Recovery and Reinvestment Act (ARRA) funding for the Retention and Evaluation Activities (REA) Initiative.

This webinar is being offered by the San Francisco Community Clinic Consortium and the California Statewide AHEC program in partnership with the Office of Statewide Health Planning and Development (OSHPD), designated as the California Primary Care Office (PCO).

guiding veterans to supportive services

Guiding Veterans to Supportive Services

Kendra Brandstein, PH.D., MPH, MSW

Joe Qualls, US Army Veteran/OIF3

  • 2.2 million have served in Iraq & Afghanistan
  • 50% percent of eligible vets report having mental health problems
  • Family members are dealing w/ deployment related issues

U.S. Department of Veterans Affairs

the issue
Veterans and mental health services

Approximately 23 veterans a day take their lives.

One active duty service member commits suicide a day. That is 8,395 of our heroes.

Of the veteran’s eligible for services approximately only 51% use the eligible services and benefits.

The Issue
mental health diagnosis data
Mental Health Diagnosis Data

High incidence of the following in our 625,384 Eligible OEF/OIF Veterans at the VA:

  • PTSD
  • Depressive and neurotic disorders
  • Affective Psychoses
  • Substance abuse
  • Suicide

U.S. Department of Veterans Affairs

the affects of mental health
The Affects of Mental Health
  • The challenges are enormous and the consequences of non-performance are significant.
    • Reported psychological symptoms:
      • 38% of Soldiers
      • 31% of Marines
      • 49% National Guard
    • Furthermore, psychological concerns are significantly higher among those with repeated deployments, a rapidly growing cohort.
    • These Figures only include self reported. Many more undiagnosed and untreated!

(Report of the DoD Task Force on Mental Hlth June 2007)

our purpose

Our Purpose

Learn about mental and behavioral health Recognize signs and symptoms

Identify local resource

the issue1
The Issue
  • One suicide a day for the past year
  • 23 suicides a day (national)


Death of unit member 48.6% 73.4%

Shooting at enemy 29.6% 78.5%

IED exploded near them 32.8% 62.4%

Responsible for death of 8.3% 48.4%


military culture 101
Military Culture 101
  • The military is a distinct sub-culture in the United States with its own:
      • Rituals
      • Traditions
      • Oaths and Pledges
      • Hierarchy
military 101

Air Force


Coast Guard




Active Duty

Nat. Guard




Core Values

Military 101
what is ptsd
What is PTSD?
  • Anxiety disorder that changes the body's response to stress
  • Can occur after a traumatic event
  • Psychological, genetic, physical, and social factors are involved
  • The cause is unknown

U.S. Department of Veterans Affairs

events that lead to ptsd
Events that lead to PTSD
  • Multi-casualty incidents
    • (Suicide Bombers, VB/IEDs, ambushes)
  • Aftermath of battle
  • Handling human remains
  • Witnessed or committed atrocities (Societal Constructs)
  • Feeling/being helpless to defend or counter-attack
  • Moral Injury
signs and symptoms of ptsd
Signs and Symptoms of PTSD
  • Re-experiencing the traumatic event
  • Avoiding reminders of the trauma
  • Increased anxiety and emotional arousal
  • Nightmares
  • Numbing
  • Isolation
treatment of ptsd
Treatments include:

Cognitive therapy

Exposure therapy



Group therapy

Family therapy

Treatment lasts 3-6 months

If multiple disorders can last up to one year

Treatment of PTSD
barriers to care
Barriers to Care
  • 1 out of 5 people say they might not get help because of what other people might think
  • 1 out of 3 people say they would not want anyone else to know they were in therapy
  • VA System
  • Insurance
  • Military Culture

US Department of Veterans Affairs

resources for ptsd help
Resources for PTSD Help
what is tbi
Traumatic Brain Injury (TBI) is a complex injury with a broad spectrum of symptoms and disabilities.

Does not heal like other injuries. Recovery is a functional recovery, based on mechanisms that remain uncertain.

US Department of Veterans Affairs

What is TBI?
what is tbi1
What is TBI?
  • Individuals with severe injuries can be left in long-term unresponsive states.
  • Change in brain function can have a dramatic impact on family, job, social and community interaction.
classifications of tbi symptoms

Loss of consciousness and/or confusion and disorientation is shorter than 30 minutes

MRI and CAT scans normal

Headache, difficulty thinking, memory problems, attention deficits, mood swings and frustration


Loss of consciousness for more than 30 minutes

Memory loss after the injury or penetrating skull injury longer than 24 hours.

Limited function of arms or legs, abnormal speech or language, loss of thinking ability or emotional problems

American Speech-Language Hearing Association

Classifications of TBI Symptoms
treatment for tbi
Treatment for TBI
  • Imaging tests
  • Rehabilitation
  • Making sure enough oxygen is going to the brain
  • Little can be done to reverse the trauma to the brain.
  • Require immediate medical attention (unlikely)
resources for tbi help
Resources for TBI Help
    • This website focuses on sharing brain injuries with others.
how are ptsd and tbi alike
How are PTSD and TBI Alike?
  • The affects of PTSD and TBI are very similar
    • Increased anxiety and emotional arousal
    • Difficulty sleeping
  • TBI doubles the risk of a solider experiencing PTSD.
  • There is no cure for PTSD or TBI, but TREATMENT is a MUST
what is depression
What is Depression?
  • Medical condition that affects physical and emotional health
  • Can be a result of biological or cognitive factors
    • Result of substance misuse
    • Other physical and psychological issues
    • Combat experience
    • Trauma

US Department of Veterans Affairs

signs and symptoms
Signs and Symptoms
  • Experiencing the following:
    • Sadness, restlessness
    • Lack of interest, energy
    • Difficulty sleeping or oversleeping
    • Extreme fluctuations in appetite
    • Weight gain/loss
    • Problems concentrating, remembering or making decisions
    • Having thoughts of death or hurting oneself
what to do
What to do
  • Help guide them towards seeking treatment
  • Provide Support
  • Take care of themselves
  • Can include:
    • Medication
    • Psychotherapy
    • Combination of medication and therapy
  • DoD at or telephone 877-877-3647.
  • Department of Veterans Affairs at
  • Military Pathways at
what is self medication
What is Self-medication?
  • Drugs or alcohol as treatment for disorders/traumas that may otherwise be treated by established medical methods
  • Temporary relief from issues but results in further development of the underlying problem

US Department of Veterans Affairs

what can you do
What can you do?
  • Educate yourself about the various mental health disorders
  • Listen
  • Understand
  • Encourage those affected to seek help
  • Be Supportive!
  • Local Community Clinics
  • Veterans Village of San Diego
  • Vet Center (specifically for combat vets with MST and PTSD ONLY)
    • Locations
      • Chula Vista
      • Liberty Station/Point Loma
      • San Marcos
  • 211 Information Line
  • VA
  • American Speech-Language-Hearing Association
  • County of SD HHS: Overview of Services for Military, Veterans, and Families
  • Global Security
  • Report of the Department of Defense Task Force on Mental Hlth June 2007
  • U.S. Department of Veterans Affairs
    • VA Forum:
contact information
Contact Information

Kendra Brandstein

619 862-6601 and

Joe Qualls