THE NORTHERN VIRGINIA VETERANS ASSOCIATION PRESENTS MILITARY CULTURE, CONDITIONS & HEALTHCARE RESOURCES

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1 THE NORTHERN VIRGINIA VETERANS ASSOCIATION PRESENTS MILITARY CULTURE, CONDITIONS & HEALTHCARE RESOURCES

2 MAJ Angela McConnell USA/USAFR (Ret) Ph.D.

3 Intent Bring greater understanding and awareness of military culture and related health issues in order for healthcare providers to more effectively and efficiently diagnose, treat, and provide care and guidance for veterans and their families.

4 WHO WE ARE The Northern Virginia Veterans Association is a non-profit that case manages and connects our most vulnerable veterans, at no cost, to a vast system of community and gov t resources addressing needs that affect ones social determinants of health and quality of life.

5 Veteran Quality of Life Cycle(C) One point of entry for local services, resources, personal support, follow-up and care.

6 WHY NOVA VETERANS NOW? We founded the Northern Virginia Veterans Association because no other organization was providing personal guidance through this complex and often confusing web of services. Nationally almost half of veterans surveyed the services and benefits they deserve. didn t know how to get 20 Veterans a day commit Suicide Suicide Affairs). (U.S. Dept of Veterans

7 WHY NOVA VETERAN NOW? It s time to... address these unmet needs and support our underserved veterans provide the compassionate support and comprehensive guidance our veterans deserves coordinate the excellent services available across the region It s time for our veteran community to enjoy the collective impact that service organizations working together can provide

8 SUMMARY NOVA Veterans Assoc provides direct personal support Comprehensive intake to determine priority of needs Advocate for and fill out applications where necessary Coordinate services with vetted service partners Provide warm hand-offs to trusted service providers Follow up to make sure needs were effectively met Promote collective impact in support of our joint veteran mission

9 Objectives of Training 1. Explain military structure & culture 2. Illustrate life on and off the battlefield 3. Delineate common health related issues 4. Describe approaches to care & treatment for Veterans and families 5. Provide federal, state and local Veteran/family resource guidance

10 Why Provide this Training Service members, veterans and their families seek care outside military treatment facilities in the civilian sector. Civilian healthcare providers may not be aware of the military-specific issues surrounding this patient population and the resources available to support them.

11 Military Specific Issues Such As: Invisible Wounds of War Post Traumatic Stress Disorder Sexual Trauma Traumatic Brain Injury Presumptive Conditions Challenges of Reintegration into Civilian Life Family Issues & Challenges: Pre/During/Post Deployment

12 Military Specific Issues Can Manifest As: Signs, Symptoms, Behaviors: Substance Abuse / Addictions Sleep Disturbances / Nightmares / Night Terrors Detachment / Numbness / Antisocial Anxiety / Stress / Anger /Domestic Violence Depression / Hopelessness/ Suicide Risky Behaviors Homelessness / Financial Hardships

13 Military Structure 101 Army, Navy, Air Force, Marines, Coast Guard Soldier, Sailor, Airman, Marine, Coast Guardsman

14 Military Structure Active Duty Reserve National Guard (State)

15 Military Rank (Army)

16 Service Member Veteran Active Duty Retired Separated Discharged Deployed Mobilized Combat-Related Disability Service-Connect Disability

17 Army Values Loyalty Duty Respect Selfless Service Honor Integrity Personal Courage

18 Reality - Welcome Home?

19

20 Families Sacrifice Too

21 Invisible Wounds of War Post Traumatic Stress Disorder (PTSD) & Traumatic Brain Injury (TBI)

22 Invisible Wounds of War PTSD Signs & Symptoms Insomnia, Nightmares, Night Terrors Depression, Crying Anxiety Substance Abuse (alcohol, drugs, medications) Antisocial, Numb, Detached Quick Tempered, Angry, Stressed Hyper-vigilance, Over Reaction Intrusive thoughts / Flashbacks

23 Operation Iraqi Freedom (OIF) Operation Enduring Freedom (OEF) 2.1 Million Deployed to Iraq, Afghanistan Source: Department of Veteran Services 20% Have PTSD Substance Abuse, TBI Suicide Risk, Depression Only 30% of Those Get Mental Health Care Though Most Acknowledge Having a Problem

24 U.S. Dept of Veterans Affairs National Center for PTSD PTSD: National Center for PTSD Consultation (866) or

25 Trauma: Definition Threatened or actual death or threat physical integrity to Response must involve helplessness or harm intense fear, Within the military, combat and sexual can produce PTS/D trauma PTSD Stories

26 Traumatic Brain Injury: Signs & Symptoms Headache or neck pain that doesn t Light-Headiness, dizziness or loss of Urge to Vomit Loss of sense of smell or taste subside balance Increased sensitivity to lights, sounds, distractions Ringing in the ears, blurred vision Difficulty remembering or making decisions Slowness in thinking, speaking, acting or reading Getting lost or confused & feeling tired

27 Sleep Soldiers' Stories on Sleep 15,204 Service Members Pre-Deployment short sleep cycles predicted PTSD/Anxiety Post Deployment (2013)

28 Traumatic Brain Injury: Definition Condition caused by sudden trauma, such as a jolt to the head that disrupts normal function of the brain.

29 Presumptive Conditions

30 Military Related Conditions

31 Presumptive Conditions Exposure Categories

32 Presumptive Conditions VA Exams & Registries s/coordinators.asp

33 NOVA Veterans Intake Questions Are you or have you been in the military service? Have you been deployed or in an environment that may have affected your physical, mental or emotional health? (e.g., exposure to burn pits, agent orange, bombings, direct fire, death, injury, high stress)? If the answer is yes to second question you can offer a post traumatic stress self-report questionnaire (PCL-M or PCL-5) and/or traumatic brain injury assessment (DVBIC TBI Screening Tool). Or depending on your profession, assessment and scope of practice. You may refer them to a provider or service that can support as indicated. PTSD/TBI Quick Facts

34 NOVA Veterans Intake Questions Are you a direct family member (spouse, child, parent, caregiver) of someone currently in or that has been in the military service? Do you feel like your health has been significantly affected by their military service, if so in what ways? They may have healthcare needs that require further action and /or want additional information on resources or support specifically for family members (provided). They may feel their spouse, family member or friend needs support you can refer them to NOVA Veterans Association, Crisis Line (press 1), or Dept Veteran Services Virginia Wounded Warrior Program.

35 Additional Resources & Training Defense Centers of Excellence for Psychological Health & TBI: Education Portal Virginia Dept of Veterans Services: Northern Virginia Veterans Association: Public Health Registries & Resources Defense and Veterans Brain Injury Center

36 I I I I I I I I Soldiers Creed am an American Soldier. am a warrior and a member of a team. serve the people of the United States, and live the Army Values. will will will will always place the mission first. never accept defeat. never quit. never leave a fallen comrade. am disciplined, physically and mentally tough, trained and proficient in my warrior tasks and drills. I always maintain my arms, my equipment and myself. I am an expert and I am a professional. I stand ready to deploy, engage, and destroy, the enemies of the United States of America in close combat. I am a guardian of freedom and the American way of life. I am an American Soldier.

37 Life After Deployment

38 Take-Aways & Tools Insight into military culture and life Know if your patient is a veteran or family member - signs & symptoms to consider Understand invisible wounds of war and how to assess & provide follow-on care/support Understand presumptive conditions and associated VA public health registries Know where to go for additional resources Know where to guide your Veteran/Family Member for additional resources & support

39 References Virginia Department of Veteran Services Virginia Wounded Warrior Program Brain Line Defense Centers of Excellence for Psychological Health & Traumatic Brain Injury Veterans Health Administration, 2013 Institute for Policy & Governance, & Dukenberger, 2010

40 Angela H. McConnell, PhD USA/USAFR MAJ (Ret) Q Integrative Healthcare Consulting, LLC Angela@IntegrativeHealthVA.com

41 Thank You For Supporting Your Local Veterans & Families