Enhancing Resilience in the Deployed Force

Transcription

1 Enhancing Resilience in the Deployed Force MG Vincent K. Brooks and CSM Jim Champagne Commanding General and Division CSM 1 st Infantry Division and United States Division-South

2 USD-S CSF Tri-Fold (Front) Pillars of Comprehensive Soldier Fitness Physical Performing and excelling in physical activities that require aerobic fitness, endurance, strength, healthy body composition and flexibility derived through exercise, nutrition, and training Emotional Approaching life s challenges in a positive, optimistic way by demonstrating self control, stamina and good character with choices and actions. Social Developing and maintaining trusted, valued relationships and friendships that are personally fulfilling and foster good communication including a comfortable exchange of ideas, views and experiences. Spiritual Strengthening a set of beliefs, principles or values that sustain a person beyond family, institutional and societal sources of strength. Family Being part of a family unit that is safe, supportive and loving and provides the resources needed for all members to live in a healthy and secure environment. USD-S Resiliency Campus Resources Cross-Fit Gym Nutritional Counseling Master Fitness Trainers Body Fat Analysis Metabolic Rate Analysis Wii Fit Fitness Literature Biofeedback Training Massage Chairs Unit Behavioral Health Advocate Training Sleep Hygiene Techniques Anger Management Techniques Smoking Cessation Classes Behavioral Health Literature EO Office DSARC Office Sexual Assault + IG literature MWR events Sumo Suits I. A.M. Strong Literature Counseling and Spiritual Guidance Meditation Room Chaplain Office Religious Literature SPAWAR Center with Private Booths Referrals for Counseling Marriage Strengthening Literature USD-S Resiliency Campus Located in Trenchard Lines behind the Basrah USO NCOIC: SFC James Padilla james.j.padilla@iraq.centcom.mil DSN: Chaplain Classroom CrossFit Gym Emotional Room Physical Room Equal Opportunity/ DSARC USD-S RESILIENCY CAMPUS PHYSICAL FAMILY SOCIAL SPIRITUAL EMOTIONAL Reception Desk:

3 Pre-Deployment USD-S CSF Tri-Fold Table of (Train-Ready / Contents Available) Behavioral Health Training Program Battalion Master Resilience Trainer Company Unit Behavioral Health Advocate Platoon ASIST Gatekeepers Squad Resilience NCO Prescription Medication Analysis and Reporting Tool (PMART) Pre-deployment Resilience Training (formerly Battlemind) Victory Resilience Program FRKS Resiliency Campus Periodic Health Assessment (PHA) Pre-deployment Health Assessment (PDHA) Chaplain Programs Strong Bonds Spiritual Fitness Events Family/Social Programs BOSS Warrior Zone Kansas State Band Mentorship Military Child Education Coalition Resilient Spouse Academy Deployment USD-S Resiliency Campus Physical Resilience Nutritional Counseling Body Fat Analysis Metabolic Analysis Smoking Cessation Relaxation Techniques Emotional Resilience Tele-Behavioral Health Suicide Risk Management Teams Anger Management Classes Deployment Resilience Training Family/Social Resilience Big Red One Society Against Sexual Assault (BRO-SASA) Family Readiness Groups Resilient Spouse Academy Spiritual Resilience Care for the Caregiver Seminars Motivational Speakers Victory Strong Program Deployment Behavioral Health Risk Assessment (DBHRA) Sharepoint Anonymous Help Line Comprehensive Soldier Fitness Training Modules Unit Leader Guides Post-Deployment (Reset / Reintegration) Identification of High-risk Behaviors and Individualized Mitigation Efforts model for Reintegration and Leave Comprehensive Behavioral Health System of Care (CBHSOC) Screening Post-Deployment Health Assessment (PDHA) Post-Deployment Health Re-assessment (PDHRA) 100% MFLC Contact (Victory Resilience Program) for Soldiers and Family Post-deployment Resilience Training (formerly Battlemind) Ringneck Ranch Warrior Adventure Quest Theater of War Seminar Entrepreneurship Boot Camp for Veterans (EBV)

4 Questions? NO MISSION TOO DIFFICULT, NO SACRIFICE TOO GREAT. DUTY FIRST! For more information, visit:

5 Train-Ready / Available

6 Behavioral Health Training Program An enormous amount of effort has been dedicated to developing BH programs, specifically in the realm of suicide prevention. Despite this, the suicide rate continues to increase and Soldiers at the platoon and squad level are still encountering significant stigma. As a result, they often do not seek help from BH professionals or Chaplains. Buddy aid is becoming more and more important, yet many Soldiers do not feel prepared or trained to help one another. In response, USD-S and 1ID has created a unified training and assessment program in order to better provide for the BH needs of our Soldiers. Each BDE will have at least one MRT in the grade of O-3 or above. Each BDE will maintain at least two ASIST Trainers. Each BN will have at least one, but preferably two MRTs in the grade of E-6 or above. Each BN will identify one lead UBHA, E-6 or above. Each Company will maintain at least two UBHAs, E-4 or above. Each platoon sized element will have at least 5% of its formation trained in ASIST and assigned as Gatekeepers. All units will nominate one member from each squad sized element to serve as the Squad Resilience NCO. Train-Ready / Available

7 Prescription Medication Analysis Reporting Tool (PMART) The Prescription Medication Analysis Reporting Tool was developed to provide a comprehensive database of medication information to healthcare providers about deploying service members prior to deployment. The database is a menu-driven Microsoft Access application, which is only accessible to the healthcare provider of the deploying unit. PMART provides prescription data from all points of service, it identifies high-risk individuals, assesses for potential alternative medication available in theater, and provides an analysis of drug use for the purposes of refining medication supply lists. By accurately assessing the medication needs of deploying Soldiers, we can ensure that the deployed force is appropriate for the medical capability in theater. Train-Ready / Available

8 CSF Pre-Deployment Modules Provided to our Soldiers prior to deployment in order to assist in setting realistic expectations about their pending deployments. It discusses the nature of combat and operational deployments and provides an overview of what the Soldier might see, hear, smell, think, and feel during these deployments. This module focuses on the self-aid/buddy-aid approach to caring for a battle-buddy and being there for one another, listening to Leaders and trusting in their training. Train-Ready / Available

9 Victory Resilience 100% Military Family Life Consultant contact for Soldiers prior to deployment. The Office of the Secretary of Defense (OSD) Quality of Life Division has contracted with MHN Government Services to manage the Military and Family Life Consultant (MFLC) Program. This program provides non-medical counseling to Soldiers and their Families through outreach, educational presentations focused on behavioral health issues, and individual, couple, Family, and group interventions. These interventions build mental resilience while normalizing the range of reactions that occur as part of the cycle of deployment to combat zones and reintegration with families and communities. MFLCs work in support of and in conjunction with VICTORY RESILIENCE and the installation Army Community Services (ACS). Train-Ready / Available

10 FRKS Resiliency Campus Ft. Riley, Kansas is in the process of developing a stateof-the-art Resiliency Campus built on the successes of the facilities at Ft. Hood and USD-S. We expect to implement lessons learned from the USD-S Resiliency Campus in order to refine the programs and ideas for Soldiers seeking to improve every aspect of their lives. Train-Ready / Available

11 Periodic Health Assessment U.S. Army Chief of Staff Memorandum dated 12 October 2006 and AR , Standards of Medical Fitness, an annual Periodic Health Assessment (PHA) is required for all general officers, officers, warrant officers and enlisted personnel, regardless of component. The PHA is a preventive screening tool designed to improve reporting and visibility of Individual Medical Readiness (IMR) for all Soldiers. Train-Ready / Available

12 Pre-Deployment Health Assessment All DoD personnel (military, civilian, contractor) deploying for greater than 30 days to areas outside the continental United States (OCONUS) with non-fixed U.S. medical treatment facilities (MTFs) must complete a Pre-Deployment Health Assessment Form (DD 2795) in accordance with DoD Instruction , Deployment Health. Train-Ready / Available

13 Chaplain Programs The USD-S and 1ID Chaplaincy offers many programs to help Soldiers improve their Spiritual resilience. Among the many programs offered, Strong Bonds, Care for the Caregiver Seminars, and Spiritual Fitness Events are amongst the most popular. There are also Deployment and Garrison motivational Speakers who present seminars on a variety of topics. Train-Ready / Available

14 Family & Social Programs USD-S and 1ID offers many MWR and ACS programs to its Soldiers and Families. The Better Opportunities for Single Soldiers (BOSS) and Warrior Zone initiatives are extremely popular and allow for healthy decompression and socialization during the Train-Ready and Available phases of ARFORGEN. Supporting the Family Pillar of Strength, the Kansas State University Band Mentorship and Military Child Education Coalition offer additional enrichment opportunities to children. The Resilient Spouse Academy is a 4-day intensive training program on Ft. Riley designed to teach spouses how to be sensors for common problems that arise after deployment. Train-Ready / Available

15 Resilient Spouse Academy The Resilient Spouse Academy is a 4-day intensive training program on Ft. Riley designed to teach spouses how to be sensors for common problems that arise after deployment. Classes include Applied Suicide Intervention Skills (ASIST) training, financial readiness, master resilience training, substance abuse awareness and domestic violence education. Train-Ready / Available

16 Deployment

17 USD-S Resiliency Campus / Victory Strong The USD-S Resiliency Campus builds and supports the Physical, Emotional, Spiritual, Family, and Social strength of our Community through programs, facilities, and services. The Campus demonstrates our commitment to Comprehensive Fitness and provides an integrated and synchronized approach to Resilience that builds and sustains every aspect of individual strength. As part of the outreach effort, the Victory Strong program allows for Soldiers from all across USD-S to visit COB Basrah in order to take advantage of a unique 5 day program that builds skills in each of the 5 pillars of strength. Deployment Campus Map

18 Latrines/Showers Resiliency Building USD-S Resiliency Campus Spiritual: Counseling & Spiritual Guidance Meditation Room Emotional: Massage Chairs Biofeedback Room Family/Social: EO Office SPAWARE Center (Skype) Sexual Assault + IG Literature Physical: Master Fitness Trainers Personal Trainers Certified Nutritionists Volleyball Court Resiliency Park Resiliency Office and CrossFit Park CrossFit Gym Resiliency Classrooms Master Resilience Trainer 7 Coping Skills Deployment

19 Tele-Behavioral Health The end of combat operations in Iraq and the Responsible Drawdown of Forces (RDoF) has led to a reduction in the number of Behavioral Health providers per basing location. Rotation of BH providers to smaller bases is sometimes impractical due to manning and transportation limitations. Video Teleconferencing (VTC) technology, utilized as virtual BH clinics, presents a potential mitigation strategy for BH service deficiencies in USD-S. It creates access, ensures continuity of care, and creates surge capacity. Deployment

20 Suicide Risk Management Teams A Suicide Risk Management Team (SRMT) is the unit Commander s way to gain vital information regarding high-risk Soldiers in the formation, to discuss details regarding Behavioral Health initiatives, and to review results from surveys and risk-assessment instruments. These meetings take place throughout ARFORGEN, but are particularly important in the deployed setting where Soldiers have ready access to lethal means. Members of the SRMT will include the Commander, Chaplain, a medical representative, and BH enablers as required. Deployment

21 Combat Stress Clinic Education Classes Combat Stress clinic Educational classes include anger management, relaxation techniques, smoking cessation, and sleep hygiene. These classes are available by appointment and are conducted in conjunction with the Resiliency Campus efforts. Deployment

22 Deployment Resilience Training Battlemind Resilience Training, the US Army s behavioral health resilience training system, is comprised of an integrated series of deployment cycle modules and life cycle training modules as well as specific training tailored for medical personnel. The training provides a developmental approach to mental health skill building timed to the specific phases of the Soldiers career and deployment cycle. Modules designed for military Spouses are also provided and are timed to the deployment cycle. Deployment

23 Big Red One- Society Against Sexual Assault (BRO-SASA) The purpose of the Big Red One- Society Against Sexual Assault (BRO- SASA) is to provide a forum for women and men from all branches of services, DoD Civilians and Contractors to unite in preventing Sexual Assault and Harassment. It accomplishes this by building self-confidence through education, developing life skills, and building camaraderie that creates positive changes in attitude and behavior through quarterly conferences and monthly seminars on COB Basrah and at Ft. Riley Deployment

24 Family Readiness Groups Family Readiness Groups (FRG) are command-sponsored organizations of family members, volunteers, soldiers and civilian employees associated with a particular unit. They are normally organized at company and battalion levels, and fall under the responsibility of the unit's commanding officer. FRGs are established to provide activities and support to enhance the flow of information, increase the resiliency of unit soldiers and their families, provide practical tools for adjusting to military deployments and separations, and enhance the well-being and esprit de corps within the unit. Deployment

25 Resilient Spouse Academy The Resilient Spouse Academy is a 4-day intensive training program on Ft. Riley designed to teach spouses how to be sensors for common problems that arise after deployment. Classes include Applied Suicide Intervention Skills (ASIST) training, financial readiness, master resilience training, substance abuse awareness and domestic violence education. Deployment

26 Chaplain Programs The USD-S and 1ID Chaplaincy offers many programs to help Soldiers improve their Spiritual resilience. Among the many programs offered, Strong Bonds, Care for the Caregiver Seminars, and Spiritual Fitness Events are amongst the most popular. There are also Deployment and Garrison motivational Speakers who present seminars on a variety of topics. Deployment

27 Deployment Behavioral Health Risk Assessment The Deployment Behavioral Health Risk Assessment (DBHRA) is a simple, leaderadministered risk assessment tool that can be implemented rapidly to assess individual and unit behavioral health risk. It standardizes Soldier risk assessment throughout 1ID, FRKS and USD-S in support of Comprehensive Soldier Fitness. By identification of high-risk Soldiers and prevention of suicide in 1ID and USD-S, we will increase the emotional resiliency of Soldiers and improve organizational readiness. Deployment

28 SharePoint Anonymous Help Line USD-S has created an anonymous help-line to assist Soldiers or battle buddies of Soldiers who are experiencing distress. Similar to the Commander 3x5 card, this allows for a mechanism to inform the chain of command if there are issues that they need to be aware of. In USD-S, we have links to Behavioral Health, EO/DSARC, Chaplain, IG and Safety. The Ask4Help button is visible on the main SharePoint page on NIPR and SIPR. Deployment

29 CSF Training Modules After taking the CSF Global Assessment Tool, Soldiers may take self-development modules designed to help increase strength and resilience in the Emotional, Family, Social and Spiritual dimensions. Soldiers are required to complete one module in each dimension and can take additional modules at any time. The modules may be completed in any order, however, it is recommended to take them in sequential order as listed under each Dimension. Deployment

30 Unit Leader Guides Unit Leader Guides provide leaders with simple tools to promote Resilience and reinforce the concepts of Comprehensive Soldier Fitness throughout the formation. Some examples are the 1 st Combat Aviation Brigade Demon Leader s Card and the 1 st Sustainment Brigade Durables Risk Assessment. Demons Durables Deployment

31 Post Deployment (Reset / Reintegration)

32 Identification of High-risk Behaviors and Individualized Mitigation Efforts Risk assessment is part of understanding how to build resilience. A comprehensive assessment is the first step in putting together a comprehensive plan of assistance. All components of this risk assessment are integrated to assist leaders and caregivers in understanding the Soldier s behavioral health status. This assessment is then communicated to the MEDDAC to facilitate resource allocation. Like 10 th MTN and 4ID, 1ID follows the Collaborative Medical Evaluation in Theater (COMET) model to identify and assist at-risk Soldiers. 1ID Commanders utilize the DBHRA to assess and engage at-risk Soldiers enabling them to receive individualized care. Reset / Reintegration

33 2-3-2 model for Reintegration and Leave Issues develop during block leave and reintegration. Indiscipline indicators typically rise during the first 180 days after redeployment. To mitigate this, the typical 4-week block leave period has been split into two 2-week blocks separated by a 3-week resiliency period of low intensity duty. This concept was developed to enhance Leadership interaction with Soldiers and Family members earlier in the Reintegration timeframe. The overall goal is to provide a more gradual transition back to the garrison environment. Reset / Reintegration

34 Comprehensive Behavioral Health System of Care Repetitive deployments have significantly increased stress reactions and behavioral health support requirements. It is imperative we help the force manage the stress it is experiencing to enable the Army to be a healthy, resilient and consistent resource for the nation. The Comprehensive Behavioral Health System of Care (CBHSOC) promotes overall Soldier and family health and well being through multiple touch points during ARFORGEN. To achieve an immediate and lasting impact, this campaign will emphasize identifying, preventing, treating and tracking behavioral health issues affecting soldiers and families, as well as educating the force. Reset / Reintegration

35 Post-Deployment Health Assessment DoDI , Deployment Health, 11 Aug 06 describes the postdeployment health activities. "The DD Form 2796 is required if a DD Form 2795 was required during the pre-deployment phase or per the decision of the COCOM commander, Service component commander, or commander exercising operational control if any health threats evolved or exposures (OEH or CBRN) occurred during the deployment that warrant medical assessment or follow-up." "Each individual who requires a DD Form 2796 must be scheduled for a face-to-face health assessment with a trained health care provider (physician, physician assistant, nurse practitioner, advanced practice nurse, independent duty corpsman, independent duty medical technician, or Special Forces medical sergeant) during in-theater medical outprocessing or within 30 days after returning to home or processing station." The purpose of this screening is to review each service member's current health, mental health or psychosocial issues commonly associated with deployments, special medications taken during the deployment, possible deployment-related occupational/environmental exposures, and to discuss deployment-related health concerns. Positive responses require use of supplemental assessment tools and/or referrals for medical consultation. The provider will document concerns and referral needs and discuss resources available to help resolve any post-deployment issues. Reset / Reintegration

36 Post-Deployment Health Reassessment The Post-Deployment Health Reassessment (PDHRA) Program is a program mandated by the Assistant Secretary of Defense for Health Affairs in March 2005 and designed to identify and address health concerns, with specific emphasis on mental health, that have emerged over time since deployment. The PDHRA provides for a second health assessment using DD Form 2900 during the three- to sixmonth time period after return from deployment, ideally at the three to four month mark. The reassessment is scheduled for completion before the end of 180 days after return. Reset / Reintegration

37 Victory Resilience Program 100% MFLC Contact for Soldiers and Family. The Office of the Secretary of Defense (OSD) Quality of Life Division has contracted with MHN Government Services to manage the Military and Family Life Consultant (MFLC) Program. This program provides non-medical counseling to Soldiers and their Families through outreach, educational presentations focused on behavioral health issues, and individual, couple, Family, and group interventions. These interventions build mental resilience while normalizing the range of reactions that occur as part of the cycle of deployment to combat zones and reintegration with families and communities. MFLCs work in support of and in conjunction with VICTORY RESILIENCE and the installation Army Community Services (ACS). Reset / Reintegration

38 Post-Deployment Resilience Training Provided to Warriors close to or soon after their return from combat and operational deployments. This module discusses the transition from a combat zone to the home zone and discusses the value of Warrior s skills but the need to modify these skills for a successful transition to the home environment. Techniques of adapting, indications that professional help may be needed and some available resources are also detailed. Provided to Warriors three to six months after they have returned from a combat or operational deployment. This training module discusses the continuing transition home, problem areas that may have arisen, selfaid/buddy-aid, Mental Fitness Checks, and some common myths associated with seeking help for behavioral health issues. Reset / Reintegration

39 BRO Ringneck Ranch Project Ringneck Ranch (BRORR) provides an opportunity for building Resiliency and providing Mentorship. During the reintegration period, Soldiers embark on a hunting retreat with a mentor at least two grades senior to them. The one-on-one Senior to Junior relationship provided by the BRORR provides excellent opportunities for mentorship and serves as a way to build the bench providing future leaders to 1ID and the Army. Reset / Reintegration

40 Warrior Adventure Quest The Warrior Adventure Quest (WAQ) combines existing outdoor recreation high adventure, high adrenaline activities with a Battlemind Leader Tool, the Army s emotional resiliency building program, to assist Units and Soldiers in adapting to a garrison environment. This training is conducted with the existing chain of command in platoon sized elements to enhance unit cohesion, provide leadership opportunities to unit leaders, and enhance NCO professional development. Reset / Reintegration

41 Theater of War Seminar Theater of War presents readings of Sophocles' Ajax and Philoctetes to military communities across the United States. These ancient plays timelessly and universally depict the psychological and physical wounds inflicted upon warriors by war. By presenting these plays to military audiences, the hope is to de-stigmatize psychological injury and open a safe space for dialogue about the challenges faced by service members, veterans, and their caregivers and families. It has been suggested that ancient Greek drama was a form of storytelling, communal therapy, and ritual reintegration for combat veterans by combat veterans. Sophocles himself was a general. At the time Aeschylus wrote and produced his famous Oresteia, Athens was at war on six fronts. The audiences for whom these plays were performed were undoubtedly comprised of citizensoldiers. Seen through this lens, ancient Greek drama appears to have become an elaborate ritual aimed at helping combat veterans return to civilian life after deployments during a century that saw 80 years of war. Reset / Reintegration

42 Entrepreneurship Boot Camp for Veterans (EBV) The Entrepreneurship Bootcamp for Veterans with Disabilities (EBV) offers cutting edge, experiential training in entrepreneurship and small business management to post-9/11 veterans with disabilities resulting from their service to our country. The EBV is designed to open the door to business ownership for our veterans by developing skills in the many steps and activities associated with launching and growing a small business, and by helping veterans leverage programs and services for veterans and people with disabilities in a way that furthers their entrepreneurial dreams. Reset / Reintegration