Issues Facing Combat Veterans

Agenda

• Virginia Wounded Warrior Program (VWWP)• Population Description– Paradox of Coming Home– Traumatic Brain Injury– Post Traumatic Stress Disorder

• Suggestions for Working with Combat Veterans

• Resources

VirginiaWounded

WarriorProgram

The Virginia Wounded Warrior Program (VWWP), in cooperation with the Department of Behavioral Health and Developmental Services and the Department for Aging and Rehabilitative Services, monitors and coordinates behavioral health and rehabilitative services and support through an integrated, comprehensive and responsive system of public and private partnerships. VWWP facilitates these services for Virginia veterans, members of the Virginia National Guard and Armed Forces Reserves (not in active federal service), and their families affected by stress related conditions or traumatic brain injuries resulting from military service.

Albemarle

AmeliaAppo-mattox

Brunswick

Buckingham

Campbell

Caroline

Charlotte

Chesterfield

Clarke

Culpeper

Dinwiddie

Fairfax

Fauquier

Fluvanna

Frederick

Goochland

Greene

Greensville

Halifax

Hanover

Loudoun

Louisa

Lunenburg

Madison

Mecklenburg

Nottoway

Orange

Page

Pittsylvania

Powhatan

PrinceEdward

Rappa-hannock

Shen

andoah

Spotsylvania

Stafford

Warren

Prince William

Acco

mac

k

Essex

Gloucester

Henrico

Isle Of Wight

KingGeorge

King William Lancaster

Middlesex

New Kent

North

ampt

on

Northumberland

Prince George

Richmond

Southampton

Surry

Sussex

Westmoreland

Chesapeake

Norfolk

Portsmouth

Suffolk

Virginia Beach

Amherst

Augusta

Nelson

Rockingham

Alleghany

Bath

Bedford

Bland

Botetourt

Buchanan

Carroll

Craig

Dickenson

FloydFranklin

Giles

GraysonHenry

Highland

Lee

Mont-gomery

Patrick

Pulaski

Roanoke

Russell

Scott

Smyth

Tazewell

Washington

Wise Wythe

Newport

Alexandria

Lynchburg

Richmond

King & Queen

Rockbridge

Hampton

James

CharlesCity Co.

Cum

berla

nd

News

York

Matthews

Arlington

Charlottesville

Our Military Population• Approx. 1.5 million Active Duty Service Members• More than half of these are 25 yrs. old or younger• More than half are married and/or have children• 100,000 are single parents

• 888,000 National Guard and Reserve Members• One third are 25 yrs. old or younger• 60% are married and/or have children• 28% are single parents• 30,000 are dual military couples

Our Veteran Population

• 21.9 million veterans in the US• 1.5 million are females• 9 million are 65 years or older• 28% of all Americans who die each year are

veterans (each month 73,000 WWII, Korea and Vietnam Veterans die)

• 823,348 veterans reside in Virginia

Current Conflicts • 30,852 U.S. service members wounded in hostile action

since the beginning of U.S. military operations in OIF and over 6,300 service members have been killed in Iraq and Afghanistan

• Approximately 2.3 million service members have deployed in OIF/OEF/OND since 9/11/2001

• Approximately 600,000 National Guard and Reservists have deployed since the beginning of U.S. military operations in Iraq

Everyone is changed by war

The Paradox of Coming Home

• Combat Zone Responses helped the soldier remain alert, safe and ready

• Challenge is to modify these responses for the transition back to civilian life

The process of moving from this….

To This:

Common Transition/Adjustment Responses

• Feeling irritable or jumpy• Becoming easily annoyed or frustrated• Feeling numb• Feeling disconnected from friends and family• Experiencing sadness or guilt

Common and Normal Transition Responses

• Sleeping too much or too little• Being uncomfortable with physical or

emotional intimacy• Having intrusive thoughts, flashbacks, or

nightmares• Having trouble concentrating or remembering

Traumatic Brain Injuries

• 28% of all OIF/OEF Troops have been exposed to blasts

• Signature wound of these conflicts• Most common- Closed- caused by changes in pressure that

cause concussions and contusions. May not exhibit physical wound and therefore go unrecognized

• Many overlapping symptoms between TBI and PTSD:

FATIGUE IRRITABILITY INSOMNIA

COGNITIVE DEFICITS MEMORY PROBLEMS ANGER FRUSTRATION DEPRESSION

PTSD Symptoms CriteriaStressor Criterion

• Re-experiencing: flashbacks, night-mares, distressing recollections

• Avoidance: anything reminding one of the past, detachment, loss of interest

• Arousal: hyper-vigilance, startle response, concentration problems, sleep problems, anger

Common Coping Strategies for Veterans with Combat Stress, TBI, and PTSD

• Alcohol abuse• Weapons as security• Isolation• Yelling, anger, outbursts• Motorcycles/Cars—speed• Overspending• Suicide – approx 6,500 Veterans / year

Throwing the Lifeline: Strategies for Helping

Link veteran with other combat veterans *support and networking groups *VWWP, WWP, VFW, AL

Help veteran think about setting new career goals (perhaps based on MOS)

Help veteran connect to appropriate resources

Suggestions for Working with Combat Veterans

If needed reassure the veteran/service member that they are home (particularly helpful in crisis settings)

Show respect and appreciation for their military service

Do not share your personal views on war or politics

Connect the veteran/service member with other veterans-help them develop a peer support network

Suggestions (cont)

Avoid use of labeling (“you must have PTSD”)

Do not say you understand what they have experienced unless you have experienced combat yourself

Involve the veterans primary support system

Long term- recognize importance in discussing grief and survivors guilt and the impact of experiences on the veteran’s spirituality and belief system

Refer to other professionals as appropriate

Resources

• Virginia Wounded Warrior Program: www.wearevirginiaveterans.org

• Center for Deployment Psychology : www.deploymentpsych.org

• National Center for PTSD : www.ptsd.va.gov

• Defense and Veterans Brain Injury Center: www.DVBIC.org

• National Resource Directory for Wounded Warriors, Veterans and Service Members : www.nationalresourcedirectory.org

Our community, our strength!