first line of defence caring for service members

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First Line of Defense:

Caring for Service Members,Veterans & Their Families 

Mimi McFaul, PsyD, Associate Director 

Western Interstate Commission for Higher Education Mental Health Program

Nicola Winkel, MPA, Program Consultant 

Western Interstate Commission for Higher Education & Arizona Coalition for Military Families

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Mimi McFaul, PsyD,  Associate Director Western Interstate Commission for Higher Education Mental Health Program

Nicola Winkel, MPA, Program Consultant Western Interstate Commission for Higher Education & Arizona Coalition for Military Families

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Boots on the Ground

Mara BoggsMember of the U.S. Military

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Nicola Winkel, MPAProgram Consultant, Western

Interstate Commission for HigherEducation & Arizona Coalition for

Military Families

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Today’s Military/Veteran Population• Over 2 million service members have deployed since 9/11

• 500,000+ from the National Guard and Reserves

• Only 44 counties in the United States have not deployed a

member of the National Guard or Reserves

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• Women comprise over 15% of thecurrent fighting force (Active Duty,

Guard, Reserve).

• As of June 2010, 3.16 million

veterans were receiving VA disabilitycompensation.

• Approximately half of all servicemembers are married and over 40%have dependent children.

Today’s Military/Veteran Population (continued

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Mimi McFaul, PsyD, Associate Director 

Western Interstate Commission for HigherEducation Mental Health Program

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Key Issues – OEF/OIF

• Combat and Operational Stress

-Continuum of stress – mild adjustment disorder; post-combat highrisk behavior; PTSD

-18.5% Iraq/Afghanistan veterans have PTSD

• Traumatic Brain Injury (TBI)-Signature injury of OEF/OIF – estimates are 20%

-Majority of TBIs are mild (concussion)

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• Substance Abuse

-Prescription medication and alcohol are significant concerns-Mental and substance use disorders caused more hospitalizationsamong service members in 2009 than any other cause.

• Suicide-From 2005 to 2009, more than 1,100 service members took theirown lives, an average of one suicide every 36 hours.

-DOD Suicide Prevention Task Force report (August 2010):

http://www.health.mil/dhb/downloads/Suicide%20Prevention%20Task%20Force%20fi

nal%20report%208-23-10.pdf

Key Issues (continued)

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Key Issues(continued)

• Employment/Education

-As of March 2010, the unemployment rate for OEF/OIFveterans was 14.7%

-Significant increase in veterans attending school under Post-9/11 GI Bill

• Family/Relationships/Parenting

-Continued stress on relationships/parenting due to

deployment and training cycles

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Barriers to Treatment• Stigma

• Concerns about impact on career

• Need for civilian providers trained inmilitary/veteran culture & key issues, especially

in rural areas

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Mental Health First Aid

• Expanding the community safety net

• 12-hour training course designed to give members ofthe public key skills to help someone who isdeveloping a mental health problem or experiencing

a mental health crisis

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Goals of MHFA Align with Needs of ReturningService Members

 – Increase mental health literacy

 – Prevention: Early identification of mental

health problems

 – Triage potential mental health crisis situations

 – Refer individuals to appropriate care – Reduce stigma

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What does MHFA include?

 – 5 Content Modules (Depression, Anxiety,Psychotic Disorder, Substance UseDisorders, Eating Disorders)

 – Symptoms, causes, treatments, andresources

 – Crisis first aid

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5-step action plan – ALGEE –  Assess risk of suicide or harm

• Have you thought about hurting yourself? Others?

 –  Listen non-judgmentally

• What not to say: “Oh, so you didn’t actually see combat?”

 –  Give reassurance and information

• “This is an normal reaction to an abnormal situation.”

• “Help is out there. I can connect you and get you started.”

 –  Encourage appropriate professional help

• VA, TriCare Providers

 –  Encourage self-help and other supports

• Who do you trust? Family, friends, pastor/priest, mentor

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Making the Invisible Visible

• It’s okay and encouraged to ask questions – About serving – Have you served? What

branch?

 – About what you don’t know – Ask aboutacronyms (e.g., FOB – Forward Operating

Base) – About thoughts of suicide – Have you

thought of hurting yourself?

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MHFA for Military and TheirCommunities

• WICHE Mental Health Program – DoD grant to test MHFAwith Armory communities in KS

• Stay Tuned for MHFA content on Service Members

• Military Cultural Considerations

• Combat-related and Deployment Psychological HealthClinical Issues

• Military-related Resources

 –  Where to begin?

 –  What questions to ask?

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Honoring their Sacrifice

• Thank Them

• Ask Them

• Help Them

You do not need to be an expert in the military ormental health to make a difference!!

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Nicola Winkel, MPAProgram Consultant, Western

Interstate Commission for HigherEducation & Arizona Coalition for

Military Families

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Community-based Approaches for SupportingService Members, Veterans & Their Families

• Mental Health First Aid

• Cross-sector collaboration(military/government/community)

• Training & equipping staff and providers onmilitary/veteran culture & key issues

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Key Resources for Service Members,

Veterans & Their Families

• Veterans Affairs OEF/OIF Program

www.OEFOIF.VA.gov

The Department of

Veterans Affairs provides5 years free health carefor all veterans of Iraq &Afghanistan, including

National Guard &Reserve servicemembers

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Key Resources for Service Members,

Veterans & Their Families

• Real Warriors

www.RealWarriors.net

An interactive site focused on

reducing stigma associatedwith seeking help. Includesvideo profiles of servicemembers and their families

and resources.

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Key Resources for Service Members,

Veterans & Their Families

• inTransition

www.Health.mil/InTransition

Mental health coaching andsupport program for ActiveDuty, Guard & Reserve servicemembers who are receivingmental health care andexperiencing a transition (new

orders, relocation, return tocivilian life, etc).

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Key Resources for Service Members,

Veterans & Their Families

• Sesame Street - Talk, Listen, Connect

www.SesameWorkshop.org/TLC

Information, resources,

activities and support forfamilies coping withdeployment, homecomings,changes and grief.

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Key Resources for Providers & Community Partners

• Defense Centers of Excellence for PsychologicalHealth & Traumatic Brain Injury

www.DCOE.Health.mil/ 

Information on bestpractices and qualitystandards for promotingthe resilience, recovery

and reintegration ofwarriors and theirfamilies.

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Key Resources for Providers & Community Partners

• Military OneSource

www.MilitaryOneSource.com

Provides resources forservice members and theirfamilies, also providesinformation and materials toproviders (to access provider information, click on 

“Military Families” select a branch under “Service Providers”)

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Key Resources for Providers & Community Partners

• Citizen Soldier Support Program

www.AHEConnect.com/CitizenSoldier

Provides free in-depthonline training on

PTSD/TBI and otherissues affecting themilitary and veteranpopulation. Maintains a

database of providers at:www.WarWithin.org

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Key Resources for Providers & Community Partners

• Military Child Education Coalition - www.MilitaryChild.org

• Zero to Three - www.ZerotoThree.org

Two national organizationsthat provide trainingfocused on working withthe children of service

members. Visit their sitesfor training dates andlocations.

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Contact Information

• Mimi McFaul, PsyDAssociate Director 

Western Interstate Commission for Higher Education (WICHE)

Mental Health Program

mmcfaul@wiche.edu / www.WICHE.edu

• Nicola Winkel, MPA

Program Consultant 

Western Interstate Commission for Higher Education (WICHE)

Arizona Coalition for Military Families

nicola@arizonacoalition.org / www.ArizonaCoalition.org

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References & Websites• http://www1.va.gov/VETDATA/Pocket-Card/4X6_summer10_sharepoint.pdf

• http://cs.mhf.dod.mil/content/dav/mhf/QOL-Library/Project%20Documents/MilitaryHOMEFRONT/Reports/2008%20Demographics.pdf

• http://www.armytimes.com/news/2010/05/gns_mental_health_051410/ 

• http://www.samhsa.gov/about/siDocs/militaryFamilies.pdf

• http://www.mentalhealthfirstaid.org

• http://www.oefoif.va.gov/ 

• http://www.vetcenter.va.gov/ • http://realwarriors.net/ 

• http://www.health.mil/InTransition/ 

• http://www.sesameworkshop.org/tlc

• http://www.dcoe.health.mil/ • http://www.militaryonesource.com

• http://www.citizensoldiersupport.org/ 

• http://www.militarychild.org/ 

• http://zerotothree.org

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Mental Health First Aid in your Community

32

• A recording of this webinar & the power point presentation willbe available on the National Council website 48 hours after it

has ended.• Visit www.MentalHealthFirstAid.org for further information on

the course and to find an instructor near you.

• Become a fan of Mental Health First Aid USA on Facebook &get updates and information on a variety of mental healthtopics.

• For any further questions, contact Bryan Gibb at

bryang@thenationalcouncil.org or Susan Partain atsusanp@thenationalcouncil.org or 202.684.3732.

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NATIONAL COUNCILfor Community Behavioral Healthcare

Meeting the Behavioral Health Needsof Our Veterans

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Meeting the Needs of Veterans

> The National Council and our 1780 member organizations -

committed to meeting the behavioral health needs of veteransand their families by:

> Creating broad stakeholder constituency for policies thatsupport re-integration.

> Extending the military’s resources by facilitating access tocommunity resources.

> Ensuring behavioral health and primary care staff competence

in the treatment and reintegration of veterans and theirfamilies.

> De-stigmatizing veteran’s challenges by promoting earlyidentification and intervention.

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National Council Policy Activity> Veterans Mental Health and Other Care Improvements

Act (became law on Oct 10, 2008)

• Establishes three-year contracting pilot with community mentalhealth centers to provide services to eligible Iraq and Afghanistanveterans without ready access to VA services.

> TRICARE Benefits/Access – prequalifying Mental HealthCenters as treatment providers

> Caregivers and Veterans Omnibus Health Services Act of2009 (became law on May 5, 2010)

• VA Hospitals are required to provide peer outreach, supportservices and mental health services for veterans as well as mentalhealth services for immediate family members of veterans

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Survey of Member OrganizationsServing veterans and their families:

› Majority (90%) of respondents are servingveterans, reservists, National Guard or their familymembers.

› Three in four provide services to veterans’ familiesas well as to veterans.

› Respondents serve an average of 70 veterans,service members and families each month.

› Two-thirds of have veterans on staff that providepeer-to-peer support.

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Veterans On The Road Home

A National Councilbook featuring casestudies and lessonslearned fromcommunity mental

health organizationsacross the countryserving veterans andtheir families.

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Online Training for Community StaffPartnership with Essential Learning

› Working with Veterans and Military Personnel: How WRAP® 

Can Make a Difference

› Epidemiology of PTSD in Military Personnel and Veterans

› Cognitive Processing Therapy for PTSD in Veterans & Military

Personnel› Meeting the Behavioral Health Needs of Returning Veterans

› Mental Health Following Deployment to a War Zone: A

Community Solution› Strategies to Prevent Veteran Suicides

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Health Promotion/ Early InterventionMental Health First Aid USA

› 12-hour program – 10,000+Mental Health First Aiders

› 5-day training for instructors – 900+ instructors certified

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Mental Health First Aid Instructor Trainings

2011 Scheduled› Jan 24 – 28 in Eugene, OR

› Jan 31 – Feb 4, 2011 in Dallas, TX

› Mar 14 – 18, 2011 in Seattle, WA

› Apr 27 – May 1, 2011 in San Diego, CA

› Jun 13 – 17, 2011 in Boston, MA› Jul 25 – 29, 2011 in Chicago, IL

› Aug in New York City, NY

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