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NEW JERSEY VETERANS HELPLINE PROGRAM
1-866-VETSNJ4… YOU!1-866-838-7654
A Partnership of UMDNJ- UBHC & NJ DMAVA
NEW JERSEY VETERANS FOR YOU HELPLINE AT UBHC-
UMDNJ Is answered 24 /7 by Veteran/Peer clinical
staff & counselors with military expertise A “Vet to Vet” experience, it is confidential,
free, and available to meet your needs New Jersey soldiers and their families
receive telephone peer counseling, clinical and suicide assessments as needed, referrals to veteran mental health treatment and customized resources available through NJ Department of Military & Veterans Affairs
NJ VETERANS HELPLINE Services Include:
“Veteran to Veteran” Peer Support Telephone Counseling Veteran Clinical Assessments Triage -Veteran Service Offices Resources Referrals to providers with military
expertise Crisis Support/Field Activity Vietnam Veterans Support Group
Meetings Family Support & Liaison activity
New Jersey Veterans Helpline CALL HISTORY- 2005- 2008Total calls : 5,637/8,882 Service Requests Call backs by Veteran/peer counselors: 3,324Telephone counseling /treatment requests:
1,5642009 (3 MO’S)TOTAL CALLS/CONTACTS= 2,894FIELD/GROUP CONTACTS = 1,977CALLS & TELEPHONE COUNSELING= 91760-70% OEF/OIFGender – 80% male, 20% female
FIELD ACTIVITY SUMMARYRECONSTITUTIONS/DEPLOYMENTS
UBHC Veteran staff participated in 58 Reconstitutions - 2005 - 2008
As a result approximately 175 veterans in therapy
Increase in 1:1 and group field activity highlighted our team in 2008
2009 selected to be “Lead” in NJ DMAVA PTSD Task Force
“Lead” in Welcome Home 1:1 sessions for Reconstitution of approx. 3,000 soldiers
“Welcome Home” is a UBHC Military One to One
Intervention Goal: To Decrease Stigma And Increase Chance
Vet Will Disclose Any Concerns Primary team of Veteran peers & clinicians Handouts- see “FORMS” Crisis triage capacity w/clinicians Goal = Engage, Psycho-Education, Crisis
Response Provide Military Support & Suicide information Encourage utilization of support services
WHO ARE YOU SERVING?New Jersey National Guard –
OIF/OEF WARRIOR SPIRIT-Acknowledge it! An intensity of life filled with energy
and readiness to act when needed protecting one’s family, neighborhood, nation and world.
A total willingness to stand up for what is right with a sense of duty greater than one’s own need. Charles Lewis Arnold, MS, BCPC, CTM, CTSS
(ret. Master Sergeant, United States Marine Corps and New Jersey Army National Guard)
WHAT YOU ARE DOING…
VOLUNTEERING TO SUPPORT OUR TROOPS AS AMEMBER OF THE UBHC- UMDNJ TEAM LED BYTHE NEW JERSEY VETERANS HELPLINE STAFF
BY GENUINELY SHARING YOUR GRATITUDE FORTHEIR SERVICE
PROVIDING PSYCHOEDUCATIONAL INFORMATION,“CHECKING IN” WITH THEM ON THEIR EXPERIENCES
BEING DEPLOYED
ASK HOW THEY FEEL AS THEY ADJUST TO RETURNINGHOME……
STEPS OF THE “WELCOME HOME” 1:1Welcome Home 1:1 Psycho
educational Session- Thank them!Introductions/Sign In/ Program
SheetReview Packet/Forms Interview-(script)Psycho educational componentOffer resources/follow-up
12
WHAT IS YOUR GOAL? Welcome Home- Soldier’s need
support Share gratitude for service Explain Confidential resource in
NEW JERSEY VETERANS HELPLINE Offer support through the–
Welcome Home 1:1 Interview Review Materials- Psycho education Ensure service to those in need
13
WHAT YOU ARE NOT DOING
• A CLINICAL/PSYCHOSOCIAL ASSESSMENT
• A CRISIS /ACUTE SCREENING ASSESSMENT
• AN INFORMAL CONVERSATION • A RIGID OR SCRIPTED SERIES OF
QUESTIONS• MEDICAL ASSESSMENT OF ANY KIND• REFERRAL TO SPECIFIC PROVIDERS• AN INQUIRY TO EXPLORE MILITARY LIFE
BEFORE YOU GET THERE
Review materials to ensure you are prepared
Bring photo ID- preferably Driver’s license
Report by 8:30 a.m. to check points to arrive by 9:00 am SHARP for morning briefing
Ask questions/receive instructions- Team Leader
WHEN & WHEREWILL THIS TAKE
PLACE?Welcome Reconstitution sessions will take place between
June 1, 2009 and June 20, 2009 atFort Dix
3601 Saylors Pond RoadFort Dix, New Jersey 08640
IMPORTANT- Confirm event prior to reporting as the schedule may change and confirmation via email or phone should be received.
LESSONS LEARNED
NJ Veterans Helpline data reflects trends in service needs and caller reporting of symptoms
VA/NJDMAVA study reflects specific information regarding the troops pre-deployment
National PTSD resources and Military resources have offered solutions to meet soldiers behavioral healthcare needs
WHAT HAVE THEY TOLD US?New Jersey National Guard –
OIF/OEFVeteran helpline Callers Clinical Issues
Depression/Mood Disorder Anxiety/Phobias Medical/Somatic Complaints Marital/Couples Post Traumatic Stress Disorder Family/Parenting Issues Substance Abuse Aggression/Violence Recent Loss Suicidal Thoughts
WHO IS OUR “HIGH RISK” CALLER?
65% counseling requests- OIF/OEF Anxiety, depression present in most
cases Anger was present in majority of cases.
Anger varied depending on the unique situation with each soldier. Multiple deployments a theme
Sleep disturbances reported frequently Long hours /difficult schedules a cause,
others report anxiety related to fear of harm etc.
Flashbacks and reaction to loud noisescommon
Military Families & New Jersey Veterans
HelplinePrimary Diagnosis/Complaint with Parenting/Family IssuesDepression 93%Anxiety 91%Aggression 89%Marital/Family 68%Violence 27%
FAMILY STATISTICS
63% of all family calls are from OIF/OEF
56% of all callers w/family issues = National Guard
Primary problems as Anxiety, Depression, Marital Discord
Majority of calls include marital discord w/aggression & violence prevalent for soldiers returned home from the war
TOP TEN COUNTIES DEPLOYED SOLDIERS –WHERE THEY LIVE
RANK COUNTY # DEPLOYED1 Burlington 1962 Essex 1923 Hudson 1884 Passaic 1655 Middlesex 1616 Camden 1587 Ocean 1538 Bergen 1329 Union 129
10 Gloucester 126
Preliminary Findings from the Pre-Deployment Survey of the New Jersey National Guard 2007-
2008Department of Military and Veterans Affairs VA
New Jersey Health Care SystemBloustein Center for Survey Research, Rutgers
UniversityPURPOSE To collect baseline information on the
mental and physical health of National Guard members deploying to Iraq
To assess the health effects of previous deployments to Iraq and Afghanistan by comparing those with and without previous OEF/OIF deployments
To use information to plan for the health service needs of returning veterans
METHODS Anonymous, self-administered surveys
were distributed to Guard members during pre-deployment medical assessments between 11/2007 and 5/2008
Questions focused on: • mental and physical health • substance abuse • combat experiences (for those previously
deployed) and • access to treatment
A total of 2,543 useable surveys were collected from the 2,890 deployed
SUMMARY
Guard members with one or more tours were significantly more likely to suffer from depression and PTSD than those with no previous tours
Alcohol misuse was high among all Guard members and did not increase significantly with previous deployment
The presence and intensity of physical pain was high among those previously deployed and increased according to the number of previous deployments
SUMMARY (CONT’D) Pain prevalence translated into significant
disability in performing physical activities, with more than 20% of those with 2 or more deployments reporting
The experience of pain and physical disability was especially high among those with PTSD, with 22% believing they did not meet physical conditioning requirements for deployment
Respondents reported significant barriers to mental health symptom reporting post-deployment, including the lack of post-deployment screening for mental health problems, a reluctance to report symptoms in order to avoid being placed on “medical hold” and discomfort in acknowledging mental health problems
Only 41% of those with PTSD were treated in the previous 12 months
DISCUSSION These data raise important questions about the
military readiness of troops returning to the OIF/OEF conflicts after experiencing previous deployments
All returning OIF/OEF troops receive a series of DoD post-deployment assessments and, prior to returning to combat, a pre-deployment medical assessment by both the National Guard and DoD. Troops in the present study had passed their National Guard pre-deployment assessment but had not yet been assessed pre-deployment by DoD
DISCUSSION While it is possible that many symptomatic
troops would be screened out by DoD, DoD reports that between 3/2007 and 2/2008, only 5.5% of all troops receiving pre-deployment assessments were referred for a medical visit, including only 1% referred for mental health reasons (DOD, 2008)
These data suggest that many symptomatic troops continue to be deployed to combat because of a reluctance to report symptoms and seek treatment
POLICY IMPLICATIONS The number of Veterans returning from Iraq
needing treatment for mental health and substance abuse problems is likely to be very high - 33% of the approximately 2,800 deployed troops, or over 900 veterans
Stigma is a serious barrier to veterans reporting and seeking treatment for mental health and substance abuse problems (see poster)
Alcohol problems are rarely treated and may require intensive outreach to impaired veterans
Mental Health Problems by Number of Previous Tours
2.3
6.6 6.69
4.2
14 14.1
25.4
0
5
10
15
20
25
30
Depression AlcoholDependence
PTSD Depression,Alcohol or
PTSD
No previous tours One or more previous tours
All values significant at p=.000
Mental Health Problems by Length of Time Since Previous OIF/OEF Tour
11.1
6.4
13.3
8.2
26.7
14.7
33.3
25.3
0
5
10
15
20
25
30
35
Depression Alcoholdependence
PTSD Depression,alcohol or
PTSD
12 months or less More than 12 months
MILITARY POPULATION TREATMENT RESISTANCE
Efforts to minimize distress may be based in desire to hasten discharge, quicken return to family, avoid compromising military career or retirement and in response to realistic fears about impact on career prospects.
Lessen risk through prevention of:• family breakdown• social withdrawal and isolation • employment problems• substance abuse
MILITARY SUICIDE RISK“The highest relative suicide risk is in
veterans who were wounded multiple times or hospitalized for a wound [suggesting] that the intensity of the combat trauma, and the number of times it occurred, may influence suicide risk in veterans with PTSD.” (National Center for PTSD)
MILITARY SUICIDE INFORMATION
Statistics 2007 (Violanti)
89 confirmed suicides in 2007 with an additional 32 deaths being investigated
2,100 suicide attempts in 2007 350 suicide attempts in 2002, the year
before the war in Iraq began 5 attempts per day Multiple deployments a risk
FORMSNew Jersey Veterans For You
Helpline FlyerRefer to Flyer in offering and
explaining serviceHighlight that flyer has
questions re; reactions the soldier may have that can be reviewed (PTSD checklist)
FORMSQPR
Explain to soldier QPR can help them and their families to help each other
Refer to FlyerQuestion, Persuade, Refer Suicide
Prevention Know the signs/symptoms
Be your “Brother’s/Sister’s Keeper” not just during times of crisis, but always…..
Question, Persuade, Refer
NEW JERSEY VETERANS HELPLINE PROGRAM1-866-VETS-NJ-4 - - - 1-866-838-7654
Free Confidential Helpline for New Jersey Veterans and their families
Question, Persuade, ReferQPR IS A SUICIDE AWARENESS TOOL
Be your “Brother’s Keeper” not just during times of crisis but alwaysRemember:
How you ask the question is less important than that you ask it!Similar to how CPR helps someone stay alive until you can get medical help;
QPR helps someone stay alive until they can get psychological help!Q – Question the Person about Suicide. Don’t be afraid to ask if they have thoughts of killing themselves?
Do they have a Plan?Tips for Asking the Suicide Question
• If in doubt, don’t wait, ask the question, be persistent!• Talk to the person alone in a private setting, allow them to talk freely• Give yourself plenty of time• Have resources handy; phone numbers, counselor’s name and any other information
that might help
P – Persuade the Person to get help. Listen carefully. Then say, “Let me help.” “Come with me to find help.” or “Have you thought about calling the New Jersey Veterans Helpline Program for someone to talk to? 1-866-838-7654”Don’t try to be their counselor; be their friend and support them in seeking help
R – Refer for help. Utilize the New Jersey Veterans Helpline Program 1-866-838-7654, local Emergency Room or Chaplain. Whoever will help!
Ask A Question, Save A Fellow SoldierQPR is not intended to be a form of counseling or treatment.
QPR is intended to offer hope through positive action.QPR is a tool to identify suicidal intentions in your fellow soldier
Be your brother’s keeper – Ask the Question!
Question, Persuade, ReferAsk a Question and be more than a friend!
Persuade someone to live instead of attempt suicide.Don’t hesitate to get involved or take the lead. Refer them to help.
Give your fellow soldier back up during a time when they need it most! 1-866-VETS-NJ-4 - - 1-866-838-7654
The More Clues and Signs Observed, the Greater the Risk. Take All Signs Seriously.
SOLDIER SUICIDEKNOW THE FACTS / BE AWARE OF WARNING SIGNS
Facts:• Asking won’t put the thought in someone’s head; it will give them an opportunity for help. • The suicide rate for veterans was found to be between 22.9 and 31.9 per 100,000. The suicide
rate for non-veterans is 8.3 per 100,000,• Most suicidal individuals express some intent the week prior to their attempt. • Suicide is the most preventable kind of death, and almost any positive action may save a life.
Signs/Cues to look for:• Warning Signs - despair, hopelessness, depression
• Suicide threats and previous suicide attempts• Alcohol and drug abuse (including prescription drugs and pain medications) • Statements revealing a desire to die or thoughts about killing oneself• Sudden changes in behavior • Prolonged depression• Making final arrangements• Giving away prized possession
• Direct verbal Cues - I wish I were dead. If x doesn’t happen, I’m going to kill myself.• Indirect verbal Cues - My family would be better off without me. Soon you won’t have to worry about
me anymore. Here take this - I won’t be needing it.IMPORTANT!
If you are dealing with a soldier that is not open to a referral of any sort and you believe significant risk for suicide, it is very important that you initiate the proper psychiatric emergency protocols to ensure the soldier’s safety as well as the safety of others is secured. REMEMBER New Jersey Veterans Helpline is always there; don’t wait until it’s too late!
1-866-VETS-NJ-4 -- 1-866-838-7654
MILITARY DEFINITIONS
RECONSTITUTION: To return the soldiers to their home base taking them off active duty status and putting them on reserve status.
DEFINITIONSREINTEGRATION: The time when
the service member eases his/her way back into a routine and returns to the day-to-day civilian life. To avoid upsetting the balance established during the service member’s absence, the veteran must slowly work his/her way back into the family. 30, 60 & 90 day events will support soldier and his/her family as a follow-up
DEFINITIONSMOS- Military Occupational SpecialtyOIF- Operation Iraqi FreedomOEF- Operation Enduring FreedomLOD- Line of DutyNJDMAVA-New Jersey Department of
Military & Veterans AffairsFAC- Family Assistance CentersVSO- Veteran Service Organization
WELCOME HOME INTERVIEW SAMPLE
Hello, my name is ____________
Welcome home and thank you for your service.
I am here from the New Jersey Veterans program to find out how you’re doing (Explain program)
What is your name?
What is your Armory?
What is your MOS (Military Occupational Specialty) and rank?
Did you work in your MOS during deployment?
Was this your first, second or third deployment?
What was it like being in Iraq?
Were you inside or outside the wire?
Were you involved in any combat situations?
Did you fire your weapon?
Did you experience any injuries or medical issues?
•If yes, was an LOD (Line of Duty) Completed?
Now that you are back home, what are your concerns?
From the contact you have had with your family while you were deployed, how are things at home?
Does your family have any needs or concerns that they have told you about?
Is your post deployment employment secure?
If the soldier shows signs of trauma or has ask specifically:
what are you thinking/feeling?
Are you having suicidal thoughts?
Is there anything else you would like to discuss?
PSYCHOEDUCATIONAL COMPONENT
Give them the forms and review • New Jersey Veterans Helpline Flyer• QPR Form• New Jersey Veterans Helpline cards
Tell the Veteran that staff from the New Jersey Veterans Helpline program will be attending the 30-60-90 day reintegrations and will be available for counseling if neededAlso advise they can call the “New Jersey Veterans Helpline” program anytime day or night
1-866-VETSNJ4…..You1-866-838-7654
WRAP UP PHASE
If no assistance is required at this time, remind the Veteran that he/she can call the helpline at any time. Ask them if they would like a follow-up call from a New Jersey Veterans Helpline staff member in a few days. If the Veteran says yes, provide New Jersey Veterans Helpline callback form and complete it.
OPERATIONSA mini “Welcome Home briefing” will be held each day for all volunteers before the reconstitutions start at 9:00 am SHARP
All information can be emailed to any individual wishing to participate in the reconstitutions. Please email/ call Jill Caravello at 732-235-3960 (caravejl@umdnj.edu) to be emailed PowerPoint and/or forms
OPERATIONSCrisis Response If the soldier seems to be having
a difficult time, there will be a triage room set up with licensed counselors available for follow up
Escort Soldier to the Triage Unit after notifying Team Leader
NEW JERSEY VETERANS HELPLINE
IMPORTANT STAFF NUMBERS HELPLINE: 1-866-VETS-NJ4/1-866-838-
7654
Jill Caravello: 732-235-3960
Chuck Arnold (cell) : 215-858-0879
Heather Altman (cell) : 856-366-0642
Cherie Castellano (cell) : 732-713-8037
SECURITY MEASURES WHEN ENTERING FORT
DIX If possible, please try to come in groups Please be sure to bring a photo ID (driver’s license
or passport) If you don’t have drivers license or passport, you will
need two forms of ID (one must be a photo and the other needs to be acceptable to the guard)
As your vehicle approaches the gate, please have your Drivers License, Vehicle Registration and Vehicle Insurance Card in hand and ready for police officers to identify you and all adult occupants. All adult passengers in the vehicle will be required to produce a photo ID. This will expedite entry
Plan to be at the gate by 8:30 AM
DIRECTIONS TO FORT DIX:To save time traveling to the installation, please contact the
individual where you are going for exact directions to their respective location. From New York and Northern New Jersey N.J. Turnpike South to Exit 7 (Fort Dix) Route 206 South (go to second traffic light -- about 1/2 mile) to Route 68 (left fork from Route 206). Route 68 will provide entrance to the installation where the SSG Terry Hemingway Reception Center is located
From Delaware and Southern New Jersey N.J. Turnpike North to Exit 7 (Fort Dix) Route 206 South (go to second traffic light -- about 1/2 mile) to Route 68 (left fork from Route 206). Route 68 will provide entrance to installation where the SSG Terry Hemingway Reception Center is located
From Philadelphia Take Walt Whitman Bridge to I-295 North, travel to Exit 40 (Route 38 East, toward Mt. Holly). Follow 38 through Mt. Holly and across Route 206 to Pemberton. Make a left in Pemberton (sign says To Military Bases) on Route 616 to where the SSG Terry Hemingway Reception Center is located
From Northern Pennsylvania Take Pennsylvania Turnpike to New Jersey Turnpike Take New Jersey Turnpike North to Exit 7 (Fort Dix) Route 206 South (go to second traffic light -- about 1/2 mile) to Route 68. Route 68 will provide entrance to the installation here the SSG Terry Hemingway Reception Center is located
DIRECTIONS TO THE T3 BATTLE LABBUILDING 3601SAYLORS POND ROADFORT DIX NEW JERSEY 08640
Route 68 South to Main Gate Pass through main gate and enter circle Take 2nd right turn from circle Travel 4/10 mile and make a left on-to Rancocas Road Travel 4/10 mile and make a right on-to Florida Avenue Travel 3/10 mile and make a left on-to Administrative Street NOTE: There will be a sign: NATIONAL GUARD BUREAU JOINT TRAINING AND
TRAINING DEVELOPMENT CENTER Travel 2/10 miles and turn right into parking area. The
building with the blue roof is where you want to go
Thank You for
Supporting our Troops!
PLEASE CONTACT JILL CARAVELLO re: YOUR AVAILABILITY
AND WITH YOUR INFORMATION FOR SECURITY
CLEARANCE FOR FORT DIX 732-235-3960 OR EMAIL caravejl@umdnj.edu
BY MAY 20TH
YOU ANSWER THE CALL OF DUTY,
WE ANSWER THE CALL FOR YOU 1-866-VETSNJ4…YOU
(1 866-838-7654)Thank you for supporting our
troops…