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WHEN WAR COMES HOME

WHEN WAR COMES HOME. THE IMPACT ON OKLAHOMA COMMUNITIES. Analysis of VA Health Care Utilization among Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), and Operation New Dawn (OND) Veterans.

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WHEN WAR COMES HOME

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  1. WHEN WAR COMES HOME THE IMPACT ON OKLAHOMA COMMUNITIES

  2. Analysis of VA Health Care Utilization among Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), and Operation New Dawn (OND) Veterans. Cumulative from 1stQtr FY 2002 through 2ndQtr FY 2014 (October 1, 2001-March 31, 2014) Suggested citation: Epidemiology Program, Post-Deployment Health Group, Office of Public Health, Veterans Health Administration, Department of Veterans Affairs, (2014) Check http://publichealth.va.gov/epidemiology for updates

  3. October 1, 2001- March 31, 2014 5,851 have died in-theater.

  4. 2.6 Million Troops have served or are serving in the two theaters of operation since the beginning of the conflicts

  5. 1,791,420 OEF, OIF, OND veterans have left active duty since FY 2002

  6. OKLAHOMA VETERAN STATICS http://www.va.gov/vetdata/Veteran_Population.asp http://www.va.gov/vetdata/docs/Maps/VetPop_State.pdf http://www.va.gov/vetdata/docs/Maps/VetPop11_Under25.pdf http://www.va.gov/vetdata/docs/Maps/VetPop_Percent_Under25.pdf

  7. Now or Later Video

  8. Challenges of OEF and OIF • No “front line” • Highly ambiguous environment • Complex and changing missions • combat, peacekeeping, humanitarian • Long deployments • Repeated deployments • Environment is very harsh • extreme heat • 24 hour operations • constant movement by ground or air • limited down time • crowded uncomfortable living conditions • difficult communications

  9. CombatExperiences • Being attacked or ambushed • Being hit by or exposed to IED, directly/indirectly • Receiving incoming artillery, rocket, or mortar fire • Being shot at, receiving small arms fire • Shooting or directing fire at the enemy • Being responsible for the deathof enemy combatant • Seeing dead bodies or human remains • Knowing someone severely injured or killed in action • Seeing ill or injured women or children whom you were unable to help

  10. Stressors in the Deployment Cycle Pre-deployment Notification Preparation Training Return from Deployment Reunion Reintegration Deployment Departure Sustainment Combat and conflict

  11. Mindset When Deployed • Stay focused on mission /nothing else matters • Truly life or death / always on the edge • Constant adrenaline “rush” • Black or white / all or nothing • Sense of purpose, invincibility • Only trust battle buddies /others are threat • Need to control environment • Real problems and needs exist in Iraq/Afghanistan Adapted from briefing by COL Kevin Gerdes, May 2008

  12. Mindset When Home • Life is now unfocused and complex • No longer on the verge of life or death • What can replace the “high” of war? • Things aren’t clear cut • No sense of purpose, nothing matters • Can’t trust anybody • Can’t be in control of surroundings • Problems at home pale in comparison to those in theater Adapted from briefing by COL Kevin Gerdes, May 2008

  13. Mindset When Deployed vs. Mindset When Home SURVIVAL SKILLS WHILE DEPLOYED HOME Withdrawal Controlling Inappropriate Aggression Hypervigilance “Locked and Loaded” @Home Anger/Detachment Secretiveness Guilt Aggressive Driving Conflict Buddies (cohesion) vs. Accountability vs. Targeted Agression vs. Tactical Awareness vs. Lethally Armed vs. Emotional Control vs. Mission OPSEC vs. Individual Responsibility vs. Non-Defensive Driving vs. Discipline and Ordering vs. Battlemind.org

  14. Reserve & Guard Personnel Stress Following Deployment • Return to civilian life • Job may no longer be available • May experience a reduction in income • Transition of health care or loss of health coverage • Loss of unit/military support system for the family • Lack of follow up/observation by unit commanders to assess needs

  15. OEF OIF OND PROGRAM OFFICE • In early 2007 a directive was issued setting up a Program Manager and Transition Patient Advocate. • Case Management positions were then separated from the Program Manager

  16. Screenings: Traumatic Brain Injury PTSD Depression Substance Use Rabies Fevers Rashes Gastrointestinal Problems Embedded Fragments Military Sexual Trauma As Indicated: Suicide Risk Assessment Risk for Homelessness

  17. TBI PHYSICAL HEALTH CONCERNS ANXIETY/PANIC RELATIONSHIP PROBLEMS

  18. RISK FACTORS POST MILITARY DISCHARGE: • ISOLATION • RELATIONSHIP PROBLEMS • UNEMPLOYMENT • FINANCIAL PROBLEMS • ADDICTION • HOMELESSNESS • DOMESTIC VIOLENCE • LEGAL ISSUES • INCARCERATION • SUICIDE • OTHERS

  19. What have we learned? Veterans do not come home from war…. They come home with war. QUESTIONS

  20. OEF OIF OND PROGRAM OFFICEOKC VA MEDICAL CENTER405-456-3215 OR 405-456-1410

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