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HRSA TRAIN THE TRAINER program

HRSA TRAIN THE TRAINER program. Preview Day 1 . Brief overview of NAO contract Version of training Experience the training before offering it Questions about implementation write down address tomorrow. 2. Preview Day 1 . Version of training Scope of the problem Military culture

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HRSA TRAIN THE TRAINER program

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  1. HRSA TRAIN THE TRAINER program

  2. Preview Day 1 • Brief overview of NAO contract • Version of training • Experience the training before offering it • Questions about implementation • write down • address tomorrow 2

  3. Preview Day 1 • Version of training • Scope of the problem • Military culture • Behavioral health issues • VA presentation • TRICARE presentation • Boots on the ground 3

  4. Preview Day 2 • Your CE event • Why train civilian providers • Description NAO project/required forms • Goals each content section • How to find speakers – each section • CSSP toolkit and handouts 4

  5. Preview Day 2 • Your CE event • Resources • CSSP provider database - demo • CE credits • Overview CE process • Have everything you’ll need 5

  6. QUESTIONS?

  7. Nao contract overview • Each AHEC site required to offer CE events • 75-100 people per site to educate • Prior to 30 September 2013 • Audiences to target • Primary care • Behavioral/mental health

  8. Nao contract overview • Required content • Military culture • Identify service members – ask the question • Behavioral/mental health issues • Keep content in mind while experiencing training today

  9. QUESTIONS?

  10. Introduction • Different kind of training • Immerse in military culture • Time format • Date format

  11. Painting A Moving Train Quote General Robert Mangus Assistant Commandant US Marine Corps 2007

  12. Introduction “The most complex and dangerous conflicts, the most harrowing operations, and the most deadly wars, occur in the head.” (Anthony Swafford, Jarhead from PBS video Operation Homecoming)

  13. Introduction “When we arrived home, it seemed surreal. I felt more out of place here than I had in Iraq. I isolated myself from friends and family and dwelled in my emptiness.” (Corporal Travis Williams, US Marine Corps testimony to US senators on a fact-finding mission in Montana)

  14. Introduction “For the first time in American history, 90% of wounded (service members) survive their injuries. “A greater percentage of men and women are coming home with …TBI and severe Posttraumatic Stress.” (Alive Day Memories: Home from Iraq HBO documentary

  15. Introduction • How many of you are… • Current Service Members • Active duty? • Guard? • Reserve? • Former Service Members?

  16. Introduction • How many of you are… • Spouse of Current/Former Service Members? • Sibling of Current/Former Service Member? • Other family member? • Know a Current/Former Service Member?

  17. Introduction • How many of you are… • Physicians? • Nurses? • Mental health professional? • Allied health professional? • Public health professional? • Others?

  18. scope of the Problem • Length of combat operations • November 27, 2006 • War in Iraq was longer than WWII • All volunteer force = multiple deployments

  19. scope of the Problem • 2.2 million Service Members Iraq and Afghanistan • “Over 75% of Soldiers and Marines [in Iraq] surveyed reported being in situations where they could be seriously injured or killed; 62-66% knewsomeoneseriously injured or killed; more than one third described an event that caused them intense fear, helplessness or horror” • (Office of the Army Surgeon General Mental Health Advisory Team [MHAT] IV, • Final Report, Nov 06)

  20. scope of the Problem • “The challenges are enormous and the consequences of non-performance are significant. Data…indicate that 38% of Soldiers and 31% of Marines report psychological symptoms. Among members of the National Guard, the figure rises to 49%. Further, psychological concerns are significantly higher among those with repeated deployments, a rapidly growing cohort. (Report of the DoD Task Force on Mental Health June 2007)

  21. scope of the Problem • Psychological concerns among family members • Area of concern • First Lady Joining Forces initiative to support family members • Dr. Jill Biden – families serve – not in uniform

  22. scope of the Problem • Psychological concerns among family members • >1 million children in US under 11 y.o. experienced deployment of a parent – sometimes both – since 9/11 • Sesame Street videos • Available to service members through Military One Source

  23. scope of the Problem • July – September 2010 • Surveyed 911 Army soldiers and Marines • All deployed OIF/OEF • Report released May 2011 • Compared to surveys 2005, 2007, 2009 Office of the Army Surgeon General Mental Health Advisory Team (MHAT) VII Report May 2011

  24. scope of the Problem • Rates of acute stress higher than any previous year except 2007 • Acute stress • Depression • Anxiety • Ratings of individual morale significantly declined since 2005 and 2009 Office of the Army Surgeon General Mental Health Advisory Team (MHAT) VII Report May 2011

  25. scope of the Problem • Suicide ideation rates the same • Higher exposure to concussive events • Service members on 3rd-4th deployment lower morale than those on 1st Office of the Army Surgeon General Mental Health Advisory Team (MHAT) VII Report May 2011

  26. scope of the Problem • Dramatic increase in combat exposure over previous surveys • Behavioral health stigma unchanged Office of the Army Surgeon General Mental Health Advisory Team (MHAT) VII Report May 2011

  27. scope of the Problem Experience20072010 Death of unit member 48.6% 73.4% Shooting at enemy 29.6% 78.5% IED exploded near them 32.8% 62.4% Responsible for death of 8.3% 48.4% combatant Office of the Army Surgeon General Mental Health Advisory Team (MHAT) VII Report May 2011

  28. scope of the Problem • Where deployed service members live • CSSP Data Maps - demo

  29. Family Issues • Military culture assumes that operational needs of the unit always take precedent over everything • Graduations • Weddings • Birth of service member’s own child • Anything must be canceled at moment’s notice if operational need arises (Jessica Meed, MPH)

  30. Family Issues • Spouses and children may think of themselves as serving when their loved one is deployed. • Families make plans for big events that do not include the service member. • (Jessica Meed, MPH)

  31. Public health model • Most war fighters/veterans will NOT develop a mental illness but… • All war fighters/veterans and their families face important readjustment issues • This population-based approach is less about making diagnoses than about helping individuals and families retain a healthy balance despite the stress of deployment (Jessica Meed, MPH)

  32. Public health model • Incorporates Recovery Model and other principles of the President’s New Freedom Commission on Mental Health • There is a difference between having a problem and being disabled • The public health approach requires a progressively engaging, phase-appropriate integration of services

  33. Public health model • This program must: • Be driven by the needs of the Service Member/ veteran and his/her family rather than by DoD and VA traditions • Meet prospective users where they live rather than wait for them to find their way to the right mix of our services • Increase access and reduce stigma

  34. Advantages of working at State & community levels • National Guard programs are organized by state • Each state has its own veterans outreach program • Builds a system of interagency communication and coordination that may serve well at times of disaster

  35. Take home point There should be NO WRONG DOOR to which service members, veterans or their families can come for help

  36. QUESTIONS?

  37. Basic Training – Military Culture

  38. Basic Training – Military Culture Understanding the nature of the military culture, combat and the stresses of living and working in a war zone are critical to establishing credibility with your clients.

  39. Basic Training – Military Culture The military has its own laws, its own clothes and its own language. To serve them better and help ease their fears about treatment, we first need to understand what being a veteran is all about and be familiar with all things military. Scott Swain, 15-year Gulf War veteran, Senior Director Veterans Services Valley Cities Counseling and Consultation Auburn, WA

  40. Basic Training – Military Culture • Army • Army National Guard • Navy • Marine Corps • Air Force • Air National Guard • Coast Guard*

  41. Basic Training – Military Culture • A word about lingo…some examples • OEF= Operation Enduring Freedom (Afghanistan) • OIF = Operation Iraqi Freedom (Iraq) • OND= Operation New Dawn (current status of Iraq)

  42. Basic Training – Military Culture • A word about lingo…some examples • IED= Improvised Explosive Device • VBIED= Vehicle Born IED (car or suicide bomb) • ROE= Rules of Engagement • The Wire = defines a relatively safe area • In Theatre/in Country = place of deployment

  43. Basic Training – Military Culture • A word about lingo…some examples • FOB = Forward Operating Base • MOS= Military Occupation Specialty – job in the military • RPG = Rocket Propelled Grenade • SAF= Small Arms Fire

  44. Basic Training – Military Culture • A word about lingo…some examples • DoD = Department of Defense • VA= Department of Veterans’ Affairs • TRICARE= military health insurance • National Guard = state organization deployed by Governor • Reserve= federal organization deployed by President

  45. Basic Training – Military Culture • A word about lingo…some examples • Marine = Marine • Navy= Sailors • Army= Soldiers • Air Force = Airmen/Airwomen • Coast Guard = Coast Guard - “Coasties” • National Guard = The Guard • Reserve= Reservist

  46. Basic Training – Military Culture • High standard of discipline helps organize and structure the armed forces • Professional ethos of loyalty and self-sacrifice maintains order during battle

  47. Basic Training – Military Culture • Distinct set of ceremony and etiquette creates shared rituals and common identities • Emphasis on group cohesion & esprit de corps connects service members to each other

  48. Take home point Know something about military culture

  49. QUESTIONS?

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