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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 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

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NEW JERSEY VETERANS HELPLINE PROGRAM 1-866-VETSNJ4… YOU! 1-866-838-7654 A Partnership of UMDNJ- UBHC & NJ DMAVA

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  1. NEW JERSEY VETERANS HELPLINE PROGRAM 1-866-VETSNJ4… YOU! 1-866-838-7654 A Partnership of UMDNJ- UBHC & NJ DMAVA

  2. 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

  3. NJ VETERANS HELPLINEServices 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

  4. New Jersey Veterans HelplineCALL HISTORY- 2005- 2008 Total calls : 5,637/8,882 Service Requests Call backs by Veteran/peer counselors: 3,324 Telephone counseling /treatment requests: 1,564 2009 (3 MO’S)TOTAL CALLS/CONTACTS= 2,894 FIELD/GROUP CONTACTS = 1,977 CALLS & TELEPHONE COUNSELING= 917 60-70% OEF/OIF Gender – 80% male, 20% female

  5. FIELD ACTIVITY SUMMARY RECONSTITUTIONS/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

  6. “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

  7. 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)

  8. WHAT YOU ARE DOING… VOLUNTEERING TO SUPPORT OUR TROOPS AS A MEMBER OF THE UBHC- UMDNJ TEAM LED BY THE NEW JERSEY VETERANS HELPLINE STAFF BY GENUINELY SHARING YOUR GRATITUDE FOR THEIR SERVICE PROVIDING PSYCHOEDUCATIONAL INFORMATION, “CHECKING IN” WITH THEM ON THEIR EXPERIENCES BEING DEPLOYED ASK HOW THEY FEEL AS THEY ADJUST TO RETURNING HOME……

  9. STEPS OF THE “WELCOME HOME” 1:1 Welcome Home 1:1 Psycho educational Session- Thank them! Introductions/Sign In/ Program Sheet Review Packet/Forms Interview-(script) Psycho educational component Offer resources/follow-up 12

  10. 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

  11. 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

  12. 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

  13. WHEN & WHEREWILL THIS TAKE PLACE? Welcome Reconstitution sessions will take place between June 1, 2009 and June 20, 2009 at Fort Dix 3601 Saylors Pond Road Fort Dix, New Jersey 08640 IMPORTANT- Confirm event prior to reporting as the schedule may change and confirmation via email or phone should be received.

  14. 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

  15. WHAT HAVE THEY TOLD US?New Jersey National Guard –OIF/OEF Veteran 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

  16. 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

  17. Military Families & New Jersey Veterans Helpline Primary Diagnosis/Complaintwith Parenting/Family Issues Depression 93%Anxiety 91%Aggression 89%Marital/Family 68%Violence 27%

  18. 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

  19. TOP TEN COUNTIES DEPLOYED SOLDIERS –WHERE THEY LIVE

  20. 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 University PURPOSE • 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

  21. 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

  22. 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

  23. 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

  24. 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

  25. 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

  26. 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

  27. Mental Health Problems by Number of Previous Tours All values significant at p=.000

  28. Mental Health Problems by Length of Time Since Previous OIF/OEF Tour

  29. 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

  30. 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)

  31. MILITARY SUICIDE INFORMATIONStatistics 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

  32. FORMS • New Jersey Veterans For You Helpline Flyer • Refer to Flyer in offering and explaining service • Highlight that flyer has questions re; reactions the soldier may have that can be reviewed (PTSD checklist)

  33. FORMS QPR Explain to soldier QPR can help them and their families to help each other Refer to Flyer Question, 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

  34. NEW JERSEY VETERANS HELPLINE PROGRAM 1-866-VETS-NJ-4 - - - 1-866-838-7654 Free Confidential Helpline for New Jersey Veterans and their families Question, Persuade, Refer QPR IS A SUICIDE AWARENESS TOOL Be your “Brother’s Keeper” not just during times of crisis but always Remember: 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 –Persuadethe 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 tryto 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 Soldier QPR 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!

  35. Question, Persuade, Refer Ask 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 SUICIDE KNOW 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

  36. MILITARY DEFINITIONS RECONSTITUTION: To return the soldiers to their home base taking them off active duty status and putting them on reserve status.

  37. DEFINITIONS REINTEGRATION: 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

  38. DEFINITIONS MOS- Military Occupational Specialty OIF- Operation Iraqi Freedom OEF- Operation Enduring Freedom LOD- Line of Duty NJDMAVA-New Jersey Department of Military & Veterans Affairs FAC- Family Assistance Centers VSO- Veteran Service Organization

  39. 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)

  40. 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?

  41. 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?

  42. 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?

  43. 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?

  44. 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 needed • Also advise they can call the “New Jersey Veterans Helpline” program anytime day or night 1-866-VETSNJ4…..You 1-866-838-7654

  45. 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.

  46. OPERATIONS A 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

  47. OPERATIONS Crisis 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

  48. NEW JERSEY VETERANS HELPLINEIMPORTANT 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

  49. 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

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