Farr's Mission: Better Tools, Law Enforcement Response to Returning Veterans in Crisis

Every day, people all across the country do solid work to help veterans successfully transition from combat to civilian life. Every effort has meaning. Every person donates uniquely to the pool. Today, I'd like to introduce you to one of these individuals: Darin C. Farr of the Utah Department of Veterans Affairs.

Clearly gifted and passionate about his work, Farr assists veterans on a local level [for example, a StoryCorps interview conducted by Farr with a former soldier who served in the Iraq War was recently broadcast on KCPW] and he also extends his knowledge and talents far and wide via his timely and well-crafted media productions.

In a summer post, I mentioned The Walking Wounded Are Coming Home, Farr's first video. Made for law enforcement officers, it showed how their understanding and response to incidents involving returning veterans in crisis can greatly impact outcomes. Farr's next feature, Transmission on Transition, further explored combat PTSD and traumatic brain injury, or TBI, and is geared toward military families.

I've also learned that it's been nominated for a Peabody Award.

The strength of both programs is in their substance, of course; but, they excel both visually and dramatically as well. Currently being shown in training/educational programs conducted by the Utah VA, Farr has also uploaded each feature online. You'll find both programs and a brief review of each in extended.

Good work, Utah VA!

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The Walking Wounded Are Coming Home

Walking Wounded is meant to 1) educate law enforcement individuals on how their presence my unduly threaten and trigger hypervigilence and other PTSD-associated symptoms in returning veterans, and 2) law enforcement's power to defuse these encounters by acknowledging and attempting to reduce the veteran's anxiety, thereby increasing the likelihood of securing a positive outcome for both officer and individual.

The film opens with a dramatization of soldiers on a mission (presumably in Iraq) coming under fire. A battle buddy is lost. Viewers are then introduced to combat trauma and PTSD through interviews conducted by a number of psychologists, suicide prevention coordinators and other VA, Vet Center and PTSD Clinic officials. Later in the program, we again meet one of the opening scene's soldiers. This time, he is spiraling out of control, flashing back to the attack.

The program shows viewers how a dangerous situation -- such as the suicide-by-cop scenario they present -- can have very different outcomes depending on how everyone involved handles the event. On the part of responding officers, the tone and skill of their response is critical. Education, the very reason for this film's production, is the key component in honing that response and securing the best outcome possible.

One thing is certain: Not only should a city's crisis intervention teams be trained to deal with these types of eventualities, all law enforcement officers should have access to these crisis response tools. Walking Wounded is a good addition to any community's law enforcement training program.



Mission: Transmission on Transition

Written and directed by Farr, Transmission was made with returning veterans and military families in mind. Offering information on PTSD and TBI, phone numbers and website addresses of some of the many available reintegration resources are interspersed throughout.

As in Walking Wounded, Transmission skillfully weaves together interviews with professionals along with various dramatized situations that veterans -- both male and female -- experience during the course of their deployment and reintegration.

Opening the feature, we find ourselves traveling with a group of soldiers on a convoy mission. They are talking about what they will do when they get back home, their dreams of returning to college, etc. A roadside bomb explodes.

In the next scene, we see a couple driving in a car casually talking. The driver, the same soldier who was driving the Humvee earlier, sees something in the road and flashes back to the attack. He starts driving evasively, swerving into traffic, and is pulled over by a police officer. He is clearly embarrassed and agitated.

There are two other scenarios presented.

One looks at a female veteran's experience of applying for a civilian job after her deployment, and the frustration of having to deal with an uneducated Human Resources department. The other dramatization follows another returning soldier and his experience in college as he struggles to understand why he is having such a hard time concentrating and remembering things.

The video closes with a look at improvements being made by the VA and a welcome by the Salt Lake City VA Medical Center.




Related Posts

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Thanksgiving, From the Frontline to the Homefront and Back Again

Happy Thanksgiving.

How is your holiday shaping up? I hope that you and yours are on your way to building a memorable one. Before moving into the heart of this post, I'd like to take a moment to personally thank the family that I'm blessed to have, who offer me the support and encouragement to continue plugging away.

This work means a lot to me, as do my studies; but, both of these endeavors take enormous amounts of time away from those that love me and that I love in return. So, I thank them for being there for me, nonetheless, through it all.

While certainly on a larger scale and scope magnitude, deployed troops also give up a lot to accomplish their goals and achieve their mission. Their families also give up one of the most valuable and perishable commodities we have in life: time with those we love the most.

This Thanksgiving, I wish you all the best -- ample hours with family and the very best of friends; a good meal; moments to relax or to kick things up if you prefer; and the grace to reflect, no matter the present appearance, on the many things we all have to be thankful for.

In extended, I've collected a few reflective stops on the media landscape, as well as a few video 'shoutouts' from troops serving overseas to loved ones back home. Let's keep them all in our thoughts, as always, and recommit to extending ourselves to the families who await their return.

Happy Thanksgiving, dear readers and friends.

Gratitude is not only the greatest of virtues, but the parent of all the others. -- Cicero (106-43BCE), Rome

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From the Seattle Times editorial board:

A war-weary military and nation await President Obama's new strategy for Afghanistan, eight years after the war began to answer the 9/11 terrorism attacks. The war in Iraq, with its regrettable and suspicious beginnings, straggles into its sixth year.

But the perspective of another war president almost 150 years ago bears reflection.

As the Civil War dragged into its 18 month, President Abraham Lincoln signed a Thanksgiving Proclamation that began the annual American tradition of counting blessings. Other presidents before him signed them sometimes, but Lincoln's began the nation's annual late-November pause.

His proclamation is a prayerful work, giving thanks to the "Most High God," but it is also a painstakingly laborious glass-half-full effort to eke out blessings in the middle of a "civil war of unequalled magnitude and severity" that threatened to rend the nation. The war would take the lives of 620,000 Americans, but the union would endure.

"Needful diversions of wealth and of strength from the fields of peaceful industry to the national defence, have not arrested the plough, the shuttle, or the ship; the axe has enlarged the borders of our settlement, and the mines, as well of iron and coal as of the precious metals, have yielded even more abundantly than heretofore ... and the country, rejoicing in the consciousness of augmented strength and vigor, is permitted to expect continuance of years, with large increase of freedom."

Though much has changed since 1863, not the least of which is the idea that coal is the hope for the future, the spirit of Lincoln's message should be emulated.

We Americans, wars and all, have so much for which to be thankful. Our troops, of course, and all those before who fought for the liberties we enjoy. Though some are calling the shooting rampage at Fort Hood an act of terrorism, we have not had another terrorist attack on U.S. soil of the magnitude of 9/11.

A historic presidential election of a man who, had he lived in Lincoln's day, might have been a slave. That election changed course in many ways, not the least of which is the U.S. relationship with the world, and goosed robust, if cantankerous, debates on health care and energy.

Obama, a student of Lincoln's presidency, signed a Thanksgiving proclamation too, but his blessings-counting can be found in remarks he made after this week's Cabinet meeting.

"Having gone through this very wrenching adjustment, we continue to have the best universities in the world, the best innovation and technologies in the world. We continue to have some of the best workers in the world, the most productive workers in the world. And we have the kind of dynamism and entrepreneurship in our economy that's going to serve us well in the long term. The key is to bridge where we are now to that more prosperous future."

In his proclamation, Obama urged Americans to help fellow citizens: "Let us be guided by the legacy of those who have fought for the freedoms for which we give thanks, and be worthy heirs to the noble tradition of goodwill shown on this day." [USA Today has a wonderful collection of ideas for ways you can give back to your community.]

In a time when so many of us have so much less than we used to and are missing loved ones fighting distant wars, it is certainly a time not only to count our blessings and catalog our strengths but to embrace them.

Count your blessings and keep the faith.

WTKR-Channel 3 [Norfolk, VA]:

As night falls at a now quiet Fort Eustis, inside the dining facility these troops are just getting started.

Turkey...check.

Gingerbread...you got it.

And plenty of potato salad to go around.

Seargent Jesse King leads this group of culinary specialist soldiers. They have been prepping for Thanksgiving day all year long. Now they are prepared and ready for the huge task ahead. This week alone they've put in 60 hours of preparation to cook a meal for 1,200 soldiers.

"We're talking over 10,000 pounds of food being prepared tonight alone. So it's not like cooking for your immediate family," King said.

Just another day for these soldier chefs. Between the beef and sweet potatoes, these soldier chefs say there is meaning behind the meal.

"I'm thankful for all the soldiers we have present and those who are deployed also," said SSGT Helen Ospy. Those who aren't cooking are cleaning and turning this dining area into a festive celebration for all seasons. "We want everyone to remember Thanksgiving all year round, not just in November," Ospy added.

No matter the month, this group says they are proud to serve and support those who serve this country. "It feels wonderful to be able to serve civilians and military personnel alike. We all work together."

Tomorrow's meal is open to anybody with a military ID. Just come to the Fort Eustis dining facility. The best part is - the meal costs only $7.

WHSV-ABC Channel 3 [Staunton / Shenandoah, VA]:

On the other side of the world, cooks in Iraq are preparing a feast for American soldiers.

The work has been going on for several days because they are feeding thousands of troops. It's all about making them feel a part of an American tradition.

"It's pretty much for morale," says Rosemary Tamba who works in food service for the military. "Back home you have your sweet potatoes, mashed potatoes, your turkeys, so we pretty much try in indeed, to have the same kind of meals that you have back home just to give you a little taste of what you're missing."

The chef is preparing the turkey in three different ways with all the fixings.

"We are making cheesecake, and then lots of pies will be there, pumpkin pie, pecan pie, sweet potato pie," says Executive Chef Amit Sharma.

Karen Jowers, Air Force Times:

Now that’s one big shopping list.

The Defense Logistics Agency has almost finished getting about half a million pounds of turkey plus other Thanksgiving dinner fixings to Afghanistan and Iraq.

The 13-item menu also includes ham, beef tenderloin, shrimp and trimmings such as vegetables, desserts and cakes.

Troops in Iraq will eat 376,924 pounds of turkey, 26,946 pies, 7,188 cans of cranberry sauce and 37,107 pounds of stuffing mix for Thanksgiving.

Much of the Thanksgiving feast is already in Iraq — and Afghanistan, as well. Service members in that theater will feast on the same types of items in smaller quantities, with one exception — they’ll get more beef tenderloin, 112,467 pounds, than turkey, 90,575 pounds.

Buyers at DLA started shopping for the Thanksgiving meal items for troops in Iraq and Afghanistan in April, getting the process started early to ensure everything gets overseas in time.

Following, a selection of Thanksgiving 'shoutouts' from troops serving overseas to those back at home. To start, the annual Fort Hood Operation Turkey Day Shoutout, Pt. 1 (2, 3, 4)



From the Army Media Center, Pt. 1 (2, 3, 4)



A collection put together by UAW Local 387:









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Join Me at 'A Sycamore Thanksgiving'

Monday evening I'm participating in 'A Sycamore Thanksgiving,' the launch of an annual event at the Sycamore, Ill., library [facebook event page]. The free evening of entertainment, which organizers hope will be reminiscent of a holiday variety show, brings together 6 authors, 8 musical groups, 2 fashion shows, a photo exhibit and more -- all mixed up to keep it lively.

Please join us for what sounds to be a fun way to kick off Thanksgiving. Details from Dennis Hines, Midweek:

Thanksgiving is coming a few days early in Sycamore. Representatives from the Sycamore Public Library and Borders in DeKalb are set to host “A Sycamore Thanksgiving” Monday, Nov. 23 at the library, 103 E. State St.

Although this festival won’t feature turkey and stuffing, there will be a smorgasbord of entertainment and activities. The event will include performances from local musicians, book signings from local authors and a fashion show with representatives from maurices, Cracker Jax and Unique Concepts Salon.

“It’s a unique event in that we’re pulling together three rather disparate things. There’s a little something for everybody,” said Larry Zevnik, director of adult services for the Sycamore Public Library.

[UPDATE November 25, 2009]: Event pictures...



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The event will feature music from Kishwaukee Flats, Tempted Turtle, Elle Smith, Glory, Zachary Harris, Demetra Dokos, Bill Leighly and The Cerny Brothers.

“I just love bringing music to the library. We don’t do enough of that, and these are all local performers,” Zevnik said. “A couple of these bands are still in high school. People that young are able to get in front of a live audience and perform, so I’m very impressed.”

Some of the authors signing copies of their books include Lorelei Bell, Richard Martelet, Diane Ladley, James Ballowe, Ilona Meagher and Anbritt Stengele. Zevnik said each author has their own writing style.

“It’s a nice mix. There’s some fiction and some non-fiction. Whatever anybody’s taste in books, I think there will be somebody there who they will be interested in talking to,” Zevnik said. “Of course, for anybody who is interested in writing, it’s always a great idea to sit down with somebody who is published and find out what the process is like.”

“A Sycamore Thanksgiving” will be held 5-8:30 p.m. in the Big Meeting Room of the library. Zevnik said residents are welcome anytime during those hours.

“People don’t have to be here for the whole thing,” Zevnik said. “That’s one point that I’m trying to get across. Because people might look at that and go, ‘I can’t spend three and a half hours there.’ There’s going to be entertainment all night. It’s always going to be changing. So if you come in for 10 minutes or three hours, either way, that’s great.”

Related Posts

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Veterans, Reintegration and Military Mental Health: A Selection of Recent Broadcasts

Sharing a few recent programs that examine some of the reintegration issues of our returning troops. Thursday's Diane Rehm Show devoted the hour to military mental health [listen].

Mental health in the military: Increasing rates of suicide, depression, and substance abuse raise concerns about mental illness in the armed forces. What's being done to assess and treat mental health problems in the U.S. military?

Guests

Yochi Dreazen, military correspondent for "The Wall Street Journal"

Nancy Sherman, Professor of Philosophy at Georgetown University and Adjunct Professor of Law at Georgetown Law School. She served as the inaugural holder of the Distinguished Chair in Ethics at the US Naval Academy from 1997-9. She is the author of three books, including 'Stoic Warriors: The Ancient Philosophy Behind the Military Mind.' She is at work on a new book titled 'The Untold War: Inside the Hearts and Minds and Souls of Our Soldiers.'

S. Ward Casscells, M.D., John E. Tyson Distinguished Professor of Medicine and Public Health, and Vice President for External Affairs and Public Policy at the University of Texas Health Science Center at Houston. He is the former Assistant Secretary of Defense (Health Affairs).

Jennifer Crane, served in the Army from 2000 to 2003. She is a volunteer with the non profit organization 'Give an Hour.' Give an Hour is dedicated to meeting the mental health needs of the troops and families affected by the ongoing conflicts in Iraq and Afghanistan.

Jeff Hall, is a Major in the Army now based in Fort Riley, Kansas. He served two terms in Iraq.

A few more selections in extended.

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An informative round table discussion, Houston PBS:

An estimated 20% of veterans suffer from post traumatic stress disorder, and 2008 has the distinction of being the year with the highest record of veteran suicides to date.

As the wars continue in Iraq & Afghanistan, what is the psychological toll taken on todays armed forces? Guests include: Captain W.O. King, U.S. Navy (Ret.); Marcus Smith, Outreach Specialist, Vet Centers-Houston; John Vincent, Ph.D, Director of Clinical Psychology, University of Houston; original broadcast date November 13, 2009.

And from The Massachusetts School of Law:

Female veteran's of the war in Iraq speak about soldiers dying on their watch, dealing with Post Traumatic Stress Disorder, and the difficulties of returning home. In this episode of The Massachusetts School of Law's Educational Forum, Professor of law Diane Sullivan interviews Kirsten Holmstedt on her book, The Girls Come Marching Home: Stories of Women Warriors Returning From The War In Iraq.

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NPR's 'Impact of War' Series Highlights Work of Soldiers Project Founder Judith Broder

A head's up: Give today's NPR's Weekend Edition Saturday a listen.

Last week, NPR introduced its month long look at the impact of war on military families -- the spouses and kids and parents doing time stateside while their loved one is deployed overseas.

Part of NPR's larger Impact on War project, its goals are to support member stations in collecting and sharing local stories, and "give a voice to the struggles and the triumphs of not just the military brass but the boots on the ground...and those affected by their absence during deployment and in death."

This morning on Weekend Edition Saturday, Gloria Hillard will introduce listeners to Dr. Judith Broder, founder of The Soldiers Project and recent Purpose Prize winner:

Broder saw a play in Los Angeles called The Sand Storm: Stories from the Front. Written by a Marine, it featured monologues of those who served in Iraq and Afghanistan.

"The most horrifying aspect of it was the sense that I got that these were really just ordinary everyday guys, and they had seen things and done things that just shattered their whole sense of themselves," says Broder. "And that they would all need help."

That's when Broder, a clinical psychiatrist, put her retirement plans on hold and founded the Soldiers Project. It provides free counseling not only to service members returning from war — but to their families as well.

Today, the Soldiers Project has more than 200 licensed therapists nationwide — all volunteers who have received specialized training in everything from combat-related traumas to military culture.

Be sure to listen in this morning (full audio should be online by 12:00 p.m. EST at NPR). Much more in extended.

Click on 'Article' link below tags for more...

In educational interest, article(s) quoted from extensively.



Encore.org on its Purpose Prize winner:

Broder created The Soldiers Project, which provides unlimited, free, confidential therapy to combat veterans. The program, unlike the U.S. Department of Veterans Affairs, also provides therapy for affected family members who request it.

The sessions aim to alleviate the behavioral problems that can result from combat trauma and address personal, moral, and spiritual crises that may follow grim wartime experiences or personal actions.

The Soldiers Project recruits volunteer therapists; gives them specialized training; and encourages conversations with troubled veterans and active-duty military personnel as well as their spouses, partners, parents, and other family members. Broder says the five-year-old program has a network of more than 200 volunteers, has treated more than 300 patients in the Los Angeles area, and is being replicated in other cities. ...

Although Broder, 69, knew very little about the military health system before she started The Soldiers Project, she knew enough about how people react to trauma to be convinced that with more than a million soldiers returning to their old lives - sometimes after multiple deployments - there would be a need for help. ...

The Soldiers Project also puts intense effort into public education about the hidden wounds of war. Broder has spoken at churches, synagogues, Rotary clubs, and military family support groups - "anyone that would have me" - noting that reaching an age when she had satisfied her professional ambitions gave her the freedom to step outside her comfort zone. "Most of my career, I sat and listened. Suddenly, to publicize the project, I had to become a public speaker, and it turns out I'm pretty good at it."

To further build momentum, Broder organized two conferences exploring mental health care; the most recent one, in May, brought together soldiers, families, VA officials, and mental health professionals. And Broder is pushing to establish a presence at local community colleges, where many veterans are enrolled.

Yesterday, the series also included a brief interview with VA Secretary Erik Shinseki, who talked about a recent visit he had with just such veterans attending college.

As for The Soldiers Project, it continues to expand, reaching out to include four California cities as well as satellite offices in New York, Washington, New Jersey, and Illinois.

Alex Parker, Chicago Tribune:

The Soldiers Project has chapters in several cities, including a Chicago chapter begun in 2007 by Kate Schechter, a faculty member at the Institute for Clinical Social Work and the Rush University Medical College Department of Psychology.

"I realized that my students would be inheriting the problem of dealing with traumatized people their age, their peers, coming into the community," she said. "It was kind of a systemic vision of education for the next generation."

Although about 80 mental health professionals offer their services in the Chicago area, fewer than 20veterans have enrolled since the program began.

Outreach is difficult, said Schechter, because the volunteers have full caseloads at their private practices. Most veterans learn about the program through word of mouth, she said.

If you or others you may know are in need, contact Soldiers Project Chicago at kschecht@uchicago.edu.


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Study of Combat Trauma, PTSD at Fort Hood Outlined By University of Texas Researcher

A couple of weeks ago, a facebook contact drew my attention to an exciting university study tapping into Ft. Hood's returning troops and aiming to comprehensively determine their risk factors for combat PTSD. I read the article, and then filed it away, hoping to have time to pass it along to you here.

Considering last week's shooting, the study may increase in interest for some; but, the work conducted by Dr. Michael Telch's team deserves attention on its own merits. An introduction by Jeremy Schwartz, American Statesman:

Are some soldiers more likely than others to develop post-traumatic stress disorder, a malady that affects nearly one in five service members returning from Iraq and Afghanistan? Is there anything in their genetics, brain structure or ability to handle stress that might make them more or less prone to PTSD? And if researchers can pinpoint risk factors for the disorder, is it possible to "inoculate" service members before they deploy to a war zone?

A study at the University of Texas, called the Texas Combat PTSD Risk Project, is seeking to answer some of those questions using methods that researchers say haven't been tried before. The study put 183 Fort Hood soldiers through a battery of tests before and after their first yearlong deployment to Iraq and had them fill out a monthly "stress log" over the Internet while they were on the battlefield. The result is one of the more comprehensive studies to search for risk factors for the illness, which, along with traumatic brain injury, military leaders call the signature disease of the current conflicts.

Lead investigator Michael Telch, a UT professor of psychology and the director of UT's Laboratory for the Study of Anxiety Disorders, said the research could lead to prevention programs for PTSD.

"Just like with the prevention of heart disease or many other medical conditions, the first critical step in addressing the problem of combat PTSD and other combat-stress disorders is to identify the factors that increase soldiers' risk for developing them," Telch said in an e-mail. "We hope that this study will ultimately provide important new insights into the causes of combat PTSD and ways to prevent it."

Video and much more in extended.

Click on 'Article' link below tags for more...

In educational interest, article(s) quoted from extensively.

Telch outlined the study's parameters and preliminary findings in detail at last month's Council for the Advancement of Science Writing conference. From the clip's introduction:

The study will provide information on possible genetic, brain, behavioral, social, and psychological factors that increase soldiers risk for PTSD and other combat-related stress disorders. That, in turn, could lead to more effective screening and prevention programs, reducing the incidence of these often debilitating disorders.

Marjorie Simoens, OnCampus:

During the past few years, soldiers have been bused from Fort Hood to Dr. Michael Telch’s anxiety disorders research lab to help determine the factors that may predispose service members to post-traumatic stress disorder (PTSD) as part of the Texas Combat PTSD Risk Project. ...

The pre-deployment assessment includes full neuroimaging at the Imaging Research Center, comprehensive clinical interviews, dozens of validated questionnaires, an eye tracking assessment and a carbon dioxide stress test where the subjects inhale a mixture of 35 percent CO2 and 65 percent oxygen for 30 seconds.

“It’s a major stressor,” Telch said. “What we do is we assess their reactions subjectively, and their hormonal response – their cortisol and testosterone responses to the challenge – and we ultimately want to link their reactions to their risk for developing combat stress problems in theater.”

Once deployed, soldiers have access to a Web-based system where they can fill out an online questionnaire every 30 days.

The questionnaire is divided into two parts, the first one assessing any stressors or stress experiences the combatants have been exposed to – such as witnessing a car bomb or participating in a firefight. After indicating exposures, soldiers are asked to specify which experience caused them the most stress. Part two of the questionnaire asks about individual stress reactions. Telch said soldiers are provided a list of symptoms related to PTSD, depression and anxiety, and asked to rate each item in terms of how severe they have experienced the symptoms in the previous 30 days.

“Rather than waiting for soldiers to come home and ask them how they have been doing, we are able to track in real time, while they are still in the combat zone, which is a new innovative piece of the puzzle,” Telch said.

When they do come home, soldiers return to the anxiety disorders lab to do a full day of assessments similar to the pre-deployment stations. Telch also conducts one-on-one interviews with each participant during the third phase of testing. During these interviews, Telch has been able to craft inferences that he wasn’t expecting, such as how the accessibility to the Internet has cause added stress for combatants.

“When you think about earlier wars, you got a letter once in a while, but the way it is working now, not only are the soldiers having to experience the stress of being away from home and all of the stressors related to combat, but they also get bombarded with the stressors from back home because of the Internet,” Telch said. “So they are getting e-mails all of the time, and there have been some real horrendous horror stories.” ...

Telch said he hopes to conduct one-year follow-ups with the soldiers who were deployed to Iraq, and eventually expand the number of service members in the study to 500. He said once his team obtains additional funding, it would switch to soldiers being deployed in Afghanistan.

Continuing, American-Stateman:

Michael Malchow, a 21-year-old soldier from Wisconsin, was one of the 183 Fort Hood soldiers who volunteered to take part in the UT study. He said he was motivated because he's seen the impact of the disorder on a cousin's father, a Vietnam veteran. "I've known for a long time that PTSD has been a big problem," said Malchow, whose unit spent a year patrolling an area near the Iran-Iraq border. "Hopefully, this study will help them find out in better terms how to diagnose it ahead of time, before it becomes a huge problem."

Baldwin, who helped develop the idea for the study, presented it to Fort Hood leaders, who quickly signed on, giving Baldwin access to companies and units. Baldwin said 85 to 90 percent of the soldiers briefed on the study volunteered to participate. ...

Shortly before deploying to Iraq in June 2008, Malchow and his unit journeyed south to Austin to undergo a testing process, paid for by the U.S. Department of Defense.

There were clinical interviews to identify current or previous mental illness or depression; genetic testing so researchers could study a variety of genetic markers, including the seratonin transporter gene, that might make soldiers more susceptible to combat stress; and imaging scans to allow researchers to study areas of the brain such as the amygdala and hippocampus, which are involved in stress reactivity and emotional processing.

Researchers also gave the soldiers eye-tracking tests, flashing pictures of faces in different emotional states to see whether they had a propensity to avoid or fixate on emotional stimuli.

Telch said that soldiers who tended to fixate on the emotional images might "focus on threatening stimuli in a war environment."

Finally, soldiers underwent carbon dioxide stress tests, in which they inhaled a mixture of 35 percent carbon dioxide and 65 percent oxygen and held it for five seconds. While feeling the effects of the mixture, soldiers were tested for heart rate and stress. Telch said that though the test produces light-headedness and breathlessness in everyone, some people react with intense emotional distress and even panic.

"If there was an exaggerated stress response to this challenge, they might present an exaggerated response" in a combat zone, he said.

The soldiers, none of whom were killed in combat, underwent the same testing when they returned this spring, giving researchers comprehensive before and after comparisons. And the soldiers' logs while in Iraq allowed researchers to see what kind of reactions the soldiers had to certain battlefield stressors such as roadside bombs and firefights.

Telch said that preliminary data indicated that soldiers who showed pronounced responses to the carbon dioxide stress test showed more stress in Iraq. And he said his group's research may also uncover factors that make some soldiers more resistant to PTSD, such as feeling emotionally supported by fellow soldiers and by friends and loved ones at home. ...

Telch said his team plans to apply for more financing and hopes to enroll 560 soldiers in future studies. He said that as the conflict winds down in Iraq, future studies will most likely use soldiers deploying to Afghanistan.

Telch said that whatever the results of the studies, they won't predict with certainty which soldiers will develop the illness. "It would depend also on the stressors encountered over there," he said. But armed with the results of such pre-deployment PTSD testing, military leaders could design prevention programs for those service members who are more vulnerable.

Rachel Ehrenberg, Science News:

Receiving bad news from home is one of the highest stressors of the battlefield, second only to hostile incoming fire, according to preliminary data presented in a morning session October 20.

“Not only do they have the stressors in the war zone, but they are constantly bombarded by messages from home,” said Michael Telch, (cq)director of the Laboratory for the Study of Anxiety Disorders at the University of Texas at Austin. “They are flooded with the Internet…. You wouldn’t believe the stories I’ve heard of women moving in boyfriends, then the boyfriends drove the soldiers’ cars, used their credit cards and all sorts of horrific things.”

The weight of various aspects of war emerged from data gathered in stress logs kept by more than 150 soldiers from Fort Hood who were deployed as part of Operation Iraqi Freedom. Keeping stress logs is one aspect of a project that aims to untangle what risk factors predispose soldiers to post-traumatic stress disorder, which can leave those who have experienced traumatic events with persistent emotional and physiological and psychological problems.

Diagnosing PTSD in veterans has been controversial, in part because most studies are retrospective—they try to extrapolate by looking back—and they often rely on self-reported questionnaires. Several factors, including a desire (unconscious or not) to suppress the effect of traumatizing events, can skew self-reported data.

Telch and his colleagues are taking a new approach to examining PTSD: evaluating soldiers before they are sent to Iraq, throughout their deployment and re-assessing them when they get home. The researchers are looking for correlations with factors that include genetics, data gathered from brain imaging and psychological history.

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Caregiver Clips: Military Combat Trauma Counseling Statistics, November 2009

This month's clips cover the current state and strain of military mental health counseling in the wake of last week's Ft. Hood shooting. First, from Emily Mullin, Scripps News Service:

Questions are emerging about how a few hundred military mental health counselors are treating thousands and thousands of men and women in the armed forces in Afghanistan and Iraq.

According to official Army figures, 308 military psychiatrists serve 1.4 million active-duty members. On average, 200 behavioral-health personnel - including psychiatrists and other mental-health counselors - are deployed in Iraq and about 30 in Afghanistan.

Dr. Nancy Sherman, a military ethicist at Georgetown University, said the military and mental health care systems in general are "very stressed."

"We are a military fighting two wars at once with a non-drafted army," she said. Sherman said there has been a shortage of military doctors throughout the wars in Iraq and Afghanistan and likely a scarcity of military psychiatrists and therapists.

Click on 'Article' link below tags for more...

In educational interest, article(s) quoted from extensively.

Mark Mueller, Star-Ledger:

Experts call it "compassion fatigue," "vicarious trauma" or "secondary trauma." By any name, it is a phenomenon that has gained wider attention in recent years. ...

[W]hile mental health workers are taught well how to care for others, "sometimes we’re not taught very well how to take care of ourselves in the process," [said George S. Everly Jr., an associate professor of psychiatry at the Johns Hopkins School of Public Health and a leading authority on stress and trauma].

"It is a problem that affects my industry," he said. "If there is a call to action, it is that we must take better care of ourselves. This takes a toll on you."

It’s been two decades since the American Psychiatric Association recognized vicarious trauma, but it has received little attention outside the field.

By empathizing with victims, by trying to picture and understand what they have gone through, caregivers sometimes feel as if they have experienced the trauma themselves, experts said. As a result, they may experience some of the same symptoms, including nightmares, panic attacks, depression and withdrawal from friends, relatives and colleagues.

In a study published two years ago, University of Georgia professor Brian Bride found that social workers who regularly work with victims of trauma are twice as likely to develop PTSD as members of the general population. Military spouses and nurses also are known to experience the problem, Bride said.

Gregg Jones and Lee Hancock, Dallas Morning News:

An acute shortage of trained mental health workers in the military has left these therapists emotionally drained and overworked, with limited time to prepare for their own war deployments.

A military mental health task force in 2007 expressed concern about the stress on nondeployed mental health personnel because of the shortage, which it said was leading to high attrition rates. "A vicious cycle has formed that will probably continue to worsen before it improves," the report said.

Dr. Layton McCurdy, a psychiatrist and dean emeritus at the Medical University of South Carolina who served on the task force, said the shortage is compounded by the thousands of troops suffering combat-related stress. "The psychiatrists are working with more people than they have time to work with," McCurdy said. ...

Secondary trauma causes similar symptoms [to PTSD]: sleep disruptions, nightmares, depression and jumpiness. Sufferers may avoid situations that remind them of past stresses. A mental health practitioner also may feel guilty about not having done more to help a patient or may obsess about individual patients – particularly those with whom they identify.

One noted study found that social workers who treated survivors, victims' families and first responders at the World Trade Center after 9/11 were most susceptible to secondary trauma if they lacked social support.

Doctors generally have relatively high suicide rates, with psychiatrists having the highest rates. Both male and female physicians are significantly more likely to commit suicide than the rest of the population, according to a 2004 article in the American Journal of Psychiatry. Among all physicians. Psychiatrists are considered to be at greatest risk for suicide, according to the 2007 version of Kaplan and Sadock's Synopsis of Psychiatry.

Secondary stress poses more potential risks for military personnel – especially psychiatrists, said the study's principal investigator, public health researcher Joseph Boscarino of the Geisinger Health System in Danville, Pa. ...

Many military professionals describe crushing schedules with 10 or more patients a day, most struggling with devastating trauma or mutilated bodies.

Benedict Carey and Damien Cave, New York Times:

The Army has added to their ranks in recent years, as the number of soldiers with the diagnosis of post-traumatic stress disorder climbed to 34,000. But the shooting has raised a pressing question: Who counsels the counselors? [Bret A. Moore, a former Army psychologist at Fort Hood] and other therapists who have worked in the military or for Veterans Affairs said that mental health evaluations of therapists themselves were nonexistent.

Military therapists face an added pressure: they can be overruled by commanders who need soldiers in the field. Since 2001, the military has deployed many soldiers with post-traumatic stress disorder or other ailments. The military has made big strides in taking mental health issues seriously, but "the focus in the military is readiness," said Charles Figley, a psychologist at Tulane University. "There is an inherent conflict that will always be there."

At Fort Hood, where traffic in and out of war zones is a constant, the work conditions were especially stressful, according to at least one report provided to the Army.

Dr. Stephen M. Stahl, a psychiatrist at the University of California at San Diego who worked on the report, said the base’s program for soldiers returning from Iraq and Afghanistan lacked the staff it needed. He said there were about 15 psychiatrists on staff, treating hundreds of inpatients and outpatients. Generally, the psychiatrists did not do therapy but prescribed medication.

Related Posts

• Combat, Trauma and Healing PTSD: A Collection of Educational Videos for Caregivers and Patients
  
• Fort Campbell Braces For 101st Airborne Return, Prepares to Study Multiple Deployment Effecfs on Soldiers and Caregiver Staff
  
• Veterans Day: Thanks to Our Service Members and Their Caregivers
  
• Shortfall of Chaplains Another Military Strain
  
• DoD, GAO Reports Show Lack of Resources, Personnel Slowing Necessary Veterans Health Care Changes
  
• Army to Hire 25% More Mental Healthcare Workers, Senate Committee Votes to Increase TBI, PTSD Screening
  
• ABC World News Looks at Combat Stress Care
  
• 1-in-3 Veterans' Counselors Reporting Burnout
  
• Navy Psychologist Warns of Mental Health Provider, PTSD Training Shortfalls
  
• Scientific American: A Look at the Work of Combat Psychologists

What Can Civilians Do? Show Them They Are Not Alone Beyond Veterans Day.

Veterans Day is over.

Most people have moved on from yesterday's momentary pause to recognize those with military service. Many have by now returned to their usual concerns. Meanwhile, others continue the work they do, 365 days a year, reaching out to the veterans and military families in their communities.

Which camp are you in?

Well, if you're reading this blog, chances are you have a pretty clear interest in issues concerning vets and returning troops. You may even be someone others look to in your area as a leader, bringing those with military service (and those without it) together to foster new dialogue and form new bonds.

But, if you're a seeker and not yet a sage, this post is for you.

To begin, allow me to introduce you to NotAlone.com.

Its founders are building a unique online space for "warriors and families dealing with combat stress to come together, where they can spend time with others and start the healing process."

Now in its second year, NotAlone will offer some dynamic member tools that I've not seen bundled under one roof anywhere else. These include: social networking, community forums, online PTSD assessments to track your progress, and live online workshops that really sound cool. Learn more (fast-forward to 6:00 for a run-down on how the site will work):



A burgeoning library of recorded interviews with notable veterans, military family members, friends and advocates, psychologists and authors like myself has already been uploaded, and I'm excited to have my interview with Jenny Andrews included among them.

One of the issues we talked about was how average citizens might get engaged by doing something, anything, to help their local vets. In extended, a few brainstorming ideas.

Be sure to take some time to listen to a few of NotAlone's clips, and good luck in extending yourself to our nation's service members beyond the usual designated days.

Click on 'Article' link below tags for more...

From Jenny's Corner:

Even if we empathize greatly with the suffering of others, sometimes it’s hard to do something about it. We think it’s not our place to comfort the stranger sobbing in the airport. More to the point, us non-military folks feel like we can’t even begin to understand what it must be like for Warriors who have been out on multiple deployments and witnessed first hand the kind of stuff that gave me nightmares just hearing about. What the hell could we possibly do to help those with combat PTS?

Turns out, we can do a lot. Ilona Meagher, subject of this week’s featured interview, has done more as a civilian to bring awareness to the issue of military PTSD than most mental health professionals. What makes Ilona so special is her absolute fearless warmth and compassion. She intuitively took up a mission that people like Edward Tick have insisted is our duty as civilians under the protection of the military, and that is the mission to serve the Warriors and families of this nation in whatever ways we can.

Warriors serve because that’s what they are compelled to do. It’s what they’re good at, it’s what they’re trained for and most of them would say that they are glad to shoulder that burden. All Ilona would have you do is the same thing, only in your own way. She is good at writing, so that is what she did–she wrote a book and began a blog to raise awareness about PTSD. But almost anything you can do can be creatively applied to help Veterans, and if you’re a civilian, that talent should be applied to do just that to whatever degree you are capable.

Each individual and community has the power to exact change. Collectively, we are a powerful force. But sometimes we as individuals simply do not know what we can or should do, or perhaps we worry that our efforts will be squandered or our valuable time will be wasted.

Or maybe what keeps us from reaching out is the belief that the problem is simply too large to fix.

To counteract these concerns, set a goal to reach out to one or two veterans in your local community to keep from feeling overwhelmed by the entire nation’s needs, and tailor your volunteer efforts to your own personality, profession or skill set.

A few brainstorming ideas...

• Writers: Write articles on PTSD in national and local newspapers, magazines. Pen letters to the editor. Interview veterans, military family members and the people who help them. Review books that tell of wartime and service and civilian reintegration.
  
  
• Lawyers: Consider helping local veterans with their legal questions -- they have many.
  
  
• Yoga, meditation, or other physical fitness instructors: Provide a special class geared to military veterans and families; they could use the stress relief! Add yourself to the Yoga for Vets list.
  
  
• Readers and booksellers: Seek out and invite military veteran authors to talk about their work and experiences; buy their books!
  
  
• Entertainers: Arrange a concert or show, donating the proceeds to a veterans’ charity or nonprofit whose work you most want to support.
  
  
• Construction workers: Donate a weekend of time to an organization which builds complimentary custom-built homes for wounded soldiers.
  
  
• Poets and songwriters: Write and perform verses to highlight the pain of PTSD. Be sure to post these offerings online so they can be viewed and comfort many more beyond performance day.
  
  
• Civilian social workers or counselors: Contact your local VA and ask if you can donate a couple of days a month. Or if you are in private practice, offer your services pro bono to returning vets and their families by listing yourself in the Give an Hour database or getting involved with The Soldier's Project.
  
  
• Firemen and police officers: Reach out by organizing events like a neighborhood BBQ or softball tournament in honor of our troops; though your stress events vary somewhat, commonality can be found. You are also familiar with a 'chain of command' mindset and are natural allies to our returning veterans. Be a good ally, by training your forces to better prepare for possible police calls from veterans in a PTSD crisis.
  
  
• Vietnam (or other) veterans and other concerned community members: Continue to share your experiences and extend yourself to your newest brothers and sisters. Find ways to let them know you're there if they want to talk or hang out. You'll not only help them, you'll be doing a load of good for yourself, too.
  
  
• Artists: Donate time at the VA teaching therapeutic art classes, shown to help many who cope with PTSD. Join with Vet Art Project to help expand their important programs across the country.
  
  
• Students and teachers: See if your local college campus has a veterans club, and reach out to them. Check out Student Veterans of America for a few leads.
  
  
• Frequent flyers: Donate your extra miles to Operation Hero Miles, and make it possible for OEF/OIF troops to fly home on leave for free.
  
  
• People with deep (or shallow, but generous) pockets: Donate, if you can't afford to actively do, to any number of organizations whose work you most favor.
  
  
• Childcare workers: Find a military family in your community and consider donating a day or two a month of free babysitting. Our military families are stressed and could use a few hours of relief from the daily grind.
  

These are just a few thoughts; I'm sure you get the idea.

The aim is to find what it is that you can and wish to do, and just go out there and find a way to deliver those gifts to those in your backyard who most need it. If you prefer to join a group already in place providing support and services to military families, go for it!

I'd love to hear what you're doing in comments.

William James said, "Of all the creatures of earth, only human beings can change their patterns. Man alone is the architect of his destiny." True, but while we have the power, we've also got to muster the will...and then, finally, act. "Human beings, by changing the inner attitudes of their minds, can change the outer aspects of their lives," James continued.

I'd add, if they change their outer actions, the inner aspects will be transformed, too. What are you waiting for?


Related Posts

• On National Day of Service: Civilians, Consider Serving Those Who Serve Us
  
• National Council Magazine Reports on Community Programs Providing Support for Military Families
  
• Proactive Reintegration Suggestions for Military Family Members
  
• Opinion: Proactive Community Needed to Help Troops Reconnect, Reintegrate
  
• What Can We Do? Make an Effort to Reach Out to Local Veterans Organizations

Thank You, Veterans, on Veterans Day

Thank you, veterans, for your service and sacrifice.

Here's a list of events and promotions to celebrate your service. And, if you're a civilian, unsure of how to extend your thanks to veterans today, here are a few suggestions.

Click on 'Article' link below tags for related posts...


Related Posts

• Veterans Day 2009 Events and Promotions
  
• NIU Veterans Club Kicks Off Its Veterans Day Events as National Military Family Month Begins
  
• Veterans Day: Thanks to Our Service Members and Their Caregivers
  
• NIU Veterans Day Ceremony Calls Upon Nation to Care for Its Heroes
  
• Veterans Day 2006

For Those Lost at Fort Hood

For condolences, an online guest book and a Prayers for Fort Hood facebook page have been created for today's shooting victims. Wish to help? Consider donating to TAPS. May their grief be comforted.

[UPDATE Nov 6, 2009 10:51 a.m.]
Today, Friday, Defense Secretary Robert Gates has ordered U.S. military forces across the world to observe a moment of silence at 2:34 p.m. EST for those lost at Fort Hood. President Obama has also ordered all federal building and White House flags be flown at half-staff from now until Veterans Day.

TAPS has suggestions for those wishing to lend support to the victims and grieving families. If you are a service or military family member, Military OneSource offers counseling options; please seek out their help (or that of others providing such support) if you are feeling the need to discuss the situation.