Managing Mental Health In
Post DeploymentCH Joe Hughes, Family Life Center, Dodd Field Chapel, Fort Sam Houston
Rationale While initial statistics gathered
from the post-deployment health surveys were not
alarming,
follow-up studies have shown a significant increase in
post-traumatic stress,
as high as 17% among service members returning from
deployment in support of OIF.
ObjectivePart I
Encourage service members to look out for themselves and others by recognizing signs and symptoms of post-traumatic stress and seeking options for assistance.
Part IIProvide leaders with
information necessary to foster vigilance for signs of distress among service members who have returned from deployment to a combat zone.
Part I
Recognizing Stress Effects
Understanding and resolvingthe problem
• Recognize: discern between normal and stress reactions• Engage: If concerned about self, then confront the problem;
If concerned about others, work with them directly. Don’t ignore or things will get better on their own.
• Refer: Seek help for self or encourage those who might be having prolonged difficulty to see their Family Physician or other help service.
• Follow-up: continue to monitor how you and others are doing, seek additional assistance as needed
Deployment is often accompanied by the following stressors:
Prolonged alertness
Frequency/intensity/ duration of battle
Excessive heat
Threat of exposure, IED’s
Sleep loss
Substandard living
High operational tempo
Chain of command and leadership
Recognize
The following post-deployment reactions are
Normal and Expected
• disappointment/boredom with routine duties
• overwhelmed/annoyed by stateside way of life
• difficulty adjusting to demands of friends and family
• wanting to or avoiding talking about experiences
Recognize
During and after deployment, the following can serve as
Protective Factors:
• sense of pride and mission accomplishment
• sense of appreciation
• sense of purpose
• increased strength and endurance
• increased spiritual faith
• increased tolerance to hardship and discomfort
Recognize
Post-deployment
Red Flags
Physiological
• frequent headaches
• stomach aches / nausea
• hypersensitive or numbed sensory response
• sleep disturbance
Recognize
Post-deployment
Red Flags
Mental
• serious difficulty problem solving, paying attention, concentrating, or remembering
• intrusive thoughts / dreams / flashbacks
Recognize
Post-Deployment
Red Flags Emotional
• irritable, rageful • extremely anxious, fearful or vigilant• distrustful • numb• lacking interest/motivation• hopeless• frequently crying• intense guilt
Recognize
Post-Deployment
Red Flags
Behavioral
• easily startled / defensive posture
• drug or alcohol abuse, gambling
• misconduct, disregard for rules and regulations
Recognize
Post-Deployment
Red Flags
Interpersonal
• uncharacteristic arguments with friends/family, scaring others
• feeling estranged from others; difficulty feeling connected or close
Recognize
Things to expectwhen returning from deployment:
• The ‘once-familiar’ will at first seem foreign, and this experience should pass.
• You may find yourself contemplating the big-picture issues of who you are, the meaning of life, or your purpose in your job.
• You may cope differently if you encounter a loss.
Recognize
Things to expect (cont’d):
• Expect bumps in the road:
– There may be frustrations related to authority and competencies of others.
– Relationships need maintaining and/or rebuilding.
– There may be cues or triggers from deployment that set off a stress reaction.
Recognize
Make an effort to:• Have realistic
expectations of yourself and others.
• Be aware of your tendencies to emotionally shutdown or become aggravated.
• Beware of tendencies to engage in compulsive behaviors (drinking, computer, sex). These may seem like the easiest way to cope/escape but are not the way to handle stress.
Engage
Go back to basics:
• Get adequate SLEEP
• Stay connected to your unit
• Stay physically fit
• Keep up military bearing
• Learn relaxation techniques
• Keep informed, ignore rumors
Engage
When you return from a deployment • Don’t necessarily expect that significant
others… – will know what happened– will be interested – will understand when to approach
and when to back off– will be supportive
• However, take the time to find those who will understand, be interested, and know when to back off and be supportive.
Remember to seek assistance before problems get worse!
Engage
Promote Post-Deployment Health
• Recognize problems early
• Engage with others to promote well-being, understanding and camaraderie
• Refer for assistance while problems are manageable—don’t delay
• Follow-up by staying engaged and practicing coping strategies
Engage
When concerned, refer yourself or others to:
• Medical
• Mental Health (Psychology, Psychiatry)
• Unit Chaplain
• Family Life Chaplain (Located at Dodd Field Chapel)
• Unit Command
• Substance Abuse Rehabilitation Program Financial/Legal Offices
• Chain of Command
• Military One Source: 1-800-342-9647
Refer
Things to Consider After a Referral
Even after you seek help or refer someone for assistance don’t forget the following:
– Keep expectations positive
– Avoid labeling
– Focus on preventing misconduct stress behaviors
– Maintaining unit camaraderie and family cohesion
– Encourage protective factors
– Be aware of red-flag post-deployment reactions
Follow-up
Part II
Promoting post-deployment health in the workplace
Leadership
The role of Commanders, NCO’s, and front line supervisors
is to assist the service member in getting help.
Specialized training is not required to
recognize severe stress reactions.
Leaders can determine if the individual is not performing his or her duties normally, not taking care of himself or herself, behaving
in an unusual manner or acting out of character.
Leadership
Leaders who recognize the presence of symptoms are not expected to act as counselors or therapists.
Leaders should encourage use of helping agencies to resolve problems such as depression, anxiety, and substance abuse.
Leadership Tasks
• Provide the appropriate environment that encourages Service Members to seek help for problems, without fear of negative consequences and before an incident occurs.
• Barriers to seeking help may need to be addressed, as the service member may have concerns about the negative career impact from seeking help. Leaders may need to remind members about the possible consequences of not seeking help, such as the condition worsening with greater impact on job performance.
• Know the warning signs to ensure that the Service Member is safe at the work place.
• Ask directly about how the Service Member is doing and how you can be supportive.
Workplace Transition
• Leaders need to be aware of workplace issues experienced by Service Members returning from deployment, as the work environment may be different, their responsibilities altered, and Service Members may feel they don’t fit into the new organization.
• During this transition period, the Service Member should be advised to talk with supervisors and colleagues to learn the whys and wherefores of the changes. Leaders should reassure the individual that re-adaptation may take time and that they are valued.
Leadership responsibilities
• Promote a culture of awareness
– Recognize: discern between normal and stress reactions– Engage: sit with your people; don’t rely on rumor,
speculation, or suspicion– Refer: encourage those who might be having prolonged
difficulty to see their Physician– Follow-up: monitor how people are doing, continue to
engage and integrate people back into the workspace
When concerned, refer others to:
• Medical• Mental Health (Psychology, Psychiatry) • Unit Chaplain• Command Substance Abuse Rehabilitation Program
Financial/Legal Offices/ACS• Military One Source (1-800-342-9647)• Chain of Command• Family Life Chaplain (221-5432)
DODD FIELD CHAPEL
Building 1721(210) 221-5010/5432
(Between the National Cemetery and Cole High School, down from the Reserve Center off of
Winans Road)
Things to Consider After a Referral
Don’t forget even after you seek help or refer someone for assistance:
– Keep expectations positive
– Avoid labeling
– Focus on preventing misconduct stress behaviors
– Maintaining unit camaraderie and family cohesion
– Encourage protective factors
– Be aware of red-flag post-deployment reactions
Remember…
Stress is an inevitable part of the post-deployment period which can create either positive behavior or reactions which might temporarily interfere with military and
personal duties.
While not everyone needs referrals to assistance resources, avoidance only makes problems worse.
Awareness of post-deployment stress in oneself and in one’s co-workers or supervisees is the responsibility of
everyone.
QUESTIONS?