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?