Sean MacMillenLock Haven University

HLTH30725 April 2012

Agenda

Veteran Population

What is PTSD

Symptoms of PTSD

Risk Factors

Positive Aspects of Culture

Negative Aspects of Culture

Existential Aspects of Culture

American Military Veterans (2010)

21.8 million veterans

1.6 million women veterans

17.5 million White veterans

2.4 million Black veterans

203,000 Asian American veterans

156,000 American Indian or Alaska Natives

9 million veterans 65 or older

1.7 million were age 35 or younger

Where Did They Serve?

7.6 million Vietnam veterans

4.8 million Gulf War veterans

2.1 million World War II veterans

2.6 million Korean War veterans

5.5 million veterans served during peacetime only

Since 2001, over 1.5 million service members have served in Iraq or Afghanistan

What is PTSD?

Psychiatric disorder than can occur following the experience of witnessing of life threatening events

Military combat

Natural disasters

Terrorist incidents

Serious accidents

Violent personal attacks

Combat PTSD

Following war, many veterans return home significantly altered

Have a changed view of the world and themselves

Reactions may be short lived (only a few months)

For others, healing may require long term vigilance

Typical Symptoms

Survivor guilt

Fear

Flashbacks

Loneliness

Revenge fantasies

Emotionally numb

Depression

Frustration

Nightmares

Distrust

Suicidal

Addiction

Hyper arousal

Difficulty sleeping

Effects of PTSD

Symptoms may not appear until months or years after combat

Can significantly impair a person’s daily life

Difficulties in social or family life

Occupational instability

Marital problems

Family discord

Difficulties in parenting

Prevalence Rates of PTSD

Vietnam: 15% to 31% of veterans

Iraq and Afghanistan: 10% to 18% of veterans

Mental health illness is 2nd largest category for which veterans from Iraq and Afghanistan seek treatment

Between 2006-2007, 70% increase in veterans seeking treatment for PTSD

Risk Factors

Longer deployments

More severe combat exposure

More severe physical injury

Traumatic Brain Injury

Lower rank

Lower level of schooling

Low unit morale

Not married

Family problems

Member of National Guard or Reserves

Prior trauma exposure

Female (twice as likely)

Hispanic ethnic group

Positive Cultural Factors

Improvements in access to health care

Physical exercise

Selfless service

Personal courage

Moving/relocating

Discipline

Social Support

Positive Cultural Factors

Improvements in health care Iraq and Afghanistan veterans eligible for 5 years

of free health care for condition related to combat after discharge

Increased staffing

Physical exercise Importance of exercise instilled in military

Used to reduce stress or tension

Distraction from difficult emotions or painful memories

Positive Cultural Factors

Moving/Relocating Veterans are used to changing duty stations

May find it necessary to move to feel safe

Living in high crime areas increases PTSD

Discipline Basic foundation of the military lifestyle

Veterans more likely to participate in treatment program and aftercare

More likely to take prescribed medications

Positive Cultural Factors

Selfless service

Put welfare of others before own

Veterans likely to volunteer; feel as though they can contribute

Personal courage

Ability to face, fear, danger, adversity

Requires courage to face own mental health issues

Positive Cultural Factors

Role of social support

Learn importance during deployments

Helps to cope with PTSD

Emotional support important to make veteran feel safe and changes habits and behaviors

Negative Cultural Factors

Stigma of mental illness

Alcohol use

Tobacco

Poverty

Negative Cultural Factors

Military structure encourages camaraderie and peer support

Double-edged sword; creates hidden barriers to seeking care

Stigma of mental illness is largest obstacle to overcome

Perception of being weak; treated differently

Members of unit may lose confidence in their abilities

50% of veterans in one study showed signs of mental illness, but refused to seek treatment due to stigma

Media portrayal of PTSD sufferers as monsters

Negative Cultural Factors

Alcohol use widely accepted in the military

20% with PTSD also have substance abuse disorder (SUD)

PTSD and SUD; likely to have other health complications

Using drugs and alcohol can make PTSD worse

Tobacco use rates higher than general population

Number of veterans who smoke is double for PTSD (about 6 in 10)

Tobacco use creates other health concerns

Negative Cultural Factors

Poverty

More than 968,000 veterans in poverty

1 in 7 homeless adults are veterans

1.5 million veterans at risk of homelessness to due to poverty

Poor diets

May not have access to mental health care

Negative Cultural Factors

Distrust in VA medical system

Vietnam veterans treated poorly upon return

Vietnam veterans – PTSD was not acknowledged as a disorder until 1980

Long waits for appointments

Many mental health professionals in VA system are not veterans

Existential Cultural Factors

Communication

Veterans have a unique language carried over from military service

Military slang and acronyms used

“Out of suffering have emerged the strongest souls. The most massive characters are seared with scars.” ~ Khalil Gibran