Over 35% of returned Iraq and Afghanistan veterans in VA care have received mental health diagnoses.

OIF/OEF (Operation Iraqi Freedom, OIF and Operation Enduring Freedom, OEF) veterans receiving Department of Veterans Affairs (VA) health care and identified high rates of posttraumatic stress disorder (PTSD) (21.8%), depression (17.4%), and alcohol use disorder (7.1%); anxiety and adjustment

Cohen et al. (2010)

1 in 4 Veterans ages 18-25 met the criteria for substance abuse disorder in 2006

1.8 million Veterans of any age met the criteria for having a substance abuse disorder in 2006

81% of justice-involved Veterans had a substance abuse issue prior to incarceration

There are 140,000 U.S. Veterans in prison, and 60% of those have a substance abuse problem

There are 130,000 homeless U.S. Veterans, and 75% of them suffer from substance abuse problems

U.S. Department of Defense, U.S. Department of Justice Bureau of Justice Statistics, U.S. Department of Veterans

Affairs

Those returning may have difficulties in meeting the developmental demands of adult life:

-Maintaining employment-Family issues and in some cases

Domestic Violence-Other social relationships such as

romantic relationships and friendships

Finley et al. (2012).

A 2009 study found that veterans with mental health diagnoses, particularly PTSD, utilize significantly more VA non-mental health medical services.

Cohen et al. 2009

Recognizes treatment of mental and substance use disorders are an integral part of improving and maintaining overall health.

From this comes the idea of modern addiction and mental health

Samhsa.gov

A modern mental health and addiction service system provides: Continuum of effective treatment and support

services such as: Healthcare (mental health and substance

treatment) Employment Housing Education

Samhsa.gov

A continuum of services benefit package, within available funding, that supports recovery and resilience, including prevention and early intervention services, an emphasis on cost-effective, evidence-based and best practice service approaches.

Samhsa.gov

A community based program that fulfils the idea of a modern addiction and mental health philosophy

The program will serve as a form of “One stop shop” for veterans with comorbidity that need services

This will be done by addressing the clients needs as they come through the door

Individual, group, and family therapy will be utilized.

An emphasis on trauma informed care will be used in all modalities of treatment, specifically that of Seeking Safety for Veterans

Research has found that this approach has helped with increased treatment attendance, client satisfaction and active coping.

Boden et al (2012)

It addresses PTSD and SUD issues together

It allows clinicians to offer PTSD as an entry point to treatment given the potential stigma around treatment for Veterans since they can be a difficult population to engage

Najavits et al. (2010)

Case management component can help engage clients in further mental health and SUD care

 Help foster reintegration to civilian life and it supports their connection with other veterans.

Najavits et al. (2012)

Male veterans with PTSD are more likely to report marital or relationship problems, higher levels of parenting problems, and generally poorer family adjustment

For this reason, family therapy will be used to help reintegrate clients into their families and help families communicate better around their unique issues

Mikulincer, M., Florian, V., & Solomon, Z. (1995)

In addition, support groups for families will be held such as: Alanon PsychoeducationCaregiver burden Other issues that may arise with

having a veteran in the family

Mikulincer, M., Florian, V., & Solomon, Z. (1995)

In conjunction with treatment, clients will receive intensive case management in order to support with: Medication Management Job readiness Housing Education

Boden MT, Kimerling R, Jacobs-Lentz J, Bowman D, Weaver C, Carney D, Walser R, Trafton JA. (2012).Seeking Safety treatment for male veterans with a substance use disorder and PTSD symptomatology.Addiction, 107, 578-586.

Cohen, B. E., Gima, K., Bertenthal, D., Kim, S., Marmar, C. R., & Seal, K. H. (2010). Mental health diagnoses and utilization of VA non-mental health medical services among returning Iraq and Afghanistan veterans. Journal Of General Internal Medicine, 25(1), 18-24. doi:10.1007/s11606-009-1117-3

Finley, E. P., Pugh, M., Noel, P. H., & Brown, P. J. (2012). Validating a measure of self-efficacy for life tasks in male OEF/OIF veterans.Psychology Of Men & Masculinity, 13(2), 143-157. doi:10.1037/a0023607

Hoge, C. W., Auchterlonie, J. L., & Milliken, C. S. (2006). Mental health problems, use of mental health services, and attrition from military services after returning from deployment to Iraq or Afghanistan. Journal of the American Medical Association, 295, 1023–1032.

Mikulincer, M., Florian, V., & Solomon, Z. (1995). Marital intimacy, family support, and secondary traumatization: A study of wives of veterans with combat stress reaction. Anxiety, Stress, and Coping, 8, 203-213.

Najavits, L. M., Norman, S. B., Kivlahan, D., & Kosten, T. R. (2010). Improving PTSD/substance abuse treatment in the VA: A survey of providers. The American Journal On Addictions, 19(3), 257-263. doi:10.1111/j.1521-0391.2010.00039.x

Norman, S. B., Wilkins, K. C., Tapert, S. F., Lang, A. J., & Najavits, L. M. (2010). A pilot study of seeking safety therapy with OEF/OIF veterans. Journal Of Psychoactive Drugs, 42(1), 83-87. doi:10.1080/02791072.2010.10399788

http://www.samhsa.gov/healthreform/docs/good_and_modern_4_18_2011_508.pdf

http://www.seekingsafety.org/3-03-06/studies.html#Veterans_from_Iraq_and_Afghanistan