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Military Culture, Mental Health and Law Enforcement
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Transcript of Military Culture, Mental Health and Law Enforcement
Military Culture, Mental Health and Law Enforcement
Crisis Intervention Team International Conference1 June 2010
Deloria R. Wilson, Ph.D.Warrior Resiliency ProgramSan Antonio Texas210-424-8946
Disclaimer
Many slides were derived from staff at theCenter for Deployment Psychology (CDP) and other Experts.
The views and opinions expressed in this presentation are solely those of the author
and do not reflect an endorsement by the U.S. Government, DoD, Department of the Army orthe Warrior Resiliency Program.
Military CultureSome similarities with Law Enforcement
Military and Law Enforcement
Indoctrination Sense of Belonging
Structure and Hierarchy
Diversity and Opportunity
Challenge and Responsibility
Culture-Similarities
Service often before self
Seeking challenge
Emotional regulation
Multiple exposure to high stress situations
Military Culture-Uniqueness
Variation across services
Variation with AFSC, MOS, etc. (jobs)
Variation in combat exposure
Subcultures
Combat Stress and PTSD
A Continuum of Combat Reactions
Combat Stress Acute Stress PTSD
AdjustmentAdjustment
Stressors
Coping Ability
Leadership
Control
Support
Stressors
Coping Ability
Leadership
Control
Support
CombatReady
Mission Event
A Continuum of Combat Reactions
Combat Stress Acute Stress PTSD
AdjustmentAdjustment
Stressors
Coping Ability
Leadership
Control
Support
Stressors
Coping Ability
Leadership
Control
Support
CombatReady
Mission Event
Typical Post Deployment Adjustment Issues
Problems sleeping Irritability/Anger More (assertive) driving? Disturbing dreams/images Feeling out of place Physical/Emotional/Cognitive Fatigue Range of emotions including
numbness
Yellow Flags
Increased drinking More withdrawn Some family difficulties Reduced work performance Occasionally late to
work/appointments Hyper-vigilance / arousal Discipline Problems
Red Flags
Alcohol Abuse/Dependence Behavior requiring paperwork Signs for Depression/Anxiety Psychotic Behavior Signs of suicidal ideation Consistently unable to control anger Increasing withdrawal and isolation
PTSD Symptoms Impact onSocial Support
PTSD and associated problems can reduce available social support Emotional numbing Detachment Hostility and aggression Distrust of others Social problem solving deficits
As symptoms persist, individuals may tire of providing support or exhaust resources CDP
Relation between PTSD and Social Support
One of the strongest predictors of recovery following trauma is social support
Deterioration of perceived social support over time may contribute to increased symptoms
In general, families provide a primary source of social support, with intimate partners typically the chief source
Other Types of Deployment Stress
Operational Stress
Separation Stress
Reunion Stress
Adjustment Stress
Traumatic Stress
Deployment Cycle and Family Considerations
Why is the family important?
Veteran’sWell Being
Spouse Well Being
Child(re
n) Well
Being
Each gear impacts the ability of the service member to complete theMission.
Stressors in the Deployment Cycle
Pre-deployment
NotificationPreparationTraining
Deployment
DepartureSustainment
Combat and conflict
Return from Deployment
ReunionReintegration
Pre-Deployment Stressors
Preparedness
Shifting expectations
Changes in family dynamics
Anticipation of threats
Perception of Mission
Lack of information/RumorsBriefing by David Riggs, June 2007
Pre-Deployment Stressors - Spouses
Confusion
Denial
Resentment
Arguing
Worrying
Planning
Briefing by Doug Lehman, May 2008
Pre-Deployment Stressors - Kids
Confusion Regression Anger Outbursts Sadness Surprise Guilt Behavioral problems
Briefing by Doug Lehman, May 2008
Pre-Deployment Stressors - Adolescents
“I don’t care”
Fear of rejection
Denial of feelings
Anger
Higher value on friends
Briefing by Doug Lehman, May 2008
Stressors in the Deployment Cycle
Pre-deployment
NotificationPreparationTraining
Deployment
DepartureSustainment
Combat and conflict
Return from Deployment
ReunionReintegration
Stressors in the Deployment Cycle
Pre-deployment
NotificationPreparationTraining
Deployment
DepartureSustainment
Combat and conflict
Return from Deployment
ReunionReintegration
Common Stressors SMStressor Deployment Postdeployment
Operational/Physical
heat, dehydration, lack of comforts, desert, noises, fumes
traffic, crowds, unarmed, access to alcohol
Cognitive boredom, monotony, unclear role or mission, experiences that defy beliefs, information overload
loyalty issues to family vs unit, secrecy vs disclosure, boredom, regrets, thoughts of losses
Emotional fear of failure, guilt, horror, fear, anxiety, feeling devalued
grief, anger, feeling unsafe, guilt, withdrawal from war “rush,” numbness
Social separation from loved ones, lack of privacy, public opinion and media
separated from buddies, overwhelmed or misunderstood by family, feelings of alienation
Spiritual change in faith, inability to forgive, loss of trust
asking why buddies died, lack of purpose, changed faith, conflicting values
Editors Charles Figley and William Nash, Combat Stress Injury (2007)
CDP
Change in Mindset: SMMindset in deployed setting Mindset once home
Stay focused on mission /nothing else matters
Life is now unfocused and complex
Truly life or death / always on the edge
No longer on the verge of life or death
Constant adrenaline “rush” What can replace the “high” of war?
Black or white / all or nothing Things aren’t clear cut
Sense of purpose, invincibility No sense of purpose, nothing matters
Only trust battle buddies /others are threat
Can’t trust anybody
Need to control environment Can’t be in control of surroundings
Real problems and needs exist in Iraq
Problems at home pale in comparison to those in Iraq
CDP
Family Re-Adjustmentcan be like driving in San Antonio
It can be hard to figure out how to merge safely
Many times families will confuse normal adjustment issues for serious problems or vice versa.
Most service members and families expect that the service member or the family will remain unchanged.
Knowing thedifference
between expected
adjustment issues and mental health problems
often depends on time.
“IF YOU WENT TO WAR AND WEREN’T CHANGED, YOU WERE CRAZY BEFORE YOU LEFT.”
Ch. Morris, Minnesotata
Changes for Family
• New routines• New responsibilities • More independence and confidence• Made many sacrifices• Worried, felt lonely• Gone through milestones that were missed
• Interrupt routine• Disrupt space• Throw off decision making• Cause family to walk on tip toes• Not make everything perfect • Not replace the sacrifices and missed milestones
Family has…
Service Member’s Return can…
CDP
Community Partnering to Maximize Positive Outcome
Common Issues during Crises
Not necessarily dissimilar than general civilian population Domestic issues/ Relationship issues Financial problems Legal Issues
Circumstances may be different May not have family nearby Possible exposure to violence in theater Injured/Wounded Service Member
Get to know
Military Leadership
Military Police
Military Mental Health/Medical
VA and other veteran’s resources
On Line and Community Resources
They May Be Able to Help With Information about service member and or family
Information about what member’s unit has gone through
Links to family and other resources
Possibly medical and personal history
Resources to collaborate with training
Follow-through after an event
Discussion and Questions