TSgt Kyle Blair Psychological Health Center of Excellence ... · Combat Stress Combat stress is an...

TSgt Kyle BlairPsychological Health Center of Excellence (PHCoE)

23 AUG 2018

“Medically Ready Force…Ready Medical Force”

Disclosure

The views expressed in this presentation are those of the presenter and do not reflect the official policy of DoD or the U.S. Government.

We have no relevant financial relationships to disclose.

We do not intend to discuss off-label/investigative use of commercial products or devices.

“Medically Ready Force…Ready Medical Force” 2

Agenda

PHCoE Overview Stress Disorders – Identifying Signs and

Symptoms Where to Refer Best Practices Scenarios PHCoE Resources


Psychological Health Center of Excellence Overview


PHCoE MISSIONImprove the lives of our nation’s Service members, veterans, and their families/

caregivers by advancing excellence

in psychological health care, readiness, and

prevention of psychological health

disorders.

Core Strategic Priorities:1. Support the services and combatant commands2. Improve care quality3. Increase access, reduce barriers, and encourage optimal use of psychological health resources4. Advance the science of psychological health5. Foster organizational development

These strategic priorities serve to improve the psychological health service delivery for Service members, veterans, and their families/caregiver and beneficiaries; translate our efforts to enhance health outcomes; maximize force readiness; and optimize value.

PTSD in the Defense Department

Estimates of the prevalence of PTSD in the more than 2.6 million Service members who have served in Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn since 2001 range from 13-20%.

From 2000 to 2014, approximately 149,000 active-duty Service members (including Coast Guard) were diagnosed with new-onset PTSD in the Military Health System.

Estimates suggest that 23-40% of those who need services do not receive care.

*Statistics from the Armed Forces Health Surveillance Center


Acute Stress Disorder*

A common, normal and often adaptive response to experiencing or observing a traumatic or stressful event such as a car accident, natural disaster or military combat.

Symptoms typically subside within three days to one month after the event.

*Diagnostic & Statistical Manual of Mental Disorders, 5th

Edition


SymptomsRacing heart

Shaking hands

Sweating

Feeling nervous or afraid

Avoiding activity that caused the event

Bad dreams about the event

Combat Stress

Combat stress is an expected and predictable reaction to combat experiences. It's not unusual for a Service member participating in combat (or seeing its aftermath) to be filled with complicated and conflicting emotions, often including fear, sadness, helplessness and horror.

Stress reactions can last from a few days to a few weeks.

http://www.militaryonesource.mil/health-and-wellness/managing-stress?content_id=282350


Common SymptomsProblems sleeping

Uncharacteristic irritability or angry outbursts

Unusual anxiety or panic symptoms

Signs of depression (apathy, loss of interest in hobbies, poor

hygiene)

Other changes in behavior, personality or thinking

Post-Traumatic Stress Disorder*

A trauma and stressor-related disorder that can occurafter exposure to traumaticevents such as combat, naturaldisasters, or assault.

Symptoms usually begin within three months after trauma, but may be delayed by months or years.

* Diagnostic & Statistical Manual of Mental Disorders, 5th

Edition


PTSD SymptomsIntrusive (reoccurring distressing memories, dreams or flashbacks)

Avoidance (of people or places reminiscent of the trauma)

Persistent negative mood or thoughts (such as excessive blame, fear, guilt

or shame)

Arousal or reactivity (irritable, hyper-vigilance, difficulty concentrating

The Difference


Main differences are in DURATION and INTENSITY

Assisting Those Who Are Dealing With Stress Disorders

Know the signs and symptoms of acute stress disorder/PTSD

Know how and where to refer Service members, their families or caregivers for help

Know the available resources


Photo courtesy U.S. Army

Where to Refer?

Service member’s Primary Care Manager (PCM)

Internal Behavior Health Consultant (IBHC) Co-located with primary care at the MTF Sees Service member for 4-6 sessions then refers if more specialized treatment

is needed

Embedded Behavioral Health Team (EBH) Located next to unit Team consists of a psychologist, social worker, case manager, nurse and

psychiatrist

Specialized clinic Located at MTF and sees more serious cases as well as neuropsychological

and forensic cases


Where to Refer?

Service member’s PCM/Primary Mental Health Provider (PHMP) may also refer to more specialized care Intensive Outpatient treatment (IOP) Inpatient care/hospitalization

Service member may also receive care through the Vet Centers, Military OneSource, Military Family Life Consultants (MFLC), chaplains, and off-post providers


In the event of an emergency or if you are concerned about the service member’s safety:

Call 911 Escort the member to an emergency department

Encourage Engagement

Stress conditions, depression and anxiety are highly treatable conditions

There are many treatments that work

These treatments take time


Best Practices

Earlier intervention leads to better treatment outcomes

Educate yourself on available resources

Minimize negative stigma

Utilize established programs and tools


Management of PTSD Clinical Support Tools

Clinical support tools to help providers comply with the “VA/DOD Clinical Practice Guideline for the Management of Posttraumatic Stress Disorder and Acute Stress disorder”*

These tools bring together important resources for providers, patients and family members, which support comprehensive, evidence-based treatment of PTSD

*Management of Post-Traumatic Stress Work Group. (2017). VA/DoD Clinical RracticeGuideline for the Management of Posttraumatic Stress Disorder and Acute Stress Disorder. Washington, DC: Department of Veterans Affairs, Department of Defense. Retrieved from https://www.healthquality.va.gov/guidelines/MH/ptsd/VADoDPTSDCPGFinal.pdf

15

https://www.healthquality.va.gov/guidelines/MH/ptsd/VADoDPTSDCPGFinal.pdf

Real Warriors Campaign

The Real Warriors Campaign is a Defense Department communications campaign to encourage help-seeking behavior among Service members, veterans and their families.


Psychological Health Resource Center


We Are•Professional health resource consultants with expertise in psychological health who understand military culture.•Available 24/7 by phone, online chat or email.We Provide•A trusted source of psychological health information and resources.•Customized responses to your specific questions and needs. If we can’t answer your question, we will connect you to someone who can.

[email protected]

LIVE CHATrealwarriors.net/livechat

mailto:[email protected]

https://www.realwarriors.net/livechat

inTransition


Provides support to Service members receiving mental health services as they transition between health care systems or providers

Provides voluntary one-on-one coaching to service members

Designed as a bridge of support for Service members when:

– Relocating to another assignment– Returning from deployment– Transitioning from active duty to reserve,

reserve to active duty or returning to civilian life

Visit http://www.pdhealth.mil/resource-center/intransition

http://www.pdhealth.mil/resource-center/intransition

Mobile Applications


www.t2health.dcoe.mil

Scenario #1

Lt Andrea Colton is a 26-year-old female serving in the U.S. Public Health Service as a structural engineer. She was part of a rapid deployment team that set up medical stations in response to a recent natural disaster. During the deployment, she witnessed multiple traumatic injuries and loss of life. Months after returning, her husband voiced concern about how little she was sleeping, how quickly she would become angry with their children, and that she seemed to be drinking more than in the past.

Are there any signs and symptoms to be concerned about? What other information would you like to know? What is your next step?


Scenario #2

SGT Jason Smith is a 29-year-old male currently serving in the U.S. Army. While deployed, he witnessed a truck in his convoy hit a roadside bomb. After returning from the deployment, he began having panic attacks and nightmares related to the event. The medications prescribed for his anxiety and sleep problems didn’t seem to help. He didn’t want to leave the house and felt anxious performing his primary duties. He regularly feels guilty that he was one of the few surviving members of the incident.

Are there any signs or symptoms to be concerned about? What other information would you like to know? What is your next step?



PHCoE Website Resources

Products and resources are available on the PHCoE website (e.g., clinical practice guidelines, fact sheets, tool kits and more) to order or download at http://www.pdhealth.mil/clinical-guidance/resource-center About PHCoE Anti-stigma Autonomic nervous system Co-occurring conditions Depression General training and eLearning Integrative health and wellness Military children and families Peer support Post-traumatic stress Resilience Stress management Substance use Suicide Traumatic brain injury Transition

http://www.pdhealth.mil/clinical-guidance/resource-center


Feedback and Questions?

TSgt Kyle Blair Psychological Health Center of Excellence ... · Combat Stress Combat stress is an...

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