READJUSTMENT : Maryland Army National Guard and Reserve IAWP National Conference June 2008

Who We Are Employer Support of the Guard and Reserve (ESGR) Butch Hensel (410) Transition Assistance Advisor Mark Olanderoff (410) Maryland Department of Mental Hygiene Laura Copeland (410) Vet Center Deputy Regional Manager Terry Luper (410)

Why We Are Here Educate employers on war experiences, combat and trauma stress, and TBI so you will have a better understanding of what employees may encounter upon their return. Provide employers with current information regarding the readjustment process of deployed National Guard Soldiers serving in the Global War on Terror (GWOT). Provide employers with useful resources to have available for employees when necessary. Foster goodwill and a collaborative environment in the workplace (Soldiers will view employers as being on the same team when they express the desire to help the veteran).

The United States is a long way from Baghdad, Kandahar, An Najaf or Fallujah…

Then they finally come home.

Home does not look the same…

Sound the same...

Or even smell the same!

And face the challenge of transition and readjustment.

Readjustment is a stressful situation and stress is normal.

Soldiers may have experienced... Receiving artillery fire. Being shot at with small arms. Firing at the enemy. The sight of dead bodies or remains. An attack or ambush. Seeing a fellow Soldier get injured or killed. Seeing injured women/children and were unable to help.

Marriage, relationship problems Medical issues Financial hardships Endless questions from family and friends Guilt, shame, anger Lack of structure Feelings of isolation Nightmares, sleeplessness Lack of motivation, forgetfulness And some veterans may experience…

Combat Stress Combat stress is a natural result of the heavy mental and emotional work required when facing danger in tough conditions. Types of combat operational stress: trauma, fatigue, grief. For many in the National Guard and Reserve, this war is their first combat experience. They are considerably older and entrenched in their home and work life and then put into life-threatening situations.

Traumatic events have always been a part of human experience. Trauma stress is a normal set of reactions to a trauma such as war, sexual trauma, or horrific accident which could be experienced by almost anyone. In the general population, the rate of incidence is 4%. Sometimes it becomes a problem with the passage of time when the feelings or issues related to the trauma are not dealt with. This can result in problems readjusting to community life following the trauma. Left untreated, trauma reactions are highly predictive of physical illness, disrupted family life, and reduced career performance. Overcoming traumatic events is easier managed when addressed early. Trauma Stress

Symptoms of Trauma Reactions Most people who are exposed to sudden, dangerous or deadly events will often experience several of the following: Startle reactions to loud noise or movement. Avoidance of people, movies or topics related to trauma experience. Sleep problems, dreams and nightmares. Guilt or depression. Isolation or alienation from others. Loss of interest in pleasurable activities. Concentration or memory problems. Reliving of traumatic memories. Anniversary reactions to the trauma. Problems with interpersonal relationships. Overly watchful or hypervigilant. Restlessness.

Distress Responses Common responses after involvement in high stress situations. Physical or emotional in nature. Usually mild, dissipate after several weeks. Problems that interfere with a Soldier’s ability to do the things that he or she needs to do in any important area of life (work, home, family, social, spiritual) are the clearest signs that a normal reaction after deployment may be turning into a more serious problem. If longer than 6 – 8 weeks, medical professional consultation necessary to obtain effective available treatment.

Traumatic Brain Injury (TBI) A blow or jolt to the head or a penetrating head injury that disrupts function of the brain. Not all blows to the head result in TBI. Previous wars referred to as “shell shock.” Commonly referred to as a “concussion.” TBI is also caused by Motor vehicle accidents Assaults Falls

TBI Symptoms Irritability Sleep problems Excessive fatigue Balance problems Ringing in the ears Vision change Headaches Dizziness Concentration/memory problems

TBI Severity May range from mild to severe Mild - a brief change in mental status or consciousness. Severe - an extended period of unconsciousness or amnesia after the injury. Encourage your employee to seek medical attention.

What Prevents Some Vets From Seeking Help? Embarrassment Worries about costs Can’t get time off from work Will it affect my career or military standing?

What Can Employers Do? Meet with Soldier before his/her first day back to work. Apprise Soldier of changes to their workplace – e.g., how has job changed, what roles have shifted, employee morale. Consider graduated schedule for return to work – offer flexibility. If schedule can’t be changed, lighten workload to allow for readjustment to the job. Understand that each Soldier adjusts in his/her own way. Some may not want to talk about their experiences right away. May appreciate your concern but not want to feel babied or set apart.

What Can Employers Do? (cont.) Listen without judging and advise coworkers to do the same. Communicate your support for his/her emotional well-being. Inquire about financial well-being. Consider loans, advance pay, or other programs to help with financial difficulties. Ask if Soldier is interested in welcome home party. Provide employee with more than one welcome home meeting or event. Allow Soldier to tell his/her story – talking in bits and pieces can be helpful. Understand resistance to getting help – Soldier may feel ashamed and view counseling as sign of personal weakness.

What Can Employers Do? (cont.) Point out that emotional problems are no different from medical problems and must be treated like any medical condition (i.e., cough, sore throat or sprained or broken ankle). Realize Soldier’s health affects the health and well-being of his/her co-workers. ASSUME SUCCESS! The majority of vets do not return with emotional problems. Use employee assistance programs, human resources, and veterans’ services as appropriate.

Resources Vet Centers VA Medical Centers Military OneSource Army Behavioral Health Hooah 4 Health Mental Health Self-Assessment Program Troop and Family Counseling TRICARE ESGR Department of Labor State Chaplain, Unit Chaplains and Chaplains Assistants Maryland Defense Force ProBono Counseling

Vet Centers Website: va.gov/rcs Confidential/free counseling services to veterans, families and significant others with war and deployment readjustment needs. Individual and group sessions. Counselors are trained to work with vets. Many counselors are vets themselves. Locations: Baltimore Silver Spring Elkton Hagerstown Washington, DC West Virginia – Martinsburg

VA Medical Centers Website: va.gov OIF/OEF vets receive two years of free medical care from date of separation from active duty. Vet must enroll first – no charge, no obligation. Maryland and surrounding area – Baltimore Perry Point Washington, DC Martinsburg, WVA RVOEC Team (Returning Vets Outreach, Education and Care) – dedicated to OIF/OEF vets.

Military OneSource Website: militaryonesource.com Department of Defense (DoD) program free to Soldiers and their families. Available 24/7/365 – Confidential/free counseling services. Soldier or family member calls for referral to counseling services in Soldier’s area. Educational materials and interactive website are available.

Army Behavioral Health Resources and information regarding mental well-being for Soldiers and their family members. Provided by the U.S. Army Medical Department. Intended for interested Soldiers, family members, and the public.

Hooah 4 Health Website: hooah4health.com/mind/combatstress/ default.htm. hooah4health.com/mind/combatstress/ default.htm Stress management info. Combat stress Q and A. Redeployment health guide.

Mental Health Self-Assessment Program Website: Militarymentalhealth.org DoD mental health self-assessment program. Voluntary and anonymous. Mental health, alcohol screening and referral program for Soldiers and families affected by deployment. Offered online and by phone. Telephone Self-Assessment –

Troop and Family Counseling Free and confidential counseling services. Soldier calls Intake Coordinator 24/7 at Soldier receives referral to outpatient provider in his area.

Other Resources TRICARE Eight free confidential behavioral health care visits / ESGR – William Hensel - Transition Assistance Advisor Mark H. L Olandoff Maryland Defense Force Mental Health Corps Chaplains Corps MDNG State Chaplain COL Sean Lee Unit Chaplains and Chaplain Assistants ProBono Counseling Department of Labor /Stan Seidel

Questions?