2. Discussion Points Introduction PTSD and TBI Suicide CVIC Response Teams

3. U.S. War Casualties  Iraq: 4,489  Afghanistan: 2,353  Combined total since 2001: 6,842 One combat veteran commits suicide every hour; 22 per day. There are 25 veteran suicides for every combat death.

4.  According to research, 33% of active duty combat veterans have PTSD and nearly 50% of reservists have PTSD. The rates are even higher from those after serving multiple deployments.  Historically, less than 20% of veterans with PTSD ever seek treatment.  The VA’s National Center on PTSD reports a direct connection with PTSD and subsequent contact with the criminal justice system.  Many combat veterans with PTSD do not seek help because they do not think it will help, they see treatment as a sign of weakness, or they are concerned about the negative reaction of others.

5. TBI – Traumatic Brain Injury Is a non-degenerative, non-congenital insult or injury to the brain from an external mechanical force, possibly leading to permanent or temporary impairment of cognitive, physical, and psychosocial functions, with an associated diminished or altered state of consciousness.

6. TBI Migraines Nausea & Vomiting Hearing Loss Ringing in Ears Dizziness Attention Problems Depression Irritability Anxiety PTSD Flashbacks Nightmares Sleep Problems Easily Startled Poor Anger Control Isolates Self TBI and PTSD; Overlap Illustration

7. Battlemind : is that which helps ensure combat survivability and which can be a negative attribute in the “real” world.  Buddies (team cohesion) vs. Withdrawal  Targeted Aggression vs. Inappropriate Aggression  Situational Awareness vs. Hypervigilance  Combat Driving vs. Aggressive Driving  Armed Legally vs. “Locked and Loaded” mentality  Emotional/Impulse Control vs. Anger Management

8. Common Battlemind Behaviors  Risky actions to feel the adrenaline rush again  Erratic or dangerous driving habits/road rage (driving down middle of the road; sudden avoidance of roadside objects; swerving under bridges; driving over curbs to avoid intersections)  Panic attacks while stuck in traffic  Alcohol abuse  Domestic violence against spouse and/or family members  Addictive actions (work, alcohol, drugs, food, adrenaline, sex)

9. Crisis Incidents from around the United States involving combat veterans in crisis  July 2013, Army Pfc. Dustin Cole fatally shot and killed Killeen Police officer Bobby Hornsby. Cole suffered from PTSD after two deployments to Afghanistan. He was highly intoxicated at the time of the shooting.  July 2014, Police in Wichita shoot and kill Icarus Randolph after attempts to intervene in his suicide attempt failed. Randolph, who suffered from PTSD, charged at police with a weapon in his hand and was pronounced dead at the hospital an hour later.  August 2014, Greely Police Officers were called to a report of an armed and intoxicated man at 3am. When they arrived, they saw 21 year old Army veteran Jacinto Zavala in the front yard. Zavala was shot and killed after he pointed a long gun at the responding officers.  December 2014, Former Marine Bradley William Stone shot and killed his ex-wife and five relatives and seriously wounded another before killing himself. Bradley suffered from PTSD and had in Iraq. He had 3 DUI arrests since returning home.  December 2014, a 27 year old military veteran suffering from PTSD barricaded himself inside his Watertown home and fired shots at police.

10. CVIC (Combat Veteran in Crisis) Response Teams  For a combat veteran, talking to someone who has not been in combat is difficult because they may not feel others cannot understand or relate to their feelings and/or experiences.  A trained CIT officer, who is also a combat veteran, can more closely relate and communicate to the veteran in crisis because of similar or shared experiences.  CVIC Response Teams are comprised of specially trained and uniquely experienced officers and are utilized whenever possible as the subject matter experts during a veteran in crisis incident.

11. Apex Police Experience  Case study or video

12. CVIC (Combat Veteran in Crisis) Response Teams Recommendations  Recommend NAMI consider creating a post CIT specialty class for all interested combat veteran law enforcement officers.  Recommend at least 16 hours of additional CIT training with on-site visit to a VA hospital.  Recommend creating county and/or regional CVIC Response Teams to assist those agencies who may not have this resource within their own ranks.  Recommend close coordination and buy-in from the Department of Veterans Affairs to become the primary receiving point for all combat veterans in crisis.

13. Conclusion