TSgt Kyle Blair Psychological Health Center of Excellence (PHCoE) 5 DEC Medically Ready Force Ready Medical Force

Transcription

1 TSgt Kyle Blair Psychological Health Center of Excellence (PHCoE) 5 DEC 2018 Medically Ready Force Ready Medical Force

2 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

3 Agenda PHCoE Overview Stress Disorders Identifying Signs and Symptoms Where to Refer Best Practices Scenarios PHCoE Resources Medically Ready Force Ready Medical Force 3

4 Psychological Health Center of Excellence Overview PHCoE MISSION Improve 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 commands 2. Improve care quality 3. Increase access, reduce barriers, and encourage optimal use of psychological health resources 4. Advance the science of psychological health 5. 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. Medically Ready Force Ready Medical Force 4

5 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 Medically Ready Force Ready Medical Force 5

6 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, 5 th Edition Symptoms Racing heart Shaking hands Sweating Feeling nervous or afraid Avoiding activity that caused the event Bad dreams about the event Medically Ready Force Ready Medical Force 6

7 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. Common Symptoms Problems 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 Medically Ready Force Ready Medical Force 7

8 Post-Traumatic Stress Disorder* A trauma and stressorrelated disorder that can occur after exposure to traumatic events such as combat, natural disasters, or assault. Symptoms usually begin within three months after trauma, but may be delayed by months or years. * Diagnostic & Statistical Manual of Mental Disorders, 5 th Edition PTSD Symptoms Intrusive (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, hypervigilance, difficulty concentrating Medically Ready Force Ready Medical Force 8

9 The Difference Main differences are in DURATION and INTENSITY Medically Ready Force Ready Medical Force 9

10 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 Medically Ready Force Ready Medical Force 10

11 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 Medically Ready Force Ready Medical Force 11

12 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 Medically Ready Force Ready Medical Force 12

13 Encourage Engagement Stress conditions, depression and anxiety are highly treatable conditions There are many treatments that work These treatments take time Medically Ready Force Ready Medical Force 13

14 Best Practices Earlier intervention leads to better treatment outcomes Educate yourself on available resources Minimize negative stigma Utilize established programs and tools Medically Ready Force Ready Medical Force 14

15 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 Rractice Guideline for the Management of Posttraumatic Stress Disorder and Acute Stress Disorder. Washington, DC: Department of Veterans Affairs, Department of Defense. Retrieved from 15

16 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. Medically Ready Force Ready Medical Force 16

17 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 . 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. resources@dcoeoutreach.org LIVE CHAT realwarriors.net/livechat Medically Ready Force Ready Medical Force 17

18 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 Medically Ready Force Ready Medical Force 18

19 Mobile Applications Medically Ready Force Ready Medical Force 19

20 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? Medically Ready Force Ready Medical Force 20

21 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? Medically Ready Force Ready Medical Force 21

22 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 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 Medically Ready Force Ready Medical Force 22

23 Connect with PHCoE Web: Facebook: intransition: Real Warriors Campaign: Point of Contact TSgt Kyle Blair Mental Health Technician/CADC Medically Ready Force Ready Medical Force 23