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Thread: Pre and post deployment support

  1. #61
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    Quote Originally Posted by 120mm View Post
    I disagree. Addiction to mental health treatments is a real and common malady, which has the additional by-product of providing job security to the same mental health professionals.

    I don't see a whole bunch of people who outgrow their therapist.
    I do, all the time. I don't work in the military--I teach--but I often have students coming back to me years after they were encouraged to seek help (for depression, addictions, SIs, EDs, the after-effects of sexual assault, and suicidal feelings) to say how support, counseling, and intervention at the right time changed their lives for the better.

    A lot of them tell me they're afraid to tell their family. Afraid they'll look weak. Afraid they won't understand. Afraid they'll be blamed. Frankly, if their parents have attitudes similar to some of those expressed in this thread, I can see why.

    At the moment, I'm worried that someone in the military who would benefit from help, will read this thread and not ask for it for fear that asking for help is somehow not "manly" or "warrior" enough to retain the respect of his (or her) peers. That would be a tragedy.

  2. #62
    Council Member reed11b's Avatar
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    Quote Originally Posted by 120mm View Post
    The counselors at the VA near Leavenworth must be veterans of the Indian Army then, since they're definitely not US nationals. And they treat the soldiers like ####, as well.

    In my experience, nearly losing a limb, and having an undiagnosed major brain trauma/personality change, I find that recovery is 90% or more on the dude with the wounds. And victims are victims. No matter how much you try to help them, they will always wallow in their own misery.

    I think you overestimate the impact you actually have as a counselor. Most of the enthusiastic counselors I have met are the same way. Hyper-inflated ego and unreasonable self-image is probably the most prevalent symptom among medical/mental health personnel.
    1) Vet Centers are part of the VA, but they are sepperate from the medical clinics. If you went to BH&SS at a VA clinic or hospital, then yes they may not have been vets. VA does not = Vet Centers, something that I seem to have difficulty making clear.

    2) Those "dudes" that do recover from there severe wounds STILL RECIEVE HELP!! How dense do have to be to realize that mental health is the same way! Yes, the soldier has to have a commitment and desire to get better and if he does not, then yes, no counselor in the freaking world can help him, period BUT... for those that do have the right attitude, help helps, you can not "suck it up" through PTSD and spreading this Bravo-Sierra is going to hurt more soldiers and that ticks me off in a really big way.

    3) If you really want to go here..
    I think you overestimate the impact you actually have as a counselor. Most of the enthusiastic counselors I have met are the same way. Hyper-inflated ego and unreasonable self-image is probably the most prevalent symptom among medical/mental health personnel.
    why don't you make an effort to check out a Vet Center first. Otherwise you are just talking out of your Alpha.
    Reed
    P.S. Rex beat me to the punch, thank you sir for your comments, same to Mr. Blair.
    Last edited by reed11b; 12-18-2008 at 08:06 PM.
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  3. #63
    Moderator Steve Blair's Avatar
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    I think everyone should take a deep breath and consider what Rex said above. Specifically:
    A lot of them tell me they're afraid to tell their family. Afraid they'll look weak. Afraid they won't understand. Afraid they'll be blamed. Frankly, if their parents have attitudes similar to some of those expressed in this thread, I can see why.

    At the moment, I'm worried that someone in the military who would benefit from help, will read this thread and not ask for it for fear that asking for help is somehow not "manly" or "warrior" enough to retain the respect of his (or her) peers. That would be a tragedy.
    Sure, therapy or what have you doesn't work for everyone. Sure, the system does overreach when it wants to put people in neat little categories. But it does work for some people some of the time. Maybe we should just scrap the whole system and go over to the WW 2 British system of stamping LMF (lacks moral fiber) on peoples' records and pack them off. Take a look at what happened in Bomber Command after Harris took over.

    Parts of the system don't work. How do we fix that? And it's also important to remember that this is a two-way street...some folks don't want to be helped. They like wallowing in their stuff, as 120mm pointed out, and are often enabled by therapists who are similar. But does that mean we scrap the whole system? I'd hope not.
    "On the plains and mountains of the American West, the United States Army had once learned everything there was to learn about hit-and-run tactics and guerrilla warfare."
    T.R. Fehrenbach This Kind of War

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    Council Member jkm_101_fso's Avatar
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    I think this is pretty simple.

    The military is required to provide help to those that need it and even those that think they need it and actually may not. So, they have to screen everyone. Not to do so would be negligent. That is what the health professionals are for. They can determine if a soldier doesn't actually require help.

    Remember, though, if said professional ends up being wrong, the results could be catastrophic. Naturally, some will inevitably slip through the cracks that don't have a damn thing wrong with them. There are worse things in life.

    If you don't need help, don't ask for it; too easy.

    Of all the post-deployment mental health screenings I've had to sit through, I think they took up a combined 30 minutes of my time.

    The Army has wasted a lot more of my time for much more ridiculous things.
    Sir, what the hell are we doing?

  5. #65
    Council Member 120mm's Avatar
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    Quote Originally Posted by jkm_101_fso View Post
    I think this is pretty simple.

    The military is required to provide help to those that need it and even those that think they need it and actually may not. So, they have to screen everyone. Not to do so would be negligent. That is what the health professionals are for. They can determine if a soldier doesn't actually require help.

    Remember, though, if said professional ends up being wrong, the results could be catastrophic. Naturally, some will inevitably slip through the cracks that don't have a damn thing wrong with them. There are worse things in life.

    If you don't need help, don't ask for it; too easy.

    Of all the post-deployment mental health screenings I've had to sit through, I think they took up a combined 30 minutes of my time.

    The Army has wasted a lot more of my time for much more ridiculous things.
    What's worse in life than being thrown out of the military because you are a head case?

    I've seen plenty of examples where a man was ruined because the "system" was wrong in the opposite direction. One man I worked with, admitted to having suicidal thoughts several years before, and he was treated like crap and eventually bullied out of the army by those holy and sacred "mental health professionals". The guy next to me in my workspace is on the way to being branded as a PTSD victim and psych case, because he won't "play along" with the PTSD bull#### that the counselor has labelled him with. And this guy never left a FOB, but refuses to "admit" he has PTSD, and the scum-sucking POS mental health professional says this proves he's in "denial". It's like the Spanish Inquisition all over again.

    Right now, I am filling out my annual PHA, where, if I were to fill it out without lying my ass off, I'd be kicked out of the army and categorized into some nice psychological "box". I have paused at the question that asks if I've ever has psych eval or counselling. Now, this survey will be seen by every PAC clerk and interested person who has access to my records for the rest of the time I'm in the army, and long after. But the mental health "professionals" are so wrapped up in their little technical worlds, that they don't understand this, and don't care as long as they get their power-game and paycheck.

    So, I am forced to abandon my honor and lie in order to be able to continue to serve. But folks like Reed don't give a crap about honor (he said so, himself) and care not a whit how much that costs me and folks like me. Thanks for your help, idiots.... Again, those of us who are warriors, and aren't into the military as a form of social welfare aren't in it for our health.
    Last edited by 120mm; 12-18-2008 at 08:43 PM.

  6. #66
    Council Member 120mm's Avatar
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    One more thing. Who are the morons who design the medical questionnaire forms?

    I admit to one TBI, non-service related. I am required to fill out a TBI questionnaire because of this. The TBI questionnaire only applies to DEPLOYMENT-RELATED TBI. I MUST fill out the TBI questionnaire, but cannot because none of the questions apply to me.

    This is typical poo-flinging monkey medical service bull####. And we want to give these guys more power.... why?

  7. #67
    Council Member 120mm's Avatar
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    Default An update, with cooler head

    What I would like to see, is a study where groups are given variable amounts of pre- and post- deployment PTSD counselling, and then studied for the incidence and seriousness of PTSD. I'm wondering to what extent "suggestibility" plays in the formation of PTSD.

    There were similar studies in WWII, but I'm wondering if they would be deemed ethical, today.

    Just in case anyone is interested, I had to argue with the doc to pass my PHA, because my vitals are too low. RHR of 39, BP of 108 over 60 and body temp of 97 degrees. All of which are normal for me, when I'm in shape. One more gripe to add to my laundry list about the medical profession and the lack of actual "thought" that goes through docs' heads. Evidently "normal" once arbitrarily defined by the quacks becomes a graven in stone "fact". Damned near got sent to the Emergency room "just in case".

    Evidently you aren't allowed to be in great shape in some "systems." Also, the doc vapor-locked over the TBI questionnaire, just like I thought. If you answer "yes" to the TBI question, you must fill out the questionnaire, which you cannot fill out if your TBI wasn't combat-related.

  8. #68
    Council Member reed11b's Avatar
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    120, even though you are high on my sierra list, you have a point that the DOD's concept of "universal screening" will not catch everyone it needs to catch and may lead to "false-positives". I also object to the DOD's apparent belief that a counselor is a counselor is a counselor. I work w/ some populations really well, others I am more likely to do more harm then good, so just hiring more counselors is probably not the best answer. There are also some questions on how and why PTSD is diagnosed. When is it PTSD and when is it PTS readjustment? The DSM says any time symptoms last over 3 months it = PTSD. However I have seen individuals rated for PTSD w/i 1-2 months of returning from theatre. Why 3 months? If you have symptoms for 4-6 months but have them go away w/o invasive therapy is it still PTSD? mTBI symptoms almost mirror PTSD symptoms, how often are they mis-diagnosed for each other? Certain established anxiety and depressive disorders can be mis-diagnosed for PTSD as well. For all that, whether it is PTSD, mTBI, pre-existing MH issues, Stress Readjustment, plain old vanilla stress, depression or drugs and alcohol, services do need to be available, and soldiers do need to feel free to use them w/o fear of repercussions. The question is how to best facilitate this with out letting it become more of a public opinion and/or political issue
    Reed
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  9. #69
    Council Member 120mm's Avatar
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    The question I have, is that what does the Army do with those folks with PTSD who don't want to be "caught?" If a PTSD sufferer can still function, but chooses to decline treatment, what then?

  10. #70
    Council Member 120mm's Avatar
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    Default Army may stop notifying COs of counseling

    Here's an interesting, and tangentially related story:

    http://www.armytimes.com/news/...nseling_army_011209/

    WASHINGTON — Army leaders are proposing to end a longtime policy that requires a commanding officer be notified when a soldier voluntarily seeks counseling in hopes of encouraging more GIs to seek aid, according to Army Secretary Pete Geren.

    The potential move comes as combat deployments have been linked with increased alcohol abuse, and the Army Substance Abuse Program is straining to keep pace.

    The proposal being worked out between Army personnel and medical commanders is “an important part of a comprehensive effort to reduce the stigma associated with seeking mental health care and to encourage more soldiers to seek treatment,” Geren says in a statement to USA TODAY on Friday.
    While this appears to only affect ASAP, I'm wondering what effect it will have on other mental health counselling systems. My beef with ASAP is similar with my beef with mental health counselling: There is just too many negative consequences for reporting, and the system is too formalized.

    I once had a soldier who drank three beers and then lay down on his bunk to sleep. The window over his bunk was shattered by a rock thrown by persons unknown, and he was cut by the falling glass. Because he was sleeping off the beers, this was classified as an alcohol-related event and he was mandatory-referred to ASAP. Otherwise, he was a terrific soldier.

  11. #71
    Council Member reed11b's Avatar
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    Quote Originally Posted by 120mm View Post
    Here's an interesting, and tangentially related story:

    http://www.armytimes.com/news/...nseling_army_011209/



    While this appears to only affect ASAP, I'm wondering what effect it will have on other mental health counselling systems. My beef with ASAP is similar with my beef with mental health counselling: There is just too many negative consequences for reporting, and the system is too formalized.

    I once had a soldier who drank three beers and then lay down on his bunk to sleep. The window over his bunk was shattered by a rock thrown by persons unknown, and he was cut by the falling glass. Because he was sleeping off the beers, this was classified as an alcohol-related event and he was mandatory-referred to ASAP. Otherwise, he was a terrific soldier.
    To be honest, this challenges the whole role of the mental health section. Their stated mission is to "advise and assist" the Co. Since I am a big believer in unit focus over individual focus, I agree w/ this. The caveat is that the MH section needs to seriously ramp up the advise portion of their mission and educate leaders, who seem to often be very ignorant about mental health issues. I also feel that there should be an appeal process of some sort where if the MH section or the soldier strongly disagrees with the CO decision they can get a second opinion. The "what else is true" in this case is that we, (the Army) is not unit focused, but is individual focused and if a soldier chooses to self nominate for counseling, under our current way of doing business, he should be able to do it confidentially. Perhaps base MH should be primarily for self referral, and brigade MH section for command referral?
    Reed
    P.S. 120 I was honored to hear that you value the opinion of a monkey-poo flinging God-complex PTSD pusher
    Last edited by reed11b; 01-17-2009 at 09:33 PM.
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    Sorry above post was if policy was a MH policy not an ASAP policy. Same basic beliefs with ASAP however.
    Reed
    Quote Originally Posted by sapperfitz82 View Post
    This truly is the bike helmet generation.

  13. #73
    Council Member 120mm's Avatar
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    Personally, I don't think the CO of a military unit has ANY right to know which of his soldiers are self-referring. It's part of the "paternalistic bull####" aspect of the Army I detest.

    We cannot have strategic corporals, if we treat them like children.

    Now, a CO "might" need to know that "X" number of soldiers have self-referred for this or that, or that referrals are increasing/decreasing, but I think it is high time for soldiers to have more of their privacy respected.

    A good commander will know what's up, and the risk to a unit and its mission is way overblown by the kind of guy who would self-refer.

    A bad commander should either be relieved for cause, or his soldiers should be protected from his/her incompetence/insensitivity by having their privacy protected.

    A great commander would be running his own referral show on the side, getting in front of mental health/alcohol abuse issues and dealing with them compassionately and at the lowest possible level.

    At no point in the above three acceptable (to me) cases, does a CO have a valid reason to know specifically about a self-referral.

  14. #74
    Council Member 82redleg's Avatar
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    But if I, as the commander, am responsible for ensuring that my Soldiers:
    1- have access to mental health treatment
    2- are properly supported in said treatment
    3- are not deployed because of said treatment

    then I have to know about their recieving treatment. If a Soldier keeps his treatment secret, his chain of command cannot support him.

  15. #75
    Council Member Xenophon's Avatar
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    I haven't read the whole thread so forgive me if this has been covered.

    I'm looking for what social service and mental health programs that exist should be kept, wich can go and what needs to be changed.
    Unfortunately, their quality isn't the issue. These programs are usually conducted immediately or almost immediately after returning to CONUS. No matter how important and well-presented they are, nobody cares (at that point). There is usually ample time to conduct these programs during redeployment in country or in Kuwait, but no resources.

    Bottom line: The best way to help the returning veteran is to be available for him if he comes for help, not to make him sit through a canned PowerPoint brief when he should be spending time with his family.

  16. #76
    Council Member 120mm's Avatar
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    Quote Originally Posted by 82redleg View Post
    But if I, as the commander, am responsible for ensuring that my Soldiers:
    1- have access to mental health treatment
    2- are properly supported in said treatment
    3- are not deployed because of said treatment

    then I have to know about their recieving treatment. If a Soldier keeps his treatment secret, his chain of command cannot support him.
    In my experience, I've never seen a commander "support" a soldier in this way. The presumption that the commander is responsible for the minute-to-minute care and feeding of his/her soldiers is paternalistic and degrading, imo.

    Regardless of intention, this kind of "support" results in stigmatization at the very least.

    I've been a commander, three times, and have dealt with alcohol-related/mental health issues on the "down low" with fairly good results. Partly, I think the attitude that mental health issues don't necessarily mean the soldier is "broken" is key to success. Unfortunately, the formal system imputes "broken-ness" as a start-point.

  17. #77
    Council Member Ken White's Avatar
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    Default Agree with 120mm...

    Quote Originally Posted by 120mm View Post
    ...The presumption that the commander is responsible for the minute-to-minute care and feeding of his/her soldiers is paternalistic and degrading, imo.
    The worse problem is that paternalistic attitude which is pervasive and goes far beyond the mental health problem treats 19 year olds like children and they resent it -- a great deal. it also causes good Officers and NCOs who realize the damage it does to tear their hair out in frustration. So the 'technique' contributes to driving people of all ranks out of the Armed Forces -- not just the Army; the USAF is better about it than the others but all are guilty...
    Regardless of intention, this kind of "support" results in stigmatization at the very least.
    Even if the CO is benign, there will be others in the chain who are not.
    ...I think the attitude that mental health issues don't necessarily mean the soldier is "broken" is key to success. Unfortunately, the formal system imputes "broken-ness" as a start-point.
    True. I'd also suggest that EVERYONE is a mental aberration to a degree; as long as the person in question can function, he or she should be left alone to function.

    As for predicting, based on the past, any future mental deviance or lack thereof in an operational setting. Heh. Good luck...
    Last edited by Ken White; 01-19-2009 at 08:06 PM. Reason: added 'or lack therefof'

  18. #78
    Council Member reed11b's Avatar
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    Default Actually ....

    I agree with 120mm
    ... so do I!
    Before anybody tries to throw out the "a history of MH correlates to higher rates of future MH" line, keep in mind that the same is true for physical injuries. Do we assume someone that sprains there ankle once is "broken" forever becouse of the increased possibilty of them getting a future sprain? The army is working hard on de-stigmatyzing PTSD, but what about plain old depression or anxiety? What about grief? Chaplains are allowed to keep confidentiality, why not have some available MH resources confidential?
    If the soldier is non-deployable or needs long term treatment, then yep, CO needs to know, but otherwise...
    Reed
    Quote Originally Posted by sapperfitz82 View Post
    This truly is the bike helmet generation.

  19. #79
    Council Member MikeF's Avatar
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    Default Warrior Transitions: From Combat to Social Contract

    From an ethics class. Excellent resource for soldiers to read pre and post deployment...

    Warrior Transitions: From Combat to Social Contract

    By Shannon E. French, Ph.D.
    United States Naval Academy
    January 2005 JSCOPE

    http://www.usafa.edu/isme/JSCOPE05/French05.html

    I. Introduction: Penance and Purification

    Warriors must not feel that they are stepping into an entirely separate moral universe when they enter a combat zone and that they will never be held accountable for what they do there. As Bernard J. Verkamp explains in his important work, The Moral Treatment of Returning Warriors in Early Medieval and Modern Times, in the early Middle Ages, Christian knights returning from war were required to do penance for acts committed during wartime that were seen as “sinful” (including injuring and killing other humans), even if the war had been judged to be a just war by the Church. As Verkamp explains:

    [T]he Christian community of the first millennium generally assumed that warriors returning from battle would or should be feeling guilty and ashamed for all the wartime killing they had done. Far from having such feelings dismissed as insignificant or irrelevant, returning warriors were encouraged to seek resolution of them through rituals of purification, expiation, and reconciliation. To accommodate these latter needs, religious authorities of the period not infrequently imposed various and sundry penances on returning warriors, depending on the kind of war they had been engaged in, the number of their killings, and the intention with which they had been carried out.[1]

    On the surface, this seems a bit unfair. You go off to fight a war in what the Church has declared to be a just cause, you survive the horrors of war, and when you return the Church wants you to do penance and ask forgiveness for what you have done? At first blush, this practice seems only designed to produce self-loathing warriors.

    In fact, however, those who created the practice did not do so to punish warriors or make them regret their calling. They simply thought they understood what a warrior returning from war needs to do in order to transition successfully back into civilian life. Warriors need to recognize that what they did in service of their country was outside the norms of human existence and cannot be allowed in civilized society. The power of life and death that they were asked to exercise over others for the good of all must be relinquished (at least until they are called to war again). However necessary the evil in which they participated might have been, it was still an evil. By asking for forgiveness, warriors acknowledge that the rules that generally govern the social contract are valid and do apply to them. They accept ownership of their actions and symbolically ask to be allowed back into the fold of their community, released from the guilt of the acts they committed in the “fog of war.”

    A vast array of cultures across the globe have understood the need for some form of spiritual cleansing and ritualized transition for the warrior passing from the world of war into the world of peace. In ancient Rome, the Vestal Virgins would bathe returning soldiers from the Legions to purge them of the corruption of war. In Africa, returning Maasai warriors had purification rites, and Native Americans of the Plains tribes conducted sweat lodge ceremonies for their warriors before they could rejoin their tribes.[2] Embedded in these rituals are essential lessons from history about what we need to do for those who have transgressed the moral lines of civil society in order to protect and defend civilization for the rest of us.
    v/r

    Mike

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