Pre and post deployment support

[reed11b]

Soldiers deploying and returning from deployment’s are run the gambit of “helpful” briefings and screenings by the DOD and VA. Unit FSGs and the community service agencies of each branch have greatly increased the benefits and support available to both soldiers and their spouses. While these programs all seem positive in and of themselves, (Battlemind, Yellow Ribbon, PDHRA, Strong Bonds, WTU’s, etc etc.) they have all been created ad-hoc, and some have limited public awareness, such as the strong bonds program. My focus is social service needs and mental health, though medical treatment falls into this. My question is, if you were to create a comprehensive program for the returning vets, what programs would you keep or model your plan on; what programs are redundant or of negative benefit? All feedback is beneficial
Reed

[Ken White]

let me suggest with personal AND family experience at returning from several wars that the current focus on such support assumes everyone needs pretty much the same thing and the need or desirability for such support is universal. I strongly doubt that. Predeployment or post deployment, tour location, length and efforts / job while deployed all have an effect and every individual and family situation is different.

My assessment of today's efforts is that it is significant overkill for most. I understand the (presumed?) difficulty in a large organization of tailoring such support as opposed to offering high volume, one size fits all solutions but I would also suggest that many people are being exposed to ideas they might never get on their own. The current processes offer excessive support that is excessive for most, adequate for a few and inadequate for a few more; the effort needs to be tailored and that, to me, means a psychological assessment for each person -- a very difficult but not impossible task -- or, better yet, such an assessment before service entry and rejection of those likely to need heavy support.

An idea which ought to fire up the PC crowd...

[reed11b]

Originally Posted by Ken White

-- or, better yet, such an assessment before service entry and rejection of those likely to need heavy support.

An idea which ought to fire up the PC crowd...

A true assessment or a simple review of existing history and the resulting go/no-go from it? I would agree if a true assessment was involved as MH diagnosis is not an exact science and I have meet many diagnosed as ODD that I would diagnose as "teenagers". A diagnosis does not make true, but a suitability screening may pay dividends. On a historical note, we had extensive MH screening during WWII and high no-go rates from them, but they had very little impact on MH casualties during that conflict, hence why we no longer use them. One thing that I do advocate for is a required mental health screening for combat vets w/i a certain period of there redeployment if they are involved in any UCMJ disciplinary actions or civilian legal violations. I feel this is often our first warning sign with a vet that fails to self-disclose.
Reed

[Ken White]

Originally Posted by reed11b

A true assessment or a simple review of existing history and the resulting go/no-go from it? ... On a historical note, we had extensive MH screening during WWII and high no-go rates from them, but they had very little impact on MH casualties during that conflict, hence why we no longer use them.

True but theoretically we're 65 years smarter today. Such an assessment won't be a panacea nor will it catch 'em all but I do believe it would be better than today's shotgun approach.

...One thing that I do advocate for is a required mental health screening for combat vets w/i a certain period of there redeployment if they are involved in any UCMJ disciplinary actions or civilian legal violations. I feel this is often our first warning sign with a vet that fails to self-disclose.
Reed

Makes sense; those that stay in are fairly well covered by the system; those that ETS -- or the RC folks -- have a different problem...

[reed11b]

Originally Posted by Ken White

True but theoretically we're 65 years smarter today. Such an assessment won't be a panacea nor will it catch 'em all but I do believe it would be better than today's shotgun approach...

What research and studies exist, suggest that is incorrect, at least in regards to MH casualties. The reason for this is that, while a history of pre-existing mental health issues make PTSD more likely, the majority of soldiers diagnosed with PTSD have had NOsignificant MH history. There is also a large body of deployed soldiers w/ MH histories that have had no Combat related MH troubles. I appreciate your participation in the subject Ken, but on this matter I am closer to being a SME. Prevention of disciplinary failures in basic and early in enlistments may be more achievable through pre-screening however.
Reed

[Ken White]

wrong direction. Don't look for pre-existing issues, they're obviously not reliable as a forecast mechanism, not what I intended at all.

Look for the mental outlook that can and will tolerate stress. Hire more sociopaths -- and yes, I'm quite serious.

Originally Posted by reed11b

...while a history of pre-existing mental health issues make PTSD more likely, the majority of soldiers diagnosed with PTSD have had NOsignificant MH history.

Obviously.

...There is also a large body of deployed soldiers w/ MH histories that have had no Combat related MH troubles.

Also obviously. I'd add that the combat flip out is variable, can occur early or later and that the number of triggers available on the battlefield is vast. MH issues in general do not show how well combat stress will be tolerated, people are too variable -- but the sociopathic trend, if not total, can aid in acceptance of most combat stressors.

...I appreciate your participation in the subject Ken, but on this matter I am closer to being a SME.

Gee, thanks. I appreciate your appreciation. Always good to deal with experts even if they do go in the wrong direction..

...Prevention of disciplinary failures in basic and early in enlistments may be more achievable through pre-screening however.Reed

Nothing to do with combat stress; in fact the guy with minor disciplinary problems is probably more tolerant of combat stress than the average straight arrow. We probably should stop trying to throw 'em all out of the service and exercise a little leadership.

[reed11b]

Originally Posted by Ken White

wrong direction. Don't look for pre-existing issues, they're obviously not reliable as a forecast mechanism, not what I intended at all.

Look for the mental outlook that can and will tolerate stress. Hire more sociopaths -- and yes, I'm quite serious.

OK, but not eneogh sociopaths exist to fill the Army's need, and many of us "straight arrows" develop sociopathic traits in service. This thread is now waaaaay of target, 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.
Reed

[Ken White]

Originally Posted by reed11b

...This thread is now waaaaay of target, 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. Reed

I merely suggested that a focussed psychological screening to detect those who may be better able to tolerate combat stress might be worth exploring. That seems consistent with what you asked.

IIRC, several recent research projects using a variety of methods including MRIs have determined that many people have a distinct aversion to violence while others seem to tolerate it well. That tracks with my observation over a number of years. The Sociopath tendency should not be totally rejected; most of us have a variety of little pathys in there and it seems to me that screening merits consideration.

With that, I'll leave you the floor.

[Stan]

Originally Posted by reed11b

I appreciate your participation in the subject Ken, but on this matter I am closer to being a SME. Prevention of disciplinary failures in basic and early in enlistments may be more achievable through pre-screening however.

Hello Reed,
Not to be a wise old retired NCO herein, but exactly what would you have expected from Ken having read your quotes below?

Let's get a little less personal with the seniors and respect the fact that Ken's background and experience is significant and plays a much larger role than some acronym SME.

Back in my days, SME translated to 15 years minimum.

Regards, Stan

Originally Posted by reed11b

4 years active duty paratrooper (mortars) and responded to Hurricane Katrina in 2005 as an untrained mental Health Specialist.

Originally Posted by reed11b

This seems to be important on a page w/ so many high grade officers and NCO's; I am a career smartass SPC. Turned down PLDC twice.

[reed11b]

Originally Posted by Stan

Hello Reed,
Not to be a wise old retired NCO herein, but exactly what would you have expected from Ken having read your quotes below?

Let's get a little less personal with the seniors and respect the fact that Ken's background and experience is significant and plays a much larger role than some acronym SME.

Back in my days, SME translated to 15 years minimum.

Regards, Stan

My knowledge comes from schooling and that I work as a outreach and education coordinator for the Readjustment Counseling Service (part of the VHA), not my military experience. I am not SME, but I do have solid specific knowledge on this topic (MH and PTSD). Sorry I touched a nerve w/ you salty old-timers, but the topic IS important. Perhaps instead of just being defensive you could make some valid suggestions.
Reed

[Stan]

Similar to my response to your PM...

I applaud your continued service and education.

No nerves touched here with me, but I'm not going to discount my military leadership education (aka PLC) in order to fix what you have indicated is a shortfall.

For the record, we attack the subject, not the members that post their thoughts and opinions.

Let's keep the thread and posts professional.

[jmm99]

for me because I think immediately of sociopaths as we think of that term in the criminal justice system - serial criminals (whether murder, rape, robbery or theft), who lack any empathy and are extremely self-centered.

I don't think that is what you are really saying, Ken - since IMO none of the criminal sociopaths I've known would have been at all useful in the military.

Slap may well have an opinion on this which is based on more experience - despite his relative youth.

There are personality types (probably galore) who can hack violence - even when it is of the cold-blooded kind. I think of three friends over the years (two still with us in the Copper Country) who were Marine snipers in Nam and who seem to have been relatively untouched by the experience. If anything, it seems to have been a positive thing - that from an outside observer who is not into their heads, but just a guy who drank a fair amount of beer with them.

On the other hand, there are personality types (again probably galore) who cannot hack violence. And, a bunch in between. So, it would seem useful to expand on some personality profiles as you guys know them (no need for shrink jargon).

Both Ken and Reed recognize what they are willing to call "sociopathy" - Ken in other threads as well as here; Reed here:

OK, but not eneogh sociopaths exist to fill the Army's need, and many of us "straight arrows" develop sociopathic traits in service.

I conclude that what you must mean as "sociopathic traits" are different from how I would use the term as a lawyer.

If what Reed said was meant, it seems to me that "sociopathic traits" or lack of same is an issue which is far from off-topic - since the support required will vary with the personality profile (METT-TC, to borrow from you guys).

[Ken White]

Originally Posted by jmm99

(Sociopath don't quite do it) for me because I think immediately of sociopaths as we think of that term in the criminal justice system - serial criminals (whether murder, rape, robbery or theft), who lack any empathy and are extremely self-centered.

Your prerogative to think of it in that manner -- and logical that you should do so. Not being burdened by being a Lawyer or a Psychologist, I do not have to be so precise. I use the term to indicate those tendencies that mirror your description, lacking empathy and being self centered and I contend that about half the people I have known in an overlong life have those traits to one extent or another. Quite obviously, the full blown legal and psychologically diagnosed Sociopath in the strictest sense of the term is not a desirable person -- and would, as you say, not be good as a Soldier.

However, as I said, we are all blends of numerous pathologies and traits both inherited and acquired so some of the sociopathic tendencies serve to insulate an individual from the horror of war -- or allow him or her to better accept the reality of war and deal with it. I mentioned several experiments that have indicated that those who can accept violence as opposed to those who categorically reject it or are repelled to such an extent that they literally freeze momentarily can be identified by various assessments including MRI scans.

There are personality types (probably galore) who can hack violence - even when it is of the cold-blooded kind. I think of three friends over the years (two still with us in the Copper Country) who were Marine snipers in Nam and who seem to have been relatively untouched by the experience. If anything, it seems to have been a positive thing - that from an outside observer who is not into their heads, but just a guy who drank a fair amount of beer with them.

On the other hand, there are personality types (again probably galore) who cannot hack violence. And, a bunch in between. So, it would seem useful to expand on some personality profiles as you guys know them (no need for shrink jargon).

More elegantly said than by me but that's the point...

I conclude that what you must mean as "sociopathic traits" are different from how I would use the term as a lawyer.

Certainment!

If what Reed said was meant, it seems to me that "sociopathic traits" or lack of same is an issue which is far from off-topic - since the support required will vary with the personality profile (METT-TC, to borrow from you guys).

I'd think so...

[MikeF]

On monday, I'm so gonna find a psychiatrist to explain my sociopathic tendacies in warfare when I positively identify my enemy. It must be something to do with the way my mom treated me as a child.

Reed- despite my lack of humor (my daughter will probably not attend college now that the economic sky has fallen; hopefully, y'all have at least smiled if not laughed so we can get back on topic), I would encourage you to take a knee and allow us to get back to your original discussion.

IMO, Ken is right-outside of his so-called PC crowd. Freudian SME's thought and regard evolved throughout the last 65 years. From shell shock to PTSD to TBIs, advances are being made.

Futhermore, I would assert that the answer to your original question is the typical timeless Ken statement of METT-TC coupled with leadership. A Patreaus/Odierno/Caldwell must be tasked with this very important subject if we hope for some resolve on our wounded (and yes, I have plenty of wounded that I care deeply about).

Initially, Ken was only suggesting that we have a holistic approach during the recruitment process and post-deployment period.

cheers,

mike

[120mm]

My experience has been that the Medical Service Corps has seized the moment to create a bigger niche for themselves in the Army.

The great majority of anger I've experienced, post-deployment, has been righteous anger directed toward this or that weaselly MSC officer putting requirement after requirement on our notably non-combat unit, making it difficult to train/have time with my family.

I am still fully convinced that Army Doctors put a ton of people on "medical hold" primarily to create the Walter Reed crisis and therefore increase their budget/officer staffing.

On a related issue, a co-worker, who has just returned from a year-long non-combat deployment, has been required, along with the rest of his section, to attend PTSD counselling sessions. When he asked to be let out of this un-paid requirement, he was automatically diagnosed with PTSD.

[slapout9]

Originally Posted by jmm99

Slap may well have an opinion on this which is based on more experience - despite his relative youth.

I missed this somehow, you know how us young folks are. IMHO a good person can turn socio/psycho/A@@hole based upon the situation and mission if he believes in it. The key is he/she can turn it off when it is not justified. A person with a true mental health issue can not make/or will not make that distinction.

[reed11b]

Originally Posted by 120mm

On a related issue, a co-worker, who has just returned from a year-long non-combat deployment, has been required, along with the rest of his section, to attend PTSD counselling sessions. When he asked to be let out of this un-paid requirement, he was automatically diagnosed with PTSD.

What does your non-combat deployed co-worker do? Feel free to PM me, I may have some insight. I am hearing a lot of animosity towards Army MH, does this extend to VA and Vet Center counselors as well? What about ACS services? While not quite what I was asking for this is still useful.
Reed

[Ken White]

Originally Posted by slapout9

... a good person can turn socio/psycho/A@@hole based upon the situation and mission if he believes in it. The key is he/she can turn it off when it is not justified. A person with a true mental health issue can not make/or will not make that distinction.

I'm wit you!!!

[reed11b]

Originally Posted by slapout9

I missed this somehow, you know how us young folks are. IMHO a good person can turn socio/psycho/A@@hole based upon the situation and mission if he believes in it. The key is he/she can turn it off when it is not justified. A person with a true mental health issue can not make/or will not make that distinction.

Research says that is difficult and unlikly. One study that supports that shows higher rates of PTSD among LEO's then comabt vets! Emotions are addictive in a sense. Open those flood gates and it is hard to close them again. I'm as type "B" as one can get, but I have been restless and wanting to go back ever since I deployed to Iraq in '03. I think the "instant" mode switcher is a myth or at the very least, very very rare.
Reed

[Ken White]

Originally Posted by reed11b

Research says that is difficult and unlikly. One study that supports that shows higher rates of PTSD among LEO's then comabt vets! Emotions are addictive in a sense. Open those flood gates and it is hard to close them again. I'm as type "B" as one can get, but I have been restless and wanting to go back ever since I deployed to Iraq in '03. I think the "instant" mode switcher is a myth or at the very least, very very rare.
Reed

and little more.

My estimate is that the number of folks who can successfully make that switch is about 30%. Another 30% are not designed for combat or LE like stress (though many can and will do it if forced with varying MH results) and the remainder can hack it and are generally but varyingly successful in tolerating the trauma. Willingness or ability (desire or wishes have little to do with it) to accept violence is the issue; that simple.

Interesting how those estimates track with the 1/3 Rule on wars...