NEW JERSEY VETERANS HELPLINE PROGRAM

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• NEW JERSEY VETERANS HELPLINE PROGRAM
• 1-866-VETSNJ4 YOU!
• 1-866-838-7654
• A Partnership of UMDNJ- UBHC NJ DMAVA

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NEW JERSEY VETERANS FOR YOU HELPLINE AT
UBHC-UMDNJ

• Is answered 24 /7 by Veteran/Peer clinical staff
  counselors with military expertise
• A Vet to Vet experience, it is confidential,
  free, and available to meet your needs
• New Jersey soldiers and their families receive
  telephone peer counseling, clinical and suicide
  assessments as needed, referrals to veteran
  mental health treatment and customized resources
  available through NJ Department of Military
  Veterans Affairs

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NJ VETERANS HELPLINE Services Include

• Veteran to Veteran Peer Support
• Telephone Counseling
• Veteran Clinical Assessments
• Triage -Veteran Service Offices Resources
• Referrals to providers with military expertise
• Crisis Support/Field Activity
• Vietnam Veterans Support Group Meetings
• Family Support Liaison activity

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New Jersey Veterans Helpline CALL HISTORY-
2005- 2008

• Total calls 5,637/8,882 Service Requests
• Call backs by Veteran/peer counselors 3,324
• Telephone counseling /treatment requests 1,564
• 2009 (3 MOS)TOTAL CALLS/CONTACTS 2,894
• FIELD/GROUP CONTACTS 1,977
• CALLS TELEPHONE COUNSELING 917
• 60-70 OEF/OIF
• Gender 80 male, 20 female

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FIELD ACTIVITY SUMMARY

• RECONSTITUTIONS/DEPLOYMENTS
• UBHC Veteran staff participated in 58
  Reconstitutions - 2005 - 2008
• As a result approximately 175 veterans in therapy
  
• Increase in 11 and group field activity
  highlighted our team in 2008
• 2009 selected to be Lead in NJ DMAVA PTSD Task
  Force
• Lead in Welcome Home 11 sessions for
  Reconstitution of approx. 3,000 soldiers

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Welcome Home is a UBHC Military One to One
Intervention

• Goal To Decrease Stigma And Increase Chance Vet
  Will Disclose Any Concerns
• Primary team of Veteran peers clinicians
• Handouts- see FORMS
• Crisis triage capacity w/clinicians
• Goal Engage, Psycho-Education, Crisis Response
• Provide Military Support Suicide information
• Encourage utilization of support services

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WHO ARE YOU SERVING?New Jersey National Guard
OIF/OEF

• WARRIOR SPIRIT-Acknowledge it!
• An intensity of life filled with energy and
  readiness to act when needed protecting ones
  family, neighborhood, nation and world.
• A total willingness to stand up for what is right
  with a sense of duty greater than ones own need.
  Charles Lewis Arnold, MS, BCPC, CTM, CTSS
• (ret. Master Sergeant, United States Marine Corps
  and New Jersey Army National Guard)

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WHAT YOU ARE DOING

• VOLUNTEERING TO SUPPORT OUR TROOPS AS A
• MEMBER OF THE UBHC- UMDNJ TEAM LED BY
• THE NEW JERSEY VETERANS HELPLINE STAFF
• BY GENUINELY SHARING YOUR GRATITUDE FOR
• THEIR SERVICE
• PROVIDING PSYCHOEDUCATIONAL INFORMATION,
• CHECKING IN WITH THEM ON THEIR EXPERIENCES
  BEING DEPLOYED
• ASK HOW THEY FEEL AS THEY ADJUST TO RETURNING
• HOME

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STEPS OF THE WELCOME HOME 11

• Welcome Home 11 Psycho educational Session-
  Thank them!
• Introductions/Sign In/ Program Sheet
• Review Packet/Forms
• Interview-(script)
• Psycho educational component
• Offer resources/follow-up
• 12

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WHAT IS YOUR GOAL?

• Welcome Home- Soldiers need support
• Share gratitude for service
• Explain Confidential resource in
• NEW JERSEY VETERANS HELPLINE
• Offer support through the
• Welcome Home 11 Interview
• Review Materials- Psycho education
• Ensure service to those in need
• 13

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WHAT YOU ARE NOT DOING

• A CLINICAL/PSYCHOSOCIAL ASSESSMENT
• A CRISIS /ACUTE SCREENING ASSESSMENT
• AN INFORMAL CONVERSATION
• A RIGID OR SCRIPTED SERIES OF QUESTIONS
• MEDICAL ASSESSMENT OF ANY KIND
• REFERRAL TO SPECIFIC PROVIDERS
• AN INQUIRY TO EXPLORE MILITARY LIFE

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BEFORE YOU GET THERE

• Review materials to ensure you are prepared
• Bring photo ID- preferably Drivers license
• Report by 830 a.m. to check points to arrive by
  900 am SHARP for morning briefing
• Ask questions/receive instructions-
• Team Leader

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WHEN WHEREWILL THIS TAKE PLACE?

• Welcome Reconstitution sessions
• will take place between
• June 1, 2009 and June 20, 2009 at
• Fort Dix
• 3601 Saylors Pond Road
• Fort Dix, New Jersey 08640
• IMPORTANT- Confirm event prior to reporting as
  the schedule may change and confirmation via
  email or phone should be received.

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LESSONS LEARNED

• NJ Veterans Helpline data reflects trends in
  service needs and caller reporting of symptoms
• VA/NJDMAVA study reflects specific information
  regarding the troops pre-deployment
• National PTSD resources and Military resources
  have offered solutions to meet soldiers
  behavioral healthcare needs

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WHAT HAVE THEY TOLD US?New Jersey National
Guard OIF/OEF

• Veteran helpline Callers Clinical Issues
• Depression/Mood Disorder
• Anxiety/Phobias
• Medical/Somatic Complaints
• Marital/Couples
• Post Traumatic Stress Disorder
• Family/Parenting Issues
• Substance Abuse
• Aggression/Violence
• Recent Loss
• Suicidal Thoughts

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WHO IS OUR HIGH RISK CALLER?

• 65 counseling requests- OIF/OEF
• Anxiety, depression present in most cases
• Anger was present in majority of cases. Anger
  varied depending on the unique situation with
  each soldier. Multiple deployments a theme
• Sleep disturbances reported frequently
• Long hours /difficult schedules a cause, others
  report anxiety related to fear of harm etc.
• Flashbacks and reaction to loud noisescommon

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Military Families New Jersey Veterans Helpline

• Primary Diagnosis/Complaint with
  Parenting/Family Issues
• Depression 93Anxiety 91Aggression
  89Marital/Family 68Violence 27

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FAMILY STATISTICS

• 63 of all family calls are from OIF/OEF
• 56 of all callers w/family issues National
  Guard
• Primary problems as Anxiety, Depression, Marital
  Discord
• Majority of calls include marital discord
  w/aggression violence prevalent for soldiers
  returned home from the war

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TOP TEN COUNTIES DEPLOYED SOLDIERS WHERE THEY
LIVE
RANK COUNTY DEPLOYED
1 Burlington 196
2 Essex 192
3 Hudson 188
4 Passaic 165
5 Middlesex 161
6 Camden 158
7 Ocean 153
8 Bergen 132
9 Union 129
10 Gloucester 126
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Preliminary Findings from the Pre-Deployment
Survey of the New Jersey National Guard
2007-2008Department of Military and Veterans
Affairs VA New Jersey Health Care
SystemBloustein Center for Survey Research,
Rutgers University

• PURPOSE
• To collect baseline information on the mental and
  physical health of National Guard members
  deploying to Iraq
• To assess the health effects of previous
  deployments to Iraq and Afghanistan by comparing
  those with and without previous OEF/OIF
  deployments
• To use information to plan for the health service
  needs of returning veterans

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METHODS

• Anonymous, self-administered surveys were
  distributed to Guard members during
  pre-deployment medical assessments between
  11/2007 and 5/2008
• Questions focused on
• mental and physical health
• substance abuse
• combat experiences (for those previously
  deployed) and
• access to treatment
• A total of 2,543 useable surveys were collected
  from the 2,890 deployed

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SUMMARY

• Guard members with one or more tours were
  significantly more likely to suffer from
  depression and PTSD than those with no previous
  tours
• Alcohol misuse was high among all Guard members
  and did not increase significantly with previous
  deployment
• The presence and intensity of physical pain was
  high among those previously deployed and
  increased according to the number of previous
  deployments

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SUMMARY (CONTD)

• Pain prevalence translated into significant
  disability in performing physical activities,
  with more than 20 of those with 2 or more
  deployments reporting
• The experience of pain and physical disability
  was especially high among those with PTSD, with
  22 believing they did not meet physical
  conditioning requirements for deployment
• Respondents reported significant barriers to
  mental health symptom reporting post-deployment,
  including the lack of post-deployment screening
  for mental health problems, a reluctance to
  report symptoms in order to avoid being placed on
  medical hold and discomfort in acknowledging
  mental health problems
• Only 41 of those with PTSD were treated in the
  previous 12 months

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DISCUSSION

• These data raise important questions about the
  military readiness of troops returning to the
  OIF/OEF conflicts after experiencing previous
  deployments
• All returning OIF/OEF troops receive a series of
  DoD post-deployment assessments and, prior to
  returning to combat, a pre-deployment medical
  assessment by both the National Guard and DoD.
  Troops in the present study had passed their
  National Guard pre-deployment assessment but had
  not yet been assessed pre-deployment by DoD

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DISCUSSION

• While it is possible that many symptomatic troops
  would be screened out by DoD, DoD reports that
  between 3/2007 and 2/2008, only 5.5 of all
  troops receiving pre-deployment assessments were
  referred for a medical visit, including only 1
  referred for mental health reasons (DOD, 2008)
• These data suggest that many symptomatic troops
  continue to be deployed to combat because of a
  reluctance to report symptoms and seek treatment

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POLICY IMPLICATIONS

• The number of Veterans returning from Iraq
  needing treatment for mental health and substance
  abuse problems is likely to be very high - 33 of
  the approximately 2,800 deployed troops, or over
  900 veterans
• Stigma is a serious barrier to veterans reporting
  and seeking treatment for mental health and
  substance abuse problems (see poster)
• Alcohol problems are rarely treated and may
  require intensive outreach to impaired veterans

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Mental Health Problems by Number of Previous Tours
All values significant at p.000
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Mental Health Problems by Length of Time Since
Previous OIF/OEF Tour
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Pain and Physical Functioning by Presence or
Absence of PTSD, among Those Previously Deployed
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Proportion Treated in Last Year Among Those with
Mental Health, Substance Use and Health Care
Problems
Note substance use treatment was measured for
those with alcohol dependence, mental health
treatment for those with PTSD and medical care
for those with chronic, intense pain.
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MILITARY POPULATION TREATMENT RESISTANCE

• Efforts to minimize distress may be based in
  desire to hasten discharge, quicken return to
  family, avoid compromising military career or
  retirement and in response to realistic fears
  about impact on career prospects.
• Lessen risk through prevention of
• family breakdown
• social withdrawal and isolation
• employment problems
• substance abuse

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MILITARY SUICIDE RISK

• The highest relative suicide risk is in veterans
  who were wounded multiple times or hospitalized
  for a wound suggesting that the intensity of
  the combat trauma, and the number of times it
  occurred, may influence suicide risk in veterans
  with PTSD. (National Center for PTSD)

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MILITARY SUICIDE INFORMATIONStatistics 2007
(Violanti)

• 89 confirmed suicides in 2007 with an additional
  32 deaths being investigated
• 2,100 suicide attempts in 2007
• 350 suicide attempts in 2002, the year before the
  war in Iraq began
• 5 attempts per day
• Multiple deployments a risk

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FORMS

• New Jersey Veterans For You Helpline Flyer
• Refer to Flyer in offering and explaining service
• Highlight that flyer has questions re reactions
  the soldier may have that can be reviewed (PTSD
  checklist)

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(No Transcript)
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FORMS

• QPR
• Explain to soldier QPR can help them and their
  families to help each other
• Refer to Flyer
• Question, Persuade, Refer Suicide Prevention
  Know the signs/symptoms
• Be your Brothers/Sisters Keeper not just
  during times of crisis, but always..
• Question, Persuade, Refer

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• NEW JERSEY VETERANS HELPLINE PROGRAM
• 1-866-VETS-NJ-4 - - - 1-866-838-7654
• Free Confidential Helpline for New Jersey
  Veterans and their families
• Question, Persuade, Refer
• QPR IS A SUICIDE AWARENESS TOOL
• Be your Brothers Keeper not just during times
  of crisis but always
• Remember
• How you ask the question is less important than
  that you ask it!
• Similar to how CPR helps someone stay alive until
  you can get medical help
• QPR helps someone stay alive until they can get
  psychological help!
• Q Question the Person about Suicide. Dont be
  afraid to ask if they have thoughts of killing
  themselves? Do they have a Plan?
• Tips for Asking the Suicide Question
• If in doubt, dont wait, ask the question, be
  persistent!
• Talk to the person alone in a private setting,
  allow them to talk freely
• Give yourself plenty of time
• Have resources handy phone numbers, counselors
  name and any other information that might help

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• Question, Persuade, Refer
• Ask a Question and be more than a friend!
• Persuade someone to live instead of attempt
  suicide.
• Dont hesitate to get involved or take the lead.
  Refer them to help.
• Give your fellow soldier back up during a time
  when they need it most!
• 1-866-VETS-NJ-4 - - 1-866-838-7654
• The More Clues and Signs Observed, the Greater
  the Risk. Take All Signs Seriously.
• SOLDIER SUICIDE
• KNOW THE FACTS / BE AWARE OF WARNING SIGNS
• Facts
• Asking wont put the thought in someones head
  it will give them an opportunity for help.
• The suicide rate for veterans was found to be
  between 22.9 and 31.9 per 100,000. The suicide
  rate for non-veterans is 8.3 per 100,000,
• Most suicidal individuals express some intent the
  week prior to their attempt.
• Suicide is the most preventable kind of death,
  and almost any positive action may save a life.
• Signs/Cues to look for
• Warning Signs - despair, hopelessness, depression
• Suicide threats and previous suicide attempts

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MILITARY DEFINITIONS

• RECONSTITUTION To return the soldiers to their
  home base taking them off active duty status and
  putting them on reserve status.

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DEFINITIONS

• REINTEGRATION The time when the service member
  eases his/her way back into a routine and returns
  to the day-to-day civilian life.
• To avoid upsetting the balance established
  during the service members absence, the veteran
  must slowly work his/her way back into the
  family. 30, 60 90 day events will support
  soldier and his/her family as a follow-up

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DEFINITIONS

• MOS- Military Occupational Specialty
• OIF- Operation Iraqi Freedom
• OEF- Operation Enduring Freedom
• LOD- Line of Duty
• NJDMAVA-New Jersey Department of Military
  Veterans Affairs
• FAC- Family Assistance Centers
• VSO- Veteran Service Organization

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WELCOME HOME INTERVIEW SAMPLE

• Hello, my name is ____________
• Welcome home and thank you for your service.
• I am here from the New Jersey Veterans program to
  find out how youre doing (Explain program)

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• What is your name?
• What is your Armory?
• What is your MOS (Military Occupational
  Specialty) and rank?
• Did you work in your MOS during deployment?

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• Was this your first, second or third deployment?
• What was it like being in Iraq?
• Were you inside or outside the wire?
• Were you involved in any combat situations?

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• Did you fire your weapon?
• Did you experience any injuries or medical
  issues?
• If yes, was an LOD (Line of Duty) Completed?
• Now that you are back home, what are your
  concerns?

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• From the contact you have had with your family
  while you were deployed, how are things at home?
• Does your family have any needs or concerns that
  they have told you about?
• Is your post deployment employment secure?
• If the soldier shows signs of trauma or has ask
  specifically
• what are you thinking/feeling?
• Are you having suicidal thoughts?
• Is there anything else you would like to discuss?

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PSYCHOEDUCATIONAL COMPONENT

• Give them the forms and review
• New Jersey Veterans Helpline Flyer
• QPR Form
• New Jersey Veterans Helpline cards
• Tell the Veteran that staff from the New Jersey
  Veterans Helpline program will be attending the
  30-60-90 day reintegrations and will be available
  for counseling if needed
• Also advise they can call the New Jersey
  Veterans Helpline program anytime day or night
• 1-866-VETSNJ4..You
• 1-866-838-7654

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WRAP UP PHASE

• If no assistance is required at this time, remind
  the Veteran that he/she can call the helpline at
  any time. Ask them if they would like a
  follow-up call from a New Jersey Veterans
  Helpline staff member in a few days. If the
  Veteran says yes, provide New Jersey Veterans
  Helpline callback form and complete it.

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OPERATIONS

• A mini Welcome Home briefing will be held each
  day for all volunteers before the reconstitutions
  start at 900 am SHARP
• All information can be emailed to any individual
  wishing to participate in the reconstitutions.
  Please email/ call
• Jill Caravello at 732-235-3960
  (caravejl_at_umdnj.edu) to be emailed PowerPoint
  and/or forms

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OPERATIONS

• Crisis Response
• If the soldier seems to be having a difficult
  time, there will be a triage room set up with
  licensed counselors available for follow up
• Escort Soldier to the Triage Unit after notifying
  Team Leader

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NEW JERSEY VETERANS HELPLINEIMPORTANT STAFF
NUMBERS

• HELPLINE 1-866-VETS-NJ4/1-866-838-7654
• Jill Caravello 732-235-3960
• Chuck Arnold (cell) 215-858-0879
• Heather Altman (cell) 856-366-0642
• Cherie Castellano (cell) 732-713-8037

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SECURITY MEASURES WHEN ENTERING FORT DIX

• If possible, please try to come in groups
• Please be sure to bring a photo ID (drivers
  license or passport)
• If you dont have drivers license or passport,
  you will need two forms of ID (one must be a
  photo and the other needs to be acceptable to the
  guard)
• As your vehicle approaches the gate, please have
  your Drivers License, Vehicle Registration and
  Vehicle Insurance Card in hand and ready for
  police officers to identify you and all adult
  occupants. All adult passengers in the vehicle
  will be required to produce a photo ID. This will
  expedite entry
• Plan to be at the gate by 830 AM

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• DIRECTIONS TO FORT DIX
• To save time traveling to the installation,
  please contact the individual where you are going
  for exact directions to their respective
  location. From New York and Northern New Jersey
  N.J. Turnpike South to Exit 7 (Fort Dix) Route
  206 South (go to second traffic light -- about
  1/2 mile) to Route 68 (left fork from Route 206).
  Route 68 will provide entrance to the
  installation where the SSG Terry Hemingway
  Reception Center is located
• From Delaware and Southern New Jersey N.J.
  Turnpike North to Exit 7 (Fort Dix) Route 206
  South (go to second traffic light -- about 1/2
  mile) to Route 68 (left fork from Route 206).
  Route 68 will provide entrance to installation
  where the SSG Terry Hemingway Reception Center is
  located
• From Philadelphia Take Walt Whitman Bridge to
  I-295 North, travel to Exit 40 (Route 38 East,
  toward Mt. Holly). Follow 38 through Mt. Holly
  and across Route 206 to Pemberton. Make a left in
  Pemberton (sign says To Military Bases) on Route
  616 to where the SSG Terry Hemingway Reception
  Center is located
• From Northern Pennsylvania Take Pennsylvania
  Turnpike to New Jersey Turnpike Take New Jersey
  Turnpike North to Exit 7 (Fort Dix) Route 206
  South (go to second traffic light -- about 1/2
  mile) to Route 68. Route 68 will provide entrance
  to the installation here the SSG Terry Hemingway
  Reception Center is located

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• DIRECTIONS TO THE T3 BATTLE LAB
• BUILDING 3601
• SAYLORS POND ROAD
• FORT DIX NEW JERSEY 08640
• Route 68 South to Main Gate
• Pass through main gate and enter circle
• Take 2nd right turn from circle
• Travel 4/10 mile and make a left on-to Rancocas
  Road
• Travel 4/10 mile and make a right on-to Florida
  Avenue
• Travel 3/10 mile and make a left on-to
  Administrative Street
• NOTE There will be a sign
• NATIONAL GUARD BUREAU JOINT TRAINING AND
  TRAINING DEVELOPMENT CENTER
• Travel 2/10 miles and turn right into parking
  area. The building with the blue roof is where
  you want to go

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Thank You for Supporting our Troops!

• PLEASE CONTACT
• JILL CARAVELLO re YOUR AVAILABILITY AND
• WITH YOUR INFORMATION FOR SECURITY CLEARANCE FOR
  FORT DIX
• 732-235-3960 OR EMAIL caravejl_at_umdnj.edu
• BY MAY 20TH

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• YOU ANSWER THE CALL OF DUTY,
• WE ANSWER THE CALL FOR YOU
• 1-866-VETSNJ4YOU
• (1 866-838-7654)
• Thank you for supporting our troops