Transcript Military Deployment Cycle: The Effect on Service Members and Families Georgene Rea, LCSW Director of Psychological Health, Nevada National Guard Dave Kaul, MHC, NCC Director.

Military Deployment Cycle: The Effect on
Service Members and Families
Georgene Rea, LCSW
Director of Psychological Health, Nevada National Guard
Dave Kaul, MHC, NCC
Director of Psychological Health, Hawaii National Guard
Military Deployment Cycle: The Effect on
Service Members and Families
The goals of this presentation are:
•
To introduce you to general information regarding the deployment cycle and
how it impacts both the Service Members and family units.
•
To gain a better understanding of common reactions to war and
reintegration/readjustment
•
To provide you with an additional tool to assist in safely responding and
interacting with a member of the military community who might be
experiencing an emotional crisis
Ground Rules
• This is not a political debate
• Questions are encouraged for group discussion
• Please be respectful of others
• If the dialogue or material become too troubling, feel free to leave the
room until you feel comfortable enough to return
http://youtu.be/CbILpVzT_J8
Video: U.S. Military Tribute – I’m Already There
Learning Objectives
• Discuss demographic and risk characteristics of military families
• Describe general and deployment related stressors for military families and
the stages of the deployment cycle
• Gain a basic understanding of the readjustment behaviors exhibited by
returning veterans
Bringing attention
1% of American men and women are fighting our wars – willingly taking on
the ultimate responsibility of protecting our nation. They do not make these
sacrifices alone – when our troops are called to action, so are their
families/friends/support systems.
•
Since 2001, there have been over 1.6 million deployments in support of
Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF).
•
•
•
1/3 have served at least two tours in combat zones
70,000 have been deployed at least five times
To date, approximately 2 million children have experienced a parental
deployment in support of OEF/OIF
Military Culture
Active Duty vs. Guard/Reserve Units
Active Duty
Guard/Reserve Units
•
Units are based at
major military
installations.
•
Units are small & based in local communities.
•
•
Part-time citizen soldiers, often working with
local police, fire, and EMS.
Full-time soldiers who expect to be deployed
•
•
Families are left at their post where a variety
of support is in place both on-post & in
communities.
Families may be left in a town with little or no
support services.
•
Mostly support units (transport, MP, etc)
•
Live on-post or nearby; other family support
•
Likely to work within local communities
•
Less need to relocate when deployed
•
Can’t relocate easily when activated
•
Access to a variety of health, welfare, &
educational services
•
Lack of military related health services
•
Need to make use of family or local supports
(church, etc.) though FRG’s are very helpful
•
Support groups in-place through soldier’s unit
The Service Member Experience
OIF / OEF
• not homogenous---heterogeneous
• Active duty
• 40% Reservists/National Guard
• joined for variety of reasons
• likely did not expect to be deployed
• Large number of civilian contractors
• wide age range: 18-60+
• married
• parenting/grand-parenting job/career
• financial responsibilities (e.g. mortgage, family)
• Multiple deployments with unknown duration are typical
• instant communication (Skype, Facebook, email)
• Unconventional warfare (no front line, IEDs, suicide bombers)
• wounded/killed ratio 15:1
Deployed Military – current statistics
•
•
•
•
Men = 90%
Women = 10%
Married = 53%
 with children = 68%
 without children = 32%
Single = 47%
 with children = 13%
 without children = 87%
Center for Deployment Psychology and Army OneSource
The Deployment Cycle
Military life has unique stresses
•
Pre-deployment stressors
 Leaving loved ones behind
 Fear of physical danger, injury, death
•
Deployment stressors
 Adjusting to a new place or foreign country
 Reintegration after returning home
•
Being in a war zone
 Harsh living conditions
 Excessive heat, cold, noise
 Constant risk of injury and death
 Death or injury of fellow soldiers or civilians
National Guard - Managing PTSD and Other Combat-Related Stress Reactions, 2010
Cycle of Deployment
Stage 1: Anticipation of Deployment
Pre-deployment Phase
•
Timeframe: When family members receive orders
•
Increased feeling of stress in home
•
Reality of change ahead is “sinking in”
•
Denial & anticipation of loss
•
Focus is on completing family pre-deployment activity checklist
•
Members may feel more emotional
•
In case of multiple deployments . . . new cycle may begin before family has
had time to renegotiate shared vision from previous deployment
Stage 2: Detachment & Withdrawal
Pre-deployment Phase
•
Timeframe: Last week before service member leaves
•
Service member is focused on preparing for mission and may distance self
from family
•
Anger, arguments may occur as family prepares to protect themselves from
“hurt” of separation
•
Communication may be difficult
•
In preparation for loss, family may begin to act like the service member is
already gone
•
Multiple deployments can result in need to repeatedly create distance; to
feel “numb” and avoid emotional connection
Stage 3: Emotional Disorganization
Deployment Phase
•
Timeframe: 1-6 weeks into deployment
•
Life without the service member may initially feel overwhelming
•
Routines change, responsibilities may be added
•
Kids may feel . . .
 Numb and not interested in doing much
 More irritable than usual
 Have difficulty concentrating – particularly at school
 Wish things would go back to “normal”
 Surprised because things seem to be moving more smoothly now that
the service member is gone
Stage 4: Recovery & Stabilization
Deployment Phase
•
Timeframe: Usually between weeks 3 and 5 after deployment
•
Family finally starts to settle into routine of life without the service member
•
It is not uncommon for the spouse to experience:







Independence
Self-growth
Financial Problems
Loss of sleep, appetite changes
Being busier than usual
Increased crying, depression, anger
Increased loneliness and anxiety
Stage 4: Recovery & Stabilization
Deployment Phase – Children & Adolescents
•
•
•
•
•
•
•
Infants to School-Aged Children
Tantrums
Toileting accidents
Separation anxiety
Aggression
Behavioral changes at
home/school
Physical/somatic complaints
Fear of abandonment
Coping with changes can be positive:
•
•
May enjoy newfound responsibility
• Sense of independence
Relief that family is functioning well
•
•
•
•
•
•
Teenagers
Angry, moody
Poor school performance, grades
Worry about deployed parent
Caretaker of stateside parent
Drug/alcohol use
Withdrawal
Stage 5: Anticipation of Return
Deployment Phase
•
Timeframe: About 6 weeks before the service member returns
•
Homecoming is coming!
•
Family is happy, excited, and feeling a boost of energy
•
Trying to make everything “perfect” for the return
•
Sense of relief that the service member will be home, combined with worries
about whether or not they will be the same
•
If the service member came home on leave at some point during
deployment, that experience may be what family members expect:
 Positive Leave Experience = Positive Homecoming
 Challenging Leave Experience = Challenging Homecoming
Homecoming = Honeymoon period
Stage 6: Return, Adjustment & Renegotiation
Post-deployment Phase
•
Timeframe: About 6 weeks after the service member returns, after initial
joy and relief have diminished
•
During time of separation the service member and all family members have
changed
•
Changes may hold pleasant surprises or may cause conflict
•
Family members may feel overwhelmed by the service member attempts to
get to know everyone again
•
Everyone needs space and time to readjust
•
Entire family must begin to renegotiate how household will look now that
everyone is together again
Service Members and Families – video profile
Stage 7: Reintegration & Stabilization
Post-deployment Phase
•
Timeframe: Up to 6 months (and beyond) after the service member returns
•
Family continues to adjust to having the service member home
•
A “new normal” is established regarding routines and expectations
•
Members may begin to feel secure, relaxed, and comfortable with one
another again
•
If readjustment challenges resurface, support is important
Why do some Service Members have
difficulties readjusting after
deployment?
Traumatic Events in Combat
•
•
•
•
•
•
•
•
•
•
Taken prisoners of war
Responsible for the care of enemy prisoners
Involved in cleanup of war zones, handling dead bodies
Sexually assaulted or harassed during active duty
Witness to or victims of injuries during training, friendly fire
Exposed to terrorist attacks
Involved in peacekeeping missions
Exposed to chemical, nuclear, or biological weapons
Death or maiming of women and children
Killing someone up close
National Guard - Managing PTSD and Other Combat-Related Stress Reactions, 2010
Realities of Combat
•
•
•
•
•
•
•
•
•
•
Fear in combat is universal
Unit members will be injured and killed
There will be communication breakdowns
Leadership failures will be perceived
Combat impacts every soldier mentally and emotionally
Combat has lasting mental health effects
Soldiers are afraid to admit that they have a mental health problem
Deployments place a tremendous strain upon families
Combat environment is harsh and demanding
Combat poses moral/ethical challenges

WRAIR Land Combat Study Team
http://youtu.be/XzbpW5NMfls
Battlemind Training
• Battlemind skills helped the Service Member survive in combat, but
may cause him/her problems if not adapted after returning home
•
•
•
•
•
•
•
•
•
•
Buddies (cohesion)
Accountability
Targeted Aggression
Tactical Awareness
Lethally Armed
Emotional Control
Mission OPSEC
Individual Responsibility
Non-Defensive Driving
Discipline and Ordering
vs.
vs.
vs.
vs.
vs.
vs.
vs.
vs.
vs.
vs.
Withdrawal
Controlling
Inappropriate Aggression
Hypervigilance
“Locked and Loaded” at Home
Anger/Detachment
Secretiveness
Guilt
Aggressive Driving
Conflict
Deployment vs. Post-deployment stressors
Service Member mindset when deployed
•
•
•
•
•
•
•
•
Stay focused on mission /nothing else matters
Truly life or death / always on the edge
Constant adrenaline “rush”
Black or white / all or nothing
Sense of purpose, invincibility
Only trust battle buddies /others are threat
Need to control environment
Real problems and needs exist in Iraq
Adapted from briefing by COL Kevin Gerdes, May 2008
Mindset of Service Members returning home
•
•
•
•
•
•
•
•
Life is now unfocused and complex
No longer on the verge of life or death
What can replace the “high” of war?
Things aren’t clear cut
No sense of purpose, nothing matters
Can’t trust anybody
Can’t be in control of surroundings
Problems at home pale in comparison to those in Iraq
Adapted from briefing by COL Kevin Gerdes, May 2008
Other Post-Deployment Reactions
•
Combat Stress: Natural result of heavy mental and emotional work when
facing danger in tough conditions; physical symptoms (headaches, racing
heart, fatigue, anger) generally gets better with rest and replenishment
•
Post-Traumatic Stress Disorder: Possible response when deployment
has occurred to war zone, natural disaster site, or urban riot location:
physical, mental, and emotional symptoms that require professional
assistance
•
Secondary Traumatic Stress: Possibly experienced by family members
upon return of soldier; stress resulting from helping or wanting to help a
suffering or traumatized person
How is this information relevant to my
job as a CIT officer?
911 – What is your emergency?
Identified problems leading to calls to law enforcement:
•
•
•
•
•
•
Viewing internet pornography and internet sex chat is becoming a norm for
deployment – increase in stateside sexually based offenses
There is a high rate of infidelity among soldiers and spouses during
deployments – resulting in conflict upon reunification (DV)
Illegal/prescription drugs and alcohol are prevalent and are used as
common coping mechanism by soldiers (deployed and at home) and by
their spouses (buying pills off the street)
Suicide (ideations, attempts)
There is a high incidence of rape and sexual molestation of deployed
female soldiers
Home is no longer viewed as a safe place to live - many now carry weapons
when at home
911 – What is your emergency?
•
•
•
•
There is a statistically verifiable increase in domestic violence and child
abuse among military families. Child abuse increases as the stressors
increase in the life of the non-deployed spouse
While deployed, many soldiers are constantly sleep deprived and share
each others medications (i.e. Ambien). Hooked on Energy Drinks.
Service Members may pursue activities which replicate the adrenaline rush
of combat (increase in cocaine use upon returning home, extreme driving)
With increased monetary incentives and a lowering of recruitment standards
the quality of the troops has been increasingly lowered: no GED necessary,
accepting recruits with DSM-IV diagnosable conditions and on medications,
increase of gangs.
Did you know??
 18.5% of veterans returning from Afghanistan and Iraq meet the criteria for
Posttraumatic Stress Disorder (PTSD) and/or major depressive disorder.
 19.5% report traumatic brain injuries (TBI) such as concussions during deployment.
 79% of those with TBI met the criteria for alcohol abuse; 37% met the criteria for drug abuse.
 Substance abuse represents one of the leading causes of medical leave for military
personnel, accounting for approximately 400,000 medical encounters and
approximately 75,000 days of enforced bed rest each year.
 30,000 suicides are committed each year on average, more than 20% are veterans.
 On average, a military veteran commits suicide every 24 hours.
 The unemployment rate of post 9-11 veterans is 10.4%, compared to a non-veteran
rate of 9%. The unemployment rate for veterans between 18-24 is 21.9%. The
unemployment rate among Reservists/National Guard may be as high as 40%.
 Female veterans are four times more likely to become homeless than men and are
more likely than men to have dependent children.
 Three out of four homeless veterans have alcohol, drug, or behavioral health problems.
Identify Indicators of Military Service & Support
•
•
•
•
•
•
•
•
•
Stickers or emblems on rear of vehicle
DOD base permit lower left corner of windshield
Dog tags/lanyards on rearview mirror
Flags – POW, military branch, KIA
Photos, plaques or awards displayed on walls
Uniforms/hats, t-shirts with branch logo
Military equipment
Tattoos
Demeanor
Evaluate Level of Distress – Suggested
Practices
•
Does probable cause exist to believe the Service Member/Family Member
is likely to harm him/herself or others if allowed his or her liberty?
•
Has he/she attempted or admitted a plan to commit suicide?
OR
Feeling depressed, angry, confused but no signs of violence or untreated
mental illness = No probable cause for involuntarily commitment.
•
How to Evaluate Level of Distress
Resolve - Arrest or mental health referral?
Drunk driving
Substance abuse related offenses
Domestic Violence
Child Abuse
Single vehicle deaths (accidental deaths or suicide??)
Traffic violations – speeding, swerving
Take away information
Army OneSource
(877) 811-ARMY
(878)www.myarmyonesource.com
American Red Cross
Military OneSource
(800) 342-9647
www.MilitaryOneSource.com
Homeless Veterans Hotline
(877) 424-3838
National Crisis Prevention Hotline
(800) 273-TALK press #1 for Veterans
www.suicidepreventionlifeline.org
Information & Referral Services
211
www.211.org
Vets4Warriors
(855) 838-8255
www.vets4warriors.com
Questions/Comments
NATIONAL GUARD BUREAU
PSYCHOLOGICAL HEALTH PROGRAM
Dave Kaul, MHC, NCC
Director of Psychological Health
Hawaii National Guard
Phone: (808) 295-7818
Email: [email protected]
Georgene Rea, LCSW
Director of Psychological Health
Nevada National Guard
Phone: (775) 224-4991
Email: [email protected]