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Reducing Stigma for American Military Personnel:

1 www.stopstigma.samhsa.gov Reducing Stigma for American Military Personnel December, 20 2007

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2 www.stopstigma.samhsa.gov Contact Us SAMHSA ADS Center 11420 Rockville Pike Rockville, MD 20852 Toll free: 1-800-540-0320 Fax: 240-747-5470 Web: www.stopstigma.samhsa.gov E-mail: stopstigma@samhsa.hhs.gov The Moderator for this call is Holly Reynolds.

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3 www.stopstigma.samhsa.gov Disclaimer The views expressed in this training event do not necessarily represent the views, policies, and positions of the Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, or the U.S. Department of Health and Human Services.

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4 Questions? www.stopstigma.samhsa.gov At the end of the speaker presentations, you will be able to ask questions. You may submit your question by pressing ‘01’ on your telephone keypad. You will enter a queue and be allowed to ask your question in the order in which it was received. On hearing the conference operator announce your name, you may proceed with your question.

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5 Speakers www.stopstigma.samhsa.gov Steve Robinson, ONE Freedom, Inc. Steve is a retired non-commissioned officer who served twenty years in the Army. He has held every job from Private to Platoon Sergeant and has also been rated in an Officer slot during his career. Since retiring in October 2001, Steve has become an advocate for veterans. He has been called to testify numerous times before the House and Senate on matters pertaining to Force Health Protection and emerging mental health issues related to this generation of returning war veterans. In his work at ONE Freedom, Steve helps veterans and their families recognize and deal with the complex issues that arise from prolonged, multiple deployments. He helps to break down the stigma of seeking help and teaches individuals and families skills to mitigate the effects of wartime trauma.

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6 Speakers www.stopstigma.samhsa.gov Abel Moreno, Vets4Vets Abel Moreno is the Media Outreach and Marketing Coordinator for Vets4Vets, a veterans' peer support organization dedicated to helping Iraq and Afghanistan veterans feel good about themselves and heal from any negative aspects of service and war. Abel served 7 years in the Army’s 82nd Airborne Division 307th Engineer Battalion as an L.E engineer. He served one deployment in Afghanistan and one deployment in Iraq. He supported the 3rd Brigade Combat team along with L.E support with Charlie Company 307th Engineer Battalion. Duties performed were fortification, engineer recon, convoy security and demolitions. Abel received the Combat Action Badge, three Army Commendation medals, and two Army Achievement medals.

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7 Speakers www.stopstigma.samhsa.gov Rob Timmins, Iraq and Afghanistan Veterans of America Rob Timmins is the Field and Outreach Director for Iraq and Afghanistan Veterans of America (IAVA), America’s first and largest Iraq and Afghanistan veterans group. He was an Infantryman with the 101st Airborne Division for the first year of Operation Iraqi Freedom, where he served in Najaf, and then Mosul. Rob escorted fuel convoys, went on patrol, and raided buildings for weapons caches, and also provided security for UN officials and helped Civil Affairs with reconstruction projects. He is an authority on the war in Iraq and issues affecting troops, military families and veterans. Rob holds a B.A. in Sociology from the College of Staten Island and continues to serve his country as a legal specialist with the Army Reserves.

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What We Know:

All Rights Reserved © ONE Freedom Inc. 2007-2008 What We Know Multiple military commissions have clearly revealed the issues and the fact is: We train warriors up to go to war; and We need to train them down to come home.

The Numbers:

All Rights Reserved © ONE Freedom Inc. 2007-2008 The Numbers The data is clear and speaks for itself. It’s time to shift from revealing the problem to focusing on the solution. The solution lies in dissolving stigma by providing awareness, knowledge and action to our Nation’s warriors and their families.

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All Rights Reserved © ONE Freedom Inc. 2007-2008 SHIFTING STIGMA Shift the National and Military dialogue to create a true understanding of the impacts of stress and trauma on service members and families and how they are fundamentally changed by their service. This shift —from pathologizing post-deployment adjustments to seeing them as natural adaptations to intense stress— begins to dissolve the stigma.

Suicide Should Not Be An Option:

All Rights Reserved © ONE Freedom Inc. 2007-2008 Suicide Should Not Be An Option No veteran sent to war should ever feel so left behind or so un-resourced that suicide feels like a viable option. We owe them so much more than the rhetoric or slogan of the day. The fact is: Resourcing our veterans and their families can save lives.

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All Rights Reserved © ONE Freedom Inc. 2007-2008 What is Resourcing? Resourcing is a multi-faceted approach that includes: self-care and personal empowerment through education and training, community based support and services, therapuetic modalities, and medical care. Resourcing means to train returning veterans and their families on how to understand and find strength through their experiences.

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All Rights Reserved © ONE Freedom Inc. 2007-2008 ONE Freedom is a Colorado-based 501(c)(3) nonprofit organization providing America's returning veterans and their families with meaningful education and training on prolonged or acute stress and teaching skills for effective reintegration from war. (i.e.—resourcing!) Who We Are

ONE Freedom Programs:

All Rights Reserved © ONE Freedom Inc. 2007-2008 ONE Freedom Programs ONE Freedom provides: Education and Training via— workshops, retreats, wilderness immersion for vets, families, kids, leadership, care providers With focus on: the neurophysiology of stress and trauma and actionable skills for self-regulation. (in other words: the brain and body’s reaction to stress and what you can do about it.)

Reducing Stigma for Veterans and Their Families:

All Rights Reserved © ONE Freedom Inc. 2007-2008 Reducing Stigma for Veterans and Their Families ONE Freedom seeks to shift the current paradigm of stigma inside the military regarding effective reintegration for veterans and families. This requires a new framework and the “naturalizing” of acute or chronic stress in relation to service.

“Naturalizing”:

All Rights Reserved © ONE Freedom Inc. 2007-2008 “Naturalizing” Stress and trauma are a natural part of human experience and the brain and body respond instinctually to prolonged or acute stress. We adapt as a result. With stress and trauma, mental outlooks and behaviors change. Fundamentally, the brain and nervous system change. This is the piece we need to know.

A. K. A. -- ONE Freedom’s Approach:

All Rights Reserved © ONE Freedom Inc. 2007-2008 A. K. A. -- ONE Freedom’s Approach Awareness –of issues and possible symptoms, etc. Knowledge –the neurophsyiology of stress (brain/body) Action –self-regulation skills, accessing strength and resources

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All Rights Reserved © ONE Freedom Inc. 2007-2008 Military training modifies behaviors, instills new norms, uses reward and punishment, provides regimen, and institutes the ‘group before the self’ mentality. They are taught to crawl, walk and run in training, to maintain and sustain, until the habits become instinctual and reflexive. How We Train Soldiers “Up”

Mission-Centric:

All Rights Reserved © ONE Freedom Inc. 2007-2008 Mission-Centric Service members are taught new skills, new methodologies and new beliefs, transforming what was a civilian mind into a military mind with a singular purpose: to accomplish the mission. The conditioned response becomes the operating norm on a bio-physical level.

How To Train Soldiers “Down”?:

All Rights Reserved © ONE Freedom Inc. 2007-2008 How To Train Soldiers “Down”? Warriors and their families need a systematic approach to training down. They can learn new ways to regulate their responses, integrate their experiences and find strength through balance on the path from deployment to stateside, wartime to peacetime, military to civilian.

The Leading Edge:

All Rights Reserved © ONE Freedom Inc. 2007-2008 The Leading Edge ONE Freedom’s methodology is based on: military training, performance optimization, sports science, the practices of wisdom traditions, current science involving the brain body connection to stress and trauma.

Rationale for Reintegration Training:

The Key Thing to Remember:

Education and Training:

All Rights Reserved © ONE Freedom Inc. 2007-2008 Education and Training Education and experiential training are vital components of the multi-faceted approach to reintegration. Education is Empowerment Helplessness is the hallmark of trauma, empowerment is the antidote.

For more information on our programs and methodologies please contact:

All Rights Reserved © ONE Freedom Inc. 2007-2008 For more information on our programs and methodologies please contact www.onefreedom.org Steve@OneFreedom.org Cell 540-537-1758 Elizabeth Hawkins, Executive Director elizabeth@onefreedom.org Toll-free 888-334-VETS Please Continue to Review The Numbers and Data

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Slide28:

Impact of Iraq and Afghanistan Wars:

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Veterans and Attached Stigma:

Veterans and Attached Stigma By: Abel Moreno

What will be covered:

What will be covered Personal story Statistics of Military Personnel Possible solutions: Overcoming Stigma Recovery

Personal story:

Personal story 7 years in the 82nd Airborne Division Afghanistan: July, 2002-January, 2003 Iraq: September, 2003- March, 2004

Possible Solutions:

Possible Solutions Assigned Mental health professional per deployed unit Leadership development training Mandatory scheduled screenings

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The End

Mental Health Stigma and Military Culture:

Mental Health Stigma and Military Culture Rob Timmins Field Director

Introduction:

Introduction

Care Providers and Troops Falling Through The Cracks:

Care Providers and Troops Falling Through The Cracks

Making Improvements…:

Making Improvements… The DOD and VA have been working to improve mental health of military personnel and eliminate barriers to care. In June of this year, the DOD Task Force on Mental Health acknowledged that “Stigma in the military remains pervasive and often prevents service members from seeking needed care.” The Task Force made dispelling stigma one of their goals.

Barriers to Accessing Care:Pre-Existing Personality Disorder Discharges:

Barriers to Accessing Care: Pre-Existing Personality Disorder Discharges

Educating the ForcePossible Remedies :

Educating the Force Possible Remedies

IAVA Recommendations:

IAVA Recommendations

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44 More Information www.stopstigma.samhsa.gov Steve Robinson, ONE Freedom, Inc. Email: Steve@onefreedom.org Abel Moreno, Vets4Vets Email: abel@vets4vets.us Rob Timmins, Iraq and Afghanistan Veterans of America Email: rob@iava.org For more information, contact:

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45 Questions for Discussion www.stopstigma.samhsa.gov 1.) What can a local church do, by way of welcome home rituals or programming, to help veterans make a healthy integration back into civil society? Are there some model programs or best practices? 2.) There are so many contractors working in Iraq alongside the soldiers…is the stigma different and how is this being addressed? 3.) Whether out-processing from the military, or merely transferring back to the states, what hands-on, one-on-one programs are in effect to decreases stigma soldiers and their families may be facing? 4.) Our young soldiers coming home may not feel the effects of the trauma they have seen until months later, maybe even after they are discharged. How can stigma still be addressed at that later time? Questions for discussion are generated by emails sent to the ADS Center. If your question does not appear below, please feel free to contact the ADS Center or the Presenters directly. Please note: Questions may have been edited for content and clarity.