“LESSONS LEARNED”
NEW JERSEY VETERANS HELPLINE
1-866-VETSNJ4… YOU!
(1-866-838-7654)
A Partnership of
UMDNJ- UBHC & NJ DMAVA
NEW JERSEY VETERANS FOR YOU
HELPLINE AT UMDNJ-UBHC
 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
NEW JERSEY 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
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
(6 MONTHS)TOTAL CALLS/CONTACTS = 7,358
FIELD/GROUP CONTACTS = 5,391
CALLS & TELEPHONE COUNSELING = 1,050
60-70% OEF/OIF
Gender – 70% male; 24% female; 6% unknown
FIELD ACTIVITY SUMMARY
RECONSTITUTIONS/DEPLOYMENTS
 UBHC Veteran staff participated in 58
Reconstitutions - 2005 - 2008
 As a result approximately 175 veterans in therapy
 Increase in 1:1 and group field activity
highlighted our team in 2008
 2009 selected to be “Lead” in NJ DMAVA PTSD
Task Force
 “Lead” in Welcome Home 1:1 sessions for
Reconstitution of approx. 2,400 soldiers
“WELCOME HOME”
RECONSTITUTION STATISTICS
June 1, 2009 to June 16, 2009
 Number of Soldiers Interviewed 2,408
 Number of Volunteers
206
 Number of Veterans Needing
Appointments Immediately
 Follow-Up Forms Completed
18
199
“WELCOME HOME”
CLINICAL ISSUES









ANGER
ANXIETY
DEPRESSION
ANGER
READJUSTMENT ISSUES
MARRIAGE/FAMILY ISSUES
EARLY STAGES OF PTSD
MULTIPLE DEPLOYMENTS
REDEPLOYMENT ISSUES SUCH AS: FINANCES, JOB,
HOME, ETC.
“WELCOME HOME”
VOLUNTEER COMMENTS

It was an experience I will not soon forget.
Hopefully the National Guard members got as much
out of the experience as I did.

It was a wonderful experience. It was important to
see the faces behind the story; those that have gone
where most of us cannot imagine.

It was one of the best volunteer experiences of my
life. I felt very proud to be a part of the endeavor to
help the returning veterans.
“WELCOME HOME”
VOLUNTEER COMMENTS

This was such a great experience for me that I would like to continue
doing every chance I get. I loved the connection I made with some of the
soldiers and it made me feel better knowing that I did a little to help.
Some of them just needed a little time and someone to listen. I think it’s a
great program that does great things for our soldiers.

It was a heart felt experience. Being one of the first few people to
welcome back the veterans, to give them time to discuss their personal
experience in Iraq and to be able to offer them the help/assistance they
identified was very rewarding. The veterans that sat with me made me
very proud of their commitment and you gave me the opportunity to tell
them so

The camaraderie, professionalism was heartwarming and endearing. I
had a fantastic experience. It was immensely rewarding and I wanted to
extend a thank you to everyone there

LESSON LEARNED – GRATITUDE/COMPASSION
60-DAY REINTEGRATION PROGRAM
Yellow Ribbon Committee 60-Day Reintegration Project
SAMPLE AGENDA


8:00 a.m. – 9:00 a.m.
9:00 a.m. – 10:15 a.m.



10:15 a.m. – 10:30 a.m.
10:30 a.m. – 11:45 a.m.
12:00 – 1:00 p.m.
(12:15 p.m.)
500 – Registration – Logistics Team & Yellow Ribbon Staff
250 – Large Group Briefing - Dr. George Everly
250 – Breakout groups for New Jersey Veterans
Administration/NJDMAVA
Post Deployment Survey Distribution – Anna Kline & Team
15 Minute Break
Groups switch 250/250
500 – Lunch
(Team Briefing – Logistics & Details)
1:00 p.m. – 1:15 p.m.
1:15 p.m. – 2:00 p.m.
2:00 p.m. – 2:45 p.m.
2:45 p.m. – 3:00 p.m.
3:00 p.m. – 3:45 p.m.
3:45 p.m. – 4:00 p.m.
Small Group Break Out Sessions
Introductions
Anger Management – 15 minute didactic & 15 minute Q & A
Substance Abuse – 15 minute didactic & 15 minute Q & A
15 Minute Break
PTSD/Compulsive Behavioral – 15 minute didactic & 15 minute Q & A
Evaluations/Certificates distribution and collection






DATES & LOCATIONS
 Saturday, September 12, 2009Team A
AM 4:00 PM

UMDNJ – 675 Hoes Lane, Piscataway
8:30
 Sunday, September 13, 2009
Team B
8:30 AM 4:00 PM

East Orange VA – 385 Tremont Avenue, East Orange
 Saturday, September 19, 2009
Team C
8:30 AM 4:00 PM

UMDNJ – 675 Hoes Lane, Piscataway
 Sunday, September 20, 2009
AM 4:00 PM

UMDNJ - Stratford Campus
Team D
8:30
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 member’s 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
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
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 one’s
family, neighborhood, nation and world.
A total willingness to stand up for what is right
with a sense of duty greater than one’s own
need. Charles Lewis Arnold, MS, BCPC, CTM, CTSS
(ret. Master Sergeant, United States Marine Corps and New Jersey Army National Guard)
“The 60-Day Reintegration” is a
Large/Small Group Experience
 Goal: Focus on resiliency and normalizing
experiences
 Decrease stigma And increase chance Veteran will
disclose any concerns
 Primary team of Veterans, clinicians & peers
 Encourage discussion/sharing
 Engage, psycho-education, dialogue
 Encourage utilization of support services
 Reinforce gratitude for service
WHAT YOU ARE DOING…
 Volunteering to support our troops as a
member of the UBHC-UMDNJ team lead by
the New Jersey Veterans Helpline Staff by
genuinely sharing your gratitude for their
service
 Providing psycho educational information
through small group didactics and discussion
 Asking them how they feel as they adjust to
returning home…… Thanking them whenever
possible
STEPS OF THE
“60-DAY REINTEGRATION”







12:15 Team Briefing
1:00 Begin Small Group Program
Utilize PowerPoints as “Guides”
Avoid Scripting
Provide Didactic
Prompt Discussion
Offer Resources/Follow Up
WHAT IS YOUR GOAL?
 Share gratitude for service
 Normalize experiences
 Review materials- psycho education,
discussion
 Ensure service to those in need
 Explain confidential resource in NEW
JERSEY VETERANS HELPLINE
 Reinforce resiliency and hope
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
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 predeployment
 National PTSD resources and Military
resources have offered solutions to meet
soldiers behavioral healthcare needs
WHAT HAVE THEY TOLD US?
New Jersey National Guard –OIF/OEF
Veterans 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
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 noises
common
 2009 Calls = Anger
Military Families &
New Jersey Veterans Helpline
Primary Diagnosis/Complaint
with Parenting/Family Issues
Depression
Anxiety
Aggression
Marital/Family
Violence
93%
91%
89%
68%
27%
TOP TEN COUNTIES
DEPLOYED SOLDIERS –WHERE THEY LIVE
RANK
COUNTY
# DEPLOYED
1
2
3
4
Burlington
Essex
Hudson
Passaic
196
192
188
165
5
6
7
Middlesex
Camden
Ocean
161
158
153
8
9
Bergen
Union
132
129
10
Gloucester
126
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
Stress Confidentiality
MILITARY SUICIDE INFORMATION
Statistics 2007 (Violanti)
89 confirmed suicides in 2007 with an
additional 32 deaths being investigated
(U.S. Army Figures)
 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
“You are greater than
you know”
Mother Theresa
Overview of the Health Needs
Assessment Survey of the New Jersey
National Guard 2007-2009
Department of Military and Veterans
Affairs
VA New Jersey Health Care System
Bloustein Center for Survey Research,
Rutgers University
Purpose and Methods
Purpose


To assess the mental and physical
health effects of deployment to
Iraq and Afghanistan on members
of the New Jersey National Guard
To use the information to assist
DMAVA and the VA in planning
for the health service needs of
returning veterans
Methods




Anonymous, self-administered
surveys distributed to Guard
members before and after
deployment to Iraq
Questions focus on:
 mental and physical health
 combat experiences
 access to treatment
A total of 2,543 useable predeployment surveys were
collected
Follow-up survey will be
conducted at 60-day reintegration
History of Previous Deployments to
Iraq and/or Afghanistan
 First deployment: 75%
 At least one previous deployment: 24.9%
 More than one previous deployment: 2.9%
Mental Health Problems by Number of
Previous Tours
No previous tours
One or more previous tours
30
25.4
25
20
14
15
9
10
5
14.1
6.6
6.6
4.2
2.3
0
Depression
Alcohol
Dependence
PTSD
All values significant at p=.000
Depression,
Alcohol or
PTSD
Proportion of New Jersey National Guard reporting health
limitations, by number of previous OEF/OIF deployments
30
25
Percent (%) with limitations
25
22.1
20.6
20
20
16.2
16.2
16.1
15
11.7
10.4
9.1
8.7
10
7.4
6.8
4.6
3.6
5
0
Health lim its bending
or kneeling
Health lim its
clim bing several
flights of stairs
No deployments
Health lim its
Health lim its w alking Health lim its w alking
clim bing one flight of m ore than one m ile
one block
stairs
One deployment
Two or more deployments
Social Stressors Associated With
Deployment
Relationship between Pain/Physical
Functioning and PTSD
Relationship between Social
Stressors and PTSD
Proportion Treated in Last Year Among Previously
Deployed Troops with Mental Health, Substance Use and
Health Care Problems
72
80
70
60
51.9
50
40
30
20
13
10
0
Substance abuse
treatment
Mental health
treatment
Medical care
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.
Symptom Screening and Reporting Among
Those with PTSD
NOTE: Questions about screening and symptom reporting refer to post-deployment briefing only.
Clinical Implications
 Veterans with mental health problems are at
higher risk for physical health problems as well
as for family and financial problems
 Stigma is a serious barrier to veterans reporting
and seeking treatment for mental health and
substance abuse problems
 Alcohol problems are rarely treated and may
require intensive outreach to impaired veterans