Community mental health for veterans f

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  • Cohen
  • Community mental health for veterans f

    1. 1.  Over 35% of returned Iraq and Afghanistan veterans in VA care have received mental health diagnoses. OIF/OEF (Operation Iraqi Freedom, OIF and Operation Enduring Freedom, OEF) veterans receiving Department of Veterans Affairs (VA) health care and identified high rates of posttraumatic stress disorder (PTSD) (21.8%), depression (17.4%), and alcohol use disorder (7.1%); anxiety and adjustment Cohen et al. (2010)
    2. 2.  1 in 4 Veterans ages 18-25 met the criteria for substance abuse disorder in 2006 1.8 million Veterans of any age met the criteria for having a substance abuse disorder in 2006 81% of justice-involved Veterans had a substance abuse issue prior to incarceration There are 140,000 U.S. Veterans in prison, and 60% of those have a substance abuse problem There are 130,000 homeless U.S. Veterans, and 75% of them suffer from substance abuse problems U.S. Department of Defense, U.S. Department of Justice Bureau of Justice Statistics, U.S. Department of Veterans Affairs
    3. 3.  Those returning may have difficulties in meeting the developmental demands of adult life: -Maintaining employment -Family issues and in some cases Domestic Violence -Other social relationships such as romantic relationships and friendships Finley et al. (2012).
    4. 4.  A 2009 study found that veterans with mental health diagnoses, particularly PTSD, utilize significantly more VA non- mental health medical services. Cohen et al. 2009
    5. 5.  Recognizes treatment of mental and substance use disorders are an integral part of improving and maintaining overall health. From this comes the idea of modern addiction and mental health Samhsa.gov
    6. 6.  A modern mental health and addiction service system provides:  Continuum of effective treatment and support services such as:  Healthcare (mental health and substance treatment)  Employment  Housing  Education Samhsa.gov
    7. 7.  A continuum of services benefit package, within available funding, that supports recovery and resilience, including prevention and early intervention services, an emphasis on cost-effective, evidence-based and best practice service approaches. Samhsa.gov
    8. 8.  A community based program that fulfils the idea of a modern addiction and mental health philosophy The program will serve as a form of “One stop shop” for veterans with comorbidity that need services This will be done by addressing the clients needs as they come through the door
    9. 9.  Individual, group, and family therapy will be utilized. An emphasis on trauma informed care will be used in all modalities of treatment, specifically that of Seeking Safety for Veterans Research has found that this approach has helped with increased treatment attendance, client satisfaction and active coping. Boden et al (2012)
    10. 10.  It addresses PTSD and SUD issues together It allows clinicians to offer PTSD as an entry point to treatment given the potential stigma around treatment for Veterans since they can be a difficult population to engage Najavits et al. (2010)
    11. 11.  Case management component can help engage clients in further mental health and SUD care  Help foster reintegration to civilian life and it supports their connection with other veterans. Najavits et al. (2012)
    12. 12.  Male veterans with PTSD are more likely to report marital or relationship problems, higher levels of parenting problems, and generally poorer family adjustment For this reason, family therapy will be used to help reintegrate clients into their families and help families communicate better around their unique issues Mikulincer, M., Florian, V., & Solomon, Z. (1995)
    13. 13.  In addition, support groups for families will be held such as:  Alanon  Psychoeducation  Caregiver burden  Other issues that may arise with having a veteran in the family Mikulincer, M., Florian, V., & Solomon, Z. (1995)
    14. 14.  In conjunction with treatment, clients will receive intensive case management in order to support with:  Medication Management  Job readiness  Housing  Education
    15. 15.  Boden MT, Kimerling R, Jacobs-Lentz J, Bowman D, Weaver C, Carney D, Walser R, Trafton JA. (2012).Seeking Safety treatment for male veterans with a substance use disorder and PTSD symptomatology.Addiction, 107, 578-586. Cohen, B. E., Gima, K., Bertenthal, D., Kim, S., Marmar, C. R., & Seal, K. H. (2010). Mental health diagnoses and utilization of VA non-mental health medical services among returning Iraq and Afghanistan veterans. Journal Of General Internal Medicine, 25(1), 18-24. doi:10.1007/s11606-009-1117-3 Finley, E. P., Pugh, M., Noel, P. H., & Brown, P. J. (2012). Validating a measure of self-efficacy for life tasks in male OEF/OIF veterans.Psychology Of Men & Masculinity, 13(2), 143-157. doi:10.1037/a0023607
    16. 16.  Hoge, C. W., Auchterlonie, J. L., & Milliken, C. S. (2006). Mental health problems, use of mental health services, and attrition from military services after returning from deployment to Iraq or Afghanistan. Journal of the American Medical Association, 295, 1023–1032. Mikulincer, M., Florian, V., & Solomon, Z. (1995). Marital intimacy, family support, and secondary traumatization: A study of wives of veterans with combat stress reaction. Anxiety, Stress, and Coping, 8, 203-213. Najavits, L. M., Norman, S. B., Kivlahan, D., & Kosten, T. R. (2010). Improving PTSD/substance abuse treatment in the VA: A survey of providers. The American Journal On Addictions, 19(3), 257-263. doi:10.1111/j.1521-0391.2010.00039.x
    17. 17.  Norman, S. B., Wilkins, K. C., Tapert, S. F., Lang, A. J., & Najavits, L. M. (2010). A pilot study of seeking safety therapy with OEF/OIF veterans. Journal Of Psychoactive Drugs, 42(1), 83-87. doi:10.1080/02791072.2010.10399788 http://www.samhsa.gov/healthreform/docs/good_and_m odern_4_18_2011_508.pdf http://www.seekingsafety.org/3-03-06/studies.html#Veter ans_from_Iraq_and_Afghanistan

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