Putting The President's Words Into Actions

After listening (on the radio) to President Obama's speech to the Marines today, I thought I would let you folks know some of the things I've been getting into in the last few weeks. The President talked about supporting the troops before, during and after deployment, and he also alluded to post-deployment issues like PTSD and other, more noticeable combat-related afflictions and injuries. The fact that he "gets" how important these things are, and is willing to discuss them honestly and without reservation, is a sign he will make a good, and possibly great, Commander-In-Chief.

I briefly touched on a few of these issues a few weeks ago, but since then, I have gotten more involved. I've been invited to and attended two meetings so far. The first was held at UNC's Odum Institute, where CSSP gathered partners together for a Database Workgroup Meeting. The overall goal of this database is to provide a comprehensive list of providers and their services/skills, so those citizen-soldiers who need the help can find them when they need them. There's a lot more to it than that, but "making connections" so that complex, multi-organizational support systems are easier to navigate and access is a big part of the project. Resources don't do you any good if you can't find them, right?

The second meeting I attended (Wednesday) was the monthly Governor's Focus VET Workgroup meeting at Dorthea Dix:

The mission of the Governor's Focus on Returning Combat Veterans and their Families is to promote best practices in the service of veterans who served in the Global War on Terrorism and their families. This effort includes the articulation and implementation of an integrated continuum of care that emphasizes access, quality, effectiveness, efficiency, and compassion. Principles of resilience, prevention, and recovery are emphasized along with state-of-the-art clinical services as part of a balanced public health and behavioral health approach. The Governor's Focus envisions a referral network of services that will comprise a system through which residents of North Carolina will have access to post-deployment readjustment assistance for veterans and their families.

Before I continue, let me say this: the folks I met at these two meetings are, in a word, amazing. Their interest and commitment are genuine, and their energy and desire to help veterans is infectious. I had originally decided to attend so I could observe and report; sort of a fly on the wall thing. That's not going to be enough. I'm still trying to figure out the best way(s) I can be of help, but help them I will. When you see me write things like, "We are doing xxxx", that's because my heart is with them.

The guest speaker Wednesday was Kenan Distinguished Professor Gary L. Bowen, who gave a very enlightening presentation of a project that he and some colleagues have been working on called Support & Resiliency Inventory (SRI). Basically, and I hope Gary won't fault me for glossing over this incredibly complex and informative project, SRI is a research tool which helps to determine not only what causes mental health-related problems with troops and their families, but also those things which can keep them from descending into family-shattering situations; what makes them "resilient", as it were. That's the "other side" of the formula that can (hopefully) be exploited to mitigate the impact of things like PTSD, and save some of those families.

Gary has worked on developing these techniques with the Air Force, utilizing a user-friendly and anonymous online questionnaire, which the Marine Corps has also adapted for its use. The questionnaire deals with demographics (family & surroundings) all the way up to relationship issues, and these metrics are used to determine the resiliency of the family. To put these findings into action, those "at risk" will also be ushered to a link where they can find help. This is one approach to bringing Moses to the Mountain, if you will, but it could also prove very helpful in early detection.

As another little sidenote, I want you to consider the fate of the 30th Brigade, which will be deploying very soon. Even considering the (likely) shorter 12 month tour, as well as the marginally safer conditions on the ground in Iraq (as compared to a few years ago), there could be somewhere in the neighborhood of 1,000 North Carolina families at risk for Post-Traumatic Stress Disorder, from this one deployment alone. Think about that for a minute, and you may understand why I am so excited about the work being done right now.

The folks at CSSP have been coordinating the training of social workers and psychologists across the state, to make sure that local providers are educated about and prepared to deal with combat-related issues when our National Guard troops go back home. One of the research documents I've received from CSSP is a spreadsheet that breaks down which counties these (trained) providers hail from and (exactly) how many 30th Brigade troops live in each of those counties. Among other things, CSSP is vigorously targeting the less-represented areas, to bring those counties up to snuff on the provider/troop ratio.

Okay, I've already been too wordy, so we'll continue this conversation soon.


This is wonderful!

You gave a most of your adult life serving your country - and you continue to do so with this work.

Please keep us updated on this project. Maybe interview different providers and/or returning soldiers?

Just a thought

And it's a good thought

I had a post-meeting chat with an MD that works for the VA the other day, and he (also) mentioned following a few of the families through this process.

Which I may do, but there are issues with confidentiality and military regs, not to mention that my (direct) involvement would (to a certain degree) alter the outcome for said family, making the results atypical and not appropriate for inclusion in any data models. I know that sounds like I'm overthinking the thing, but trustworthy and replicable results are key to this program, as the end goal is to see it implemented nationwide.

I wasn't really thinking about it as a data project

but as a compassionate thing. Your having written about it here may have altered the outcomes (positively, I assume) for participants, you know? It's the whole butterfly effect.

Confidentiality makes it stickier, that's for sure, as do applicable military regulations. Suffice it to say - I'm interested in hearing whatever you feel you can comfortably share.

Actually, you're right

I am hoping to (somehow) change the outcomes for some of these families, and so are the folks working on these projects. It's kind of a weird situation, because I know that extraordinary measures need to be taken to detect the early stages of PTSD so the families can be salvaged.

But I'm not a clinician, you know? I'm aware of the value of confidentiality; not just as a "right", but also as a critical part of the treatment itself. People won't ask for help if they think everybody will find out they have a problem. Psychologists and social workers tend to be very concerned about maintaining confidentiality, and for some very good reasons.

But...if we wait until the problem becomes apparent, it's often too late. Okay, it's never too late to get treatment, but you know what I mean. They've lost their job, they've fell into substance abuse, maybe even physical abuse of the family, separation/divorce, and maybe even jail. They need help before these things have happened, and I'm not sure they can get it if we tiptoe too much.