Robin's Eccentricities: December 2012

Thursday, December 13, 2012

Points of Concern For Soldiers

There is a great deal of military speak in this, I will put in parenthesis what the acronym is when it appears the first time.) R and R would be correctly written as R ampersand R but Blogger won't let me use an ampersand.

My areas of concern:

1) PCP (Primary care provider) not immediately referring soldier to R and R (Resilience and Restoration Center) or other resources when presenting with problems that could be both physical and mental health. IE: sleep disorders, sex drive, panic attacks

2) TriCare referral system: PCP requests referral to psychiatrist for soldier; soldier waits approximately 2 weeks to receive paperwork in the mail; referred Doctor is booked for months out; Tricare cannot change the doctor; soldier has to return to PCP and restart the process (Soldier is still not referred to R and R)

3) When a soldier that has never had a discipline problem or one that has always been a leader suddenly exhibits bad behavior that is out of their character the CoC (Chain of Command) needs to ask themselves “Why?” If the CoC does not personally know the soldier they need to find out about their character and refer soldier to R and R or give the soldier a packet of resources.

4) Inform family member when possible. Family member may be able to provide insight and should be given a resource packet to be able to help their soldier.

5) ASAP (Army Substance Abuse Program):

a) Only for SUD (Substance Abuse Disorder). Many with SUD have mental health issues that need to be addressed and referred to the proper treatment place.

b b) More options available than the 12-Step program. No one thing helps every single person.

c c) ASAP and R and R need some form of combined program to address dual SUD/Mental health issues at the same time.

d) From an outsider view it appears that ASAP is failure focused. (Relapses have to be reported to command and soldier faces separation.) Relapse is a part of recovery.

6) When a soldier has mental health and /or SUD they should immediately be considered/screened for WTU (Warrior Transition Unit) and until that time a soldier is accepted or has recovered should have someone assigned to help the soldier with appointments and making sure they are kept. Even if it’s a PVT that is acting as a reminder system to help take strain off from the CoC. Often the soldier feels that if they remind CoC of an appointment that might be missed because they are placed on a mission they will get in trouble. It is not logical thinking but mental illness affects the logical process. It should not be left to a family member to discover and initiate the WTU process.

7) The likelihood of a soldier having discipline problems with untreated conditions is high. Especially when there are two conditions such as SUD/Mental health. If one is treated and the other is not, the soldier is still not getting better and will exhibit poor behavior/relapses.

a) A soldier should be punished and help accountable as with any person however, every effort to should be made to make sure all avenues of treatment were offered to the soldier within a reasonable time.

b) If the behavior came before a soldier was being fully treated for SUD and/or mental health condition consideration should be given and punishment suspended until soldier receives needed care and can prove they are getting better.

c c) DCoE (Defense Center of Excellence) What Leaders Need to Know: States a soldier should not be removed from a leadership position. Losing rank is not helping any soldier.

d d) Suspension should also be considered so the soldier does not have other worries while they are concentrating on recovery. Financial, sleep deprived from extra duty, etc.

8) PCP, CoC, ASAP and R and R need a packet with all available resources in it to give to soldiers. Something similar to an in/outprocessing or SRP (Soldier Readiness Processing) packet that the soldier carries so each place knows the soldier has the needed information. I am only suggesting this for soldiers that show out of character behavior or have sought help with any agency and enrolled in treatment. I am certain all soldiers are made aware of programs and take suicide prevention classes but when a soldier is depressed or has other problems often their memory is not good enough to recall this information.

9) If a soldier only has an option to see a doctor off base because of waiting periods, whatever diagnosis they receive from licensed doctor should be as good as a diagnosis from an on base doctor.

10) Some form of mental health triage to assess that goes beyond “Are you suicidal?”

Wednesday, December 12, 2012

PTSD and Substance Abuse Research

I am working on a presentation that will be presented to Fort Hood General Milner and then through a chain to the Pentagon. I need help from you in the way of research.

I am going to be presenting the fact that soldiers are still not being properly diagnosed and treated when a mental health issue arises. By the time a soldier realizes they need help the problem could be more than the soldier can handle which often times leads to suicide. The Chain of Command probably would not even notice or recognize many of the problems a soldier is already having.

I want to present that because PTSD goes unnoticed for so long that when poor conduct appears it should be taken into consideration when a soldier is counseled.

I want to present that PTSD and Substance Abuse{drugs and/or alcohol} treatment need to be combined for soldiers with both problems. (Which is quite common.) I want to show that without both being treated together there is a high chance of relapse. Often causing more problems for an already troubled soldier.

I want to present that PTSD affects each person that has it in different ways. Although the guidelines for a diagnosis will remain the same, not everyone will experience all the symptoms and not all will abuse substances.

I want to present that soldiers seeking mental health treatment need a better form of triage to determine who is most at risk. When we go to an emergency room, the person with a broken toe which is not life threatening will have to wait longer even if they were there before the person that just walked in having a heart attack. The same should hold true for soldiers seeking mental health care. Beyond putting someone that is immediately suicidal into an inpatient facility.

Here is where you come in. I want stories. All information will be confidential. You do not need to use your names or give any contact information. I just want to hear from you. I don't care what your rank is, if you are active, retired. I just want to know if you (or someone you love) has dealt with any of the presentation points above. The email address is ptsdandsubstanceabusestudy@gmx.com

If you do not have the problem would you share the post with someone who might? To the civilian world this may seem like it shouldn't be an issue. I promise you, it is. So please, spread the word to help soldiers facing this problem.

Meanwhile, I will be researching and educating myself even more. This is perhaps the mission in life that I have been given. I knew it was to help soldiers, I just didn't know the capacity.

Fighting a broken system.

I have been in a fight lately. A fight for someones life and livelihood. Not for myself. For an Army soldier.

What I have learned in the past year is that the Army has really big talk for suicide prevention and treatment for PTSD but they have no desire to actually act on their big talk.

What I have learned is that the Army chooses to punish soldiers with illness rather than deal with the issues at hand. This situation could have escalated because command changed so often that no one really knew who the soldier was.

What I have learned is that the Army does not like to be told they are doing this.

What I have learned is that when you point out the problem the Army punishes the soldier more.

What I have learned is that the Army simply does not care about their Soldier.

Here is a scenario. A soldier spends many years in the service. He gets awards for excellence and everyone goes to them whenever they need something done. For as many years the soldier has never been a disciplinary issue.

After multiple deployments that same soldier starts to have problems at home. Nightmares. Anxiety. Depression. The soldier really doesn't know why and just tucks it all away thinking it will go away soon enough. It really doesn't go away so the soldier might turn to drugs or alcohol to self medicate the problem.

A few more months pass and nothing is getting better. In fact it's getting worse. The soldier goes to see a doctor at the clinic. Discusses sleep issues and anxiety and drinking. The doctor does blood work and tells the soldier to come back for the results.

The soldier might feel hopeless and start to give up. Their chain of command probably doesn't notice the problem because the soldier has always been exemplary and the soldier knows how to wear a smile and pretend everything is okay.

At the point a soldier realizes there is a deeper problem they have probably missed work or not fulfilled their duty while at work. Their chain of command punishes this behavior. Now the exemplary soldier has become a discipline problem.

The soldier goes to ASAP, the Army Substance Abuse Program aimed at treating ONLY alcohol/substance abuse. The soldier spends up to 30 days in a 12-step program addressing a symptom of an illness. (To me that is like sending someone with terminal cancer to an inpatient program to treat a cough they got from the cancer but ignore treating the cause of the cough.)

Now his doctor sends a referral to TriCare for the soldier to see a psychiatrist and while he's waiting the two weeks for the approval puts him on some random antidepressant without monitoring changes in mood or behavior. Once the referral is received the soldier calls to make an appointment. The soldier is told the first appointment is three months away. So the soldier will call Tricare to ask for a different doctor to see only to be told that he will have to go back to his primary doctor and request a new referral that starts the process over again.

The soldier makes appointments with social workers and ASAP counselors only to have those appointments canceled or rescheduled on a regular basis.

With all hope lost and no light in the tunnel, three days later the soldier attempts suicide. He can't handle the dreams, the feelings, the fear. He feels he is worthless and the world is just better off without him. With the gun loaded and cocked and aimed at his head, seconds before the trigger is pulled, he realizes he can't let his wife find him. That he needs to rethink his plan of suicide so she isn't traumatized. The drinking continues again, there has to be a way to numb the pain for the soldier.

The problem is still kept mainly at home. The soldier knows at this point his chain of command is no help. A few days later the side effects from the medication and the nature of PTSD and depression are so bad that the soldier has such an extreme nightmare that he can't wake from his spouse has to call someone for help. His chain of command takes the soldier to the hospital and he is readmitted into another facility that addresses alcohol with a 12-step program. They would like to call themselves a dual treatment facility but the main issue addressed is still alcohol with any other problems being secondary. After 2 1/2 weeks in a 30 day treatment facility the soldier is released because the new medication might appear to at least not making them worse.

After a soldier is releases from these facilities there are a few things they have to do upon returning to their garrison. They go to a place called R&R. This is the Resiliency and Restoration Center that a soldier goes for psychiatric care. A nurse asks them a few questions then schedules appointments. There is still a waiting period to see an actual doctor.

The soldier is still depressed, still having the same symptoms they have been having for almost a year and still has not received help. As hard as the soldier tries the soldier still needs to numb the pain. When the soldier comes home the soldier has a couple drinks to numb himself so he can fall asleep. Because of such heavy drinking the soldier may have developed other health issues that affects metabolism of alcohol.

So here is what happens. LOTS of soldiers drink. Lots of soldiers drink all the time. Lots of soldiers smell like alcohol in the morning. BUT, once a soldier has been an issue they are singled out. So regardless if they are guilty or not they are guilty. (This was told to me by a retired Sergeant Major.)

Now let me discuss a little about BAC (blood alcohol content)
Some states the legal limit is .10
Some states the legal limit is .08
The Army has a legal limit of .05
Fort Hood has a legal limit of .04

If this soldier is .041 they are considered drunk on duty.

If this soldier pleads guilty and asks for mitigating circumstances and that the punishment be suspended because he had not been able to get help until after this happens the command doesn't care. They will strip a soldier of rank causing them to lose a great deal of money per month, place them on extra duty which amounts to 12-18 hours a day with no break for up to 45 days, put them on restriction (kind of like jail in the civilian world) and take 1/2 of their pay for two months with absolutely no consideration to mitigating circumstances.

A soldier is not allowed to have a lawyer at these proceedings. That is reserved for court martials. I was a spokesperson for this soldier. I am not in the Army I was so scared. I kept my calm. I presented dates, timelines, medical records, research into dual diagnosis of PTSD and Alcoholism. I presented documents that showed one cannot be treated without the other being treated. It did not matter. I feel like I failed because the soldier received full punishment. I am telling myself I did everything, but could I have done more? I was dismissed from the hearing and the soldier was called back in. I was not there for the 'sentencing.' When the soldier came back out his eyes were dead. I could tell their life had just been stripped from them.

It is a look that will forever be burned into the front of my brain.

So yes, I have learned the Army will take a person send them to war then punish them without regard to circumstances. Once upon a time I used to be the most patriotic person there was. Now I am so disillusioned at how the Army treats soldiers if anyone were to ask me what I felt about enlisting I would have to say if you want to destroy your life, sure why not.

I am off now to work on the appeal. I pray that my words will make sense and stress that this soldier needed help but could not get it. I pray that if I cannot get the punishment changed that I can get it suspended until the soldier truly has a chance to prove himself.

I would love to have your feedback. So please sound off.

Tuesday, December 4, 2012

It will never happen to me.

No matter where you live there is always a chance for a disaster that will leave you without power, water and food. I am not telling you to go out and become a doomsday prepper. I'm just saying that no matter where you are you need to have a plan.

Think about where you live. Now look at the list below and determine which type of emergency could happen to you. I put an X next to the ones I have to consider.

Hurricanes
Floods
Earthquakes
Wildfires X
Tornadoes X
Home Fires X
Blackouts X
Biological Threats X

That is quite a few for me. Most I can just stay at home. Wildfires might require evacuation. So I plan accordingly and keep an emergency bag in the car and a bag inside that could be grabbed on my way out the door.

The most common statement is "This happens to other people. I never thought it would happen to me." Have you heard people say that on the news during an interview? I have, many times. I used to think the same way. FEMA recommends a 3 day supply of food and water. That should really just be a starting point. During Hurricane Katrina and Sandy people were without power for much longer than 3 days. Most large disasters do take more than 3 days to reach everyone.

Now consider this. Think back to what you paid for food 3 years ago. It was less than what you pay now. Anything you buy today beats inflation of tomorrows prices. Think of it as investing in food. Food that is in your hands, not some bank waiting to be handed out. Or worse yet, not at all.

Building your food supply.
There are many ways to build your food supply. Buy a couple of extra food items each shopping trip. Canned foods, pasta, beans. Even if you spend an extra $5 a trip it will add up. You might be surprised how quickly it builds up. I buy both long and short term food.

When I first became interested in long term food storage I researched every long term food storage company there was. I don't have a large budget to just buy a few months of storage all at once. There was one company that let you make payments and once you paid a couple thousand dollars they would send you the food. Then I found Shelf Reliance! They let you set your budget AND ship food to you every month. It works by creating what is called the Q. You simply shop for everything that you want and need and add it to your Q. Then you go in and enter how much you can afford each month. As much or as little as you want. Each month they send you that amount of food. You can also change what they are sending if there is something you want right away. It was a perfect solution for my tight budget. Want to know more? You can email me or go to Shelf Reliance to see for yourself.

Ok, moving beyond food. This is a list floating around the internet and all are free to the public. I have not checked them all but I do know there is some very good information in some of them. Most are google documents.

Being prepared does not make you crazy, it simply makes you prepared.

FEMA has some great resources for beginners.