Peer to Peer Support

					                               2011
               Best Spiritual Practices Conference


                          Building the
                      Veteran’s Battle Mind

                  NEBRASKA’S P2P
                     MINISTRY




Joint Force Headquarters – Nebraska
Chaplain (COL) Rod Armon
MSG Daniel Fullerton
Supporting America’s Warriors
Nebraska Army National Guard


BRIEFING:                                          SGT
                                                   Coleman
                                                   Bean

   The Threat: PTSD, mTIBI, SUICIDE
         (Battle Graphic Display)
                                                Linda Bean, whose son, Sgt. Coleman
   Peer Support Philosophy & Goals              S. Bean, killed himself in New Jersey
                                                 after two tours of duty in Iraq, one on
   NE ARNG Solution  Peer-to-Peer Support       active-duty with Army and the other
                                                  with the Maryland National Guard,
                                                said it was essential for the Army to
   How & Why Peer-to-Peer Works                  persuade soldiers to get mental
                                                              health help.
   Training Outline for Phases I & II          But Ms. Bean said the reality was that
                                                   most soldiers were reluctant to
   Financial Costs                             seek help for fear it would derail their
                                                                careers.
   Q&A                                                 (New York Times, 2/5/09)




                                                                                    2
UNCLASSIFIED BRIEFING – FOR OFFICIAL USE ONLY
 Supporting America’s Warriors
 Nebraska Army National Guard
  Life Cycle:
  Post-Deployment Mental Health Issues
  0-3 Months         3-6 Months      6-9 Months        9-12 Months    12-24 Months    24-36 Months

• Honeymoon        • Anhedonia      • Anger           • First         • Suicidal     • Reluctant
  Phase              (absence of    • Marital           seekers for     Ideation       PTSD
• Work/School,       pleasure) is     Discord –         PTSD          • Separation     Treatment
  Family, Peer       noticeable       Start seeking   • Addiction                      Seekers
                                                                      • Divorce
  & Community      • Irritability     help              Issues                       • Fear
  Reintegration    • Sleep          • Financial         (Alcohol,                      Stigmatization
• Thrill Seeking     Problems         Problems          Gambling,                    • Barriers to
                                                        Drugs)                         Treatment
• Spending         • Sexual &       • Nostalgic
                                                        Begin
                     Intimacy         views of                                       • Lack of
                                                        Surfacing
                     Problems         Deployment                                       Providers/Serv
                                      Begin           • Domestic                       ices
                                                        Violence
                                                                                     • Money &
                                                                                       Insurance
                                                                                       Issues



                                                                                                  3
 UNCLASSIFIED BRIEFING – FOR OFFICIAL USE ONLY
  THE SITUATION: ‘Terror’ continues to attack … Post Mobilization
 becomes a ‘battle front’ as PTSD, mTIBI & Suicide attacks at home

                                                                                                  Mobilization
                                                             TIME
                                                                                                    Period
                                                                       WEATHER




                                                              ENEMY




                                                                                ENEMY
                                                                       ENEMY
                                                                       TROOPS
 Pre MOB, MOB, De-Mob                                                                                     Pre MOB, MOB, De-Mob
                                                                            TRAINING
                                               EQUIPMENT

                                                                                              FAMILY
                                                                                             SUPPORT
                    ENEMY                                       BATTLE                                                ENEMY
                                        ESGR               ENGAGEMENT AREA                                                           SUBSTANCE
                                                           TRADITIONAL GUARD                                                         USE
                                                               WARRIORS
              FINANCIAL                                                                        YOUTH       MARRIAGE        SINGLE SOLDIER
                 ISSUES                                                                      PROGRAMS      PROBLEMS         RELATIONSHIPS
                             CIVILIAN
                                         JAG                                                                          ENEMY     PROBLEMS
                             CAREER

    COLLEGE          ENEMY                                  VULNERABILITY                   MINISTRY
                                                                                              TEAMS
                                                                                                                                        SUICIDE



                                                                                          PEER-TO-PEER
   THE PROBLEM: In a geographically                                                                      PROPOSED SOLUTION:
                                                                           ENEMY




                                                                                            SUPPORT
                                                               ENEMY




                                                                                           SPECIALISTS
   diverse state – there are extremely                                                                   Fully Trained Peer-to-Peer
   limited peer groups to assist with Post                                                               (Veteran-to-Veteran) Support
                                                                 POST MOB
   MOB issues & Stigma of seeking help                             PTSD
                                                                                                         Specialists
                                                                   mTIBI
UNCLASSIFIED                                                      SUICIDE
                                                                                        Post MOB                         FOR OFFICIAL USE ONLY
Supporting America’s Warriors
Nebraska Army National Guard


THE THREAT (cont):
    2011: 1500+ NEANG Soldiers will return from duty in Iraq & Afghanistan.
    These soldiers were involved in security, convoy & detention duties; high
     stress environment.
    Depending on which data you accept as true as many as 25% could require
     some formal/informal help with the affects of Post Traumatic Stress Disorder
     (PTSD).


    2011 = 400+ Nebraska Soldiers could be under attack by PTSD
                (the equivalent size of an entire battalion)

             Projections for the next 5 years … 2011-2016?
              (Soldier Health; Retention; Soldier Family Recruitment)



                                                                                 5
UNCLASSIFIED BRIEFING – FOR OFFICIAL USE ONLY
Supporting America’s Warriors
Nebraska Army National Guard


THE THREAT (cont):
PTSD Can Lead to Other Problems
 Depression & Anxiety
 Anger and Irritability
 Substance Abuse: Alcohol & Drugs
 The Spiral of Depression
 Suicide


Why Do Some Have Difficulty Seeking Help?
 Fear of being seen as weak (65%)
 Fear that unit leadership would treat them differently (63%)
 Fear that members of the unit would have less confidence in their abilities (59%)
                                          - Hoge (2004), New England Journal of Medicine



                                                                                       6
UNCLASSIFIED BRIEFING – FOR OFFICIAL USE ONLY
Supporting America’s Warriors
\
Nebraska Army National Guard


Peer-to-Peer Support Philosophy & Goals
A Peer Support Philosophy:                      Peer Support Goals:
The philosophy of Peer Support is to               Friend to talk with
  provide all of the NE NG members                 Plugged in with others
  with the opportunity to receive                  Making sense of
  emotional and tangible peer support               experiencenes
  in times of personal or professional
                                                   Resource Facilitator
  crisis and to help anticipate and
  address potential difficulties.                  Mental Health First Aid
A Peer Support program must have a                 Intervention
  procedure for Mental Health
  consultation & training.



                                                                              7
UNCLASSIFIED BRIEFING – FOR OFFICIAL USE ONLY
Supporting America’s Warriors
Nebraska Army National Guard

                      POG MIND VS. BATTLEMIND
                          POG MIND (People Other than Grunts)




                                                                8
UNCLASSIFIED BRIEFING – FOR OFFICIAL USE ONLY
Supporting America’s Warriors
Nebraska Army National Guard


                                    BATTLEMIND




                                                 9
UNCLASSIFIED BRIEFING – FOR OFFICIAL USE ONLY
Supporting America’s Warriors
Nebraska Army National Guard
      City             County             # of Soldiers in Each Town
1.    Lincoln          Lancaster          271         (20%)
2.    Omaha            Douglas            125         (9%)
3.    Kearney          Buffalo            60          (4%)
                                                                        Most Nebraska
4.    Columbus         Platte             45          (3%)            Cities & Counties
5.    Norfolk          Madison            38          (3%)            have a low density
6.    Hastings         Adams              35          (3%)            of ARNG Warriors
7.    Wayne            Wayne              30          (2%)
8.    Chadron          Dawes              26          (2%)             requiring a large
9.    McCook           Red Willow         25          (2%)           number of trained &
10.   North Platte     Lincoln            23          (2%)           mobile Peer to Peer
11.   Gering           Scottsbluff        22          (2%)
12.   Scottsbluff      Scottsbluff        18          (1%)
                                                                         Specialists!
13.   Alliance         Box Butte          17          (1%)
14.   Grand Island     Hall               17          (1%)
15.   Bellevue         Sarpy              17          (1%)            Nearly 40% Live in
16.   Lexington        Dawson             16          (1%)               73 Counties
17.   Sidney           Cheyenne           15          (1%)             Across Nebraska
18.   Fremont          Dodge              14          (1%)
19.   Beatrice         Gage               12          (1%)
20.   York             York               10          (1%)
      Remaining 73 counties              510          (38%)
      TOTAL                            1,346

                                                                                           10
UNCLASSIFIED BRIEFING – FOR OFFICIAL USE ONLY
Supporting America’s Warriors
Nebraska Army National Guard


NE ARNG Solution: Peer-to-Peer Support
Peer Support Specialists (PSS):                                      How it Works
  Report to Peer Support Program Coordinator
  Initial 18 Hours of Training                                          and
                                                                     Why it Works
  Follow-up 10 Hours of Training
  Coordinate with Unit Commanders (Battle Drills for PTSD issues)
  Coordinate with Chaplains to support War Veterans Groups

Peer Support Program Coordinator:
  Coordinates Activities of Peer Support Specialists
  Travels with Chaplains for
          Emotional Support Group Meetings

          VISION STATEMENT
  THE GOAL: To meet with each returning
    Veteran and offer “communication and
 facilitation” to each Veteran and their family
      77,358 square miles makes Nebraska
        the 16th largest state in the USA

                                                                                    11
UNCLASSIFIED BRIEFING – FOR OFFICIAL USE ONLY
    Supporting America’s Warriors
    Nebraska Army National Guard


Peer to Peer Support Training: Phases I & II
        PHASE I TRAINING (2 Days; 18 hours)                                        PHASE 2 (10 hours)
DAY 1                               DAY 2                                         Refresher Training From Phase I
    History & Concerns of Combat       Listening Skills Exercise                Communication And Counseling
    Confidentiality issues             Assessment of the Exercise               Extensive Role Playing
    Communications skills              PTSD Mental Health Briefing
                                                                                  Review Of Resources
    Ethical issues                     Outreach Resources
                                                                                  Round Table Discussion Of
    Problem assessment                 Reaching Out Nebraska
                                                                                   Lessons Learned
    Problem Solving Skills             Inter-Church Ministries of Nebraska
    Alcohol & Substance Abuse          Mental Health Outreach
    Medical conditions often           Nebraska ARNG Chaplain Services
     confused with psychiatric          State Benefits Provider                     Two Phase 2 Courses
     disorders                          AAR
    Stress Assessment
                                                                                       planned for 2011
    Suicide Assessment                     Through March 2011
    Depression & Burnout               250 Peer Support Specialists
    Grief Management                   Have Already Completed the
    Domestic Violence                    Initial 18 Hour Training!
    Crisis Management                  3 Courses Planned for 2011



                                                                                                               12
    UNCLASSIFIED BRIEFING – FOR OFFICIAL USE ONLY
Supporting America’s Warriors
Nebraska Army National Guard


THE COST



Cost per event per course: (Class Size limited to 15 students)
 $15,576 for Soldiers (Lodging, Mileage, Per Diem)
 $2,500 for Director (Dr. Kayne)
 $200 for Administrative Costs
 TOTAL: $18,276 per training event




                                                           13
UNCLASSIFIED BRIEFING – FOR OFFICIAL USE ONLY
   Supporting America’s Warriors 2011
              Best Spiritual
   Nebraska Army National Guard Practices Conference


                             Building the
                         Veteran’s Battle Mind

                       NEBRASKA’S P2P
                          MINISTRY


       QUESTIONS?

Joint Force Headquarters – Nebraska
Chaplain (COL) Rod Armon
MSG Daniel Fullerton
                                                       15
    UNCLASSIFIED BRIEFING – FOR OFFICIAL USE ONLY
Supporting America’s Warriors
Nebraska Army National Guard




          POC FOR QUESTIONS?
        Building a Veteran’s Battlemind
           Nebraska Chaplain Corps

                       A Mental Health Component of
                       Nebraska’s Family Life Ministry

            JOINT FORCE HEADQUARTERS – NEBRASKA
Chaplain (COL) Rod Armon     EMAIL: rod.armon@us.army.mil        CELL: 402.326.4246
Chaplain (MAJ) Phil Houser   EMAIL: philip.houser@us.army.mil CELL: 402.326.4254
MSG Daniel Fullerton         EMAIL: daniel.fullerton@us.army.mil CELL: 402.314.7730



                                                                                      16
UNCLASSIFIED BRIEFING – FOR OFFICIAL USE ONLY

				
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