Mental Health Support - Individual/Group & Moral Injury/PTSD

Greetings, friends,

We've been talking about Moral Injury on the American Heroes Network radio broadcast lately (15Oct), and a new discussion yesterday has provoked new thinking.  

[An example of moral injury would be a fierce firefight that resulted in the inadvertent killing of innocent civilians that haunts a veteran afterward. This has gone on as long as war has been waged.]

Two issues are provided for your thought here today.  

When a unit experiences a trauma together that goes against personal values and creates a moral dilemma, service members are forever changed.  In past eras, it was very hard to reconnect with members of a unit, especially if the war fought was considered an Unjust War (Vietnam).  With today's Social Media capabilities, we learned a great deal from a wonderfully articulate Marine who has found 80% of his unit.  This online effort has now grown to include annual reunions that are highly significant and meaningful to them.

This unit/peer connection appears to be a growing phenomenon and began years ago with Facebook pages for a specific unit, and has morphed into using GPS geo-locators for identifying other veterans (POS REP). The action of organically connecting to prior unit members is showing positive outcomes for many, including finding some semblance of peace and improved mental well-being.  

Interestingly, most mental health care is administered to each individual. Which works best?This is a tough question to answer since everyone is different, but research appears to be saying that for combat vets, a shared experience and peer connection may be an excellent way to heal.  

Secondly, is Moral Injury separate or a component of PTSD?  Moral Injury is under study to discern whether it is separate from PTSD, even though many symptoms may be the same. Is moral injury defined by guilt and a moral disagreement with personal values and PTSD more a danger response (with biological, psychological symptoms) coupled with a spiritual outlook?  Does this help explain drone operators who are not in physical danger, but suffer greatly as we now know.

This topic will be discussed more fully on the American Heroes Network (www.AmericanHeroesNetwork.com) on 05 November at 11am EST and archived afterward on iTunes and the AHN website.  Let us know what you think of the group versus individual approach to Moral Injury and/or PTSD may be?

Linda Kreter & the VeteranCaregiver team

Seeking Help - Part 1 Reprise

Greetings, friends,

For many of you, the following information will be basic and instinctive to you. We originally posted this in December, and scores of calls and emails are asking the same questions about how to navigate the medical or legislative system, and we thought the following guidance might be helpful.

What do I do when I need caregiver help?

If you are already in the National Caregiver Program, contact your Caregiver Support Coordinator (CSC) at your local VA medical center.  If s/he is not in, ask for the alternate, and leave a voicemail.  It’s a good idea to also follow-up with an email, and their email can usually be found through an Internet search.  You can ask for the email address, and if it’s not forthcoming, ask who else can help you.

If you’re not in the Caregiver Program, you can still use the Caregiver Support Line and request help and guidance.  If your issue is outside the responsibilities of the CSC, then ask who you should be directed to for problem resolution.  It will likely be someone else in the Social Work Office. 

What do I do when I need help with my Veteran’s medical care?

If you have already spoken with your primary care physician, or in the case of mental health, the psychologist, we suggest contacting various VA advocates.  If your veteran is an OIF/OEF/OND veteran, there is a specific OIF/OEF Coordinator, whose name may be found with an Internet search, a VA website search, or by calling your local VA medical center.  They are often able to cut through issues very simply for you.

If the issue relates to a disagreement over care or other conflict, you would contact the VA Patient Advocate at your local VA.  This person may be found on the VA website, through an Internet search or by calling.  If there is a formal report or complaint to make, ask for the proper forms and be sure to follow all the steps directed so that you will find resolution.  You may need to be quite persistent, and you will need to judge the seriousness of your issue.

What do I do if I need help understanding VA process (paperwork, fee base, etc.)?

The Internet is an excellent source of information, but it may be a huge undertaking to find out the nugget of information needed.  Obtain one of the VA Handbooks on Benefits (you can download it or obtain a hard copy at your local VA) to find out who to talk with for specific needs.  

Why use a VSO?

We also highly recommend contacting one of the chartered Veterans Service Organizations (VSO’s) such as AmVets, Vietnam Vets of America, DAV, the Legion and others.  You can find a list on the va.gov website.  It is highly recommended that you use an organization to help you since VA benefits and processes change with the legislation and it can be a daunting task keeping up with the changes.

The importance of peers is...

Ask your fellow caregivers.  Your peers often have great experiences to share, so post here, write to your friends, and seek out others locally who can provide you practical information.  Seek out others while at the VA and absorb all you can; what you learn will either help you, or others in the future.

This is a starting point...

Linda Kreter & the VeteranCaregiver Team

Caregiving Monday Musings

Caregiving is both a loving and a draining experience.

Love can wax and wane and the caregiving experience feels different depending on your phase.

Being thoughtfully pensive is different than being mired in a recurring mental spiral.

Fairness has varying definitions depending on your perspective; learn to raise or lower your expectations depending on your mental outlook of the day. Life is not always fair...

Peers and friends who “get it” are priceless.  It is lonely and isolating to walk this path alone, so please don’t!

As much as possible, give patient, educated responses when coping with the muddle of bureaucracy.  You’ll sleep better when you're less agitated.

Find your “anchor” (a friend, your faith, your journal, your dearest pet…) or a quiet place and give yourself permission to hold still when needed.  Your work will wait.

Finally, know the people that care for YOU in your life and lean on them when necessary. They fervently want to help you.

You matter so much to those that depend on you.  Do you really need to wonder why you’re tired? 

Please be kind to yourself.  You do a huge job, and you’re not going to be perfect, but you are going to do your best.  

You always do.

Caregivers, you are a gift to those you support.

Blessings to you,

Linda Kreter & the VeteranCaregiver Team