Current and Relevant Trends in Caring for the Behavioral Health Needs of the Connecticut National Guard .pptx

i wan to disscuss this on may studets

1. Current and Relevant Trends in Caring for the Behavioral Health Needs of the Connecticut National Guard Michael Dutko MA, LPC, LADC Susan Tobenkin LCSW

2. Mission   No soldier should ever feel alone. Our primary goal is to serve and advocate for service members of the Connecticut National Guard by providing support, case management resources, and referrals. We also aim to improve unit readiness and the psychological health of the Connecticut National Guard through outreach, education, and resource development. Every attempt will be made to ensure service members and their families are receiving the support they require. An important goal of the CTNH BH Team is helping service members develop life skills by enhancing protective factors that directly build resilience. Along with striving to eliminate stigmas associated with seeking help.  The CTNG Behavioral Health Team will promote suicide prevention/ postvention and awareness.   CT National Guard Behavioral Health Team

3. Behavioral Health Team MAJ Javier Alvarado, LCSW State Behavioral Health Science Officer C: [phone] Fax: [phone] [email protected] Susan Tobenkin LCSW, SCSA Behavioral Health Specialist C: [phone] Fax: [phone] [email protected] Michael Dutko MA, LPC, LADC Behavioral Health Specialist C: [phone] Fax: [phone] [email protected] James G. Fox, LCSW Behavioral Health Specialist C: [phone] Fax: [phone] [email protected] 1LT Luigina Facchini Admin. Support O: 860-691-6023 C: 860-655-9322 Fax: [phone] [email protected] SGT Harry Murray Admin. Support O: 860-691-6023 C:860-822-3509 Fax: [phone] [email protected] Air Guard Director of Psychological Health Mrs. Linda U. McEwen Cell: 860-519-8125, Office 860-292-2561 [email protected]

4. The Connecticut National Guard Current Strength CT National Guardsmen - 3589 Male / Female – 3,035 / 554 Average Age of CTARNG Soldier – 29 Age: 17 – 25: 1,487 26 – 35: 1,130 36 – 50: 789 51 > 183 Combat Over 500 to deploy 2017 Over 5,000 SM’s deployed since 11 Sep 2001 Multiple Deployments (2-4) Common issues BH Issues / Adjustment Financial stressors / Employment Relationship - Family / Marital / Significant Others Substance Use Active Army vs. National Guard

5. AGE RANK SUICIDE DATE 23 SPC 8/12/14 26 1LT 6/4/14 26 PFC 5/2/13 22 SPC 4/20/13 21 SPC 12/25/12 29 SGT 7/14/12 18 PV1 12/8/11 27 SGT 7/21/11 26 SSG 7/1/11 47 SFC 5/18/11 CTNG Deaths By Suicide

6. Suicide Factors and Prevention Suicides General Factors: Male Age: 23.62 (18-24 years old) White Single PFC or SPC 5 Years of Service More Likely M-day Non-prior service Not in-training Combat MOS Roughly two-thirds never deployed & one-third deployed Mitigation Strategies: Master Resilience Training Emphasis on Yellow Ribbon Programs / DCS RSP and Unit Leader Resilience Training Packages RSP Resilience Training Program Enhanced Accession Criteria / BH screening Emphasis on Service Member and Family Sponsorship Leader Stress Management Control Training Review ARNG accession criteria / screening process Collaborate employment with GSD-EDU, ESGR, USAR Substance Abuse Prevention, Outreach & Treatment

7. 7 Behavioral Health Big 3 SUICIDE PREVENTION Training (Suicide Prevention- Postvention -Intervention and Response) - Flank suicide prevention efforts – also address overall wellbeing - initiatives that focus on sleep, physical fitness etc. BHT RESPONSE Work with Command to prioritize early identification & intervention (maintain 100% assessment at PHA's for force fitness) - Emphasis on mobile and rapid crisis response by BH Team and COC. Promote command consultation & collaboration.   RESOURCE DEVELOPMENT: Ongoing community outreach/partnership, development of CHPC, Fresh Check, CTSAB, In order to monitor and track the needs of Soldiers – Improve electronic data collection (Metrics – Enhance Outcome Data).

8. Periodic Health Assessments (PHA) Required of every Service Member and is a preventative screening tool designed to improve reporting and visibility of Individual Medical Readiness for all soldiers Soldier Readiness Process (SRP) Consists of several different examinations, evaluations, and interviews to determine overall medical and deployment readiness Post Deployment Health Assessment (PDHA) Occurs upon redeployment and Behavioral Health Team will assess needs of Service Members to address integration issues and connect to providers in the community and provide appropriate support. Tag Policy 24 SM’s who arrested or convicted of a crime will meet with CTNG Behavioral Health for an assessment. Goal is to provide support and identify needed resources.

9. Screening Tools: Behavioral Health Questionnaire (BHQ) Utilized during the course of the PHA to help capture, assess, and screen unit support, trauma indicators, areas of concern, deployment history, and resource needs Behavioral Health Assessments Along with the BHQ these face to face interviews of 100 percent of the force are used as the springboard for discussions about personal details that help to assess the mental state of the individual SM’s Patient Health Questionnaire (PHQ) offers clinicians concise, self-administered screening and diagnostic tools for mental health disorders Columbia Suicide Severity Rating Scale (C-SSRS) Is a rating scale created by researchers at Columbia University to evaluate an individual's degree of suicidal ideation

10. Why Use the Columbia Suicide Severity Rating Scale: One page quick screen Three page in-depth assessment completed in minutes Best Practice: Predictive and Easy to use by all community GATE Keepers, not just BH Professionals. Intensity of Ideation and use of deterrents compared Thresholds indicate NEXT STEPS Reduces false positives and catches missed risk than other measures NO COST

11. TOTAL CSSRS: 15,229

12. Suicide Prevention ASIST Designed to teach leaders at all levels to identify those who may be at risk of suicide or suicide ideation. This gives Soldiers the opportunity to speak to someone trained in mentoring and fostering an environment of understanding. PMCS Focused on individual SM’s and building camaraderie through conversation. Primary goal is to proactively address the needs of our CTNG SM’s – “Take Action Before They Arise”. The program depends on leadership buy in and ongoing unit level implementation. PMCS is meant to be executed during downtime at drill. BH Coin Over the years many of our soldiers have gone above and beyond to care for each other ensuring their wellbeing. The coin is presented to soldiers, and distinguished community partners who serve and advocate for the needs of SM’s and their families. PMCS Preventative Maintenance Checks and Services of Service Members 2.0 Connecticut National Guard

13. Suicide Intervention Family Brochure Brochure developed through collaborative efforts with the CT Suicide Advisory Board. Understanding is that SM’s spend 2 days a month with the Guard Family but spend a majority of their time with loved ones. BH 24 hour Help Line Unit Briefings CCIRs

14. Suicide Postvention Postvention training Teaches about memorial services , military and civilian resources and support, and how to provide an integrated response to a suicide death. Using nationally designated best practice protocols, didactic learning, discussion and interactive case scenarios, participants learn important steps for reducing risk of contagion and promote healing Commander Talking Points In the event that we experience a suicide, we want to ensure that we implement an integrated response to a suicide death that promotes healing and prevents further at risk behavior through a focused and direct message on safety and safe messaging.

15. COMMUNUITY RESOURCES WORK AND LIVE IN OUR COMMUNITIES REQUIRE SERVICES CLOSE TO HOME/VA VET CNTR/CLINICIANS Increase coordination of services. Reduce redundancies Partnerships Include: Veteran’s Administration (VA) Vet Center Military informed Community Providers CT Military Support Program (MSP) CT Suicide Advisory Board CTNG BH TEAM – FINAL RECOMMENDATIONS

16. Partnerships with Community Providers Community Health Promotion Council (CHPC) The Committee is comprised of NG, VA and Vet Center representatives, created to promote various internal/external programs that provide assistance to SM's and their families Jordan Porco Foundation Fresh Check Events Fresh Check Day is the signature program of The Jordan Porco Foundation (JPF). Fresh Check Day aims to create an approachable atmosphere where Service Members are encouraged to engage in dialogue about mental health, build a bridge between Service Members and the mental health resources and programs that exist in the CT National Guard, in the community, and on a national level. CT Suicide Advisory Board Zero Standard Learning Collaborative and Initiative The Zero Suicide continuous quality improvement approach is founded in the belief that suicide deaths for individuals under care within health and behavioral health systems are preventable

17. Case Example SM’s Risk Factors: Male Age: 25 White Single SGT 5 Years of Service M-day Combat MOS Deployed x1 Mitigation Strategies: Referred by peer BH Assessment completed Positive C-SSRS Referred to and coordinated Inpatient Treatment Collaboration with Treatment facility while SM was inpatient Collaboration with Discharge Planning Follow up services coordinated in community BHT Case management Communication with Unit Goal of return to duty

18. Conclusion: Bottom Line, Up Front (BLUF) The Way Forward Leadership support of BH mission Rapid and mobile response Screening/Assessment Community Resource Development Case management Data Collaboration Communication Comradery Community Cohesion

19. “As a service member, you need to be open and honest when you share, and you need to listen when others share with you. You need to know that you’re never alone, that there is another way out- that is, a way to deal with your pain constructively, and even ways to fix it.” ~ SPC McDonald, (OIF Veteran, Ret.)

20. Questions?