Page 10 nursing.elitecme.com Complete Your CE Test Online - Click Here Disclaimer The information provided in this activity is for continuing education purposes only and is not meant to substitute for the independent medical judgment of a healthcare provider relative to diagnostic and treatment options of a specific patient’s medical condition. ©2018: All Rights Reserved. Materials may not be reproduced without the expressed written permission or consent of Elite Professional Education, LLC. The materials presented in this course are meant to provide the consumer with general information on the topics covered. The information provided was prepared by professionals with practical knowledge of the areas covered. It is not meant to provide medical, legal, or professional advice. Elite Professional Education, LLC recommends that you consult a medical, legal, or professional services expert licensed in your state. Elite Professional Education, LLC has made all reasonable efforts to ensure that all content provided in this course is accurate and up to date at the time of printing, but does not represent or warrant that it will apply to your situation nor circumstances and assumes no liability from reliance on these materials. Quotes are collected from customer feedback surveys. The models are intended to be representative and not actual customers. Statistical data pertaining to the mental health of veterans Research shows that approximately 20 to 25 % of veterans suffer from mental health problems upon returning home, including, but not limited to, depression, Traumatic Brain Injury (TBI), and Post Traumatic Stress Disorder (PTSD) ((National Alliance on Mental Illness, 2018). This makes it likely that nurses will encounter a veteran who needs mental health assistance. Thus, nurses must know how to recognize and assess the mental health of veterans. They must also know how to counsel family members and friends to help them obtain help for their loved ones. General data Various agencies compile data pertaining to the health of veterans on a regular basis. Some especially pertinent data include (SAMHSA, 2017): ● ● There are approximately 23.4 million veterans in the United States and about 2.2 million military service members and 3.1 million immediately family members. ● ● The demands of military service and experiences of combat can cause psychological distress and mental health disorders, which can be further complicated substance use and related disorders. ● ● A significant number of service personnel experience devastating issues such as trauma, suicide, homelessness, and/or involvement with the criminal justice system. An estimated 18.5% of service members returning from Iraq or Afghanistan have post-traumatic Stress disorder (PTSD) or depression, and 19.5% report experiencing a traumatic brain injury (TBI) during deployment. ● ● Treatment issues (or lack thereof) are troubling. Only about 50% of returning service members who need treatment for mental health disorders seek help. However, only more than slightly half of those who receive treatment receive adequate care. ● ● Between 2004 and 2006 7.1 % of U.S. veterans met the criteria for a substance use disorder. ● ● The Army suicide rate reached an all-time high in 2012. ● ● Between 2005 and 2009 more than 1,100 members of the Armed Forces took their own lives. This was an average of one suicide every 36 hours. ● ● Mental and substance use disorders caused more hospitalizations among troops in 2009 than any other cause. ● ● According to a Treatment Episode Data Set (TEDS) report, about 70% of homeless veterans also have a substance use disorder. ● ● Cumulative lengths of deployments are associated with more emotional problems among military children and more mental health diagnoses among U.S. Army wives. ● ● Children of deployed military personnel have more school, family, and peer related emotional problems compared with national samples. Much of the available data on mental health issues experienced by veterans have been obtained from studies on the wars in Afghanistan and Iraq (Operation Enduring Freedom/Operation Iraqi Freedom (OEF/ OFF) troops). These conflicts are the longest combat operations since Vietnam (U.S. Department of Veterans Affairs, 2015a). Therefore, the actual numbers of veterans affected by these illnesses and disorders may be much higher, when factoring in veterans from past conflicts. Research findings show that the following stressors have been identified by OEF/OFF troops as contributors to the development of mental health problems (U.S. Department of Veterans Affairs, 2015a). ● ● Being away from home for long periods of time. This may be even more stressful for members of the National Guard and Reserve who had not expected to be away for so long. Nearly half of those who served in the current wars have been National Guard and Reservists. ● ● Military Sexual trauma (MST). MST is defined as sexual assault or repeated threatening sexual harassment that occurs in the military. It can affect men as well as women. Furthermore, MST can occur during peacetime, training, or war. ● ● Seeing dead bodies. ● ● Being shot at. ● ● Being attacked/ambushed. ● ● Receiving rocket or mortar fire. ● ● Knowing someone who was killed or seriously injured. Nursing consideration: Research shows that Soldiers and Marines who had more combat stressors experienced more mental health problems (U.S. Department of Veterans Affairs, 2015a). Nurses must investigate length of service, location of service, and experiences occurring during service when screening for mental health issues. Be aware that this is a difficult topic to discuss for many of those affected. The problem of homelessness Mental health issues can also contribute to the problem of homelessness among veterans. Because of the transient nature of homelessness, it is difficult to obtain an accurate count of the number of homeless veterans. The U.S. Department of Housing and Urban Development estimates that 39,471 veterans are homeless on any given night (National Coalition for Homeless Veterans, 2017). Mental illness compounds the homelessness problems among veterans. Mental illnesses such as PTSD and depression can interfere with the ability of affected persons to hold jobs, attend school, maintain good interpersonal relationships, and/or ultimately function effectively in society. These kinds of problems can also interfere with a person’s ability to accrue adequate financial means to maintain a home. Additionally, veterans may spend their money on drugs, alcohol, or gambling—ineffective coping strategies used to diminish the memories of military experiences (Jackson, 2013). Characteristics of the homeless veteran population include (National Coalition for Homeless Veterans, 2017): ● ● The majority of the nation’s homeless veterans are male with roughly nine percent being female. ● ● Most homeless veterans are single and live in urban areas. ● ● The majority of homeless veterans suffer from mental illness, alcohol and/or substance abuse, or co-occurring disorders. ● ● About 11% of the adult homeless population are veterans. ● ● About 45% of all homeless veterans are African-American or Hispanic, despite the fact that these groups account for only 10.4% and 3.4% of the U.S. veteran population, respectively. ● ● Nearly half of the homeless veterans served during the Vietnam era. ● ● Homeless veterans are younger on average than the total veteran population. About nine percent are between the ages of 18 and 30, and 41% are between the ages of 31 and 50. Nursing consideration: Risk factors for homelessness among veterans include poverty, lack of support networks, and dismal living conditions in overcrowded or substandard housing (National Coalition for Homeless Veterans, 2017). Nurses must support efforts to reduce these risk factors and work to reduce the problem of homelessness.