2. “Joining Forces”
(Mrs.Obama and Mrs.Biden)
approached NASW in 2012 to
join the initiative
SW announced Standards
for Practice with Veterans
and Military Families
(credentialing, free 5 course
training module for all social
workers)
SW are system-savvy, and
largest providers of mental
health in U.S - uniquely
situated to help reach
troops, says Mrs. Biden
(Jackson, 2013)
BACKGROUND: SOCIAL WORK AND THE
U.S. MILITARY
3.
4. SW precept, as per NASW Code: Meet Clients Where They Are (Cultural
Competence and Social Diversity)
BUT difficult to meet clients where they are if you don’t know where
they’ve been
Perspective 1: “I don’t need to know the culture of all people I work with
but am able to meet my clients where they are when the arrive”
Perspective 2: Difficult to make therapeutic alliances without knowledge
of unique challenges, i.e. sacrifices, seen and unseen war injuries
ETHICAL DILEMMA=
CULTURE CLASH
5. Military personnel in austere environments, other cannot understand,
requires huge allegiance (also by family) that is not conceptual but
literal.
Upon return difficulties include divided loyalties to one’s military
brothers/sisters and one’s family
Serving in combat zone affects how you see the world
Schools responsibility to provide training in military culture?
At minimum, military social workers need to understand different military
occupations, rank, branches, deployment cycle, uniform code of military
justice, warrior ethos, and perceived stigma of being seen with a mental
health issue
Others feel military social workers should read and ask questions but do
not require formal training in military culture, Just need Cultural
Competence in general and understand PTSD, not the schools’
responsibility
(Jackson, 2013)
CULTURE CLASH CONTINUED
6. Added to the discussion is high rates of
military suicide and gun control debate =
1. Are social workers prepared through the MSW
training to best serve military families or is
additional specialized training required to
become competent in serving this population,
especially veterans in post-deployment?
2. As social workers, how do we conceive of gun
control policies best serving veterans and their
families considering complex factors of: high
rates of gun suicide (and homicide) among vets;
gun rights; significance of weapon- carrying for
veterans; and our personal beliefs about gun
control?
3. What is unique about military culture as it
applies to social work in both micro and macro
contexts? How do these unique features pose
challenges and opportunities to the social work
field?
ETHICAL DILEMMA DISCUSSION
7. Stressful and emotionally
disturbing experiences of war has
been documented for perhaps
thousands of years:
Achilles’ “blind rage” described
in Homer’s Illiad closely
resembles what we now identify
as PTSD resulting from the loss
of a close companion
The term “soldier’s heart” was
used to describe Civil War men
who experienced hardships
adjusting to life after the war
“Shellshock” for WWI veterans
“Combat fatigue” for WWII
veterans
HISTORY
8. History
Continued
IT WAS NOT UNTIL 1980 THAT THE DIAGNOSTIC AND
STATISTICS MANUAL OF MENTAL DISORDERS
FORMALLY IDENTIFY THE SYNDROME OF COMBAT-
RELATED PTSD AFTER THOUSANDS OF VIETNAM
VETERANS WITH ACUTE PSYCHOLOGICAL ISSUES
GAINED NATIONAL ATTENTION
9. 2005 - 2010, service member suicide rates estimated at 1
every 36 hours
A 2013 Department of Defense report estimated 349 suicides
by military men and women from all branches of the Armed
Forces in 2012
*does not include unsuccessful suicide attempts or suicide rates amongst veterans
who served prior to Operation Iraqi Freedom (OIF) and Operation Enduring Freedom
(OEF)
Between 2008-2010, 2/3 completed suicides involved
handguns (Harrell & Berglass, 2011, p.1), (Kaptur, 2013),
(Zakaria, 2014)
High Risk Groups: Male veterans (ages 30-64); those with
physical and emotional injuries related to OIF and OEF
(Traumatic Brain Injuries/TBI’s, chronic pain, PTSD, substance
abuse, anger management)(Harrell & Burglass, 2011), (Kaplan,
McFarland, Bentson, Huget, & Valenstien, 2014)
*Major unprecedented study found 1/4 of all soldiers with one or more mental health
disorders; 2x’s rate of their general population peers (Zwerdling, 2014)
RESEARCH AND STATISTICS
10. Despite growing evidence - access to firearms as a contributive
factor in successful suicide attempts,(2009 Pentagon report),
discussion in rate reduction strategies by Army Task Force and the
DOD Task Force failed to broach the subject (Cameron-Ritchey,
2012), (Shapiro, 2014)
National Defense Authorization Act 2011 restricted commanding
and medical personnel from discussing privately owned weapons,
(2013 version of the same law lifted the restriction)
Proposals for tougher gun laws, post 2012 Connecticut school
shooting failed to pass Congress
September 26, 2013 - Marcia Kaptur (Rep. OH) and David McKinley
(Rep. West VA) - Examining America’s Mental Health Services Act of
2013 H.R. 1615 - rise in public mass shootings where perpetrators
shared significant common factors, such as untreated mental health
issues, access to firearms, and military membership
(Cohen, 2014), (Kaptur, 2013), (Zakaria, 2014)
RELEVANT POLICIES AND LAWS
11. Policies &
Laws cont.
FEBRUARY 2014 - INSTITUTE ON MEDICINE (IOM)
RELEASED THEIR FIRST ROUND OF RESULTS OF A LARGE-
SCALE EXAMINATION ON MILITARY PREVENTION
PROGRAMS, "PREVENTING PSYCHOLOGICAL DISORDERS
IN SERVICE MEMBERS AND THEIR FAMILIES: AN
ASSESSMENT OF PROGRAMS”
“KEY RECOMMENDATIONS FOR SYSTEMIC CONSISTENCIES
AND ENFORCEMENT IN REGARDS TO ACCESS
RESTRICTIONS, BASED ON THEIR FINDINGS THAT,
“CERTAIN STRATEGIES WITH STRONG EVIDENCE OF
EFFECTIVENESS ARE UNDERUSED, SUCH AS RESTRICTING
ACCESS TO PERSONAL FIREARMS TO PREVENT SUICIDE
OR HOMICIDE IN DOMESTIC VIOLENCE CASES…,”
(IOM, 2014)
12. CNN’s GPS with Fareed Zakaria
What in the World: Military Suicide
http://www.cnn.com/video/data/2.0/video/best
oftv/2014/04/05/exp-gps-0406-witw.cnn.html
AFTERMATH: UNINTENDED
CONSEQUENCES
13. Cameron-Ritchey, E.(2012, Jan-Feb). Suicide and the United States
Army: Perspectives from the Former Psychiatry Consultant to the Army
Surgeon General [Electronic version]. Cerebrum. PMCID: PMC3574805.
New York, NY: The Dana Foundation.
Cohen, T. (2014, April 3). Latest Fort Hood Shooting Revives Broader
Gun Debate. Retrieved
from www.cnn.com/2014/04/03/politics/fort-hood-security/
Harrell, M. C. & Berglass, N. (2011, October). Losing the battle: the
challenges of military suicide [Electronic version]. Policy Brief.
Washington, DC: Center for a New American Security
Institute of Medicine. (2014). Preventing Psychological Disorders in
Service Members and Their Families: An Assessment of Programs.
Washington, DC: The National Academies Press
Jackson, K. (2013, March/April). Working with Veterans and Military
Families. Social Work Today. Vol.13. No.2 pp 12-16
Kaplan, M.S., McFarland, B., Huguet, N., Valenstein, M. (2014, Feb. 8).
Suicide risk and precipitating circumstances among young, middle-aged,
and older male veterans. American Journal of Public Health 131-7.
Washington: American Public Health Association
102:1
REFERENCES
14. Kaptur. M. [Speaker]. (2013, Sept. 26). H.R. 1615 [Electronic
version]. Congressional Record. Washington, DC: U.S.
Government Printing Office
Miller, C.T. & Zwerdling, D. (2012, March 13). Aftershock: The
blast that shook psycho platoon. ProPublica. Retrieved from
http://www.propublica.org/article/aftershock-the-blast-that-
shook-psycho-platoon
Shapiro, J. (2014, April 3). Health News: Shooting unfairly
links violence with mental illness — again [Radio broadcast].
Washington, DC: National Public Radio
Zakaria, F. [CNN: GPS]. (2014, April 4). What in the World:
Military Suicides [Video file]. Retrieved from
http://www.cnn.com/video/data/2.0/video/bestoftv/2014/04/05/e
xp-gps-0406-witw.cnn.html
Zwerdling, D. (2014, April 4). All Things Considered: Shooting
revives old questions about mental health in military [Radio
broadcast]. Washington, DC: National Public Radio
