Author Topic: Best practices for documenting traumatic exposure?  (Read 679 times)

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Offline Brihard

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Best practices for documenting traumatic exposure?
« on: November 01, 2018, 12:20:57 »
So a conversation with a buddy a while back got me to wondering about how we as a military keep track of the operationally routine exposure to heinous stuff that guys will see. BLUF, I'm looking to know if we have / what are our best practices for documenting such things in a manner that allows for it to be referred to later?

We know some things about mental health. We know that mental health disorders can be wholly unpredictable, and that someone can go through years and years of stuff and not struggle with any of it, and then down the road becomes sensitized to some particular trauma or exposure and feels effects. We know that it can take years after a particular exposure before it manifests itself as a mental health problem. My own tour is almost ten years behind me now, and I can't remember what data was captured in our post deployment screening. Now I'm not asking because I'm personally affected by anything, but more because as a leader, and as someone engaged in mental health stuff, and seeing how guys struggle to prove things to VAC, I worry about the 'if it's not written down, it never happened?'

I'm not talking about the really obvious stuff, necessarily - your platoon gets ambushed, a couple of guys get badly hurt, it's all well documented, etc. But more the incidental stuff that's almost part of the background noise... Torn up dead bodies, maybe videos the local army/police show you in training of some of the shitty stuff they saw/did, the 'forced to watch' stuff our UNMOs might see and document in some report to the UN that they'll never see again or have access to... Basically, how does a switched on MCpl or Sgt make sure that if his guys see some rough stuff, that it's documented in a pers or medical file somewhere so that if it becomes relevant years later, that information is recoverable and accessible? Not from the standpoint that we expect guys to be messed up, because most will see and experience this stuff and be fine, but really in the same precautionary manner that we would track things like workplaces that exposure excessive noise, fumes, stuff like that. Purely an occupational health and safety perspective.

I know in the police world, my organization at least, people are getting better about documenting potentially traumatic exposure on our equivalent to the DND663 or CF98. Plus by the nature of it usually there's going to be some sort of investigative reports for serious violent offences, human deaths, etc, so a lot more documentation is inherent to the event.

So- those in the know, what do we have for this? To what extent are junior leadership briefed/educated about using it if it exists? We take a lot of kids without much life experience, train them up, and send them to some bad places to see and do bad things. Are we capturing that data adequately when those same individuals may need to prove it years later?
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Offline dangerboy

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Re: Best practices for documenting traumatic exposure?
« Reply #1 on: November 01, 2018, 12:50:12 »
I am not aware of anything beyond the post tour mental health questionnaire.
All right, they're on our left, they're on our right, they're in front of us, they're behind us... they can't get away this time.
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Offline Brihard

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Re: Best practices for documenting traumatic exposure?
« Reply #2 on: November 01, 2018, 13:05:41 »
I am not aware of anything beyond the post tour mental health questionnaire.

So that's a problem... It relies on self reporting and probably half of us lied on it anyway. Guys fear the consequences of disclosing stuff that may come back to bite their career in the ***. I'm thinking more a mechanism whereby leadership can say 'OVer the course of the last few months, Cpl so and so, in the course of his duties was exposed to _____, _____, and _____. Maybe even some of the same questions on what was seen and experienced, but filled out by immediate supervisors. Am I making sense?
Pacificsm is doctrine fostered by a delusional minority and by the media, which holds forth the proposition it is entirely possible to pick up a turd by the clean end.

Offline garb811

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Re: Best practices for documenting traumatic exposure?
« Reply #3 on: November 01, 2018, 15:25:46 »
A DND663 fits the bill for this.

At Block One, select other and put in "Exposure".  IAW the instructions for completing the 663:

Quote
Exposure: A person is exposed to hazardous materials or conditions that is or could result in future medical problems. If this results in lost or restricted workdays, the “Disabling Injury” square in this section must also be selected. The DND 663 form for this type of occurrence must be retained locally for 30 years instead of the usual 10 years for other types of occurrence.

When you start looking into the various Guardian codes you will find ones for "Mental Pressure, Mental Stress" for the source of the injury, "Psychological" for the type of hazard and accident type etc.

I haven't submitted any for psychological but I have submitted DND663s for pers who were in a smoke filled environment with no apparent immediate ill-effects because who knows in 20 years if that member is suddenly going to start coughing up a lung for no obvious reason?

The post tour letters do a bit of this as well when they document things like having been in an area where patrols were conducted with the threat of IEDs, the camps were subjected to rocket attacks etc, but those seem to have become simple cut and pastes lately instead of tailored to what each individual was exposed to...