Post Traumatic Stress Disorder

[RHFC_piper]

I believe the best therapy out there is a site like this where you can connect with others who have had the same difficulties... 

I couldn't agree more.  This site, in particular, has been a great help since I've been home.  Thanks to people I've met here, and my ability to vent frustrations (to people who actually listen) I've been able to get things sorted out.  Example; Since my last post in this thread, I've been contacted by every organization with whom I had problems getting through to before, thanks to certain members who have higher contacts with said organizations.  Things have turned around since then, and everything is starting to piece together.

With that said; perhaps I should have mentioned something about all this when I first came home; 11 months ago.

reference the OSISS reps, I dont see any point where they should 'step in' (unless you are meaning they are asked to assist with a case).  I believe this should be initiated by one or more of three triggers:

a) individual self-declares a need for OSISS assistance;
b) supervisor or higher recommends a need for OSISS assistance;
c) or, medical, social or mental health worker recommends a need for OSISS assistance.

Assistance needs to be immediate - not in months, but in days and preferably within a week.  If OSISS cant do this, then they need to get their act together and stop acting like an external specialist. 

As much as I agree with you, GreyMatter, there are some issues with these triggers;
a) Individual self declaration: Most soldiers who are in need are, for the most part, unaware of the services offered by OSSIS.  I was first told about OSSIS when I was in Germany (hospital) and only briefly...  I was also on enough Morphine, fentanyl, demerol and other opiate-based painkillers to stuff a horse into a tight coma for a month, so I don't remember much about it, except what comes in hazy flashbacks.  Once I got home, I knew of their existence, but thought they were part of, or another name for, the OSI clinic.  I was also grossly misinformed about what the OSI clinic was and what they could do as well... but that's another issue which has since been resolved. 
But, back on track here, with all that said; of the few soldiers who know about OSSIS and what they can offer, even fewer will take the help, as it is not enforced (which it shouldn't be). But this is much like any other service offered (social worker, OSI clinic, etc.); It is up to the soldier to reach out for help and then accept the help given.  With that in mind, most soldiers are of the mentality that they can 'soldier through' any issues they might have, and ignore the help offered... this is more so the case when the soldier doesn't have the right information... and it usually takes a catastrophic meltdown for the soldier or his/her family to sort out help (been there, done that, know the signs now). 
What is the solution? Like a bad drivers test; there is now %100 solution, but the best answer I can think of is direct initiation of contact by these organiztions to help the soldier understand their options.  As much as it is up to the soldier to reach out, it may help if someones hand was already there reaching back.

b) Supervisor / CoC: Again, another issue;  Most supervisors within the CF are either unaware of the resources available, or of two like-opinions which can be a detriment to their subordinates health; 1) It's the soldiers personal business (one man, one kit), or 2) the soldier can soldier on (the 'old-school' attitude), and as above, it usually goes on until a catastrophic breakdown (not necessarily an emotional one, but sometimes within the chain of command).  As much as it is a supervisors job to stay in tune with their subordinates (know your troops and promote their welfare), generally this can become a 'Too close for comfort' issue which most supervisors don't want to get involved in, and in some cases; neither does the subordinate.  My personal experience;  My current 'supervisor' has to know my every issue to report to higher (a new mandate which came from higher-higher... aka, LFCA). 
As much as I appreciate their new found attention to detail, I am still not comfortable sharing some personal information, which he needs to do his job... not because I don't like him; far from... I think he's a good guy, and a great officer... but because I'm just not comfortable telling anyone  certain things about my physical and mental well being...  Also because of the number of people who have access to the weekly reports he submits. 
Most soldiers (including myself) would not be comfortable with this kind of scrutiny (as necessary as it may be), and many supervisors would be uncomfortable dabbling into someone's personal life.

c) Military Health Services: This is the organization which has the most say and control.  These are the people who need to do the leg-work and push a soldier towards the help.  But the soldier should be made aware of their resources immediately, weather by forcing the issue (medical staff setting appointments with OSI / OSSIS) or by contact from these organizations (OSI / OSSIS initiating contact after being contacted by med staff).  Either way, the military medical side of the house should be all over this... which they are.  Every soldier returning from operation has to conduct a 'post-deployment screening'; this is the opportunity for further help to be pushed... but there are issues with the post-deployment screening system as is (at least for the reserves... due to lack of contact after re-deployment).
But, as it is right now, this is the best, and most effective way for a soldier to organize help; Through the medical system.  If this breaks down for any reason (weather through the HSC or through contact with OSI / OSISS) then there is going to be a gap and a crack for the soldier to fall through.

Consider this; I was once told (by someone in either OSI or the military social services field... can't remember which) that for every one soldier who is receiving the necessary help, there are at least 10 who are not.  This is not any one groups fault, but a gap that is created by everyone involved, including the soldier.  And with more deployments, more soldiers having multiple deployments and the nature of some of the more recent deployments (combat) there will be many more soldiers who will need the help, but will be hindered by either; Lack of information, lack of contact, lack of self-identification.  There are many cogs in the machine, all of which have to be running together or the machine crashed to a hard halt.       

At this point it gets a bit blurry - 48th says he had a good experience with OSISS (if i recall correctly), Piper says he had a bad experience with OSISS.  Should we at this point take a poll and see what others think of OSISS services?

I haven't had enough experience with OSISS to have a particularly bad opinion of them, which is really the problem.  I wasn't completely sure what they could offer in the way of help until shortly after my last post in this thread.  But, that really isn't their fault... thats just a breakdown in the dissemination of information (which I find is the basis for most problems in the CF and society in general... but I'll save that for another rant).  Had I known what OSISS does long ago, when I first came home, I may have had more of a need and will to initiate contact with them, but the information just wasn't there... at least not all of it.  All I knew of them was that at some point I might want to talk to them, but that would be sorted out by the people who were taking care of me. Now I have a keener understanding of their resources, and to be quite honest, I don't think I'm in need of their services anymore...  I have a pretty good social support circle going as is. Between my friends from deployment and my unit, my family, the OSI clinic, HSC social workers and these forums, I have many outlets to vent frustrations and discuss problems / issues.
But, I will keep in contact with them, as they may, someday, become a valued resource.

Anyway, Sorry I've turned this into a long-winded diatribe (yet again)... just thought I'd share my insight into issues in which I now have much more experience than I wish I had.  Hope it helps.

The system isn't broken, it just needs a tune-up... and maybe a new oil filer...

 

[Greymatters]

Piper, excellent feedback, I hope your words help others who are currently on their way home right now. 

Of note, I just read an article yesterday (Freedom Tags Say Tour of Duty Ending) where the reporter says that the troops are getting 4 days 'decompression' in Cyprus prior to returning home and part of their re-orientation is information on PTSD. 

 

[the 48th regulator]

GreyMatter,

My questions were not directed at Piper, if you click on the links associated witht he quote, it will help.

Hope that corrects any confusion

dileas

tess

 

[RHFC_piper]

Of note, I just read an article yesterday (Freedom Tags Say Tour of Duty Ending) where the reporter says that the troops are getting 4 days 'decompression' in Cyprus prior to returning home and part of their re-orientation is information on PTSD. 

True; when the troops get to the 3rd party decompression location they are informed of the resources available to them, but only the general details.  Not a whole lot of specifics are available until they get home, then for the most part, it's up to them to utilize the resources. 
Also, PTSD can take months, and sometimes, years to surface... even the most mild signs. It can become difficult for some members to access the resources when they need them if they don't initiate contact immediately... Especially those members who leave the forces after a traumatic tour (there are quite a few in this boat).

There are other variables to consider with the "decompression";
- As much as the troops don't want to talk about it (publicly) and the CoC wishes it didn't happen, the reality is; while on decompression, troops spend the majority of their time involved in recreation activities... such as drinking and partying...  Not saying there's anything wrong with this, but it can interfere with troops access to resources which could benefit them... also, it sometimes becomes habit forming when they come home, causing even more problems.  I'm not saying the troops shouldn't be partying it up, 'cause god knows they've earned it, I just believe the troops should be encouraged (by their CoC) to take every advantage of the resources available.  By 'encourage' I mean positively... not denial of freedoms; CB-ing the troops to the hotel and keeping the decompression "dry" is not the way to go... it just makes for angry troops who will drink and party anyway, which will result in charges and other disciplinary actions.  Positive reenforcement through incentive might be the best way to go... keep the troops happy and instill the want for accessing help as needed.    This may also defeat the idea that seeking this help is a "weakness"; Recovering from a mental wound is no different from recovering from a physical wound.  Help the soldiers recover and they will be more effective.

- The other issue is that not all soldiers go through the 3rd party location decompression, sometimes its not in the same location, and some soldiers have more time in the decompression location than others.  Example; Anyone who was wounded and repatriated had NO decompression in any 3rd party location (with few exceptions; some were fit enough to go to Cyprus to help the decompression team... but they were working)... Most of us didn't speak with a social worker until months after repatriation, if at all.  Also, after talking to other soldiers from my Roto, both regular and reserve, some had their decompression in Cyprus, some had it in other undisclosed locations... Some were there for 4 days, some for a week (7 days) and some stopped there over night on their way home. It all comes down to available time, flight timetables and many other variables. And, because of previous groups activities in the decompression location, some soldiers were confined to their resort/hotel, with 'no drinking' policies in place... with left them disillusioned and annoyed... not just at the CoC, but at their peers, who ruined it for them before they even got there.  Inconsistencies like these create tension, especially for the troops which get the short end of the stick.

But, like I've said before; there's no 100% right answer.  Those in the know are doing their best to solve the problems for the next group who go through.  As with any system like this, the better care will always be for the troops who deploy after you. 

 

[HItorMiss]

Piper

I would like to know who did not spend the mandatory time in the Cyprus TLD, because It was just that MANADTORY if you did the full tour. As for the majority of time spent drinking and partying doing recreation activities your damn right they/we did and while doing that we talked and talked and talked. I was not the only one in tears a few times, I had more then on friend cry on my shoulder over this and that, and when the morning came they were better then they had been in months. Your way off base in just about all your assertions and I think it's because you didn't do the TLD and as such only have second hand info. I did it yes, your semi right that it was the basics of the services available but I know more the one soldier who stayed after a lecture or briefing to talk with someone (OSISS being a prime example).

I can't say how you were handled after you came home with me in Sept but I know I was more pissed with people trying to get in my head then I was with being wounded. I turned down services so much they thought there had to be something wrong with me ( I am not the only one talk to the OC he had the same thing) Something in terms of physical medicine were lacking but that all came out in the wash.

That all just my experience though when it comes to being in Canada. But your dead wrong about the TLD IMO

 

[HItorMiss]

Oh an as for the the TLD going "Dry" I know of only one group where that occured all the rest were still wet but th added a no booze in your room restriction, which I and many thought was more then reasonable.

 

[RHFC_piper]

Piper

I would like to know who did not spend the mandatory time in the Cyprus TLD, because It was just that MANADTORY if you did the full tour.

Well... as stated; none of the wounded who were repat'd (unless they went back in...).  Anyone who was on force protection (reservists) of which there are 4 from my unit; they spent 2 days in another undisclosed location.  Some of the last few to come back who were working in KAF (2 of which from my unit) had a 1 day stop over in Cyprus.  and the other 3 who were with battlegroup from my unit; 1 got the full deal, and the other 2 were CB'd and were there for 5 days. 

After talking to a few from Bravo, they spent some time CB'd and some time free, but there were a few who only spent 3 days in Cyprus (excluding there departure day... which kicked off at 0500h)... BTW, more reservists.  Now, granted, they may have been embellishing their plight, but I found these people to be fairly reliable.

Everyone I've talked to who went through Cyprus or another decompression location have told me many different stories about their stays... the only common factor between them was the alcohol consumption and parties.

Your way off base in just about all your assertions and I think it's because you didn't do the TLD and as such only have second hand info.

True... My info is second hand. I won't deny that, but yours is as well... did you go on every decompression trip?  Were you there for all the platoons and companies who went through?  If it was so consistent, than why are there so many complaints and stories about it?  Why isn't everyone's story the same? 
While at an LFCA leadership symposium, I spoke to two others who were on our tour, both reserve, each with different elements working in theater (NSE and force protection), both went to Cyprus,  both for different amounts of time and neither were impressed... Maybe they got hosed for what ever reason... but again, if it was so regimented and mandatory, why the different stories?  Even from other reservists who were with the battlegroup.... some from our Coy...  All different stories.  Was it different for Regular and reserves?  We they all separated with the Regs getting the mandatory time, and the reserves shipped off early?  I think not. So I guess neither of us can speak for all who went through the decompression.  In which case, disregard my statements on the duration, and start asking around for yourself.

your semi right that it was the basics of the services available but I know more the one soldier who stayed after a lecture or briefing to talk with someone (OSISS being a prime example).

I'm not saying the time spent there was a waste... I'm sure it helped some (hopefully most) troops, but could have it been better?  Why only a few soldiers seeking help? 

I can't say how you were handled after you came home with me in Sept but I know I was more pissed with people trying to get in my head then I was with being wounded. I turned down services so much they thought there had to be something wrong with me ( I am not the only one talk to the OC he had the same thing) Something in terms of physical medicine were lacking but that all came out in the wash.

It seems as though some were offered a lot, and some are still waiting, weather they went on the decompression or not.  Be thankful you have the luxury of "turning down" support instead of fighting for it.  After long discussions with representatives from LFCA and NDHQ who are concerned with the care of soldiers after deployment I have learned that there are many soldiers who are/were lacking the support they needed.  Now things are starting to change, but very slowly.  Perhaps you and the OC (and others) were given the right amount of attention, but there are many who have already slipped through the cracks and many who are hanging on by a thread... If it weren't such a problem, why are there so many complaints?

That all just my experience though when it comes to being in Canada. But your dead wrong about the TLD IMO

Perhaps I am wrong about TLD... Perhaps it has helped everyone who went through...  Perhaps the soldiers know all about the resources available and are just choosing not to use them.  But that just seems unlikely,  especially when I mention the OSI Clinic and OSISS to other soldiers from my unit, all of which went through the TLD, and they have no clue how to get in touch with them... Maybe it's different with the regular force members then. 

As for those of us who circumvented the TLD system... the fight continues.

Oh an as for the the TLD going "Dry" I know of only one group where that occured all the rest were still wet but th added a no booze in your room restriction, which I and many thought was more then reasonable.

(you added this while I was typing.... I type slow)

Again, maybe only at Cyprus, but other locations were dry... and the last few who went through Cyprus were very limited.  I heard all about the "no drinks in rooms" rule, but also about the 10pm curfew, no leaving resort property, no public drunkenness, and the parade of charges that followed... I'm sure we can both name at least one soldier who was charge for their actions in Cyprus.
Either way, the complaints I've heard from everyone very from when they went...  Not so much from the first couple groups, since they seemed to have the most fun, but definitely from the last couple.  Either way, it's of no consequence, as I'm sure most of the bugs have been ironed out, or are being ironed out, since our tour... hopefully.

I'd like to hear more about this from those who just came through the process. 

 

[3rd Herd]

From MSM
The usual disclaimer:
http://www.thenews.com.pk/daily_detail.asp?id=66889
Canadian troops decompress in Cyprus after Afghan tour
LARNACA, Cyprus: After tours of duty in Afghanistan, war-weary Canadian soldiers are being treated to five-star luxury on the Mediterranean island of Cyprus to prepare them for the return to civilian life.

Most of Canada’s 2,500 troops in Afghanistan will undergo “decompression” — military terminology for a programme designed to ease the physical and mental rigours of life in the combat zone.

After completing their six-month tour on the Afghan battlefront, some 2,100 soldiers are under orders to enjoy five days of sun and sea in this holiday playground before they go back home.

But it is not just gratuitous pampering. The programme is also about mending the battle-scarred minds of those who may be grappling with the pain of loss.

“Some soldiers have experienced the loss of friends and colleagues; that’s why we have mental health staff on hand to deal with such cases,” said Major Michel Ouellet, the 47-year-old Montreal native in charge of a 40-person team overseeing the month-long decompression tour.

“A fair amount of soldiers will have been affected by such loss. This was expected and that’s why we planned for it,” he said. Since the US-led occupation of Afghanistan was launched in October 2001, 66 Canadian soldiers have been killed there — 22 of them this year alone.......article continues.

Edit for Tess: some upto date stats from the UK
'Stress risk' for British troops
http://news.bbc.co.uk/1/hi/health/6927659.stm

........A team at King's College London looked at the effects of the number and lengths of deployment in a random sample of military personnel sent on operations.

They calculated that those deployed for over the average recommended amount of 13 months or more in a three-year period were 20-50% more likely to have symptoms of PTSD.

.........Ministry of Defence figures show the number of new cases of mental disorders, of all types and regardless of cause, in the first quarter of this year was 0.58% and the rate of new cases of PTSD was 0.03%.