where you belong either. so, it, the dynamic is very interesting when you are watching it. it kinda feels like you are in a bubble all by yourself and you really don't know where you belong. when i came home from overseas, i was very sick. that was the first thing that i lost a ton of weight while i was deployed from dehydration and bad nutrition and everything else-i just really didn't have the time for it quite frankly. and i came home and i had already begun to have nightmares and flashbacks. and i had already isolated myself from my family. i began that process actually while i was deployed. so, when i walked in the door, my family saw me, everybody was happy and crying and i was just very numb. i, i didn't feel anything. i did not want to be there. i wanted to be back overseas-that was where i felt i belonged. and i didn't know-i no longer belonged in my own life back in the united states. so, i very quickly decided that i was going to figure out a way to get rid of the nightmares. i was going to try to figure out where, where

i fit in this thing called family. and i started using drugs. i ended up homeless. i did that on and off for about 3 years. i finally ended up at my local va, where i went into their substance abuse program. i abused, anything that was amphetamine like cocaine, methamphetamines. you name it, i pretty much did it-anything to get rid of kinda what i was feeling. i was also a self-mutilator. it allowed me to feel some kind of emotion, some kind of pain, i guess, it was the inward pain that i couldn't express i was able to do outwardly. and i eventually ended up in a substance abuse program. i then found out that i had chronic post-traumatic stress disorder. i ended up in the program for that and 5 weeks into my program, i left the program and i started using again. i ended up getting involved in solicitation. i was homeless again, living out of my car. and how did you come out of that?

it, it was amazing actually, i, right after that period of time, it was only about 3 months. and i ended up getting arrested, and i said, "i am done." i was jag corps in the military; i wanted no part of being on the wrong side of the law. and i said, "i'm going to get my life together." so, i did. i went through a drug court program. i got counseling. i got on the right meds. i did what i needed to do. and i started talking about it. and started really feeling what i had been through. and i eventually just started to get better with time. very good. barbara, what is there that needs to happen when a family, when a, when a military, ah, service member goes and gets deployed? how should we be working with the families in order to continuously provide support and what type of support need to be there in order for that military member, upon return, to be able to find a better environment to be integrated as mike mentioned earlier?

the, the family needs to be prepared right from the get-go, before the deployment actually even happens. as far as the family getting together, that includes the service member who is forward deploying. irregardless, if it's the husband or a brother as far as getting together to talk about, you know, what's coming up. a lot of the services have programs as far as for families to go to a predeployment briefing. there's a lot of information thats available through the department of defense, as far as on the websites. for families as far as to go to as well, there's military one source, as far as programs. so, families need to get prepared before the deployment happens. get their wills in order, medical power of attorneys, who's going to pay the bills while they're gone, those types of things. if i rent a home or a mortgage. if i'm single, who's going to be taking care of all of that while i'm gone. then once the service member forward deploys, then the families also need support. no only as far as, who the military, but from their communities as well, as kathryn had mentioned before, i mean, we do live out in the communities.

in fact, 85 percent, um, of our families actually attend public schools, and 65 percent actually live out into the communities. and so, where our neighbor, we are your neighbor. um, and so, therefore, that we need support from the communities as well. and if i'm not near a military instillation, so, therefore, i don't have those types of services, then it is even more important to make sure that i am accessing what's available to me, either online or within my local community. and just before they come back, some of the services will actually provide, um, a prereturn, like a reintegration type program, and it is very important for families to go to that as well and engage. and family, as we discussed before, is a fairly broad definition, and so everyone who has a touch point with a service member who's coming back needs to be engaged with those types of program. military one source is a department of defense program. and it is available for parents if they want to get involved. now, once they come back, it's also important for programs to

be available at that particular point in time. and the guard and reserve are doing yellow ribbon programs. and again, families should be involved with that as well. and they are taught signs and symptoms, what to look for if someone's having, um, you know, traumatic brain injury, or showing post-traumatic stress. and where to go as far as for help. and, um, what sort of resources are available. the va even offers a program called coaching into care, which is available as far as for families, so that then reach out to them and they'll help them, guide them, assist them in getting the veteran now into care as far as through the va. so you need, um, a continuum of support for families not only through the department of defense but also as far as through, um, the communities as well. and now the department of veterans affairs is getting very involved in helping families through their vet centers. so, there are a lot of areas which families can go to. but sometimes, they don't know what they don't know. and there is so much out there that they just don't know, where, um, um to go.

um, and that was the piece that was missing for me when i came home. and we have those pieces now, like, my brother, he's done phenomenally because of, we had the information, we had all the programs available to us that weren't available before. what programs did he access, for example? he accessed the yellow ribbon programs that was one i heard, also the, all the va programs. i didn't know about them when i came home, he does, so and he had all that information because he had an educated family who knew what was happening, knew what he was going through, knew what to look for, and where to send him. very good. mike. well, and i think one of the things was just brought up is, is the other side of a very positive coin, meaning that there are lots of programs out there now in a position to help. but one of the things you hear from veterans and military families over and over again is there is so much out there that they become overwhelmed. there are so many programs, there is so much information that it really becomes a challenge, um, trying to identify what the right channel of support is for

their particular issue, their particular problem. kathryn in, in terms of substance use disorder and mental health issues, behavioral health issues, what is important for families to know and, and how can they help the service member? obviously, jen experienced and, and she's not an isolated case. um, well, i think that the most important thing is for people to, as barbara suggested, to get educated and to get smart. and frankly, um, most people whether they are civilian or military are not that well educated about what behavioral health conditions look like. in other words, what are the signs and symptoms of someone who may have a substance abuse or addiction or disorder? what are the signs and symptoms of someone who, who has a mental illness, or who may have a mental health problem? and frankly, that is one of the things that the substance abuse and mental health services administration is pushing is that we really want people to become more knowledgeable about that through programs like mental health first aid, which is a wonderful, um, red cross-like, training program.

in about 2 or 3 days, in which you become smart about what behavioral health conditions look like in humans and how they manifest themselves. a nd where is this program manifested? where is it offered? it's available through the national council of community behavioral health care or you can get training in it across your communities. they can get information about it from samhsa. and so, mental health first aid is the first thing because we are not taught growing up how to pay attention to our emotional health and our emotional well-being. we are taught about what to do about our physical health, a headache, a broken bone, but not about our emotions. so, the first thing is that families, particularly families with military members, i think, need to become more educated about what are those signs and symptoms that barbara referred to. and then, i think there are particular emotional clues, the touch points, um, how they are behaving socially. how are they, are they going back and getting an education, are they looking to, where are they going to work. are, are they being connected with peers? because, a lot of times, the individuals that have

behavioral disorders, a substance abuse problem, or a mental health problem will be referred to by peers. in other words, it will be a friend who will say, "don't you know that you really don't want to hurt yourself" or "what do you mean you are thinking about hurting yourself?" or "are you thinking about doing something that's dangerous and, and putting yourself in harm's way?" it's a friend or a peer that often helps that individual get connected to the supports and services that are needed. and so, just being aware of those signs and symptoms and being educated about, and be willing, to talk to people about suicide. be willing to talk to people. i was just going to bring that point up exactly. i mean, i mean, we are looking at, taking it away from the issue of the military, even the national football league, some of them, some of the members of the national football league, you are seeing incidents of suicide from traumatic brain injury, and this is something that the service men and women suffer constantly. and, and so how does one, um, in a family environment,

look out for that particular person? i mean, they may have been assessed and i go back to it, that mike has mentioned, everyone has mentioned, there are tons of programs that can assess, that can identify, but what does the immediate family need to be very sensitive to in terms of that military member? well, i think jen referred to the isolation. so, i think family members really need to pay attention. and, and be of assistance as possible whenever necessary, to be sure and make sure that people are not isolated. they are not separate. they're not alone. that they have some sort of social support. that they have some activities to do. people want to be reconnected to something. it's that lost [inaudible] military. even though they may be putting everyone in harm's way? that's right, and that is when you have to be able to say to people, "i understand, i'm trying to empathize with why you are disconnecting, but, but because we love you, we want you to be reconnected with us."

and when we come back, i want to be able to continue this topic because i think this is very important that the public understand the dynamic of what is going on. we will be right back. for more information on national recovery month , to find out how to get involved, or to locate an event near you, visit the recovery month website at recoverymonth.gov. every day i seek a positive... ...direction for my life through my accomplishments... ...and now with help... ...and support from my family and others i own... ...i own... ...i own my recovery from addiction and depression. join the voices for recovery. it's worth it. for more information on mental and substance use disorders, including prevention and treatment referral, call 1-800-662-help. brought to you by the u.s. department of health and human services.

[music] they say a service member commits suicide approximately every day, once a day. at maryland's commitment to veterans, we are navigators. our focus is mental health and substance abuse treatment services to insure that veterans and their families are accessing those services to reach out to our program, but we are really here to insure that veterans and their families are accessing the benefits that they are entitled to. we are also, here to, um, connect them with not only federal resources and state resources but also with their communities. i went to church and i was going to make my peace with god. and i had, um, um, a bullet that was sitting home that

i was going to use when i got back. i had lost my family and, um, thought i was going crazy, i still saw people i lost. and this one guy, he was, he just kept talking to me and he, um, he says, "you got ptsd and you got it bad." he says, "there's someone you need to talk to." i'm glad that you doing that. i think that would be nice for you to have. my son jason had, you know, after 911, felt like he needed to go serve his country, went over. he came back from there. he started gambling or, started to use recreational drugs, and, thank goodness, i got arianna day's name and her program was just phenomenal. you would call the 800 number that we have listed and you'll reach a live person. i'm thinking that maybe housing voucher, you know, applying for that is going be probably a good option for you.

and then they are going to direct your call to our program. and really listen to what the needs are, the challenges are with that veteran or family. i've had difficulties in the fact that i have nightmares. and so, in that situation of having those nightmares and having those flashbacks, um, it was very difficult for, for the reunion. family members are, you know, are really impacted because they really sacrifice a lot while their spouse is in theater. you know, they are taking on a number of different roles, and so when their spouse returns, it is, it can be even more challenging. they come back and they're, they're in this heightened state of awareness. and their, you know, their adrenaline is rushing and now they're supposed to come back and just flow into everyday life. in situations where we need to expedite something for a veteran to get va healthcare services,

we're able to really get those needs met timely. in the case of the veterans' program, we do a lot of transportation to mental health appointments. and we'll try and get the vet to the place that they need to be while arianna is arranging for either intake at a specialized treatment center or some temporary. if programs like this were not available, everybody, families would be struggling on their own, not knowing what resources were out there. my father served in the military and it was his career, and so for me the military has always been a second family. in working with this program, it was just a great opportunity for me to show my appreciation for the life that i was given as a child of the military. they're not here to coddle you. but, they're here to let you know we can help you, get you to resources wherein we can help you move forward.

so, mike, you wanted to add a little bit after kathryn noted, um, the issues with the suicide, ah, concerns. just to put some context into the conversation, so everyone understands, so veterans represent approximately 6 percent of the u.s. population. but they represent 20 percent of all the suicides in this country. so, you know, clearly the discussion that we're having is, is very important, um, the, and i think as we talk about community and the extent to which we can address some of these ideas around isolation with the support of the community, i think, it, there's also another challenge here that the community didn't go to war, you know, 1 percent of the country went to war and the peer research group released a study just a couple of months ago where they actually surveyed americans. and, um, asked them questions about the extent to which this past decade of war has impacted

their lives in any meaningful way. and the majority of americans responded, really, a decade of war hasn't impacted me at all. and further, upwards to 80 percent of americans said that they really don't understand the issues and challenges facing the community of veterans. so, i think as we talk about addressing issues like suicide and the extent to which we need to educate the family, um, it's critical that we also broaden that focus with regard to educating all of america with regard to the issues facing this community. so, that there really can be that broad-based community support. i think there is this issue relative to the discussion of suicide, that i had mentioned, that is important. and i think it is the difficulty, the discrimination, and the myths about the way you have to engage to talk about suicide is one thing we have to overcome. and that's particularly true in the military because of the warrior culture. and the military itself is shifting their own philosophy

and values and saying it's acceptable to talk now about the fact that you might be considering suicide. you have to understand that that may be going on in the military. and the great thing about the fact that, that military members become depressed, also think about suicide, which is a normative experience in many ways, that what is available is 1-800-273-talk, which is the national suicide prevention lifeline and when anyone calls that number, if they are a veteran or want to be connected with a veteran, they hit the #1 and they are immediately connected to condigo, new york, and the host of trained counselors on the phone. so, we are able to get people connected immediately and walk them through the crisis. and i think having those kinds of resources available and that the community knows about is one way to combat the issue. and barbara, you were noting before, during the break, that essentially it's not just about the service man or woman-it

really goes beyond that it extends into the family in terms of the, the threats that suicide poses? well, our families have been under stress for, at 10 years of war and plus and what research has been showing is that our families are having increased need and request for mental health services. also, seeing an increase in alcohol and drug abuse, um, especially when the service member is deployed. and so as, um, our study found that depending on how well the communication was going on between the nondeployed spouse and the children dictated as far as how well the household did but also how well the children did. and if the nondeployed spouse was experiencing any sort of mental health issues that in itself increased issues within the children. they have not been tracking as far as what's happening as far as with our families. are our suicide rates up as far as with our spouses and

with our children? are our attempts up with those particular population as well? we appreciate the fact that there is a lot of focus on our service members, our guard and reserve, and our veterans, but, also, to our families have been under a tremendous amount of stress; they, too, are experiencing issues. there is still stigma that exists as far as with them. they're afraid as far as to come forward to mention that they themselves are having issues because what's the impact now on the service member, the guardsmen, the reservists. so they are reluctant as far as to come forward and we hear stories constantly as far as when they do come forward, sometime situations happen that they did not necessarily want to have happen. so, there is an issue as far as looking to see how the mental health of our providers are doing. you know, they have also been forward deployed, seeing all the injuries in battlefield. then they come back and are deployed, i mean now they are assigned to our military treatment facilities. at walter reed, bethesda, or um, down at bamc as far as

brook and how are they doing, are they having, have they had opportunities to reintegrate with their families, have they had the right amount of dwell-time? and now they are back taking care of the same service members or guardsmen and reservists that they took care of in theater and they are still having all of the stresses as far as with their job and not necessarily had time to come down as far as being in theater. and that's who our families are going to. i mean, we're more likely, research has shown, in the civilian sector in this research that just came out with the, um, what'd you call it, medical surveillance monthly report showing basically that provider, i mean, you have gone in to see a provider, a healthcare provider, you know, within the first 30 or 60 days before you've either attempted or, or um, actually completed suicide. so, as we are looking at that particular piece, we need to make sure that our providers are healthy, so that when we do come in to see them that they are assessing us for how

we are doing for our mental health. jen, i want to go back to give an hour. talk a little about that program and what it tries to do. sure, give an hour is a national nonprofit and we provide free mental health care to post 911 veterans, their families, and the communities. so, it's anybody who's been impacted by the current conflicts overseas. what happens is that they can come to our website and they search our provider data base and they can find somebody who's willing to donate therapy to them. so, i mean, we have psychiatrists, psychologists, social workers, r.n.s, l.p.n.s, we have a whole entire gamut of people who are willing to donate their services to try to help out our military families and communities. well, that is very honorable. um, kathryn, along with that, the president has made the services to military families a priority. talk to us a little bit about what samhsa is specifically doing under the strategic initiative. part of the president's initiative included pulling together the 16 cabinet secretaries to create

a report called strengthening military families. and samhsa represented hhs the department of health and human resources in that group. and our samhsa initiative is really derivative of that report and that report's focus. and in that report, there was a, um a, goal, the first goal was to strengthen the psychological health of military service members, veterans, and their families. and so the department of health and human services, as a partner, basically, with the va and with the department of defense pledges to do whatever it can to support the psychological health of this population. so, samhsa has taken on the military service members, veterans, and their families as an initiative to focus specifically on the behavioral health issues for this population. and to insure that any individual who needs it has access to appropriate behavioral health services. and those services are what are considered to be

evidenced-based practices that are focused on recovery. that includes the center for trauma? that is correct. and we have, we have a variety of resources with-in samhsa, we have a trauma initiative, we have, um, the center for trauma-informed care, we have, um, a focus on a, making sure that what we call recovery-oriented services are available through our community providers and through the states. so, samhsa is not, um, getting in the way either va or dod doing their appropriate mission. but we are partners with them in the sense that both state authorities and behavioral health and community service agencies are understanding this population. and so, our role is to, is to certainly educate our partners in cultural competence of what it means to be in the military and get those individuals like folks that jen works with in terms of the professionals understanding what it means

to be, ah, in the military and the military culture and the military environment and seeing themselves as partners, so that if an individual chose not to use either va services or other services, we would make sure they were aware of those services, but that our community providers would also be available to provide behavioral health-particularly focused on substance abuse disorders, addictions, and mental illnesses. and that happens quite often, you find a lot of military and veteran personnel who don't want to go to the federal agencies. they don't want to go to the va because we're afraid of that, the stigma. stigma that barbara was talking about? absolutely, the stigma, we're warriors, we're soldiers, we're supposed to be able to handle everything. that's the mentality, that, you know, we have instilled in us. but not only that, but it's the confidentiality thing as well. we don't get that when it goes on our permanent record. so, by being able to go to these outside community resources where everything is confidential, it will never get back to my military community or my veteran community, i feel safer in going and talking to them,

so some vets and military personnel choose to do that. and i think that is what i find very novel about that, that program. and when we come back, we will be continuing our chat about the resources available to help our military men and women. we will be right back. [music] before, addiction and depression kept me from living my life. and now, every step i take in recovery benefits everyone. there are many options that make the road to recovery more accessible. it begins with the first step. join the voices for recovery. for information and treatment referral for you or someone you love, call 1-800-662-help. brought to you by the u.s. department of health and human services.

[music] dav's mission is simply to build better lives for disabled veterans and their families. we are known for helping veterans with their claims for veterans' benefits. what do you need assistance with today? i'm looking to check on my claim for my ptsd. about 2 in 10 have ptsd,

a little bit more for major depression. and it goes up from there. in fact, bipolar is roughly 3 in 10. your iu claim is a new claim and it's been issued 2 weeks ago? we first look for the physical disabilities. and many times, a physical disability is the cause of a mental disability. all i had to do was sit home and, you know, try and recuperate and i, and i went into a depression. once we can get them treatment for the mental disorder, then we can control their substance abuse. and that is what we look for when we tell them to seek treatment at a va facility. since all of dav's natioanl service officers are disabled veterans, we have a connection with the veteran who sits across the table with us. and we are able to get them to relax a little bit more and give us a little bit more information about their mental health conditions and the symptoms that they have with it and how they are treating those symptoms. when a veteran comes in and they have got this barrier up

about their mental health, they don't want to get treatment, they don't want that stigma. i always look at 'em and i ask 'em, "if you had a broken leg, and the bone is sticking out of your, out of the skin, would you sit here and say, 'oh, it will be all right, everything is going to get better,' or would you go to the hospital and get treatment?" families are the backbone of the military. you know, a lot of veterans who come home who have mental health conditions don't realize it. the spouses and the children are the first to realize that they're a changed person. a spouse can come to us and say, "my husband has these symptoms what should i do?" are you currently getting treatment? yes. if a veteran doesn't seek proper mental health treatment for their mental health or substance abuse, worst case scenario is death. we start using to escape things that you don't want to think about it. and all of a sudden, you're right back here and you got nothing but time to think. and the last thing that you wanna do is think about it. they can go to the va-it's free and it's unlimited.

i've seen veterans who came back, they had everything going for 'em, but they didn't get treatments. and the next time i saw them, they were living in their sister's basement, no job, no money, no wife. take your early effective date and iu claim and we'll see where you, we can go from that. so, what we do is try to identify what type of mental disorder they have. once we get them identified, then we send them to the necessary places, va medical centers to get a diagnosis, and then we help them with their claim to establish benefits for mental disorders. counselor out there said that it's not actually a light at the end of the tunnel, it's a candle in the middle of the tunnel and you've got to go get this, pick up that little light and keep going, 'cause that's not the end. barbara, i heard you, um, wanted to make a comment at the end of the last panel. i did. so, samhsa is, ah, doing a wonderful job through their state policy academics as far as educating providers along with