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Veterans are people who have served in an army for long period of time and are no longer in service for some reasons. The fact that they have been in army and exposed directly to traumatic events such as war, violence, death of comrades, terrorist attack, hardship experience, physical or sexual assault has affected their lives. These events have impacted their lives, families, health, and constitute a permanent stressor and threat for their mental and physical health.
Veterans are considered part of the vulnerable population because of their past experiences, exposure that put them in high risk of health problems.
As part of the community, they need a holistic care and support to reintegrate the community where they can actively function and live well.
Jean M. Duax et al’s (2014) article “Post Traumatic Stress Disorder Symptoms, levels of social Support and Emotional Hiding in Returning Veterans” has analyzed the connection between social support, emotional hiding, and positive screening for posttraumatic stress disorder (PTSD) in a sample of 536 Iraqi veterans.
The study took place at the Department of Veteran Affairs Ann Arbor Healthcare system. They asked returning veterans to complete a screening questionnaire for the study. The results showed 30% were positive for posttraumatic stress disorder (PTSD) and an increase of 32-40% of emotional hiding from spouses, friends, and family. Also, veterans who did not get a social support were positive for PTSD and avoid talking about their feelings and emotions in relation with the traumatic events.
In our community (zip code 53211), veterans also are part of vulnerable population because of their past exposure and events that increases the risk of developing mental and physical health issues.
They need a strong support system from the community and government to help them deal with mental health disorders and behavioral adjustment such as anxiety, depression, posttraumatic stress disorder, pain, isolation, insomnia, etc. Most of them after military services are unemployed and rely mainly on government social support and community resources.
According to US census data facts finder 2017:
In Jeanne M. Duax et al’s article, the author has reviewed the results of the study done by Ann Arbor Healthcare System (VAAAHS) servicing the veteran Affairs through a screening questionnaire. The study included questions regarding demographics, perceived levels of social support, work and social adjustment, mental health and medical problems, and treatment utilization. The outcome of the testing has shown that veterans who have been exposed to trauma also have symptoms of social isolation or withdrawal, avoidance, numbing and detachment, irritability and anger that affect negatively the quality and quantity of social support by denying potential resources. On the other hands, veterans diagnosed with posttraumatic stress also have marital distress, intimacy and sociability difficulties, relationship abuse and parenting issues. The author concluded that a strong social support after exposure to traumatic events lowers the risk of posttraumatic stress disorder, facilitates social and work adjustment, decreases mental and medical problems, and lowers treatment costs.
One of the objectives of Healthy People 2020 is to increase the proportion of adults aged 18 years and older with serious mental illness (SMI) who receive treatment: MHMD-9.1. The overall goal is to improve mental health through prevention and ensuring access to appropriate, quality mental services (www.healthy people.gov). Knowing that mental health affects physical health, it is crucial to address issues related to mental health in our community.
Some of the interventions that address the need of this population are screening of all returning veterans for posttraumatic stress disorders and offering a strong social support from family, friends, spouses, and community. Also, psychological interventions are effective first line of nonpharmacologic interventions for posttraumatic stress disorders. It consists of cognitive behavioral therapy (CBT), cognitive processing therapy (CPT) and prolonged exposure therapy (PE).
Healthy people 2020 has also suggested interventions categorized in two levels of prevention for mental health disorders:
One way to implement these two interventions is to collaborate with Veterans Affairs (VA) clinics and healthcare facilities to contact veterans in person or by telephone and have them complete a screening questionnaire. Answers can be either anonymous or with demographics data. Another way is to have them join a support group of other veterans where they can share their story or a common interest such as music, art, movie, bingo and help them express their emotional state.
The nurse role varies as he/she approaches circumstances differently. As an educator, the nurse promotes health and prevent illness through education. He/she educates the population about mental health screening, the effect on physical wellbeing, relaxation technique, anger management, identification of symptoms of posttraumatic stress disorder, healthy food, exercise, sleep hygiene, treatment options and where to go to get help. Some barriers about education in regards of posttraumatic stress disorders is denial from patient or family and the myths and social stigma about mental health disorders.
The nurse as an advocate, identifies resources in the community that support and empower veterans to improve their quality of life. One of the veteran advocacy group is the Veteran Affairs and vetlinks.org that connect veterans to services, support, and programs that help them.
The nurse as a caregiver provide a holistic and compassionate cares to veterans. He/she uses therapeutic communication techniques by listening, identifying and understanding the person feeling for a trustful relationship with the patient.
Our community resource and referral center of Veteran Affairs is located on 1818 Martin Luther King Jr Drive Milwaukee, WI 53212. They provide a variety of services for veterans such as healthcare benefits, disability benefits, education and training benefits, employment benefits, housing assistance, life insurance, and burial & memorial benefits. Services are available Monday through Friday 8am-6pm, and Saturday from 8am-12pm. It’s a cost-free service healthcare, however having a private insurance does not affect eligibility. It is a walk-in service with handicap entrance, nearby public transportation (Bus line 21,30,19, Greenline). They can also access services via telephone 414-263-7673 or via website www.va.org.
In order to help our veterans to improve their quality of life and function adequately and independently in the community, a various social support is crucial. Mental health and physical health are linked and affect each other. People who are mentally ill cannot take care of themselves and quickly become a burden for the community. Exposure to traumatic events such as war, physical or sexual assault, death, military deployment… can put someone at risk of posttraumatic stress disorders. Veterans are one of the groups at risk of posttraumatic disorders because of their past experiences. Research has shown the connection between posttraumatic stress disorder and lack of social support. To promote effective recovery from posttraumatic stress disorders we need to provide social and community support to our veterans. The nurse has to play different role to provide a holistic care to our veterans.
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