Transcript Utah Ahead conference May 9, 2009 St. George, Utah

Wounded Warriors: Issues, Context, Accommodation
UTAH AHEAD CONFERENCE
DIXIE STATE COLLEGE, MAY 9, 2009
Edward A. Martinelli, Jr., Ph.D., Utah Valley University
OUTLINE
Impacts and Prevalence
 Intake Issues
 Qualification Issues
 Accommodation Issues
 Local Issues

IMPACTS AND PREVALENCE
SCOPE OF THOSE INVOLVED

Since October 2001
 Approx.
1.64 million troops have deployed as part
of Operation Enduring Freedom (OEF; Afghanistan)
and Operation Iraqi Freedom (OIF; Iraq).
 As compared to past deployments
 Higher
proportion deployed
 Deployments have been longer
 Breaks between deployments have been infrequent
 Redeployment to combat has been more common
SCOPE OF THOSE INVOLVED

Nevertheless-- Operations
have employed smaller forces
 Casualty rates (killed or wounded) are lower
 Technology has led to more surviving….
 But “invisible wounds” are beginning to emerge
THREE MAJOR IMPACTS

RAND Study focused on 3 major conditions:
 Post-Traumatic
Stress Disorder (PTSD)
 Major Depressive Disorder and associated
symptoms, and
 Traumatic Brain Injury (TBI)
All three affect mood, thoughts, and behavior
 1,965 servicemembers were surveyed

 24
Geographic Areas
KEY FINDINGS

Mental Health Issue Rates in the Past 30 Days
 14%
screened positive for PTSD
 14% screened positive for Depression
 19% reported a probable TBI
Depression is not considered a combat-related
injury, but it is highly associated with combat
exposure
 Not possible to know the severity of TBI issues

PREVALENCE (CONT)
About 1/3 of those previously deployed have at
least one of these three conditions
 About 5% report symptoms of all three
 Some groups (Reserve Components and those
who’ve left the service) may be at higher risk

TREATMENT

Of those reporting a probable TBI
 57%

had not been evaluated by a physician
Rates for TX of Depression or PTSD
 Comparable
to general population (53%)
INTERSECTION WITH DISABILITY SERVICES

Like most issues, we can expect these issues to
emerge in three or four major ways
 Intake
 Eligibility
Determination
 Accommodation Provision
 Specific Institutional Issues
INTAKE ISSUES
SELF-IDENTIFICATION
Label stigma
 Self-Identity
 Knowledge of services and location
 Differences between VA and School services

QUALIFICATION ISSUES
SUBSTANTIALLY LIMITED

Invisible disabilities more difficult for us to
quantify
 TBI

issues may present much later
Dynamic nature of some diagnoses
 May
be situational
 Course content related
 Time of year related

Individual may not have much experience with
academic setting
 Their
experience so far may be simply with nonacademic tasks
 Memorization, short/long term memory, etc.

Documentation may be atypical
 Military
looks at disability sometimes from a
compensation not a limitation standpoint

In summary, functional impacts may be hard to
identify
 Relationship
important to returning for additional
help
 Adjustments may be needed mid-term
ACCOMMODATION ISSUES
DEPRESSION
What are you doing with other psychiatric
issues?
 Watch for anniversaries, holidays, etc.

PTSD
Anxiety Issues
 Issues around sights, smells, locations, context
 Testing issues
 Classroom environment
 Interactions with others
 More often than not the individual simply wants
to remove themselves from the situation

TBI

Not surprising to see
 Memory
issues
 Concentration issues
 Comparison to past performance
 Old versus new learning and skills

May be emotional issues
 Impulse
control
 Mood swings
LOCAL ISSUES
WHAT HAVE BEEN YOUR EXPERIENCES?