hi I'm Audra burns from Dartmouth Health welcome to heads up a year-long mental health awareness Journey Dartmouth Health's webinar series which focuses on important mental health concerns and topics that affect all of us today we will discuss the unique mental health challenges of our military veterans and active duty members of the military so the goal of this year-long series is to help change the conversation around mental health and to end the stigma associated with it mental health is a significant issue among our nation's military veterans and active military members the VA reports that 17 veterans commit suicide each day in the United States but some studies suggest that that number might be even higher from post-traumatic stress disorder or PTSD to re-entry to civilian life substance misuse depression and other issues a large portion of our veterans struggle with active duty members of our Armed Forces also face significant mental health challenges so I have two really great panelists here with me today to discuss this really important conversation and they have a unique perspective that they can offer first let's meet Dr Evan Bick he is a clinical psychologist at Dartmouth health and a U.S army veteran hi Dr Beck Hi how are you also joining us is Patrick Jordan he's the chief operating officer at Dartmouth health and a U.S army veteran welcome Patrick hello everyone so Evan I'm going to start with you first thank you for your service what can you tell us about the unique mental health challenges our veterans and active duty members of the military face I think there's there's a couple of things that that may put veterans or active duty service members at um at an increased risk of dealing with different kinds of of mental health challenges and the first is some of the some aspects of just sort of the nature of military service itself I think um when we we think about the mental health challenges of veterans and service members we often sort of immediately think about um about PTSD about post-traumatic stress disorder um which as as the name sort of suggests is you know a kind of collection of different mental health problems related to to having been exposed to to different types of sort of extreme experiences and um military service by its nature sometimes leads to um service members being exposed to to to combat to extreme violence to different um to different forms of trauma that that can be difficult um difficult to sort of process and and come come to terms with in a way that um in a way that works I think there's um some other aspects that are that are worth talking about as well one is some of the ways that um the the culture of the military can sometimes make it difficult to just to talk about mental health problems and to talk about um acknowledging some of the issues that service members or veterans May um may be struggling with um and finally I do think it's worth noting some of the challenges that service members themselves or their families May deal with in terms of um both separation when it's sort of during a deployment or during sort of extended training or as as service members sort of leave the military and are working on ways to um to integrate themselves into sort of um in into the civilian World in a way that um that allows them to to build the kind of life that they're looking to build you bring up such important points I think one of the things you you mentioned was about how um you know the stigma of bringing it up within the military groups and and you know the purpose of this project that we're doing with heads up is thinking the stigma you know breaking the stigma um just for everyone to know um so it's it's interesting to know that it doesn't just it's not just so broad it's these pockets of organizations that within those organizations the the members that they have um are also struggling with that and I think that's important for their loved ones to know as well um so thank you for sharing that perspective so now Pat let me turn to you um thank you so much for your service and I would love to hear you know a little bit about um situations that you faced on active duty um that challenged your mental health or the health of your fellow service members and and what kind of support did you have at the time yeah you know uh I served in the 82nd Airborne Division for eight years I deployed to uh Panama during The Invasion there and uh also the first uh Gulf War um but you know to Evan's point I was thinking you know we both are graduates of the US Army Ranger school which is the Premier Ranger course or leadership training in in the Army 57 days of no sleep no food and uh what we learned there was to really Drive ourselves and drive our people in our mission um so you know I think about the mental health uh uh uh availability to us I think you know I was in the mid 80s it was pretty limited and any mental discussion of mental health was how do you make yourself tougher and stronger so that you could drive on with the mission take care of your soldiers and accomplish the mission um so I can only imagine that the the military has grown uh Leaps and Bounds in that regard over the years given some of the issues uh but it certainly can be a challenge so that that makes me think about the difference with you know returning back to home and so let's talk about your experience returning home from deployment and how that might differ from National Guard who immediately return home and they're right into Family Life civilian life and jobs I mean how does that um how does that differ I think that's a great great Point Audra uh you know when I returned from Panama in the first Gulf War I was still in the 82nd Airborne Division there were 32 000 soldiers at Fort Bragg where I was stationed uh that we could you know be comrades with and share our stories and and share the pain that we might have uh I you know I often wonder about the these folks that are in the Army Reserve or the National Guard uh who first off uh get a culture shock when they go back on active duty full-time deploy maybe are in combat operations and then as soon as it's over over they are back on Main Street United States of America and I cannot only imagine that that is significantly more challenging than those of us that had the support and collegehip of being uh on the ACT in active duty uh at a military base and you know that's that's a great segue and a topic I want to discuss with you Evan so knowing when they come back and and the support that they're going to need what are some signs of you know mental health concerns that maybe loved ones could be looking for for their service members or their veterans and where can they turn for help I think this is is something that that's really important for for all of us veterans or or service members or or civilians or family members to sort of be aware of all all the time of sort of what what are some of the signs that might might help me recognize that that something is going on here that there's something here that's not working and then I might want to change um some of the some of the symptoms that I think are are particularly sort of you know kind of noticeable or important to pay attention to are things like increased sort of frustration or irritability or anger um I always want to ask about sort of changes in sleep people are sleeping more or sleeping less um you know just sort of subjective changes in mood I notice I've you know feel feel more down or I'm you know pulling away from other people or sort of not saying you know saying no to things that I used to be to be saying yes to um might be a sign that it's worth um worth having a conversation with with a family member with a a trusted friend or a or a mental health provider um I do also like think it's important to acknowledge sort of changes in um changes in sort of substance use whether that's sort of you know increased use of alcohol or increased use of um other drugs that that might sort of serve this role of kind of um trying to kind of control emotions in a way that that sometimes you know can work in the short run um but ends up having um ends up having some some longer term consequences um you know Pat had made a really important point about some of the ways that the sort of culture within the military tends to um tends to sort of make it difficult to acknowledge acknowledge ways that we might be struggling my sort of the point I I like to make a lot is to say you know I was in the military I'm not going to tell you that my knee hurts much less that I'm sort of feeling depressed or that I'm feeling um like I'm struggling with with different aspects of um of service and I think being willing to to do something that might feel really hard might feel really challenging the moment and and reach out to somebody and say you know something here is not working something about this um the way I'm dealing with my experiences or the way I'm dealing with this sort of transition into into civilian life um it's just not working right now and I and I need to think about ways to do something different and you offered some really great um signs to look out for for those caregivers because it might be the caregiver or the loved one um that might be the one who notices the signs and can and can advocate for them to get their help and for our viewers we'll be sure to have a link to resources at the bottom of this video so Pat what was it like for you when you left the military and transitioned to civilian life yeah so you know between my Reserve time when I was in college and active duty time which was eight years I was in the military for 11 years and uh I think I'm a very lucky person because my first job out of the military was in healthcare working at Massachusetts General Hospital and I guess I was about a year out when I started realizing something was uh not exactly right and I I I I happen to be very fortunate that one of my senior leaders uh had great contacts in the Mass General Hospital of uh Department of Psychiatry and I quickly met a a psychiatrist who has been very helpful to me through the years uh you know I don't think this is a one and done issue this stuff can crop up and periodically uh hit you um and that that that psychiatrist has been a resource to me for years uh and and not just about things related to uh the military but things in my purse life and challenges that we all face every day um you know and one of the great things though is what I think has evolved in health care over the years uh going back to my original uh employer I think about the home base program at Mass General Hospital and how extraordinary that is and treating veterans with uh traumatic brain injuries and other mental health issues and it's absolutely free to Veterans uh sponsored by the MGH as well as the Boston Red Sox but then I think about the incredible resources that we have at Dartmouth Hitchcock both in our EAP programs we have uh we have a dedicated military employee Resource Group that brings Veterans of all walks of life together people that have commonalities in their deployments their training and they meet on a regular basis uh to talk about what's important to them we celebrate our veterans uh in many different ways to include you know on Friday we have a big event for Veterans Day we have a wall of honor at Dartmouth Hitchcock where we post the pictures of all veterans that are willing and talk about you know what their experiences were what they've done since in their civilian life we get Awards all the time working with uh current members of the National Guard and Army Reserve for our policies and uh and how we take care of them uh while they're serving both roles as employees at Dartmouth Hitchcock as well as serving their Nation uh and finally we've worked very hard to recruit veterans across New England to come to work for us we know how good they are we know how results oriented they are and we just love getting them and we we need more right now so yeah we certainly have a great group within our Dartmouth health system and it's so powerful for both of you to be sharing your very personal experience on this topic in hopes that you know the viewers or loved ones who might see this can it's going to help them open up for themselves so thank you so much to both of you so before we wrap up I'd love to know just a quick takeaway from this conversation that you really want to have our viewers understand or learn from so Pat I will start with you I think it's hard to ask for help but I can tell you through my own personal experience that once you've asked for that help and you begin talking about the things that you're failing uh it makes a huge uh huge difference so please don't hesitate to ask for help wonderful and Evan I think alongside some of the the points that Pat just made I think I it's important to kind of recognize that you know one one thing that makes it sometimes a little bit easier to think about reaching out for for mental ferment for mental health care is recognizing that you know we in the military as Veterans as Healthcare Providers talk talk a lot about um you know physical fitness about physical health and I think recognizing that um that that mental mental Fitness is sort of part of your overall health is part of your overall Fitness um and is is important and it's something that um that we're really able to make sort of positive contributions and um and work with people who are seeking help to to really see some positive changes you know I think the only other thing I would add is we sort of had this balance of um talking about the the unique sort of mental health challenges that veterans and service members May face um and alongside that I think I want to sort of reinforce what what Pat said which is um to highlight a lot of the sort of strengths that that people have been able to bring out of their military service are able to bring into um you know whether it's sort of working as a civilian at dark Hitchcock or in any kind of line of work I think this is um this is a group of people who with a lot with a lot to offer that's a that's the perfect closing for they do have a lot to offer and I'll be sure to link to our resources um and available um job postings that we do have within our Dartmouth Health System um so thank you so much to both of you not only for your time here but for your service and your insights it's been it's been a wonderful conversation so thank you both thank you Audra so to view past heads-up segments you can visit at the link you're seeing on our screen and we'll have our resources posted below this video take care