As a medical provider serving the military, I found myself facing a profound realization after a harrowing encounter during my deployment to remote Ethiopia. It became starkly evident that my previous understanding of the intricate challenges faced by military personnel grappling with Post-Traumatic Stress Disorder was incomplete. Authentic comprehension of their experiences, akin to walking in their very footsteps, is essential in crafting a genuinely effective anti-suicide initiative. This revelation has come to define my perspective as Maj. Shannon Dee Revit, DANG, (Ret.), DNP, FNP-BC.
LIST OF ISSUES
Drilling Down the Complexity of Coping:
Sometimes, It is not even PTSD, It’s Life... Too Much Too Fast.
In the current landscape, contemporary military personnel confront a multitude of challenges that surpass any previous era. They find themselves compelled to absorb and react with a swiftness akin to the rapidity of online communication. This pressure applies even to those individuals without underlying PTSD, as the combined effects of escalating perstempo demands, sequestration-driven budget reductions, and the escalating cost of living place considerable stress upon members of all ranks, from the junior E-1 personnel to the seasoned two-star officers. Each of these individuals is confronted with the imperative to accomplish more with fewer resources, spanning both personnel and equipment.
Adding to this already taxing situation is the burden of readiness for combat, which, when coupled with personal adversities such as relationship breakdowns and vehicular malfunctions, can lead to moments of anxiety and compromised cognitive clarity. Envision being situated within a military installation, a Department of Defense facility, or a VA environment, surrounded by hundreds or even thousands of peers, yet feeling utterly isolated without a means to cope. Paradoxically, the success of supervisors and chain of command personnel hinges on the unwavering 100% engagement of every member on a daily basis, crucial to meeting mission-ready benchmarks.
In situations where a member is stationed thousands of miles from their hometown, cut off from their primary support network, or, in more challenging scenarios, reliant solely upon a partner for emotional sustenance, the resultant emotional distress becomes a deeply poignant source of turmoil. At this juncture, the question emerges: where can one turn for solace?
Regrettably, the current options are limited and devoid of safety. Be it within our VA facilities, on military installations globally, or on properties managed by the Department of Defense, a void exists. Military personnel, whether active-duty, veterans, or retirees, encounter a daunting process that necessitates confronting a barrage of customary inquiries pertaining to suicide, coupled with the arduous task of completing forms before they can utter a single word regarding the mounting waves of anxiety and stress that threaten to engulf them. More disheartening still, the anticipated connection is typically established with a civilian, whose heartfelt dedication notwithstanding, is hindered by an inability to fully comprehend the nuances of our unique language. This aspect is pivotal in determining whether support efforts succeed or falter. Lingering within this context is the persistent notion that, should members voice their inner struggles, they run the risk of being fundamentally misunderstood, facing potential career loss, forfeiture of benefits, and being unjustly branded as "unstable".
When your issue is related to PTSD
Upon a military member's reintegration into civilian life after enduring mental trauma, the intricacies of
"re-assimilation" can be likened to extricating oneself from quicksand armed with nothing more than a plastic toy shovel. Should physical afflictions also be present, the process of resuming duty, reclaiming mastery over one's existence, and rekindling a sense of joy becomes substantially more formidable.
Living with PTSD can be similar to driving a vehicle with your brain as the engine. Despite pressing the gas pedal to its limit, your top speed remains capped at 60 miles per hour, while the rest of the world effortlessly races forward at 100mph as it seems.
The experience of grappling with PTSD can often mimic the sensation of having a fractured mind or even Alzheimer's disease. Memories become unreliable, emotions vacillate between subdued and explosive, and an ever-present state of hyper-vigilance wears one down, leaving them perpetually on edge, anticipating an unseen threat. Picture the emotional roller coaster of navigating the unfamiliar terrain of the VA health care system, compounded by the challenge of comprehending its intricate language. The act of being on duty, donning the uniform itself, can constitute a traumatic ordeal. This weight is further magnified for Reservists or Guardsmen, whose civilian employers grow frustrated when VA medical appointments overlap with standard business hours, creating an overwhelming level of stress. Amidst all this, these individuals often find themselves without an immediate outlet for their thoughts and concerns. The majority of VA-endorsed psychiatrists and psychologists are not readily accessible via text or app, unless in immediate danger of suicide. Even then, contacting them by phone leads to being instructed to hang up and call 911 or the national suicide hotline at 988. The prospect of finally opening up to a civilian mental health professional, only to be redirected elsewhere, is truly disheartening. One can only imagine the added confusion when the provider is unavailable on a given day or during weekends.
This is where "Mile in Our Treads" comes into play. We comprehend the unique challenges faced by military members, veterans who have navigated their own paths, whether marked by trauma or not, and possess an innate understanding of the terminology. Retired military personnel constitute a valuable resource, alongside VA caregivers with military backgrounds or an extensive tenure within the system, grasping the broader context. Our most valuable asset lies within our own community. The Department of Defense boasts an abundance of retired military personnel, while the VA houses caregivers and CAREgivers who boast a military background or have spent ample time within the military milieu. They genuinely care and are eager to provide assistance.
The most effective means for us to offer assistance to ourselves is by drawing upon our internal resources. We got your six.
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In the VA or DoD settings, Mile in Our Treads (MiOT) participants, who undoubtedly share some common experiences with military members, will proudly sport vibrant red lanyards embellished with the prominent Mile in Our Treads/MiOT branding. On military installations, these MiOT contributors will be bestowed with morale-boosting patches to signify their affiliation.
In either scenario, precisely at those instances when the weight of life's pressures or the sensation of operating at a mere 60 miles per hour in a world hurtling at 100 threatens to push someone toward becoming one of the distressing statistics of the 22 individuals lost daily, a simple glance around for the telltale lanyard or patch is all that is required. In this pivotal moment, a member possesses the agency to decide with whom they wish to converse. They can opt to approach a familiar acquaintance or someone unknown. As they approach the wearer of the lanyard or patch, they tap the corresponding area on their own attire to signal a "MiOT moment," indicating a desire for a brief interaction. Naturally, the response will be an affirmative one, signifying that the MiOT volunteer is indeed available and willing to lend a listening ear.
Two critical aspects that demand comprehension;
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One must recognize that the source of anxiety or emotional distress often doesn't stem directly from the memory of traumatic events. Instead, it tends to be triggered by extraneous factors, such as added responsibilities, family unit breakdown, financial strain, or challenges navigating the VA system. Experiencing a sense of being overwhelmed is a common response, and it's natural for individuals to require a brief respite, akin to "letting the air out of the tires," lasting approximately ten minutes.
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It's worth noting that the typical individual may engage in multiple interactions, seeking guidance from three separate MiOT volunteers and accepting the informational card provided, before mustering the courage to pursue professional assistance. This process is reminiscent of "taking three bites at the apple," signifying the incremental steps often necessary before seeking help from a qualified expert.
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We are fortifying the resilience of our armed forces, the Department of Defense (DoD), the Department of Veterans Affairs (VA), and educational institutions, among others, through the engagement of volunteers who have likely weathered challenging periods in their own lives, such as divorce, family loss, or traumatic events. This seemingly straightforward concept holds the potential to yield a remarkable outcome: shattering the code of silence surrounding mental health.
Within the circles adopting the MiOT system©, a profound and enduring sense of unity will take root, transcending racial, ethnic, and socioeconomic boundaries. The MiOT initiative embraces inclusivity, extending an open invitation to all volunteers, while enabling users to select their conversation partners based on personal comfort levels.
The time has arrived to depart from the conventional approach of relying on PowerPoint presentations and brief, timed group sessions, as well as other well-intentioned yet ultimately ineffectual anti-suicide programs. These initiatives have been tossed about with a measure of hope, analogous to blindfolded individuals attempting to play Lawn Jarts amidst a garden party.
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At the time of this composition, the distressing reality stands that 4,441 military members have tragically succumbed to suicide since the onset of 2016.
Our prospect of dismantling the entrenched stigma surrounding mental health rests on a compelling approach: extending a warm embrace to our most valuable assets—our people. By creating an avenue for them to momentarily release the pressure, just ten minutes at a time, we embark on a journey that could ultimately ensure that every single member is unequivocally aware that "We've Got Your Six." This represents a significant stride forward—an initial step toward breaking the silence that shrouds mental health discussions. It's imperative to understand that it's absolutely acceptable to seek assistance well before anyone contemplates becoming a part of the heart-wrenching statistic of the "22."