Military Families Domestic Violence And PTSD

Civilian Response to Military FV Past Preservation of career Anger mgt. +

ANP

=

Dismissal

Present Building a better Military Reduction in Force (RIF) Behavioral health emphasis =

Justice

- PTSD, TBI, Reunion and Reintegration Issues

FEAR Led by Isaac Aguigui

Forever Enduring Always Ready

- Wife found dead in home - Stockpiling weapons - Charged with killing two teenagers to conceal a plot to use $87,000 worth of munitions - Blow up a fountain

- Bomb a dam - Kill President - Overthrow government

The Soldier Defendants

Sgt. Anthony Peden • 26 years old • 3 combat tours • Sent home from Iraq in 2010 for threatening to shoot fellow soldier • At home, pointed loaded rifle at wife

Pvt. Chris Salmon • 25 years old • Demoted from specialist in 2011 • Charged with 12 misdemeanors before enlisting in 2006 • Received a “moral conduct waiver”

2006 - DoD issued 30,615 special Soldier dispensations to accept Crime Wave troops with criminal may be records fueled by (17% of all enlistees)

Army ignoring distress September 12, 2012

Bloomberg News Article

- DoD reduced number of troops discharged for misconduct by 30%

Soldier Crime Wave may be fueled by Army ignoring distress

2006 – 2011 Violent crime committed by active duty soldiers (at home and overseas) -

September 12, 2012 Bloomberg News Article

Rose 31% 399 per 100,000 troops A crime committed in Army every 6 minutes One homicide every 63 hours

The Result High Risk behavior with increasingly more severe outcomes. “We saw this in Vietnam – you get these substandard troops and pretty soon you’re screwed.” Retired Four Star General Barry McCaffrey

Deployments

and Child Deaths

Army Times September, 2011

- Deaths of military children * 14 in 2003 * 29 in 2010 * Peaked at 36 in 2008 - Child abuse was lower in military until large scale deployments - Rate is now 2X that of civilian population - These are “rarely discussed symptoms of stress”

Underlying Problem Insufficient coordination between military health care providers, law enforcement agencies, civilian psychiatric facilities and the chain of command.

An Epidemic Of Abuse

Army Times, August, 2013

In 2011 Civilian Rate of Child Abuse: 27.4 per 1000 kids Army Rate of Child Abuse: 4.5 per 1000 kids

Between 2008 and 2011 1.1% Civilian Increase 28% Army Increase

Ready to Prosecute? Criminal History

Military and Combat Experience

PTSD?

Warrior History Generation

Label

Napoleonic Wars U.S. Civil War WW I WWII Korean War Vietnam Gulf War I

Nostalgia Irritable Heart Shell Shock/Effort Syndrome Battle Fatigue Acute Combat Stress Reaction Agent Orange, Subst. Abuse, PTSD Gulf War Syndrome

PTSD - Stress Physiology

A

Post Traumatic Stress Disorder Post-traumatic stress disorder (post-traumatic stress disorder, PTSD) is a severe anxiety disorder that can develop after exposure to any event that results in psychological trauma. This event may involve the threat of death to oneself or to someone else, or to one's own or someone else's physical, sexual, or psychological integrity, overwhelming the individual's ability to cope.

Differences in Trauma Civilian • Home/ Illusion of Safety • Single event • Unprepared

Warrior • Daily potential for trauma • Multiple events • Trained for it – It’s my job – I am “mission ready”

Potentially Traumatic Events • Being attacked or ambushed • Receiving incoming artillery, rocket or mortars • Being shot at / small arms fire • Directing fire at the enemy • Being resp. for death of enemy combatant • Being resp. for death of noncombatant • Seeing dead bodies or human remains

PTE • • • • •

Handling or uncovering human remains Seeing dead or seriously injured Americans Knowing someone seriously injured or killed Participating in demining operations Seeing injured women or children and unable to help • Being wounded or injured

PTE • Had a close call (was shot or hit but protective gear saved you) • Had buddy shot or hit near you • Clearing/searching homes or buildings • Engaged in hand-to-hand combat • Saved the life of a civilian Taken from “Once a Warrior, Always a Warrior” Hoge, New England Journal of Medicine, 2004

“The Three Legged Stool” of PTSD • Fear and Terror • Loss and Grief • Moral Injury – Shame, guilt and rage torture the conscience – You didn’t do wrong by the rules of war, but by your own humanity, it was wrong. – I can’t forgive myself, and the people who can forgive me are dead. » Captain Timothy Kudo, Iraq and Afghanistan War

Excerpt from Warrior book report My depression, anxiety and anger does not stem from my individual life threatening moments, but from decisions I made as a leader that resulted in the death of others. » Retired Chief Warrant Officer » After reading “Once a Warrior, Always a Warrior” » By Charles Hoge, MD, Colonel, U.S. Army

“What It is Like to Go to War” • Need an end to our chirpy, parade approach to veterans. • This is NOT a football game . We are talking about killing people. • Is like clapping for a surgeon who amputated a leg.

Solemn Parade • We need – recognition of the MORAL DAMAGE we all suffer when we send our fellow citizens into battle. – a willingness to talk about it. The good the bad and the ugly. » Karl Malantes, Vietnam Vet » Author of “What it is Like to go to War”

Post Traumatic Stress Disorder Misused as a catchall term for ANY postwar behavioral problem Is considered a mental disorder, but is actually a physical condition that effects entire body Is best understood through emerging science of

STRESS PHYSIOLOGY

I always ask…. Have either of you deployed? If so, how recently? How many times? And for how long? Is anyone deploying soon? If so, when? Has there been any formal mental health diagnosis, such as Traumatic Brain Injury (TBI) or PTSD?

Is the issue . . . • • • • •

Reunion and reintegration? (2 wks – 2 mos) Pre Deployment Anxiety/Fear? Post combat stress? (acute; requires rest) Post traumatic stress? Post traumatic stress disorder?

• Family Violence Perpetrator?

Reality Adjustment disorder with Post Traumatic & High anxiety attachment True of ALL combat veterans AND their spouses and kids

Taking out the D…. We need a phrase that links the impact and injury of the combat situation and deployment experience to the long lasting and often permanent effects on the body and mind . . . to take away stigma or assumption that:

You got it because you weren’t strong enough.

“NOT ONE PROFILE, BUT TWO” Understanding PTSD As An illness With Dual Neuro-Physiological-Behavioral Profiles

Drawings and Content : Courtesy of Back To The Wall, LLC © 2010 Chrysanthe L. Parker, All rights reserved. Reproduction in any format is prohibited by law. Used for the limited purpose of this presentation with consent of the author and copyright holder

When is a criminal justice response appropriate?

Bell County Misdemeanor FV Year

Total Assaults

Active Duty

% Military Involved

2010 (May)

815

238

29%

2011

1277

292

23%

2012

1289

300

23%

Monthly Military Involved

Monthly Military Involved

Military Involved - Decembers

DEF. VIC. BOTH

2011 13 10 10

2012 2 4 14

Child Abuse Spike 2001-2004 DURING deployments:

Female civilian spouses Child neglect quadrupled

Physical abuse tripled. Cites lack

of sleep as a reason. JAMA, August 2007

Child Abuse Spike Cases of abuse and neglect in the Army: 2009: 2,626 2012: 3,698

A 40 % increase

Prosecuting Soldiers - Four Jury Trials on six FV Charges - Acquittals on all four assault cases - Convictions with maximum punishment on other charges (Int. w. 911 and Unlawful Restraint)

Good Soldier Defense • The accused’s general good military character is a pertinent character trait • if there is any nexus, • however strained or slight • between the circumstances surrounding the crime and the military. • Taken from “Officer Basic Course, Military Rules of Evidence” regarding Rule 404, emphasis by the author (not me)

Plea Bargains Deferred adjudication - Frequently more than 12 months Dismissals for BIPP - PTSD assessment - Ft. Hood program

Military Points of Contact Chiefs of Military Justice Fort Hood – Maj. Dan Everett – 254.287.3651 Ft. Sam Houston – Capt. Chris Crall – 210.295.9402 Fort Bliss – Maj. Derrick Grace – 915.744.6949 Lackland AFB – Capt. Kurt Mabis – 210.671.2007 Goodfellow AFG – Capt. Yolanda Miller – 325.654.3203 Sheppard AFB – Capt. Jacob Nist – 940.676.7196 Dyess AFB – Capt. Joni Holder – 325.696.3305 Naval Air Station Corpus Christi – Lt. Alex Homme -361.961.1605 Naval Air Station Ft. Worth – Lt. Lauren Hugel– 817.782.7991

Unique Military Victims Far from home No local friends or family Employable? (length of stay) MM controls all pertinent info MM is source of all benefits

Military Benefits 1. BAH (basic allowance for housing) 2. Tri Care and Dental (health ins.) 3. Access to Post/Base - Commissarry - Post/Base Exchange 4. Command and spousal support

Command & Spouse Support Past -

Formal greeting process Coffees Social rosters

Present -

All is optional Social media Crisis????????

On Post/Base Resources Family Advocacy Program (FAP) - Classes (Conflict Res., Anger Mgt.) Social Work Department - BIPP Readiness Centers - “Soldier” “Airman and Family”

Family Advocacy Program 4000 Defense Pentagon Room 5A725 Washington D.C. 20301-4000

Air Force

Navy

AFMOA/SG300 2664 Flight Nurse Building 801 Brooks AFB, TX 78235-5135 (210)536-2031/32

Navy Personnel Command P6661 Department of the Navy 5720 Integrity Drive Millington, TX 38055-6610 (901)874-4355

Marines

Army

HQMC M&RA (MRO) 3280 Russell Road Quantico, VA 22134-5009 (703)784-9546

HQ DA, FMWR Command Department of the Army 4700 King St., 4th Floor Alexandria, VA 22302-4418

Militaryacronyms.com Know the Language –TDY (temporary duty) –PCS (perm. change of station) –ETS (expiration of term of serv) –MOS (mil. occupation specialty)

Online Resources Military One Source - Militaryonesource.com - (800)342-9647

Army One Source Military Child Educ. Coalition

Military Protective Order Department of Defense Form 2873 Lawful order - Commander to Service Member Enforceable on and off base No minimum or maximum duration Has menu or boiler plate provisions – – – – –

No contact, communication, etc. Order to vacate on base residence Provision of temporary residence in barracks Mandatory Counseling No Firearms

Military Justice Options Court Martial – Confinement – Punitive Discharge

Non Judicial Punishment (Article 15, UCMJ) – Loss of Rank – Loss of Pay – Extra duty/restriction

Adverse Administrative Actions – – – –

Official Reprimand Negative Evaluation Reports Bar to Reenlistment Administrative Separation

Transitional Compensation Authorizes payments for “abused family members of military personnel.” (MM) MM Must be 1. Separated administratively or 2. Court martial for dependent abuse (child abuse or domestic violence)

TC Benefits 1. Tri Care Benefits -

Includes behavioral health

2. Dental Benefits 3. Commissary and Post/Base Exchange Access 4. Monthly payments

For THREE years

How to Apply Contact: Family Advocacy Program Manager - FAP Victim Advocate - Army Community Service Center Victim Witness Liaison - Staff Judge Advocate

Victims of Abuse Monthly Rates Spouse Spouse only With one child With two With three With four With five With six With seven With eight

Child Only $1,195 $1,491 $1,787 $2,083 $2,379 $2,675 $2,971 $3,267 $3,563

One child Two children Three children Four children Five children Six children Seven children Eight children

$505 $726 $947 $1,128 $1,308 $1,448 $1,668 $1,849

Fiscal Year 2013 Branch Population Army Navy Marines Air Force Navy Res .

552,100 322,700 197,300 329,460 62,500

Total Reduction by 10/13

Must Reduce by: 9,900 3,000 4,800 3,340 3,700 24,700

Texas Veteran’s Centers Amarillo Arlington Austin Corpus Christi Dallas and Dallas County El Paso Ft. Worth Killeen Heights Harris County

Houston Laredo Lubbock McAllen Midland San Antonio NE San Antonio NW Tarrant County Taylor County

Veteran Centers Part of the VA Community based Provide broad range of counseling Outreach and referral services

Free to eligible veterans

Texas Veteran’s Centers

Eligible Veterans Veterans who served during periods of “armed hostilities.”

Combat Veterans

WW II Korea Lebanon Grenada Panama Persian Gulf Somalia Vietnam Iraq and Global War on Terrorism (GWOT)

The VA The Veteran’s Administration

What is the VJO Initiative? Outreach to Veterans in contact with the justice system through:  Police / local law enforcement  Courts  Jails Goal is to provide timely access to VA services for eligible justiceinvolved veterans Purpose is to avoid unnecessary criminalization and incarceration of Veterans with mental health and/or substance use disorders

Veterans charged with non-violent offenses are considered a priority population for the initiative

Who Is a Justice-Involved Veteran? In contact with local law enforcement and can be appropriately diverted from arrest to mental health treatment In a local jail, either pretrial or serving a sentence Involved in adjudication or monitoring by a court

Does NOT include: - Veterans in prisons - Veterans with a criminal background {those on probation or parole)

Books That Changed My Life Where Men Win Glory The Odyssey of Pat Tillman - by Jon Krakauer

Two Wars One Hero’s Fight on Two Fronts – Abroad and Within - by Nate Self

De-Mystifying “PTSD” Once a Warrior Always a Warrior Navigating the Transition from Combat to Home – By Charles W. Hoge, M.D., Colonel, U.S. Army (Retired)

I I Always Sit With My Back to the Wall Managing Traumatic Stress and Combat PTSD Through the R-E-C-O-V-E-R Approach for Veterans and Families - By Harry A. Croft, M.D and Rev. Dr. Chrys Parker, J.D.

Unbelievably Accurate You Can Tell When the Men Are Gone A Collection of Short Stories set at Ft. Hood, Texas - By Siohban Fallon

Anne Potts Jackson Assistant Bell County District Attorney [email protected] (254)933-5215 Lt. Colonel Michael L. Jackson, USAF