enhancing resilience in the deployed...

Enhancing Resilience in the Deployed Force

MG Vincent K. Brooks and CSM Jim ChampagneCommanding General and Division CSM

1st Infantry Division and

United States Division-South

USD-S CSF Tri-Fold (Front)

Pillars ofComprehensive Soldier Fitness

USD-SResiliency Campus

Resources

Physical

Performing and excelling in physical activities that require aerobic fitness, endurance, strength, healthy body composition and flexibility derived through exercise, nutrition, and training

• Cross-Fit Gym • Nutritional Counseling • Master Fitness Trainers • Body Fat Analysis • Metabolic Rate Analysis • WiiFit • Fitness Literature

Emotional

Approaching life’s challenges in a positive, optimistic way by demonstrating self control, stamina and good character with choices and actions.

• Biofeedback Training •Massage Chairs • Unit Behavioral Health Advocate Training • Sleep Hygiene Techniques • Anger Management Techniques •Smoking Cessation Classes •Behavioral Health Literature

Social

Developing and maintaining trusted, valued relationships and friendships that are personally fulfilling and foster good communication including a comfortable exchange of ideas, views and experiences.

• EO Office • DSARC Office •Sexual Assault + IG literature• MWR events • Sumo Suits •I. A.M. Strong Literature

Spiritual

Strengthening a set of beliefs, principles or values that sustain a person beyond family, institutional and societal sources of strength.

• Counseling and Spiritual Guidance • Meditation Room• Chaplain Office • Religious Literature

Family

Being part of a family unit that is safe, supportive and loving and provides the resources needed for all members to live in a healthy and secure environment.

SPAWAR Center with Private Booths • Referrals for Counseling • Marriage Strengthening Literature

Located in Trenchard Lines behind the Basrah USO

NCOIC: SFC James [email protected]

DSN: 318-858-4414

USD-S Resiliency Campus

ChaplainClassroomCrossFit GymEmotional RoomPhysical RoomEqual Opportunity/DSARC

318-858-4224318-858-4235318-858-4410318-858-4204318-858-4283318-858-4586

USD-S RESILIENCY CAMPUS

PHYSICALFAMILYSOCIALSPIRITUALEMOTIONAL

Reception Desk: 318-858-4238

USD-S CSF Tri-Fold Table of Contents

• Behavioral Health Training Program• Battalion Master Resilience Trainer

• Company Unit Behavioral Health Advocate

• Platoon ASIST Gatekeepers• Squad Resilience NCO

• Prescription Medication Analysis and Reporting Tool (PMART)

• Pre-deployment Resilience Training (formerly Battlemind)

• Victory Resilience Program• FRKS Resiliency Campus• Periodic Health Assessment

(PHA)• Pre-deployment Health

Assessment (PDHA)• Chaplain Programs

• Strong Bonds• Spiritual Fitness Events

• Family/Social Programs • BOSS• Warrior Zone• Kansas State Band Mentorship• Military Child Education Coalition• Resilient Spouse Academy

Pre-Deployment (Train-Ready /

Available) Deployment

Post-Deployment (Reset /

Reintegration)

• USD-S Resiliency Campus• Physical Resilience

• Nutritional Counseling• Body Fat Analysis• Metabolic Analysis• Smoking Cessation• Relaxation Techniques

• Emotional Resilience• Tele-Behavioral Health• Suicide Risk Management Teams• Anger Management Classes• Deployment Resilience Training

• Family/Social Resilience• Big Red One Society Against

Sexual Assault (BRO-SASA)• Family Readiness Groups• Resilient Spouse Academy

• Spiritual Resilience• Care for the Caregiver Seminars• Motivational Speakers

• Victory Strong Program• Deployment Behavioral

Health Risk Assessment (DBHRA)

• Sharepoint Anonymous Help Line

• Comprehensive Soldier Fitness Training Modules

• Identification of High-risk Behaviors and Individualized Mitigation Efforts

• 2-3-2 model for Reintegration and Leave

• Comprehensive Behavioral Health System of Care (CBHSOC) Screening

• Post-Deployment Health Assessment (PDHA)

• Post-Deployment Health Re-assessment (PDHRA)

• 100% MFLC Contact (Victory Resilience Program) for Soldiers and Family

• Post-deployment Resilience Training (formerly Battlemind)

• Ringneck Ranch• Warrior Adventure Quest• “Theater of War” Seminar• Entrepreneurship Boot Camp

for Veterans (EBV)

Unit Leader Guides

Questions?

NO MISSION TOO DIFFICULT, NO SACRIFICE TOO GREAT. DUTY FIRST!

For more information, visit: http://www.riley.army.mil/Resiliency

Train-Ready / Available

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Behavioral Health Training Program

An enormous amount of effort has been dedicated to developing BH programs, specifically in the realm of suicide prevention. Despite this, the suicide rate continues to increase and Soldiers at the platoon and squad level are still encountering significant stigma. As a result, they often do not seek help from BH professionals or Chaplains. Buddy aid is becoming more and more important, yet many Soldiers do not feel prepared or trained to help one another. In

response, USD-S and 1ID has created a unified training and assessment program in order to better provide for the BH needs of our Soldiers. Each BDE will have at least one MRT in the grade of O-3 or above. Each BDE will maintain at least two ASIST Trainers. Each BN will have at least one, but preferably two MRTs in the grade of E-6 or above. Each BN will identify one lead UBHA, E-6 or above. Each Company will maintain at least two UBHAs, E-4 or above. Each platoon sized element will have at least 5% of its formation trained in ASIST and assigned as Gatekeepers. All units will nominate one member from each squad sized element to serve as the Squad Resilience NCO.

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Prescription Medication Analysis Reporting Tool (PMART)

The Prescription Medication Analysis Reporting Tool was developed to provide a comprehensive database

of medication information to healthcare providers about deploying service members prior to deployment. The database is a menu-driven Microsoft Access application, which is only accessible to the healthcare provider of the deploying unit. PMART provides prescription data from all points of service, it identifies high-risk individuals, assesses for potential alternative medication available in theater, and provides an analysis of drug use for the purposes of refining medication supply lists. By accurately assessing the medication needs of deploying Soldiers, we can ensure that the deployed force is appropriate for the medical capability in theater.


CSF Pre-Deployment Modules

Provided to our Soldiers prior to deployment in order to

assist in setting realistic expectations about their pending deployments. It discusses the nature of combat and operational deployments and provides an overview of what the Soldier might see, hear, smell, think, and feel during these deployments. This module focuses on the self-aid/buddy-aid approach to caring for a battle-buddy and “being there” for one another, listening to Leaders and trusting in their training.


Victory Resilience

100% Military Family Life Consultant contact for Soldiers prior to deployment. The Officeof the Secretary of Defense (OSD) Quality of Life Division has contracted with MHN

Government Services to manage the Military and Family Life Consultant (MFLC) Program. This program provides non-medical counseling to Soldiers and their Families through outreach, educational presentations focused on behavioral health issues, and individual, couple, Family, and group interventions. These interventions build mental resilience while normalizing the range of reactions that occur as part of the cycle of deployment to combat zones and reintegration with families and communities. MFLCs work in support of and in conjunction with VICTORY RESILIENCE and the installation Army Community Services (ACS).


FRKS Resiliency Campus

Ft. Riley, Kansas is in the process of developing a state-

of-the-art Resiliency Campus built on the successes of the facilities at Ft. Hood and USD-S. We expect to implement lessons learned from the USD-S Resiliency Campus in order to refine the programs and ideas for Soldiers seeking to improve every aspect of their lives.


Periodic Health Assessment

U.S. Army Chief of Staff Memorandum dated 12 October 2006 and AR 40-501,

Standards of Medical Fitness, an annual Periodic Health Assessment (PHA) is required for all general officers, officers, warrant officers and enlisted personnel, regardless of component. The PHA is a preventive screening tool designed to improve reporting and visibility of Individual Medical Readiness (IMR) for all Soldiers.


Pre-Deployment Health Assessment

All DoD personnel (military, civilian, contractor) deploying for greater than 30 days to areas outside the continental United States (OCONUS) with non-fixed U.S. medical treatment

facilities (MTFs) must complete a Pre-Deployment Health Assessment Form (DD 2795) in accordance with DoD Instruction 6490.03, Deployment Health.


Chaplain Programs

The USD-S and 1ID Chaplaincy offers many programs to help Soldiers improve their Spiritual resilience. Among the many programs offered, Strong Bonds, Care for the

Caregiver Seminars, and Spiritual Fitness Events are amongst the most popular. There are also Deployment and Garrison motivational Speakers who present seminars on a variety of topics.


Family & Social Programs

USD-S and 1ID offers many MWR and ACS programs to its Soldiers and Families. The

Better Opportunities for Single Soldiers (BOSS) and Warrior Zone initiatives are extremely popular and allow for healthy decompression and socialization during the Train-Ready and Available phases of ARFORGEN. Supporting the Family Pillar of Strength, the Kansas State University Band Mentorship and Military Child Education Coalition offer additional enrichment opportunities to children. The Resilient Spouse Academy is a 4-day intensive training program on Ft. Riley designed to teach spouses how to be “sensors” for common problems that arise after deployment.


Resilient Spouse Academy

The Resilient Spouse Academy is a 4-day intensive training program

on Ft. Riley designed to teach spouses how to be “sensors” for common problems that arise after deployment. Classes include Applied Suicide Intervention Skills (ASIST) training, financial readiness, master resilience training, substance abuse awareness and domestic violence education.


Deployment

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Campus Map

USD-S Resiliency Campus / Victory Strong

The USD-S Resiliency Campus builds and supports the Physical, Emotional, Spiritual, Family, and Social strength of our Community through programs, facilities, and services. The Campus demonstrates our commitment to

Comprehensive Fitness and provides an integrated and synchronized approach to Resilience that builds and sustains every aspect of individual strength.

As part of the outreach effort, the Victory Strong program allows for Soldiers from all across USD-S to visit COB Basrah in order to take advantage of a unique 5 day program that builds skills in each of the 5 pillars of strength.

Deployment

USD-S Resiliency CampusLatrines/Showers

VolleyballCourt

CrossFit Gym

Resiliency Office and

CrossFit Park

Resiliency Park

Resiliency Classrooms• Master Resilience

Trainer• 7 Coping Skills

Resiliency Building

Spiritual: • Counseling & Spiritual Guidance

• Meditation Room

Emotional: • Massage Chairs• Biofeedback Room

Family/Social: • EO Office• SPAWARE Center (Skype)• Sexual Assault + IG Literature

Physical: • Master Fitness Trainers• Personal Trainers• Certified Nutritionists

DeploymentBack to Main

Tele-Behavioral Health

The end of combat operations in Iraq and the Responsible Drawdown of Forces (RDoF) has led to a reduction in the number of Behavioral Health providers per basing location. Rotation of BH providers to smaller bases is sometimes

impractical due to manning and transportation limitations. Video Teleconferencing (VTC) technology, utilized as virtual BH clinics, presents a potential mitigation strategy for BH service deficiencies in USD-S. It creates access, ensures continuity of care, and creates surge capacity.


Suicide Risk Management Teams

A Suicide Risk Management Team (SRMT) is the unit Commander’s way to gain vital information regarding high-risk Soldiers in the formation, to discuss details regarding Behavioral Health initiatives, and to review

results from surveys and risk-assessment instruments. These meetings take place throughout ARFORGEN, but are particularly important in the deployed setting where Soldiers have ready access to lethal means. Members of the SRMT will include the Commander, Chaplain, a medical representative, and BH enablers as required.


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Combat Stress Clinic Education Classes

Combat Stress clinic Educational classes include anger management, relaxation techniques, smoking cessation, and sleep hygiene. These classes are available by appointment and are conducted in conjunction with the Resiliency Campus efforts.


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Deployment Resilience Training

“Battlemind” Resilience Training, the US Army’s behavioral health resilience training system, is comprised of an integrated series of deployment cycle modules and life cycle training modules as well as specific training tailored for

medical personnel. The training provides a developmental approach to mental health skill building timed to the specific phases of the Soldiers’ career and deployment cycle. Modules designed for military Spouses are also provided and are timed to the deployment cycle.


Big Red One- Society Against Sexual Assault (BRO-SASA)

The purpose of the Big Red One-Society Against Sexual Assault (BRO-SASA) is to provide a forum for women and men from all branches of services, DoD

Civilians and Contractors to unite in preventing Sexual Assault and Harassment. It accomplishes this by building self-confidence through education, developing life skills, and building camaraderie that creates positive changes in attitude and behavior through quarterly conferences and monthly seminars on COB Basrah and at Ft. Riley


Family Readiness Groups

Family Readiness Groups (FRG) are command-sponsored organizations of family members, volunteers, soldiers and

civilian employees associated with a particular unit. They are normally organized at company and battalion levels, and fall under the responsibility of the unit's commanding officer. FRGs are established to provide activities and support to enhance the flow of information, increase the resiliency of unit soldiers and their families, provide practical tools for adjusting to military deployments and separations, and enhance the well-being and esprit de corps within the unit.


http://en.wikipedia.org/wiki/File:ArmyFRG.jpg

Resilient Spouse Academy

The Resilient Spouse Academy is a 4-day intensive training program

on Ft. Riley designed to teach spouses how to be “sensors” for common problems that arise after deployment. Classes include Applied Suicide Intervention Skills (ASIST) training, financial readiness, master resilience training, substance abuse awareness and domestic violence education.


Chaplain Programs

The USD-S and 1ID Chaplaincy offers many programs to help Soldiers improve their Spiritual resilience. Among the many programs offered, Strong Bonds, Care for the

Caregiver Seminars, and Spiritual Fitness Events are amongst the most popular. There are also Deployment and Garrison motivational Speakers who present seminars on a variety of topics.


Deployment Behavioral Health Risk Assessment

The Deployment Behavioral Health Risk Assessment (DBHRA) is a simple, leader-administered risk assessment tool that can be implemented rapidly to assess individual and unit behavioral health risk. It

standardizes Soldier risk assessment throughout 1ID, FRKS and USD-S in support of Comprehensive Soldier Fitness. By identification of high-risk Soldiers and prevention of suicide in 1ID and USD-S, we will increase the emotional resiliency of Soldiers and improve organizational readiness.


SharePoint Anonymous Help Line

USD-S has created an anonymous help-line to assist Soldiers or battle buddies of

Soldiers who are experiencing distress. Similar to the Commander 3x5 card, this allows for a mechanism to inform the chain of command if there are issues that they need to be aware of. In USD-S, we have links to Behavioral Health, EO/DSARC, Chaplain, IG and Safety. The Ask4Help button is visible on the main SharePoint page on NIPR and SIPR.


https://msc.forces.iraq.centcom.mil/usds/KM Shared Documents/Ask4Help/ASk4Help_files/slide0001.htm

CSF Training Modules

After taking the CSF Global Assessment Tool, Soldiers may take

self-development modules designed to help increase strength and resilience in the Emotional, Family, Social and Spiritual dimensions. Soldiers are required to complete one module in each dimension and can take additional modules at any time. The modules may be completed in any order, however, it is recommended to take them in sequential order as listed under each Dimension.


Unit Leader Guides

Unit Leader Guides provide leaders with simple tools to promote Resilience and reinforce the concepts of Comprehensive Soldier Fitness throughout the

formation. Some examples are the 1st Combat Aviation Brigade Demon Leader’s Card and the 1st Sustainment

Brigade Durables Risk Assessment.

Demons Durables

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Deployment

Post Deployment (Reset / Reintegration)

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Identification of High-risk Behaviors and Individualized Mitigation Efforts

Risk assessment is part of understanding how to build resilience. A comprehensive assessment is the first step in putting together a comprehensive plan of assistance. All components of this risk assessment are

integrated to assist leaders and caregivers in understanding the Soldier’s behavioral health status. This assessment is then communicated to the MEDDAC to facilitate resource allocation. Like 10th MTN and 4ID, 1ID follows the Collaborative Medical Evaluation in Theater (COMET) model to identify and assist at-risk Soldiers. 1ID Commanders utilize the DBHRA to assess and engage at-risk Soldiers enabling them to receive individualized care.

Reset / ReintegrationBack to Main

2-3-2 model for Reintegration and Leave

Issues develop during block leave and reintegration. Indiscipline indicators typically rise during the first 180 days after redeployment. To mitigate this, the typical 4-week block leave period has been split into

two 2-week blocks separated by a 3-week “resiliency” period of low intensity duty. This concept was developed to enhance Leadership interaction with Soldiers and Family members earlier in the Reintegration timeframe. The overall goal is to provide a more gradual transition back to the garrison environment.


Comprehensive Behavioral Health System of Care

Repetitive deployments have significantly increased stress reactions

and behavioral health support requirements. It is imperative we help the force manage the stress it is experiencing to enable the Army to be a healthy, resilient and consistent resource for the nation. The Comprehensive Behavioral Health System of Care (CBHSOC) promotes overall Soldier and family health and well being through multiple “touch points” during ARFORGEN. To achieve an immediate and lasting impact, this campaign will emphasize identifying, preventing, treating and tracking behavioral health issues affecting soldiers and families, as well as educating the force.


Post-Deployment Health Assessment

DoDI 6490.03, Deployment Health, 11 Aug 06 describes the post-deployment health activities.

"The DD Form 2796 is required if a DD Form 2795 was required during the pre-deployment phase or per the decision of the COCOM commander, Service component commander, or commander exercising operational control if any health threats evolved or exposures (OEH or CBRN) occurred during the deployment that warrant medical assessment or follow-up."

"Each individual who requires a DD Form 2796 must be scheduled for a face-to-face health assessment with a trained health care provider (physician, physician assistant, nurse practitioner, advanced practice nurse, independent duty corpsman, independent duty medical technician, or Special Forces medical sergeant) during in-theater medical out-processing or within 30 days after returning to home or processing station."

The purpose of this screening is to review each service member's current health, mental health or psychosocial issues commonly associated with deployments, special medications taken during the deployment, possible deployment-related occupational/environmental exposures, and to discuss deployment-related health concerns. Positive responses require use of supplemental assessment tools and/or referrals for medical consultation. The provider will document concerns and referral needs and discuss resources available to help resolve any post-deployment issues.


Post-Deployment Health Reassessment

The Post-Deployment Health Reassessment (PDHRA) Program

is a program mandated by the Assistant Secretary of Defense for Health Affairs in March 2005 and designed to identify and address health concerns, with specific emphasis on mental health, that have emerged over time since deployment. The PDHRA provides for a second health assessment using DD Form 2900 during the three- to six-month time period after return from deployment, ideally at the three to four month mark. The reassessment is scheduled for completion before the end of 180 days after return.


Victory Resilience Program

100% MFLC Contact for Soldiers and Family.

The Office of the Secretary of Defense (OSD) Quality of Life Division has contracted with MHN Government Services to manage the Military and Family Life Consultant (MFLC) Program. This program provides non-medical counseling to Soldiers and their Families through outreach, educational presentations focused on behavioral health issues, and individual, couple, Family, and group interventions. These interventions build mental resilience while normalizing the range of reactions that occur as part of the cycle of deployment to combat zones and reintegration with families and communities. MFLCs work in support of and in conjunction with VICTORY RESILIENCE and the installation Army Community Services (ACS).


Post-Deployment Resilience Training

Provided to Warriors close to or soon after their return from combat and operational deployments. This module discusses the transition from a combat zone to “the home zone” and discusses the value of Warrior’s skills but the need to modify these skills for a successful

transition to the home environment. Techniques of adapting, indications that professional help may be needed and some available resources are also detailed.

Provided to Warriors three to six months after they have returned from a combat or operational deployment. This training module discusses the continuing transition home, problem areas that may have arisen, self-aid/buddy-aid, “Mental Fitness Checks”, and some

common “myths” associated with seeking help for behavioral health issues.


BRO Ringneck Ranch Project

Reset / Reintegration

Ringneck Ranch (BRORR) provides an opportunity for building Resiliency and providing Mentorship. During the reintegration period, Soldiers embark on a hunting retreat with a mentor at least two grades senior to them. The one-on-one Senior to Junior

relationship provided by the BRORR provides excellent opportunities for mentorship and serves as a way to “build the bench” providing future leaders to 1ID and the Army.

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Warrior Adventure Quest

The Warrior Adventure Quest (WAQ) combines existing outdoor recreation high adventure, high adrenaline activities with a “Battlemind” Leader Tool, the Army’s

emotional resiliency building program, to assist Units and Soldiers in adapting to a garrison environment. This training is conducted with the existing chain of command in platoon sized elements to enhance unit cohesion, provide leadership opportunities to unit leaders, and enhance NCO professional development.


“Theater of War” Seminar

Theater of War presents readings of Sophocles' Ajax and Philoctetes to military communities across the United States. These ancient plays timelessly and universally depict the psychological and physical wounds inflicted upon warriors by war. By presenting these plays to military audiences, the hope is to de-stigmatize psychological injury and open a safe space for dialogue about the challenges faced by service members,

veterans, and their caregivers and families. It has been suggested that ancient Greek drama was a form of storytelling, communal therapy, and ritual reintegration for combat veterans by combat veterans. Sophocles himself was a general. At the time Aeschylus wrote and produced his famous Oresteia, Athens was at war on six fronts. The audiences for whom these plays were performed were undoubtedly comprised of citizen-soldiers. Seen through this lens, ancient Greek drama appears to have become an elaborate ritual aimed at helping combat veterans return to civilian life after deployments during a century that saw 80 years of war.


Entrepreneurship Boot Camp for Veterans (EBV)

The Entrepreneurship Bootcamp for Veterans with Disabilities (EBV) offers cutting edge, experiential training in entrepreneurship and small business

management to post-9/11 veterans with disabilities resulting from their service to our country. The EBV is designed to open the door to business ownership for our veterans by developing skills in the many steps and activities associated with launching and growing a small business, and by helping veterans leverage programs and services for veterans and people with disabilities in a way that furthers their entrepreneurial dreams.
