Montana National Guard’s Proactive PTSD Program Becoming National Model

Great Falls Tribune

March 1, 2009, Helena, MT –  Two years after former Army Spc. Chris Dana committed suicide after struggling with post-traumatic stress disorder, the Montana National Guard is spending approximately half a million dollars a year to make combat deployments easier for its soldiers and their families.

The Montana Guard’s Yellow Ribbon program has become a model that the rest of America should adopt, said U.S. Sen. Jon Tester, D-Mont.

“We’re getting terrific responses to the program from the families of our soldiers, but also some great suggestions,” said Col. Jeff Ireland, chief of manpower and personnel for the Montana Guard. “For instance, we were told it would be useful to have a special breakout session for spouses.

Ireland said officials believe the session was a great idea.

“We plan to act on it and other suggestions until we meet all the needs we’re aware of,” he added.

With the approval and funding of the National Guard Bureau in Washington, D.C., the Montana National Guard is adding five positions and spending approximately $500,000 to fund the Yellow Ribbon program, Ireland said.

The core of the program is twofold: mental health assessments every six months after deployment and crisis response teams that can be activated immediately to check out concerns about the emotional wellbeing of a soldier.

“The genius of the Montana screening model is that it happens every six months,” Matt Kuntz, Dana’s stepbrother, told the Senate Veterans Affairs Committee last week during testimony in Washington.

“I really — in my heart — believe that if they would have sat down with Chris six months (after his redeployment to Iraq), when he could no longer go to drill, when he was having the flashbacks, when he was having trouble dealing with his own family — that’s when that counselor could have gotten him out of his shell,” Kuntz said. “But I tell you, we tried later — a year later — and it was too late.”

Dana returned from his redeployment, had trouble adjusting to drills and was dishonorably discharged prior to committing suicide.

To help prevent that type of situation, the Guard’s new program goes beyond additional mental health assessments. For example, some family meetings are now held in convention facilities instead of armories.

“The primary focus of our Yellow Ribbon program is that it’s a proactive program, not reactive,” Ireland said. “We try to get medical assistance and information to our soldiers before there’s a crisis.”

After Dana’s suicide on March 4, 2007, a task force charged with recommending reforms concluded that many soldiers and their families weren’t aware of the benefits available to them, nor did they know how to access them.

“And that surprised us because we had presented it to them multiple times in multiple ways,” Ireland said. “So we had to conclude they just weren’t listening to us.”

Those briefings occurred in the days immediately preceding a deployment, when the soldiers and their families were so preoccupied with the ordeal facing them that they weren’t terribly concerned about the aftermath.

The Guard now holds an “academy” two or three months before deployment to present that information to soldiers and their families.

“The beauty of it is that we’ve received funding from the National Guard Bureau to put on our academy in a civilian facility and they (the soldiers) can wear civilian clothes to the meetings,” Ireland said. “We can pay for meals, motel rooms, mileage and childcare. That takes the stress off them.”

As many as 60 vendors — ranging from TriWest Healthcare to Veterans Affairs to educational services, finance and legal counseling — may be present over the weekend to explain various programs.

When the soldiers are gone, family readiness units are activated to keep track of their families.

“Family support groups do monthly checks on each family, and we have Webinar training programs that spouses can take from their own homes,” Ireland said in referring to Internet-based training.

Shortly before the troops return, the National Guard sponsors a special reunion workshop so spouses will know how to be prepared.

“Everyone expects that when a soldier comes home, everything will go on as usual,” Ireland said. “Unfortunately, that’s not the case. When the soldier leaves, family life continues for everyone but the soldier, so he and his family have to readjust to life together again.”

In every other state in the nation, soldiers returning home from deployment get a three-month break from drill weekends. In Montana, personnel officers found that the soldiers struggling to readjust to civilian life need their buddies as a support group during that time.

“So we hold drills 30, 60 and 90 days after deployment that are like the academies, except that we focus on family reintegration,” Ireland said. “We have training on marriage enrichment, anger management, symptoms of depression and how to reconnect with your children.”

For soldiers accustomed to driving fast and swerving around potential dangers in Iraq, there’s a session with a Montana Highway Patrol officer to remind them of the civilian rules of the road.

Additionally, mental health assessments are held every six months for the first two years after soldiers return from deployment, and the crisis response teams are on alert for any suggestions that a soldier is beginning to experience symptoms of post-traumatic stress disorder.

“Our crisis response team has been very effective, and the embedded counselors have been very helpful,” said Wing Command Chief Larry Seibel of the Montana Air National Guard on Gore Hill.

He said the crisis team has intervened to get airmen immediate psychological help in four or five cases during the past year.

“We dealt with one case about a month ago,” Seibel said. “It involved a person who had been to Iraq two or three times and was basically showing a lot of signs of stress at work.

“Putting a uniform on and driving through the main gate brought back all the bad things this person had been through, and there was a meltdown at work during a drill weekend,” Seibel said.

Mental health counselors assigned to the unit took the airman to Benefis Health System immediately, after which counselors at Malmstrom Air Force Base took over.

The patient is now in recovery, he said.

“This situation turned out to be a total success story, but it very easily could have gone the other way,” Seibel said.

Siebel added that the Guard’s crisis response teams are scheduled to get additional training in assessing symptoms of emotional problems and in dealing with crisis situations.

The Montana National Guard also has added a Yellow Ribbon program coordinator and two support positions to assist soldiers and airmen, as well as their families. It also is seeking to hire a director of psychological health and a military family life counselor.

Last year, TriWest Healthcare launched a pilot program in which it assigned mental health counselors to spend one weekend a month at Army and Air Guard armories when the units were at drill.

That worked so well that the National Guard has taken the program over and funded it, Ireland said.

“We see sometimes 50 guys a day and spend between five and 45 minutes apiece with them,” said Rich Kuka, a Great Falls counselor assigned to the Army National Guard in Helena.

He estimated that the prevalence of problems in Montana is about the same as the Rand Corp. national predictions: one in four soldiers will suffer post-traumatic stress disorder and one in three deployed military members will experience either PTSD, traumatic brain injury, major depression or a combination of all three.

“And I’d guess that 99.5 percent of the guys I’ve seen exhibit symptoms of hypersensitivity and hypervigilance,” Kuka said.

Hypersensitivity may mean a soldier hits the ground at a sudden sound or loses control at the sound of a helicopter — for many infantry soldiers, a chopper means a firefight or casualties flown from the scene of a battle.

Hypervigilance may lead a soldier to constantly scan rooftops for snipers, check out apartment windows for suspicious individuals or have a lot of trouble sleeping at night.

Another common symptom is an explosive temper, Kuka said, adding that a lot of infantry soldiers drive their own vehicles at high speeds, quickly avoiding trash or parked cars and swerving around obstacles.

“Everything you hear and read about these guys is true — plus some,” Kuka added.

The Montana National Guard is making its Yellow Ribbon training sessions available to all members of all branches of the military service, including active and reserve members, Ireland said.

“Our funding from the National Guard Bureau makes it possible for anyone who needs that training to attend,” he said, adding Yellow Ribbon is the most cohesive outreach program in the nation.

In a news release last week, Tester said legislation is being prepared to make many of the reforms employed in Montana mandatory nationwide.

“The big thing that Montana has learned the hard way — and now the nation is learning it, as well — is that we just can’t wait for service members’ lives to fall apart before they reach a counselor,” Kuntz said. “By that time, it could be too late or it could be harder to treat.

“This will take the Montana model of face-to-face screening every six months after deployment to the entire country,” he said. “That means that every active-duty, Reserve or Guard service member returning from combat will get the help they need.”

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