The Work Place Benefit Every Company Should Offer

On a daily basis, hundreds of thousands of workers struggle with stressors they don’t feel comfortable enough discussing  at work: mental illness, substance abuse, family problems.  Personal problems can cause significant absenteeism, reduction in quality of work and even staff turnover. Recognizing this, many employers provide EAP or Employee Assistance Programs aimed at assisting employees with identifying and resolving personal concerns.  Employee Assistance Programs can give your employees a way to cope with personal issues that can have a negative impact on their job performance. With most EAP’s, employees have telephone access to trained counselors 24/7 as well as in-person access if necessary. Counselors can also respond on-site when there is a critical incident that could potentially affect workers such as an employee death, incident of work place violence or even lay-offs.

EAPs allow individual workers and their family members to confidentially access counselors for a variety of issues related to mental health (such as depression, ADHD or bipolar disorder), substance use disorders, legal problems or marital concerns. Work & home stress can build up over time and could possibly lead to conflicts with other employees or even escalate into a violent situation. With the EAP, the employee can seek help during the early stages of a problem, which can prevent it from turning something more serious. Employees typically have access to an EAP hotline 24 hours a day, so there is no need to wait to seek assistance.

According to the Department of Labor study “What Works: Workplaces Without Drugs,” for every dollar invested in an EAP, employers generally save anywhere from $5 to $16. Data provided by the Houston-based Interface EAP, claims that employee use of EAPs has been shown to result in a:

  • 66 percent decline in absenteeism after alcohol abusers have been identified and treated.
  • 75 percent reduction in inpatient alcohol and other drug abuse treatment costs.
  • 33 percent decline in use of sickness benefits.
  • 65 percent decline in work-related accidents.
  • 30 percent decline in workers’ compensation claims
  • EAPS also benefit the organization by:
  • Attract & retain employees
  • Increase productivity
  • Reduce absenteeism
  • Boost morale
  • Prevent employee theft
  • Promote workforce cooperation
  • Enhance organizational health
  • Prevent disability claims
  • Decrease medical costs by promoting healthier lifestyles
  • Balance work & personal life
Top 3 Reasons a Phone Operator Beats an Automated System

Telehealth in Alaska: Unfulfilled Potential

Alaska leads the country with the highest rate of deaths by suicide with the Mat-Su death rate being twice the national rate. Research has found that consumers are not accessing care until they are in a crisis situation which leads to over-utilization of Emergency Departments. Elizabeth Ripley, Executive Director of the Mat Su Health Foundation which operates Mat Su Regional Medical Center, stated the following in a February, 2015 blog, “Even though it doesn’t offer psychiatric services, it is the number one purveyor of mental health care in our community.” She goes on to report that the ED sees five times the number of behavioral health consumers than their community mental health center. Mat Su Regional Hospital charged services totaling 23 million dollars in 2013 which mostly went unpaid due to consumers being under-insured or having no coverage at all. The need to expand digital technology and Telehealth services in Alaska is at the forefront of agencies wanting to expand coverage, raise consumer satisfaction, and stream-line services.

What is a telehealth Assessment? Telehealth assessments are those assessments completed using video conferencing or phone. They are often used to complete behavioral and co-occurring assessments for mental health and substance abuse facilities, and, are showing to be highly effective when used by emergency departments. Qualified mental health professionals (QMHP’s) can be reached 24/7 in a centralized location to expand the number of clinicians available to rural Alaskan’s and bridge the gap between ED utilization and, on-going preventative care. For consumers who feels trapped geographically or who have limited access to transportation, telehealth could make the difference between having an unfilled, hopeless life or finally having a plan and means to make positive change. Consumers or family members who believe there is mental illness but have no means to get assessed often feel hopeless and helpless that life can get better.

Understanding why mental health utilization rates in preventative service areas are so low is imperative in developing a plan to bridge this gap. What are some of the barriers to receiving mental health services in Alaska? More than 60% of rural America live in mental health professional shortage areas; 90% of all psychologist and psychiatrists and 80% of MSW’s work exclusively in metropolitan areas.  Law enforcement officers are the number one responders in rural America for a mental health crisis adding an upwards of about 2 million to law enforcement costs. Primary care doctors are now providing more than 65% of rural America with mental health care which basically means they are not getting that specialized, individually tailored MH treatment.

Are there more mentally ill people living in rural areas than urban? No. Prevalence is not the factor here as rates between rural and urban areas are about the same. Factors that limit consumers in rural areas are accessibility (getting there and paying), availability (someone there when you’re available), and acceptability (choice, quality, knowledge).

When discussing accessibility it is paramount to understand that rural Americans travel further to provide and receive services. They are also less likely to have insurance benefits for mental health care and are less likely to recognize mental illnesses. Many rural Americans do not understand their care options.

Consumers in rural areas are reporting the wait for an initial mental health appointment to be anywhere from 30-120 days with the average wait time 90-120. Rural areas suffer from chronic shortages of mental health professionals with specialty providers rarely accessible. Comprehensive services are not often available which then puts the burden on CMHC to service all. Mat Su houses 12 to 13% of the state’s population and yet receives only 4% of community based behavioral health funding. The population in this area has doubled from fifty thousand people to almost one hundred thousand. yet the funding for mental health has remained the same. Mat Su Regional Hospital currently has only two psychiatric beds, limiting doctors choices of treatment to either sending the client home or hoping the Alaska Psychiatric Institute has availability.

The acceptability of treatment options is the third major barrier to treatment in rural Alaska. Few programs train professionals to work competently in rural places leading to a lack of choice in selecting a provider. Stigma and lack of psycho-educational programs to combat mental health stigma also play into acceptability of care. It is assumed that urban models will work in rural areas which are most often not the case. Rural people are often not well informed of mental health services with access often being confusing and complex. Providers are isolated from each other and lack accessibility to service rural areas. Rural people enter care later, sicker and often come with little to no means to support their illnesses.

How should mental health care look in Alaska? Consumers would have quick, easy and convenient access to care. There would be comprehensive continuums of care with providers who are culturally competent. Systems and providers would work together and share resources by utilizing the “no wrong door” policy. In practice, this means that every door in the public support service system would be “the right door” with a range of services accessible to everyone from multiple points of entry. This commits all services to respond to the individual’s needs by either providing direct services for both their mental health and drug and alcohol problems or linkage and case management instead of sending a person from one agency to another. Digital technology services such as Telehealth will be paramount in making this policy reality.

It is clear and evident that current in-places services are not enough to meet the mental health care needs in Alaska. There is a misalignment between providers and consumers with access to care being nearly impossible to a large population of the state. As a whole, the United States has one qualified mental health provider for every 790 citizens.  System reform is challenging, and will require change at the conceptual, organization and provider levels. So what can we do now? Expand mental health access through the digital sphere; expand telehealth services.



Alaska Psychiatric Institute:  http://dhss.alaska.gov/dbh/pages/api/default.aspx

Alaska Public Media: http://www.alaskapublic.org/2015/02/05/mat-su-behavioral-health-report-reveals-lack-of-services/

SAMHSA: http://www.samhsa.gov/

Alaska Psychiatric Institute: http://dhss.alaska.gov/dbh/pages/api/default.aspx

Western Interstate Commission for Higher Education: http://www.wiche.edu/

The Wall Street Journal: http://www.wsj.com/articles/where-are-the-mental-health-providers-1424145646?utm_campaign=KHN:+First+Edition&utm_source=hs_email&utm_medium=email&utm_content=16079207&_hsenc=p2ANqtz–TKlI5-rvYxu0oFgrp6YkZ7TnjlyXuwn8yqq3EDyDjHhUT442lFRbTPjqemGUHeMhhzciFuY1CAXbPCNHwBMZEd1nLNuMaRZcE4GQ70-xcvNaW6XQ&_hsmi=16079207

Why Alaska Needs Medicaid Expansion

Alaska is a popular destination for many travelers who are looking to experience the outdoors in its most pure and intended state. The snow-capped mountains, breathtaking glaciers and extraordinary wildlife give the individual a glimpse into nature unparalleled any place else within the U.S. Yet, behind the beauty and splendor of this beautiful state lays unsettling facts concerning mental health and the access to care. Alaska has the highest rate of suicide per capita in the country. The rate of suicide in the United States was 11.5 suicides per 100,000 people in 2007 with Alaska’s rate of 21.8 per 100,000; Alaskan Natives were 35.1 per 100,000. The Suicide Prevention Resource Center reports that 78% of individuals who have suicided are men, 22% women. Alaskan Native men between the ages of 15-24 have the highest rate of suicide among any demographic in the country with an average of 141.6 suicides per 100,000 each year. Suicide deaths consistently outnumber homicide deaths three to two and 90% of people who die by suicide have depression, treatable mental health or substance abuse disorders according to the American Association of Suicidology.

On July 19, 2015 Alaskan Governor Bill Walker announced plans for Alaska to become the 30th state to expand Medicaid coverage which would provide benefits to hard-working families, young adults, veterans and more. Walker provided a 45-day notice of his intention to accept additional Federal and Mental Health Trust Fund Authority money to expand Alaska’s Medicaid. Expanding Medicaid would bring $146 million to the state in its first year and provide health care to more than 20,000 working Alaskans. DHSS reports that nearly 42,000 Alaskans will be eligible for expansion with approximately 21,000 expected to enroll in the first year. Additionally, Medicaid expansion would reduce state spending by $6.6 million in the first year with more savings to the state’s general fund. Governor Walker states, “Every day that we fail to act, Alaska loses out on $400,000. With a nearly $3 billion budget deficit it would be foolish for us to pass up that kind of boost to Alaska’s economy”. A major supporter of Alaskan Medicaid expansion is the Mat-Su Health Foundation that has a goal to help Mat-Su become the healthiest borough in the U.S. In an article published in the Mat-Su Valley Frontiersman on July 20th, Mat-SU Executive Director Elizabeth Ripley stresses the need for improved access to health care, managing chronic diseases and preventing unnecessary hospitalizations. Ripley points out that mortality rates in expansion states have declined compared to non-expansion states. Will Medicaid expansion reduce the suicide rate in Alaska? Only time will tell. But it is clear that the need and want for a mentally and financially secure Alaska is a top priority for its Governor, and, over 150 agencies that would be able to provide additional resources to our nation’s number one per capita suicide hot spot.

News Resources:

Office of Alaska Gov. Bill Walker www.gov.state.ak.us

Legislative Budget and Audit Committee Chairman Rep. Mike Hawker (R) www.housemajority.org

Department of Health and Social Services http://dhss.alaska.gov

Americans for Prosperity Alaska www.americansforprosperity.org Alaska Senate Majority www.akleg.gov

Alaska House Majority www.housemajority.org

“Thank you Gov. Walker, for expanding health for more Alaskans” www.frontiersman.com

Cyberbullying & Your Teen: What Every Parent Needs to Know

What is cyberbullying? Wikipedia defines cyberbullying  as, “The use of information technology to repeatedly harm or harass other people in a deliberate manner. According to U.S. Legal Definitions, Cyber-bullying could be limited to posting rumors or gossips about a person in the internet bringing about hatred in other’s minds; or it may go to the extent of personally identifying victims and publishing materials severely defaming and humiliating them.”

Traditionally, when looking back on school age fighting and “traditional bullying” we associate this with playground fighting. The bullying event was usually held at a specific time and place with designated roles played by autonomous participants; victim, bully and bystanders. While “playground” fighting still exists, today’s adolescents face a potentially more dangerous threat; cyberbullying. Cyberbullying has extended the reach of bullying from the playgrounds, hallways and lunchrooms into cellphones, laptop and tablets. A study published by the University of British Columbia in 2012 reports that 25-30% of young people surveyed admitted experiencing or taking part in cyberbullying; but only 12% said the same about traditional bullying. The same study showed that 95% of youth felt that what took place online was meant to be a joke while the other 5% intended to do actual harm. The social change website “Do Something” reports that as high as 43% of adolescents have been bullied online with 1 in 4 being bullied more than once. This same site reports that 90% of teens who have seen social media bullying have ignored it; 84% report having seen others telling the bully to stop. Only 1 in 10 victims will inform a parent or trusted adult of their abuse with girls being twice as likely to be the bully or target of cyberbullying.

In Cyberbullying, the roles of participants are no longer as clear cut as victim, bully, or bystander with participants now playing multiple roles within the event. The identified victim of cyberbullying is now often called the target and bystanders are now witnesses. With up to 70% of students reporting seeing frequent bullying online the reach of the cyberbullying crisis is staggering.

Cyberbullying and Suicide

Peer victimization in children and adolescents is associated with higher rates of suicidal ideation and attempts with cyberbullying being strongly related to suicidal ideation in comparison with traditional bullying. The average statistic nationwide reports that youth victimized by their peers were 24 times more likely to report a suicide attempt than youth who reported not being bullied. Students who are both bullied and engage in bullying behaviors are the highest risk group for adverse outcomes. Targets of cyberbullying can experience significant psychological and emotional problems including depression, anxiety and panic, anger and suicidal behavior. Moms Team, an online source for sports-parents, reports that over 150,000 kids nationwide are staying home from school because of bullying; daily.

Types of Cyberbullying:

Flaming: Using inappropriate or vulgar language to attack or fight with someone

Harassing: Repeatedly sending inappropriate, hurtful or hateful messages

Outing: Sharing a victims secrets or personal information in a public forum

Exclusion: Intentionally and publicly excluding someone from a group, and tormenting them after exclusion

Impersonation: Posing as someone for the purposes of damaging their reputation, inviting an attack, or sharing real or fabricated information about them

Stalking: electronically “following” someone and sending them targeted messages with the intention of scaring, harming or intimidating them

Trolling: the practice of trying to lure other Internet users into sending responses to carefully-designed incorrect statements or similar “bait.”


3 Worst Social Media Sites for Bullying:

Facebook: Facebook is a popular free social networking website that allows registered users to create profiles, upload photos and video, send messages and keep in touch with friends, family and colleagues. The site is available in 37 languages. Despite declining popularity amongst teens, millions are still using it. The most common form of bullying on Facebook is posting negative comments on a user’s selfie; typically posted for positive affirmations with the target receiving just the opposite.

*Eighteen year old Jessica Logan suicided after coming home from the funeral of a boy who had suicided. Jessica was a target of cyberbullying on Facebook after her boyfriend shared nude pictures of her with classmates who would call her a slut and a whore incessantly on the site.

 Instagram: Instagram is a free, online photo sharing and social network platform that was acquired by Facebook in 2012. An unfortunate byproduct of the rise of Instagram is the popularity of “rate me” posts or impromptu beauty contests. Teens, most frequently girls (but boys get into the act too), post pictures of themselves with a hashtag (#rateme, #hotornot) or referencing a contest (#custestteen) looking for likes or positive comments.

Ask.fm: Ask.fm is a global social networking site where users create profiles and can send each other questions, with the option of doing so anonymously. The site was founded in Latvia and launched on June 16, 2010 as a rival to Formspring. Bullies are free to sign up for a fully anonymous account, and therefore can bully without fear of their real identity being uncovered. Ask.fm has been linked to 9 teen suicides in the past year.
Runners up for cyberbullying include the following sites:

Formspring.me: Formspring is a global social network where members ask each other questions and learn more about one other through interesting, funny and personal responses. People use Formspring to get to know friends (and friends of friends), have conversations with favorite celebrities, and connect with others around common interests.Until a rebranding in 2013, it was known as Formspring, a question-and-answer-based social network launched in 2009. Users of the site can follow others privately. While logged in as a registered user, people can also ask questions to his or her followers from the homepage. Spring.me also asks one question per day named “Formspring Question of the Day” which is flashed in user’s inbox.

Chatroulette: An online chat website that pairs random people from around the world together for webcam-based conversations. Visitors to the website begin an online chat (text, audio and video) with another visitor.

* In May, 2010 thousand’s of people watched powerless while a man was hanging by a rope from the ceiling, slowly swinging, for hours and hours on the popular website Chatroulette. The hanging man was in fact Brooklyn based artist Franco Mattes, and the whole scene a set up. The artist recorded  the performance and then posted it online. In the video, titled “No Fun”, one can see all possible reactions, from the most predictable to the most unthinkable: some laugh, believing it’s a joke, some seem to not care at all while others take pictures with their phones. Apparently, out of several thousand people, only one called the police.

* No fun video: The following video may disturb and trigger some readers. If you are in a crisis, please contact the Suicide Life Line at 1-800-273-TALK (8255) http://0100101110101101.org/no-fun/

Snapchat: A mobile app that allows users to capture videos and pictures that self-destruct after a few seconds. When a user sends a message they get to decide whether it will live for between 1 and 10 seconds.

* Teen girl turned suicidal after boy gave out Snapchat nude: http://nypost.com/2014/06/29/teen-sues-boy-over-nude-snapchat-spread-on-social-media/

Twitter: Twitter is an online social networking service that enables users to send and read short 140-character messages called “tweets”. Registered users can read and post tweets, but unregistered users can only read them.

* The suicide of Rutgers’s Freshman Tyler Clemnti is linked to cyberbullying. Clementi’s college roommate set up a hidden webcam and streamed footage of him kissing another man. Tyler became a target of the then new social media site Twitter and became a topic of constant ridicule.   www.tylerclementi.org/tylers-story

JuicyCampus: website focusing on gossip, rumors, and rants related to colleges and universities in the United States.

Txtspoof.com: TxtSpoof lets you send a text message that appears to come from someone else’s cell phone.


For resources on Cyberbullying, please contact the Cyberbullying Resource Center at http://cyberbullying.us


Additional Cyberbullying Resources:






Why Everyone Should be Familiar with the Military Form DD214

If you are a veteran, work with veterans, or are assisting someone who has served on active duty it is imperative that you understand the basics of the DD214. Knowing how to obtain this document can save valuable time for the veteran or dependent in a crisis. Understanding its uses post-military service can link a veteran or their surviving dependents to numerous benefits; some of which may prevent huge financial burdens.

What is a DD214?

The DD Form 214, Certificate of Release or Discharge from Military Duty, is a document issued by the United States Department of Defense upon an active duty service member’s retirement, separation, or discharge from active duty military service. Note that this is a form for active duty members and not National Guard, Reserves or IRR (Inactive Ready Reserves). For example, the Army National Guard uses the NGB-22 issued by the National Guard Bureau. The DD214 is usually issued at the final out-processing appointment prior to retirement or separation and is the most important post-military document issued; detailed instructions below for obtaining a copy of the DD214.

**Note: The first DD214’s were issued in 1950 replacing forms WD AGO or “War Department Adjutant Generals Office” and the “NAVPERS” which was issued to Naval Personnel.

Who uses a DD214?

Whether you are trying to apply for a VA loan, access Department of Veterans Affairs Benefits (e.g. healthcare, mental health),education benefits such as the GI Bill or Yellow Ribbon programs you will need to have a copy of the eligible veteran’s DD214. If you are trying to plan or arrange a funeral utilizing military benefits or would like military honors a DD214 will be required. Starting Sept 1, 2000 the National Defense Authorization Act enabled, upon the family’s request, that every eligible veteran may receive military funeral honors at no cost to the family; see below for a link explaining military funeral honors and a separate link for military funeral benefits. If the veteran is purchasing a funeral plan, it could be very helpful that the funeral home have a copy if military funeral honors or funeral benefits will be requested.

** Military funeral honors could include the playing of TAPS, rifle services, flag folding & presentation, caisson or flyover.

Other uses for the DD214 include entrance into most veteran’s organizations like the VFW and verifying employment. Person’s claiming prior military service for means of employment will often be asked to provide this document which verifies completed trainings and schools, awards and decorations and nature of discharge. Not to add any confusion surrounding this form, but be mindful that there are two versions of the DD Form 214. The first, usually referred to as “short” is an edited or deleted copy whereas the “long” is unedited. The edited or “short” copy omits a great deal of information, chiefly the characterization of service and reason for discharge; most people requesting the DD214 will not accept the short.

Options for Storing & Sharing DD214:

It is vital that a veterans next of kin or emergency contact person has a copy of this document, and it is recommended that is be included in any estate or will documents. If the veteran does not have a next of kin or adequate support person they can file their DD214 at their local court house to keep it on record. Another option that assists in storing and sharing military documents can be found online at “Google For Veterans”; I store a PDF of my DD214 here so that in an emergency my family has it readily accessible.

Instructions for Requesting a DD214:

Contact the National Personnel Records Center (NPRC):
NPRC: http://www.archives.gov/veterans/military-service-records/index.html

Records can be requested online, by mail or fax. Additionally, personnel records and medical records are available through this agency as well. You will need to submit an SF-180 Form for this request which is found here -> http://www.archives.gov/research/order/standard-form-180.pdf

** Quick Link to request DD214 online through the NPRC:   https://vetrecs.archives.gov/VeteranRequest/home.html

If you are mailing send to:
National Personnel Records Center
Attn: Military Personnel Records
1 Archives Drive
St. Louis, MO 63138

If you are faxing send to: 314-801-9195

** Important: Please Note: Next-of-kin (the un-remarried widow or widower, son, daughter, father, mother, brother or sister of the deceased veteran) must provide proof of death of the veteran, such as a copy of the death certificate, a letter from the funeral home or a published obituary.

**Urgent Request through NPRC:
If your request is urgent (e.g. upcoming surgery, funeral, etc.) and there is a deadline associated with your request, provide this information in the “Comments” section of eVetrecs or in the “Purpose” section of the SF-180 and fax it to the Customer Service Team at (314) 801-0764. NPRC goal is to complete all urgent requests within two working days. However, in some instances we can complete requests the same day if necessary. Contact customer service staff at (314) 801-0800 if you have questions or require same day service.

** Additional References:

Information Found on the DD214:
•Date and place of entry into active duty
•Home address at time of entry
•Date and place of release from active duty
•Home address after separation
•Last duty assignment and rank
•Military Job Specialty
•Military Education
•Decorations, medals, badges, citations and campaign awards
•Total creditable service
•Foreign Service credited
•Separation information(type of separation, character of service, authority and reason for separation, separation and reenlistment eligibility codes

Google for Veterans: https://www.googleforveterans.com/
Military Funeral Honors: https://www.dmdc.osd.mil/mfh/getLinks.do?tab=Home
Military Burial Benefits: http://www.cem.va.gov/burial_benefits/
U.S. Department of Veterans Affairs: http://va.gov/
VA Dependent or Survivor Benefits: http://www.va.gov/opa/persona/dependent_survivor.asp

Why do we have PRIDE Month?

June is a special time of year. For students, many are finally out of school for the summer and spending time with family and friends. For most, it’s a time for relaxation and enjoying the summer months. However, June has special significant for the LGBTQ community. Beginning in 1981, the month of June has been dedicated to the celebration of the lives of gay and lesbian people in the United States. A Pride Festival has taken place every year since which gives gay and lesbian people the opportunity to celebrate who they have become, and to be publicly proud without shame or discrimination. The goal of Pride Month is to foster an understanding and equality for the LGBTQ community in the general population by raising awareness through educational programs and events.

Pride Month exists to fight against the ideological system known as heterosexism. Heterosexism is commonly defined as an ideological system that denies, denigrates, and stigmatizes any non-heterosexual forms of behavior, identity, relationships, and community. Heterosexism should be noted because it advances the superiority of heterosexuality with the assumption that everyone is, or should be, heterosexual and abide by heteronormativity—the mundane, everyday ways that heterosexuality is privileged and taken for granted as normal and natural. Simply put, heterosexism is the belief that heterosexual relationships are the only acceptable form of sexual relationship. In fact, as of 1973, homosexuality remained listed as a mental disorder in the Diagnostic and Statistical Manual. Even with this change, many people still regard LBTQ as a social deviance.

Negative attitudes towards those who consider themselves homosexual have been common throughout history. From a sociological understanding, individuals go through ways of changing themselves in order to be more socially accepted. Ways in which this is commonly done include career successes, making a joke or mockery of transgressions, or propping up masculinity/femininity in other ways. In order to fit in with others and feel accepted by heterosexual peers, many LGBTQ individuals feel they must meet high expectations or prove themselves in some way. These high expectations cause many individuals to feel insecure about themselves, and as a result, are forced to pretend to be someone that they are not. Many LGBTQ individuals from a religious background have undergone “reparative therapy” which included the psychological and therapeutic interventions whose aim is to change the orientation of lesbian, gay, and bisexual individuals to that of an orientation which is primarily heterosexual. While the form of discrimination may vary, it sends a solid message that says: “there is something wrong with you- you are ‘less than.’

Pride Month is an opportunity for people in the United States to recognize, appreciate and celebrate those in the LGBTQ population. BHR Worldwide exists to support and assist individuals in crisis and seeks to celebrate the LBGTQ population for who they are, understand the trials that they have faced and support them in their fight for equality.

Author: Seth Showalter, MSW, LMSW

Are Traumatic Brain Injuries Increasing Veteran Suicides?

One of the greatest risks to returning service members in the United States is the lack of mental health care services. There is a far greater risk of becoming a psychological casualty of war than actually being killed on the battle field. Approximately 2.6 million American service members have fought in Iraq or Afghanistan alone adding 1.5 million veterans to the pool of those needing VA health care services since 2001. At least 20% of returning Iraq and Afghanistan veterans are experiencing PTSD, and the rate of veterans dying by suicide is estimated to be at 22 per day. During my lunch break today, which is not during a peak time as I work very early, I attempted to schedule a mental health appointment at my local VA Hospital. I waited an extensive amount of time before being transferred back to the operator and then finally being disconnected; deep breaths. Luckily for me I was not in need of crisis services and was just trying to gather research for this article. But, had I been in a place where the more “colorful” symptoms of my PTSD were present this could have gone another way. Yes, I am a veteran and am writing this from lived experiences acquired during my 6 year tenure of service, 1999-2005; when I was deployed in support of Operation Enduring Freedom.
An estimated 250,000 veterans living with Traumatic Brain Injuries (TBI) have been identified since 9/11; the VA began mandatory TBI screenings in 2007. The TBI is often called the “signature wound” of the Iraq and Afghanistan wars and occurs when a sudden trauma or head injury disrupts the functions of the brain. Often times these injuries are associated with explosives blasts (IEDs), falls or motor vehicle accidents. A TBI can happen at any point where the head has been struck hard enough by an object that would change consciousness resulting in disorientation and confusion. The vast majority of TBI’s are sustained by Army soldiers and are reported as MTBI’s (mild) which research is finding may lead to more suicidal thoughts that more severe TBI’s.

Many people are familiar with concussion related injuries suffered by NFL athletes, but little is known by the American public about the effects on the American soldier’s mental health after suffering a TBI. In fact, little is known to the public of the effect of TBI’s on athlete’s mental health. Last season, Ohio State football player Kosta Karageorge, 22, suicided after suffering a string of concussions that his family reported were “affecting his mind”. Karageorge was a college wrestler before joining the football team and had no known history of mental illness prior to taking his life. Many believe that the increase in veteran suicides are in direct correlation with the “signature wound” of today’s modern warfare; the TBI.

A study conducted by Craig Bryan, assistant professor of psychology at the University of Utah and associate director of the National Center for Veterans Studies found that military members with multiple TBI’s were more likely to be at risk for suicide ,not only in the short term but throughout their life. Many of these military members sustained early TBI’s from athletics and then compounded their injuries by entering military training or combat. Bryan studied active-duty soldiers in Iraq in 2009 finding that over one in five, 22%, who experienced more than one TBI in their life time reported thoughts or preoccupation with suicide. The rate for soldiers with only one TBI was 6%. The rate of suicide thought occurrence among military members with multiple TBI events was 267% higher than those with only one TBI event. Those with no history of TBI reported no suicidal thoughts. Some of the members that took part in this study had up to six reported TBI’s before joining the military with 20% sustaining concussions during basic training. Bryan states that theses earlier injuries can create a “preexisting vulnerability that gets activated” by another head injury sustained in combat. According to VA research, some service members have sustained as many as 15 traumatic brain injuries while per deployment deployed with the modern day service member completing three overseas tours of duty. Other opportunities for TBI exist between deployments due to excessive and rigorous training schedules and leadership academies.

The Veterans Health Administration has a Polytrauma System of Care to treat and care for veterans with TBI alone or in in conjunction with other mental or physical health care needs. For more information on military TBI, please visit military.com at http://www.military.com/benefits/veterans-health-care/tbi-rehabilitation.html or check out the list or resources provided below. Please note these resources are not provided in lieu of medical advice and 911 should always be called for a medical emergency.

Follow on Twitter:@BartAndrews

#SPSM #zerosuicide

Veterans Crisis Line: Option 1: 1-800-273-8255

AMVETS (To get help with your VA Disability) : 877-726-8387

Request a free copy of your form DD 214 (Military Separation Papers) http://freedd214.com/reference/FreeDD214_SF180.pdf

Wounded Warrior Project: Clay Hunt Suicide Prevention Project: https://www.woundedwarriorproject.org/featured-campaign/president-obama-signs-into-law-


Are you a Caregiver or a Companion?

Grief is a complicated, complex, and intricate symptom of life most will experience multiple times over. One often associates the term grief with the death of person, but grief can manifest in many different forms. We grieve the loss of a pet, the loss of a relationship, career, and social status. Grief can follow a miscarriage, financial hardship, and even separation from one’s religion. When we are caring for this person who is grieving, what do we call ourselves? Some use the term “caregiver”. Dr. Wolfelt, founder and director of The Center for Loss & Life Transition, has his own philosophy he discusses in his books Companioning the Bereaved and The Handbook for Companioning the Mourner. Dr. Wolfelt discusses taking liberties with the noun “companion” and making it into the verb “companioning” as it captures the type of counseling relationship for which he supports and advocates for. He imagines companioning as sitting at a table together, being present with one another, sharing, communing, and abiding in the fellowship of hospitality. Dr. Wolfelt states that companioning the bereaved and grieving is not about assessing, analyzing, fixing or resolving another’s grief. Instead, it is about being totally present to the mourner.

The companioning model is anchored in the “teach me” perspective; it is about observing rather than needing to give guidance or constant validation. Often when I am trying to go through the steps of companioning I have to remind myself to “just be”. The meaning of “observance” comes to us from ritual. It means not only to “watch out for” or ” bear witness”. The caregiver’s awareness of this desire to learn is the essence of true companioning. Is it your desire to support a fellow human in grief? If so, then you must create a “safe place” for that person to embrace their feelings of profound loss and separate your needs from theirs. Present to the griever with a cleaned-out, compassionate heart. This open heart truly allows you to be present with another human being during his or her hour of need. Bereavement caregivers are companions, not guides. To accurately follow the companioning model means to watch and learn, not assume knowledge over another which you could not possibly ever know. Companioning is free from analytics, numbers, and data sets and takes on a more person-centered approach that encompasses what it truly means to be a human and to show empathy.

True companioning teaches that our awareness of the need to learn as opposed to playing the expert is the essence of being truly present . True companioning is the art of bringing comfort to another by becoming familiar with their story, experiences and needs. To companion and not guide the grieving person may involve your own tears and sorrow and tends to involve a give and take of story; it is a partaking and undertaking that will require you as the companion to apply your own self-care throughout this process. Grief is complicated.



Dr. Wolfelt’s 11 Tenets of Caring for the Bereaved

1.)Companioning is described as being present to another person’s pain; it is not about taking it away.

2.)Companioning is about going into the wilderness of the soul with another human being; it is not about thinking you are responsible for finding the way out.

3.)Companioning is about honoring the spirit; it is not about focusing on the intellect.

4.)Companioning is about listening with the heart; it is not about analyzing with the head.

5.)Companioning is about bearing witness to the struggles of others; it is not about judging or directing these struggles.

6.)Companioning is about walking alongside; it is not about leading or being led.

7.)Companioning is about discovering the gifts of sacred silence; it is not about filling up every moment with words.

8.)Companioning is about being still; it is not about frantic movement forward.

9.)Companioning is about respecting disorder and confusion; it is not about imposing order and logic.

10.)Companioning is about learning from others; it is not about teaching them.

11.)Companioning is about compassionate curiosity; it is not about expertise.

“But grief is not a disease. Instead, it is the normal, healthy process of embracing the mystery of the death of someone loved. If mourners see themselves as active participants in their healing, they will experience a renewed sense of meaning and purpose in life” Dr. Alan Wolfelt


For more information on Companioning, please visit http://www.centerforloss.com/about-dr-alan-wolfelt/


BHR Recognized at 18th Annual What’s Right with the Region


BHR CEO Pat Coleman & Board Member Kim Gladstone
BHR CEO & Board Member Kim Gladstone


On May 7, 2015, BHR was invited to participate in the 18th Annual What’s Right with the Region! FOCUS award night hosted by FOCUS St. Louis. What’s Right with the Region recognizes the efforts of 20 individuals, organizations and/or initiatives that are making a difference in our region. This year’s awards were presented in five categories which included:

• Demonstrating Innovative Solutions

• Fostering Regional Cooperation

• Improving Racial Equality and Social Justice

• Promoting Stronger Communities

• Responding to Community Needs & Entrepreneurs

BHR was recognized for its role in fostering regional cooperation and this was the first ever nomination for the organization. As noted by FOCUS St. Louis, “BHR’s primary asset has been the ability to connect individuals in need with other providers and resources in the community. From BHR’s inception to its current operation, BHR is a picture of what regional cooperation should look like in making St. Louis a better place to live.’ BHR’s CEO Pat Coleman and Board Member Kim Gladstone accepted the award on behalf of the organization and were joined in attendance for the event by many members of the BHR executive, administrative and clinical teams. Recently, BHR was recognized by the American Association of Suicidiology as the Crisis Center of Excellence Award Winner 2015. The true depth of BHR and its desired impact on the community is best summed up by their mission statement which reads, “We envision a world where all people are empowered to receive essential help and support to promote healthy living.”


Author: Allison Alsop, MA, PLPC


BHR Chosen to participate in Give STL Day 5/5/2015

On Tuesday, May 5 2015 , be part of Give STL Day and make a difference in St. Louis by donating to the BHR Crisis Lines.

Give STL Day is a 24-hour giving event with local impact. BHR is raising funds to support staff self-care and will sponsor a self-care week in July which will include a variety of resources supporting the well-being of BHR staff. BHR is manned 24/7 and does not close for inclement weather, holidays or other events because we know that a crisis is not limited to business hours. Our clinicians are always available to respond to crisis and work collaboratively with schools, parents, law enforcement and beyond to provide our customers with the level of care that they need and deserve. The management staff at BHR strives to work with clinicians and staff to support their needs and understands the emotional toll that helping others can have. Clinicians in the helping professions can experience compassion fatigue and burn out and we are constantly exploring new tools and approaches to remain emotionally and clinically healthy.

Recently, HBO created a documentary entitled Crisis Hotline: Veterans Push 1. This documentary gives powerful insight into the real emotions that call center clinicians face on a daily basis. Information on this documentary can be found at http://www.hbo.com/documentaries/crisis-hotline-veterans-press-1/synopsis.html#/.

With your help, we can provide our clinicians with additional tools to continue their engagements in selfcare so we can also continue to carry out our mission to care, listen, and respond 24 hours a day.


Author: Allison Alsop, MA, PLPC