How Telehealth Helps Veterans Transition To Civilian Life
PTSD vs. Transition Stress
The Department of Defense (DoD) has been using telehealth since the early 1990s and has been a leader in its innovation. Being one of the first to see its potential in the support of operational medicine; the use of telehealth has expanded from the field of battle to the homefront.
The DoD was required to increase the use of telehealth throughout the Military Health System (MHS) by The National Defense Authorization Act of 2017 (Sec. 718).
Yet challenges still exist with the current transitioning practices and resources available. The Military Treatment Facilities (MTF) lack the ability to reach access standards for the MHS. With the use of telehealth, these standards can be met.
The expansion
In 1993, the Army used telehealth in Somalia to remotely analyze imaging studies (Health Affairs). Since then, the U.S. military has expanded telehealth, providing services in 18 time zones, 30 countries and territories and over 60 specialties.
The MHS uses operational medicine in deployed or war settings where clinicians, patients and resources are at risk. Treatment facilities are typically on U.S. military bases or overseas.
Telehealth enables efficient identification of injuries to decide if evacuations are necessary, thus saving many soldiers’ lives. While allowing medical officers in dangerous areas to access experts remotely without placing them in harm’s way.
From the field of battle, the DoD has brought the use of telehealth to its veterans providing services for their transition home and making healthcare available throughout their return.
Transition Assistance Program (TAP)
TAP is a collaboration among the DoD, Department of Homeland Security (DHS), the Veterans Affairs (VA) and Veterans Employment and Training Services (VETS). TAP provides resources and information to veterans and their families to prepare for the transition to civilian life.
All service members are required to partake in The Transition Assistance Program (TAP) to meet the Career Readiness Standards (CRS) distinct to their civilian career goals. Service members begin either one to two years before leaving the military depending on separation or retirement.
It’s offered online for service members that are unable to attend in person due to their location or military duties.
Common challenges transitioning to civilian life
According to the Department of Veterans Affairs (VA), approximately 250,000 military service members return to civilian life each year. As many soldiers prepare to leave military service, they are faced with a new challenge. Civilian life. While it may seem like an easy feat, there are many difficulties with the transition, such as:
Relating to people
Many civilians do not understand what military personnel have experienced
Reconnecting with family / re-establishing a role in the family
Military families make adjustments to life while their loved ones are absent
Both the veteran and family members have to adjust to the return
Preparing to enter the workforce
Some veterans have never worked a civilian job
There’s a learning curve in understanding how to apply their military skills elsewhere and in navigating the application / interview process
Returning to a job
If deployed, service members will have to adjust to changes in the workplace; a new position, trainings or even the loss of a job
Independence
A veteran will have to learn how to make their own decisions and take care of themselves outside of the military’s structure and support
Physical and mental health
Some veterans return home with physical and/or mental injuries
Some may struggle to ask for help and accept it
Post-Traumatic Stress Disorder (PTSD) vs. transition stress
PTSD
Post-traumatic stress disorder is a psychological condition of mental and emotional stress. Some symptoms include flashbacks, lack of sleep due to nightmares and triggered distress. PTSD and other psychological disorders can have a devastating impact on veterans returning to civilian life.
According to the VA, anywhere from 11% to 30% of veterans will experience PTSD in their lifetime (depending on their service era). PTSD can be related to combat experience, reactions to training, sexual trauma and personal trauma.
Many service members are reluctant to seek treatment due to the stigma around PTSD and may go undiagnosed. With transition stress being a first consideration, service members may be more reluctant to seek help. Thus, decreasing the number of no-shows for clinicians.
Transition stress
Transition stress is not the result of traumatic experiences but the anticipation and struggle of readjusting to a new life. Many service members experience transition stress, which is often misdiagnosed as PTSD or other mental illnesses, thus treated incorrectly.
Transition stress is caused by the challenges with separating from the military, including:
Housing insecurity
Adjusting post serious injury
Feelings of isolation
Loss of identity and purpose
The difference is that PTSD is the after effect of trauma exposure, while transition stress is caused by readjusting to civilian life without adequate preparation or support. With more research, clinicians can accurately diagnose transition stress and provide the proper resources to aid veterans as they adapt to civilian life.
Note: The study of transition stress is recent, there is little information that currently exists.
The telehealth advantage
According to the Veterans Health Administration (VHA), approximately 45% of VA telehealth patients reside in a rural or remote area. This prevents easy access to specialists and providers for veterans. Telehealth eases travel for veterans with mobility issues and those with long commutes.
Clinicians are not limited to psychiatric care for veterans but can provide care in over 50 specialties including remote physical therapy. Clinicians can provide sessions remotely without removing a veteran, sustaining serious injury, from the comfort and safety of their own home.
The VA offers several types of telehealth services and specialties, such as:
Technology resources
Clinical video conferencing
Remote patient monitoring
Store-and-forward telehealth
Audiovisual technology
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