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Decades After Desert Storm, inTransition is There for You

Image of General Schwartzkopf inspecting troops in 1991. General Schwartzkopf inspecting troops in 1991

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inTransition | Posttraumatic Stress Disorder | Mental Health is Health Care

January marks 32 years since the start of the first Gulf War—Operation Desert Storm. For those who have experienced post-traumatic stress disorder, anniversaries of traumatic events can be one of many triggers, even years later.

These "anniversary reactions" may cause PTSD symptoms, according to the Department of Veteran Affairs. “Those dates always just kind of come back,” said U.S. Army Iraq War veteran Guillermo Sanchez on the VA’s AboutFace program. “Even if you don't ever make an effort to remember that date … it'll just hit me out of nowhere.”

As a veteran of Desert Storm, or of Afghanistan or Iraq, you may or may not have sought out behavioral health resources for treating PTSD, mild traumatic brain injury, or other mental health impacts of traumatic events.

But if you need help, the Defense Health Agency’s global inTransition program is here to assist you with your behavioral health information needs worldwide, 24/7/365 via phone, chat or email, helping to link service members and veterans to care.

Don’t Fall through the Cracks

inTransition is a voluntary, free, confidential program that offers specialized coaching and assistance for active-duty service members, U.S. National Guard members, reservists, veterans, and retirees who need access to behavioral health care while in a state of transitioning or any time after discharge.

Nicholas Polizzi, inTransition’s program manager who holds a doctorate in educational psychology, explained that the program “can help clients discern what services they're qualified or eligible for. And then help get them connected to providers, wherever and however they're moving.”

Polizzi said, “We have that really narrow, but so important, scope of making sure people don’t fall through the cracks after transitioning because health care, especially behavioral health care, are what's the first thing often to go by the wayside when somebody is transitioning, or even just moving from one location to another.”

One veteran who used the program, retired U.S. Army Capt. Joel Serrano, said when he transitioned after 26 years in the U.S. Army, he felt a sadness and struggled understanding why. “The inTransition Program ... it gave me the stability, a type of mentorship guiding you to stay on the path.”

Continuity of care is important because “situations like these are precisely when behavioral health care is needed the most, due to the stressors of transitioning and being potentially more at risk as a result,” said psychiatrist Dr. Charles Hoge, the senior scientist at the behavioral health division of the Office of the U.S. Army Surgeon General, in Falls Church, Virginia. “inTransition is one of the safety nets.”

inTransition services are available to all military members regardless of length of service or discharge status, and there is no expiration date to enroll.

Leaving the Military

Most notably, inTransition supports service members and veterans who are transitioning between behavioral health care providers, mostly because they are leaving the Department of Defense or separating from service or they're retiring.

“They're leaving the DOD and that culture, becoming a civilian, and pursuing behavioral health care in the civilian sector,” Polizzi explained. “We help them find resources in their geographic area, and then support them until they are connected to the resources providers who are working for them. And then we follow up to make sure they’re happy with the care,” he said.

“We won't rest until we help you get connected to care that works for you,” he stressed.

You can also just “kick the tires” at inTransition if you don’t want help now, Polizzi said, “It's good for you to know that inTransition remains as a service should you wish to use it in the future.”

If your situation or mental health changes, “just reach out to us anytime day or night to get that ball rolling again,” he said.

Game Planning

inTransition coaches, who are licensed behavioral health care professionals steeped in military culture, work with clients to create specific goals for getting them connected to care. Those goals depend on where the service member or veteran is in terms of his or her desire to get connected or how motivated they are, Polizzi explained.

“The service member or veteran identifies what's important to them, what their goals are, in terms of getting connected to care. And then the service member or veteran and the coach come up with a mutually agreed upon action plan, a game plan, that the veteran or service member is going to engage in between now and the next coaching call,” Polizzi explained.

That could involve as few as one to three goals, such as “contact the VA.”

The power is in the client’s hands: “We're not telling the service member or veteran what to do; we are mutually coming to an agreed-upon number of goals to address between now and the next coaching session. And they are all designed to help move the ball down the field,” Polizzi stressed.

PTSD Awareness infographic
Not all wounds are visible. Post-traumatic stress disorder can still affect you decades after a traumatic event. (Kimberly Farcot, MHS Communications Web team )

PTSD Awareness and Treatment

PTSD has been around since wars began under various names, such as battle fatigue and shell shock.

But in the past 30 years because of Iraq and Afghanistan, “there has been a huge leap both in the awareness of the problem, as well as the efforts to help people to feel more comfortable coming into care, as well as the types of treatment, and the diversity of treatments that are now available that were never available before,” said Hoge.

A retired U.S. Army colonel, Hoge is the former head of the Walter Reed Army Institute of ResearchOpens WRAIR military psychiatry program,which was responsible for measuring the psychological and neurological consequences of the Iraq and Afghanistan wars. He still serves as an attending psychiatrist at Walter Reed National Military Medical CenterOpens Walterreed.TRICARE.mil in Bethesda, Maryland, providing treatment to warriors and family members. He authored the first paper to describe PTSD in Iraq and Afghanistan veterans in 2003, deployed to Iraq in 2004, and then deployed to Afghanistan (as a civilian) in 2011 to improve combat stress care in the field.

Hoge said PTSD therapy can work, but noted that there is still a stigma attachedOpens Health.mil to seeking help.

“People are always concerned that mental health care is going to make them viewed differently by their peers or leaders, or that it might affect their ability to perform their job or their security clearance. These are the fears which we’ve tried to address and dispel the stigmatizing perceptions.”

However, many patients drop out of mental health treatment for a variety of reasons, Hoge said. “Because of that, I think the most important thing is trying to help service members or veterans become comfortable coming into care, and also feeling comfortable staying in care.”

“One of the biggest priorities of treatment needs to be focused on retention in treatment rather than on any particular type of treatment being used,” Hoge said, adding: “Research has shown that there are a whole lot of treatments that are about equally effective, both those that are specific for PTSD (trauma focused) as well as non-trauma focused therapies and medications.”

Resources

For inTransitionOpens Health.mil, its 20 FAQs are a helpful introduction to the program. You can call 800-424-7877, or at 800-748-81111 in Australia, Germany, Italy, Japan, and South Korea only. You can also email the program at: dha.ncr.j-9.mbx.inTransition@health.milOpens email.

The Military & Veteran Crisis LineOpens Veteranscrisisline, text-messaging service, and online chat provide free support for all service members, including members of the National Guard and Reserve, and all veterans, even if they are not registered with the Department of Veteran's Affairs (VA) or enrolled in VA health care.

A great place to start any search is Military OneSourceOpens militaryonesource, the DOD’s 24/7 gateway to trusted information for service members and families that provides resources and confidential help. Call 800-342-9667.

The Military Health SystemOpens Health.mil has many other mental health resources available to help any service member, families, or veteran beneficiaries who are struggling with mental health challenges.  Read Mental Health is Health CareOpens Health.mil for a complete list of resources for immediate assistance or to make appointments.

Here’s one veteran’s experience with the program at the word “experience”.

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Last Updated: January 27, 2023
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