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G-1, Human Resources Policy Directorate

Supporting Soldiers, Families & Civilians – Active, Guard, Reserve and Retired

3 September 2008

53

1.

With the current shortage of medical personnel, is it probably inevitable that medical staff will focus on the physical injuries, leaving the invisible psychological injuries untreated. How would you modify your policies and procedures to ensure that Soldiers like this one receive the psychological care they deserve? (Make a routine psychological assessment part of the initial admission physical and schedule routine psychological follow-up sessions during the course of treatment. Do not have staff wait until a psychological crisis arises before obtaining mental health services. Educate staff regarding dual- and multiple diagnosis cases and the needs of such cases for early mental health intervention.)

2.

As a health care provider, you are concerned that returning injured Soldiers seem to be withdrawing socially and distancing themselves from friends and loved ones. Would you make any changes in your treatment plans? If so, what kinds of changes? (for discussion).

3.

How can one reduce the boredom and sense of hopelessness/helplessness experienced by Soldiers in Warrior Transition Units? (Find meaningful work and activities for the Soldier’s when they are not being treated.)

4.

What is the best way to deal with individuals in WTU’s who appear to be “padding their nest”, i.e. presenting greater disability than can be accounted for on the basis of their injuries? (First, understand that, if an error in judgment is to be made, it is better to err on the side of the Soldier. Secondly, it is often very difficult to differentiate between malingering and factitious disorders [disorders wherein medical complains appear to be expressed for the sole purpose of gaining the attention of health care providers]. Also understand that many Soldiers feel, perhaps justifiably, that they will be “short-changed” by the Medical Evaluation Board. Thus, in order to receive “justice”, they must present with an overabundance of symptoms so that, in the end, they will be properly reimbursed. If malingering can be firmly established, the Soldier should be confronted and made aware of the consequences of such behavior. However, it will frequently take some sort of “face-saving” maneuver to permit such individuals to gracefully give up their excess symptoms).

5.

How can line officers and health care providers better cooperate to reduce suicides? (for discussion).

Scenario #8 - Post-Deployment

STRATEGIC QUESTIONS and ANSWERS:

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