Treating Post-Traumatic Stress Disorder in a Military Correctional Setting
Keller, Nathan, Bachmeier, Kathleen, Corrections Today
America has been engaged in continuous combat operations in Iraq and Afghanistan since October 2001, representing the longest sustained ground combat operations involving American troops since the Vietnam era. (1) Service members have been called to participate in multiple deployments that expose them to combat-related traumas for unprecedented lengths of time, often with little time to rest between deployments. (2) As a result, service members are experiencing high rates of debilitating mental health issues, including post-traumatic stress disorder (PTSD). The Department of Defense has placed special emphasis on implementing evidence-based treatment programs to assist all members of the military recovering from PTSD. The condition is not limited to combat veterans, but can occur when any individual experiences an event they perceive as traumatic, such as being involved in a serious accident, experiencing physical/sexual abuse or surviving a natural disaster.
According to the National Institute of Mental Health website, individuals with PTSD typically display three types of symptoms: (3)
* Re-experiencing symptoms: flashbacks reliving the trauma over and over with physical symptoms such as a racing heart or sweating, nightmares and frightening thoughts;
* Avoidance symptoms: staying away from places, events or objects that are reminders of the experience; feeling emotionally numb or feeling strong guilt, depression or worry; losing interest in activities that were enjoyable in the past; and having trouble remembering the traumatic event; and
* Hyperarousal symptoms: being easily startled, feeling "on edge" or tense, having difficulty sleeping and/or having angry outbursts.
Despite these debilitating PTSD symptoms, many service members do not seek help to resolve their conditions and often arrive at correctional facilities untreated. Service members have identified some barriers that inhibit them from seeking care for their mental health problems, such as their belief that treatment would not be kept confidential, and would constrain future job assignments and career advancement; doubts of even good mental health care being effective; and not having enough time to participate in treatment, money or convenient access to mental health care. (4) As a result, service members often attempt to resolve or manage their symptoms on their own. They try to ignore or distract themselves from their symptoms through behaviors that can become self-destructive--social isolation, unhealthy relationships, unsafe adrenaline seeking activities, and self-medication with drugs and alcohol. The attempts to self-soothe are often unsuccessful, as veterans suffering from deployment-related mental health conditions are more likely to have higher rates of unhealthy behaviors (e.g., smoking, drug and alcohol problems, overeating, unsafe sex, traffic violations); higher rates of physical health problems and mortality; and a tendency to miss more days of work. They also are more likely to experience impaired personal relationships; disrupt marriages; aggravate difficulties with parenting; be involved in physical altercations; and have a higher rate of trouble with the law. (5)
Military corrections has estimated that seven percent of the inmate population at the U.S. Disciplinary Barracks (USDB) at Fort Leavenworth, Kan., have PTSD symptomology, according to the USDB Fort Leavenworth, Kan., Directorate of Inmate Services (2012). These inmates typically have a more difficult time adjusting to the correctional environment and are more likely to participate in behaviors that put themselves, other inmates, staff and the greater community at risk. Recognizing the negative impact of PTSD, military corrections has placed importance on providing PTSD treatment programs as a critical part of the inmate's rehabilitation process.
One such PTSD treatment program can be found at USDB Fort Leavenworth, Kan. …