For my PHC 6534 grant proposal, I chose a topic that was near and dear to me. Having served on active duty in the military, I have been on my fair share of deployments to combat zones. I now work as a civilian for the military, in deployment and logistics, deploying others to those same combat zones. While I am familiar with the effects of PTSD, as I have seen it first hand, prior to this course, I was unaware of the correlation of ACEs scores to how someone might process combat stressors.
Blosnich et al. (2014) identified the importance of studying the prevalence of adverse childhood experiences (ACEs) within the military community, as the military branches often contain multitudes of members who have enlisted as a means to escape adverse environments. As individuals with ACEs histories often cope differently than those with no exposure, military members that score one or above for ACEs and have been exposed to combat stressors are at a higher risk for suicide, depression, ACE-related health issues, etc. While military members are given annual mental health assessments and post-deployment health assessments, there is no prevention or research to support adverse childhood experiences within the military community. This grant proposal seeks the monetary funds to establish a interactive, web-based platform to administer a third-party questionnaire that would be made available to military members. The questionnaire would examine pre-military service ACEs exposures and provide means for prevention for long-term health consequences for military members affected by ACEs.
Trauma-Informed Principles the Grant Will Utilize
Trustworthiness and Transparency – Following in the footsteps of SAMSHA’s (2014) principle of trustworthiness and transparency, individuals/patients/participants will be fully informed of the program’s goal to build and maintain trust while simultaneously providing vital information and resources.
Empowerment, Voice and Choice – Individuals’ experiences will be taken into consideration, as they will be able to voice their concerns and seek help without the invisible weight and stigma that military members often feel when discussing mental and behavioral health issues. Individuals will have the choice, with program success, of choosing whether to seek care on a military installation or off, at their choosing.
Peer Support and Mutual Self Help – Participants will be provides outlets outside of therapy and counseling through the web-based platform. Based off the input location (done by the participant), programs specific to that location will be listed on the site. Online forums will also be incorporated, allowing individuals to build trust and enhance collaboration with others in similar situations.
Levels of the Social Ecological Model
While the central vein of this grant focuses on the individual, all levels of the CDC’s (n.d.) Social Ecological Model will be affected. Tools the individual receives from participation hold the possibility of leading to further treatment and assist in the processing of trauma-related occurrences. Those tools in turn can affect the relationships the individual has, the military community the individual is a part of and society as a whole. While the primary focus of this grant proposal is the individual, it promises impact at all levels of the model as resources designed for the military member will matriculate outward.
Public Health Framework
This program will initially focus on screening, and later branch out more towards prevention. Subsequently, treatment options will contribute to the preventative focus of the program. By focusing primarily on screening in the beginning stages, the program will be able to identify underlying disease and the connection of such disease and emotional barriers often accompanying individuals with ACEs that have been exposed to combat stressors and show signs of PTSD. In identifying the relationship between ACEs and combat stress, veterans will be educated on the wider-ranging impact and return to the site to explore alternative treatment options if they do not wish to seek behavioral/mental health counseling due to the stigma surrounding it in the military environments. The program will be able to illustrate prevention while also educating participants.
Private capital can be encouraged due to military members assimilating into the civilian population following service commitments. With an emphasis on helping combat veterans to adjust, this creates a “buy-in” for private capital. Following initial program success, the door would be open for funding to provide treatment for military individuals who do not wish to seek treatment within the military community and/or environment. Ultimately, the public health framework of the program seeks to provide the research and background in order to incorporate prevention measures for future military members entering combat situations when a history of ACEs exist.
REFERENCES
Blosnich, J.R., Dicter, M.E., Cerulli, C., Batten, S.V., & Bossarte, R.M. (2014). Dispartities in adverse childhood experiences among individuals with a history of military service. JAMA Psychiatry, 71(9), 1041-1048. Doi: 10.1001/jamapsychiatry.2014.724
CDC. (n.d.). The social-ecological model: A framework for prevention. Retrieved from https://www.cdc.gov/violencepr...ecologicalmodel.html
Substance Abuse and Mental Health Services Administration|SAMHSA. (2014). SAMHSA’s concept of trauma and guidance for trauma-informed approach. HHS Publication No. (SMA), 14-4884. Rockville, MD: Substance Abuse and Mental Health Services Administration.
*Photo credit: Joshua Seybert, USAF Public Affairs
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