National Alliance on Mental Illness
page printed from NAMI Indianapolis
First Installment of Shawn Appleget’s Story About His Current Work in a Combat Stress Control Unit in Irag
My unit is broken up into several teams. These teams cover all of Central Iraq. There is a different CSC (Combat Stress Control) unit that covers the north and one that covers the south. There are two types of teams, prevention and restoration. Prevention teams cover smaller bases and areas. Their job is to conduct classes to units (such as suicide prevention, resiliency, team building, substance abuse prevention, etc), and basically let people know that the CSC is available and what we provide. If a soldier needs further, more intense treatment, they are referred to a restoration clinic in either Baghdad or Balad. This would be considered “inpatient”, where the soldier stays at the clinic for 3-5 days. Here they receive more in depth classes (such as homefront issues, anger management, goal setting, self-esteem building, communication skills, conflict resolution, sleep management and relaxation) that primarily revolve around Rational Behavioral Therapy. Soldiers receive one-on-one time with a behavioral health technician and licensed provider (i.e., psychologist, social worker, and psychiatrist). If still more intensive treatment is necessary, they are evacuated to Germany. These would be soldiers who are often more acutely suicidal, homicidal, have some sort of psychosis, or a medical condition.
We have three parts to our clinic. The prevention team, outpatient care, and inpatient care. The prevention team does pretty much what I’ve already described, traveling out to the various units on base (we house around 30,000 troops and civilians) to conduct classes. The clinic consists of four behavioral health technicians, one Ph.D psychologist, one LCSW social worker, two psychiatrists, one occupational therapist, and two certified OT assistants. We average about 18 soldiers a day. These include new soldiers and follow up appointments. The two main reasons we see soldiers are stress due to homefront issues and conflict with their leadership. The inpatient side averages 4 soldiers on any given day. When a soldier is referred, we require an escort to be present. This is kind of similar to how AA uses “sponsors” with their members. We ask that the escorts be supportive and attend classes with the soldier. They will learn the same coping tools as the soldier and once the soldier returns to their unit, they will have someone to support them and to confide in when things become difficult. No one in the clinic (staff, patients, visitors) has weapons. Each day is different and very client focused.
So here is what I do…I am responsible for any and all reporting, all statistical data about who we see and why. I am responsible for quality control where I monitor and make changes to standard operating procedures based on client feedback. My goal this deployment was to ensure that when a soldier walked into this clinic, he or she got something out of the experience and would not hesitate to return.
Staff is scheduled to work six days a week, ten hours per day. It is also my responsibility to make sure staff training takes place, as well as conducting staff meetings each morning to discuss inpatient and outpatient cases. Another aspect of my job is to ensure the staff stays happy! We hear some pretty horrific stories from the clients, work long hours and are away from home like everyone is, I really try to make this place as enjoyable as possible.