February 3, 2023

It’s a simple question the state’s military leaders would like more health care providers to ask patients: Have you or a family member served in the military? They say the answer can inform treatment, and the question can make a patient feel seen and understood – both critical to successful treatment.
Aiming to increase awareness of military culture and its impact on service members, veterans, and their families, the state Department of Military Affairs and Veterans Services plans to invest up to $250,000 in a statewide training program. Topics will range from military core values, terminology, and branches of the service to the impact of deployment and challenges of returning home. 
“There’s absolutely a need,” said Tracie Parker, a longtime member of the military and a social worker with the Mental Health Center of Greater Manchester. She offers 90-minute small group training on military cultural competence through her organization.
“There’s a huge amount of stigma that goes along with seeking mental health treatment,” Parker said. “It’s hard enough for our community to ask for help. And to ask for help from people who don’t understand what we’ve been through is really difficult.”
For example, don’t call Air Force members “zoomies” (they are airmen) or Marines soldiers (soldiers serve in the Army and National Guard). And don’t equate the trauma of combat duty with the trauma of a car crash. 
“If they verbalize that to someone in the military, it almost diminishes what their experience is,” Parker said. “I understand it. The brain processes trauma the same. But those traumas are really different experiences.”
There are nearly 100,000 veterans and 4,000 active service members in New Hampshire. The Department of Military Affairs and Veterans Services already provides health care providers and anyone working with military members and veterans free online cultural awareness and suicide prevention training through its website, dmavs.nh.gov
And for the last several years, the department has promoted its “Ask the Question” campaign, urging health care providers to ask patients about military experience because so many members and veterans were being misdiagnosed. 
Those efforts inspired the new training, said Warren Perry, deputy adjutant general at the department. 
“What do you do if someone says yes? That’s why we are doing this,” he said. “Providers have to have this understanding. It helps them better provide care and understand the causes so they can treat the patient.”
The training will be free and in-person. Online was not an option, Perry said, because he wants providers to sit in a room together and share experiences and talk face-to-face.
In the department’s proposal seeking organizations interested in providing the training, it pointed to a 2014 study by the RAND Corporation of military cultural awareness among health care providers. Only 8 percent of those working outside military settings or the military’s health benefits network had a high level of awareness.
Tye Thompson, a recreation therapist at Northeast Passage in Durham, works with veterans and said awareness of military culture is no less important than awareness of racial, ethnic, gender identity, or sexual orientation culture. 
“I think cultural competence is an ethical requirement for all health care practitioners,” Thompson said. “Understanding the clients you are serving creates a safe and welcoming place and supports clients’ in getting what they need.”
Thompson said the training will be a good opportunity to encourage providers to think and rethink their understanding and provide better care.
Perry said he hopes to begin the training later this year, after the department has reviewed proposals and chosen an organization. In the meantime, Parker suggests starting with curiosity.
“It’s important not to come across with an attitude, as a civilian, that you know what they’ve been through,” she said. “It’s important to be humble. You don’t know their experience. And they are not going to be offended if you ask questions.”
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