Giving Tuesday is recognized as the Tuesday after Thanksgiving in the United States, and has recently become a powerful global movement to inspire people to give, collaborate, and celebrate generosity. Here’s how Magellan Federal gives back to the community each and every day. Will you join us in building a better world?

Our Legacy of Service

One of the most unique aspects of Magellan Federal is our non-profit history. The story of our legacy dates back to 1879 through the establishment of a nonprofit organization to care for surviving spouses and children of fallen soldiers. Through the years, many families of fallen soldiers received support regarding military benefits, survivor benefits, and more through this non-profit.

In 2000 the Member Services department of this non-profit spun off and formed a for-profit corporation that embodied the values of giving back, service, and providing the best possible assistance to the military and their families. Armed Forces Services Corporation (AFSC) was born, formed by a Vietnam Veteran Service-Disabled service member whose mission was to expand services to warriors, veterans, and families. As a service-disabled, veteran-owned small business (SDVOSB), AFSC embedded a spirit of service throughout the organization by establishing a “double bottom line” mission to achieve not only business aims but also positive impact. For AFSC, success encompassed improving the lives of service members, veterans, and their families.

Growing Generosity

In 2016, AFSC joined Magellan Health, one of the nation’s largest healthcare companies, to create Magellan Federal, which strengthened the historical mission of AFSC’s service. Today, as Magellan Federal, we continue our legacy of service through our Community Partnership program, which formalizes and promotes activities of service and generosity. Through this program, we have streamlined our actions to support organizations that share our passion for giving back to the military and federal community.

Magellan Federal mobilizes and creates opportunities for employees to engage in volunteerism and philanthropic endeavors in the community. We give all Magellan employees eight hours of volunteer time off annually. As denoted in our values, we care deeply about each other, our customers and the communities we serve. Therefore, if there is something that needs to be done in any of these areas, we believe it is our job to do it. As it was in our inception, so it is today, if there is a need, we endeavor to serve until the need is met. You can view our #MFedCares team member stories on LinkedIn.

Call to Action

On Giving Tuesday—and every day—we invite you to join us in serving and giving back wherever and however you can. Whether it’s some of your time, a donation, or the power of your voice in your local community, no contribution is too small. It will always be our collective engagement to show up and serve that makes the most difference. As stated on GivingTuesday.org, here are some ways to serve:

• Support your local social good organizations, mutual aid networks, and community organizers
• Combat loneliness by reaching out to a relative, seniors, or veterans.
• Do an act of kindness or help a neighbor
• Identify your gifts, pick a cause that gets you fired up, and give back – not just for Giving Tuesday but every day.
• 50 ideas for acts of kindness

Every act of generosity counts and everyone has something to contribute toward building the better world we all want to live in.

This article is co-written by Elizabeth Duprey, LMHC.

Domestic violence, also known as intimate partner violence, is not about violence; it is about control. It is a pattern of behavior a person uses in a relationship to gain and maintain power and control over an intimate partner. Domestic violence is not just physical. It can be sexual, emotional, economic, psychological, and technological. These behaviors intimidate, silence, isolate, and manipulate another person. The common denominator is that all these areas can be used to dominate over another.¹

Domestic violence is a pervasive problem worldwide, including in the United States, and affects approximately 10 million people in the US every year. One in four women and one in nine men are victims of domestic violence. Since 2015, over 100,000 domestic violence cases have been reported in the military. However, most instances are not reported. ²

In addition, domestic violence cases can go unnoticed. Abusers and victims can go to great lengths to keep the abuse a secret for various reasons. Abusers will often engage in tactics such as coercion, threatening, manipulation, physical violence, and more to keep victims from exposing the abuse. On the other hand, victims of domestic violence may feel guilty, ashamed, scared, helpless, and/or hopeless, which can create barriers to exposing the ongoings of the abuse. Recognizing warning signs of domestic violence, understanding barriers to reporting, and dispelling common myths are important steps in helping a victim of domestic violence.

Warning Signs of Domestic Violence Victims

Domestic violence warning signs in the military can often be overlooked due to several factors, such as Permanent Change of Stations (PCSs), limited knowledge of support services, little understanding of healthy relationship counseling/education, financial dynamics within a military family, and limited reporting.

Signs of physical abuse

• Bruises, black eyes, busted lips, marks, sprained wrists
• Excusing aggressive behaviors
• Reports of aggressive behaviors: Yelling, physical violence, having personal property damaged
• Wearing clothes that cover the face, neck, and arms when the weather, cultural, or personal norms cannot better explain it
• Reactivity to loud noises
• Significant absences or tardies to daily activities

Abusers often work to isolate victims, such as by controlling what they do and who they talk to. They may use jealousy or concern as a rationale. Abusers may also prevent victims from getting or keeping a job and/or limit their access to money.

Signs of isolation and mental abuse

• Little access to social network
• Withdraws and isolates self from family and friends
• Cancels appointments or meetings at the last minute
• Drops out of activities they would usually enjoy
• Absenteeism at work
• Limited access to resources: communication devices, money, vehicles
• Checks in often with the abuser; the abuser calls the victim several times to find out about whereabouts

The following warning signs should be considered in context. They indicate something is wrong, and with some more context or in conjunction with the signs listed above, may be a sign of domestic violence.

Other warning signs

• Tired, lethargic, poor sleeping
• Trouble concentrating
• Agitation, anxiety, or constant apprehension
• Depression/sadness
• Feelings of hopelessness
• Low self-worth
• High levels of stress reported related to home life
• Excessive privacy concerning personal life or intimate partner

Barriers to Reporting

Many victims of domestic abuse in the military have reported various barriers to reporting abuse, most notably a lack of confidence that the situation will be dealt with adequately and financial barriers. Other barriers include but are not limited to fear of retaliation, limited access to resources, fear of outcome, lack of counseling services, limited insight into community support services, fear of not being believed, and limited access to legal counsel.

There are some notable differences between the military and civilians regarding reporting domestic violence in the military. With its rule-based system, the military adheres to its chain of command, influencing how domestic violence is reported. Reporting domestic violence in the military has traditionally allowed commanding officers the responsibility to address domestic violence reports with judicial administrative or other types of punishments for both domestic abuse and violence. Although corrective action is directed at the abuser, it can often negatively impact the victim, creating more difficulties for the victim than the intended support. One of the most significant reported barriers is the victim’s concerns over the financial impact due to most military families being single-income families. ³

Domestic Violence Myths

Dispelling myths about domestic violence can help remove some of the obstacles to helping.

1. MYTH: There is a typical profile for a domestic violence victim.  

FACT: Anyone can be a victim, regardless of age, background, community, education, military rank, culture, ethnicity, sex, ability, etc. That said, women are more likely to be victims. In the military, victims are more likely to be women and civilian spouses of active-duty personnel.⁴

2. MYTH: Victims lack self-confidence and are too weak to stand up for themselves or escape the situation.

FACT: Power and control behaviors can be hard to notice at the beginning of a relationship and may not be apparent at all. Over time, the abuser seeks increasing control, and due to the reasoning and rationale offered for the abuser’s actions (manipulation and gaslighting), victims may not recognize it, may dismiss it, or may believe it is themselves that needs to change. In this way, even the strongest and most confident people can become victims.

3. MYTH: Victims behave in a way that leads to violence against them. 

FACT: Remember that domestic abuse is not about violence but about power and control. Due to the dynamic of power and control, violence in relationships is never equal. One person is always the primary source of power, control, and abuse. Victims who fight back or even instigate violence do so as a result of this unequal dynamic or may be trying to diffuse a situation. However, the abuser may use instances of this behavior to blame the victim and defend abusive retaliation.

4. MYTH: If the abuse were bad, the victim would report it or leave.

FACT: The most violent outbursts and anger often occur when victims seek freedom, such as defending themselves, asking for more access to resources, countering manipulative reasoning, or trying to escape.  Leaving an abusive relationship can be dangerous; 75% of domestic violence-related homicides occur at that time.⁵

As long as the victim is passively agreeing with the parameters and perceptions of the abuser, the relationship will be smooth.  But when abusers perceive they are losing control of the intimate partner, they may escalate violent behavior in an attempt to regain power.  When there are children involved, the question of leaving becomes more complicated.  Some abusers threaten to hurt the children.

5. MYTH: Reporting abuse or leaving may be dangerous, but the victim may also not accurately perceive the abuse as bad as it is. 

FACT: Because of the slow and manipulative nature of emotional and psychological abuse, victims may believe they are the problem or excuse the abuser’s behavior. After particularly violent behaviors, when both parties know a line has been crossed, the abuser often shows remorse, promises change, and attempts to cater to the victim for a while. The victim may believe the relationship is improving, be reminded of why they fell in love with the other to begin with, and often negate thoughts of reporting or leaving during those times.

How to Help a Victim of Domestic Violence

Military OneSource

The military recognizes the negative impact of domestic violence and has been working to address the issue in various ways. The military notes that more must be done to support victims. In 2021, the Department of Airforce (DAF) noted an objective to create more “confidence in leadership and enhance survivor support capabilities.” They have taken a sharp stance, stating, “There is no place in our Air and Space Forces for domestic violence or interpersonal violence in any form.” DAF notes that they will explore the implementation of various support services to promote the trust and needs of victims. DAF reports wanting to “make improvements to the application process for transitional compensation for abused dependents, which in certain circumstances provides economic support, medical, and on-base, privileges to eligible survivors of domestic violence.”

The U.S. Army has identified the importance of comprehensive assistance for victims of domestic abuse, crisis intervention, risk assessment, safety planning, medical treatment support, counsel on legal rights and Judicial proceedings, and resources and referrals to local community support centers. Other military branches have also taken on the responsibility to make changes that will allow ease of reporting, confidence that action will be taken, and supporting victims.

Magellan Federal Solutions and Support

Magellan Federal’s assists the Department of Defense in delivering the Military Family Life Counseling Program (MFLC). Magellan Federal counselors are embedded at various installations and schools nationwide and overseas to offer non-medical psychoeducation, consultation, and referrals to service members and their families. In the schools, they teach about healthy relationships to youth so that they can recognize signs of abuse before entering a committed relationship. With service members and spouses, the MFLC program supports resiliency and healthy relationships; MFLCs teach emotion regulation, communication, conflict management, and decision-making strategies that have been shown to impact relationships and reduce domestic abuse positively (RAND Study, 2021). Moreover, Magellan Federal is proud to offer pilot programs in partnership with the MFLC program that directly supports couples and family resiliency.

A large-scale study by RAND Corporation suggested that the Armed Services can benefit in reducing and preventing domestic violence by focusing on awareness, support, education, diversification of services, and more emphasis on identifying risk factors. They also noted “the importance of having other organizations outside of FAP help in supporting Domestic violence victims.” The MFLC program is one of those other organizations. Magellan Federal MFLCs can provide psychoeducation to prevent military dependents and single service members from entering abusive relationships, and they are well-trained on risk factors and identification of domestic abuse, making them an excellent resource for intervention.

Tips for Helping a Victim of Domestic Violence

Historically, the general public’s view of domestic violence is that conflicts between a couple are personal, and it is not appropriate to intervene. As we learn more about the power dynamics and how difficult it is to get out of this situation by oneself, it becomes clear that we must dispel this notion and learn how to help.

1. Increase your situational awareness by learning the warning signs and dispelling myths.

• If you see something, don’t be afraid to communicate concern respectfully: “I am concerned about your safety….”, “I am noticing…”

2. Support the victim with respect.

• Be supportive, letting them know they are valuable and deserve to be treated with respect and dignity.
• Listen without judgment. Be patient, kind, and respectful. Understand that the victim may have ambivalent feelings due to the illusion that it is getting better during periods of peace. Alternatively, the reality of the abuse, especially if it is verbal or emotional, may not be readily evident to the victim. There may also be fear of retaliation or change. On average, a victim of domestic violence will leave the abuser and return approximately seven times before completely breaking away from that relationship.
• Offer supportive words such as “This is not your fault…” “I believe you.”

3. Be familiar with local and federal resources.

• Help a victim connect to local domestic violence support and learn about the local domestic violence centers near you. Some domestic violence centers will offer free Mental Health counseling services for victims of domestic violence.
• Connecting the victim to local resources. Providing resources such as case management can be an integral part of ending domestic violence. Victims often don’t have access to finances, personal documentation, clothing, housing, or other important resources.
• Safety planning with an advocate, domestic violence therapist, or case manager.

There is still work to be done to break down the perceived barriers to reporting in the military. Since domestic violence is about one person seeking power over another, help from community sources is imperative for the safety and wellbeing of the victim. The military has made great strides in addressing the problem of domestic violence through implementing more resources and engaging in victim support, including Military OneSource and the Military Family Advocacy Program. Magellan Federal is proud to help those impacted by domestic violence by delivering our expertise through our victim advocacy and family support services. Together with the government, our programs add an extra layer of protection, intervention, and prevention from domestic violence for our service members so that they may be empowered to take action to improve their overall wellbeing.

References:

1. https://www.justice.gov/ovw/domestic-violence
2. https://www.ncbi.nlm.nih.gov/books/NBK499891/
3. https://www.military.com/
4. National Coalition Against Domestic Violence. https://ncadv.org/
5. https://stoprelationshipabuse.org/educated/barriers-to-leaving-an-abusive-relationship/
6. Kendall, Frank. (January 23, 25, 2023). [Letter from Secretary of Defense Frank Kendall to Department of the Air Force (DAF), 2023]. Retrieved from https://www.af.mil/Portals/1/documents/2023SAF/PolicyUpdates/Domestic_Violence_Message_to_the_Force.pdf
7. Miller, Laura L., Dmitry Khodyakov, Joachim O. Hero, Lisa Wagner, Coreen Farris, Katie Feistel, Emily Dao, Julia Rollison, Rosemary Li, Jamie Ryan, Stephanie Brooks Holliday, Laurie T. Martin, and Amy L. Shearer, Domestic Abuse in the Armed Forces: Improving Prevention and Outreach,RAND Corporation, RR-A1550-1, 2023. As of October 4, 2023: https://www.rand.org/pubs/research_reports/RRA1550-1.html

Elizabeth Duprey, LMHC, is a MacDill regional supervisor and has been with Magellan Federal since 2020, when she started as a school MFLC. Born in Fayetteville, NC, Elizabeth was a “military BRAT” who traveled with her family and even lived overseas. Elizabeth is passionate about providing MFLC services to our service member and their families, as she understands the pressures of military life. Elizabeth received a bachelor’s degree in psychology from Florida Atlantic University and a Master’s in Counselor Education from Florida Atlantic University before becoming a Licensed Mental Health Counselor. With a great passion for helping people, Elizabeth has worked in the field of domestic violence, substance abuse, and juvenile rehabilitation. She now has the honor of working to provide support for military service members and their families.

In her free time, Elizabeth enjoys traveling and photography. She notes both traveling and photography allow her to see the world from a different perspective and to gain a greater appreciation for the differences that make people and places special.

Each year, many Americans suffer from different mental health conditions, like Major Depressive Disorder and Anxiety Disorders. Some seek help, while others deal with the negative symptoms alone. Stigma, mistrust, misinformation, fear, or socioeconomic status can prevent us from seeking help.

Addressing these negative symptoms is very important. They can affect several aspects of our lives, including work, social interactions, and personal relations.

Here are some important facts about mental health:

• In 2020, 21% of U.S. adults (52.9 million) experienced a mental health condition. ¹
• Due to COVID-19, the number of anxiety and depressive disorders grew worldwide. Depressive symptoms grew from about 193 million people to 246 million worldwide. This represents an increase of 28% in cases. Anxiety disorders grew from 298 million to 374 million, close to a 25% increase. ¹
• In the U.S., young adults ages 18 to 25 have the highest rate of experiencing mental health conditions (30.6%). They are followed by those ages 26 to 49 (25.3%) and adults ages 50 and over (14.5%).¹

Every year, Mental Illness Awareness Week occurs in the United States during the first week of October. During this week, various organizations come together to promote activities about mental health. This campaign aims to raise public awareness about mental health issues in support of individuals and families. While the week has passed, the importance of bringing awareness to this topic remains year-round.

Activities take place to increase understanding and support for those living with mental illness. The education and resources provided during this week can reduce stigma and other factors preventing us from seeking help.

These activities can include:

• Educational Events: Workshops, seminars, conferences, and informational sessions. They provide information about mental health conditions, treatment options, and strategies for managing mental health challenges. ² (NAMI | National Institute of Mental Health)
• Public Awareness Campaigns: Mental health organizations often launch public awareness campaigns using various mediums to share stories, statistics, and information related to mental health. These include social media, posters, and online content. ² (S. Department of Health and Human Services)
• Community Outreach: Local events, support groups, and community discussions are often organized to foster understanding and support among individuals, families, and communities affected by mental illness. ² (988 Suicide & Crisis Lifeline)
• Advocacy Efforts: During this week, advocacy groups champion improved mental health services, insurance coverage, and policies that support individuals with mental health conditions. ² (NAMI | National Alliance on Mental Health)
• Media Coverage: Media outlets may cover stories related to mental health, including personal stories of recovery, interviews with mental health professionals, and discussions about the importance of mental health awareness. ² (SAMHSA | Mental Illness Awareness Week)
• Sharing Personal Stories: Individuals who have lived experiences with mental illness may share their stories to help and inspire others to seek help. ² (S. Department of Veterans Affairs | Mental Health)

We can all participate in these activities every month to learn more about mental health topics, help raise awareness, lower judgment, and be mindful of others experiencing mental health challenges.

Look out for what Magellan Federal has to offer on this topic!

¹ Mental Health Statistics. (2023, March 9). Forbes. https://www.forbes.com/health/mind/mental-health-statistics/#:~:text=Worldwide%3A%20Due%20to%20the%20COVID.

² Mental Illness Awareness Week | NAMI: National Alliance on Mental Illness. (n.d.). Nami.org. https://nami.org/Get-Involved/Awareness-Events/Mental-Illness-Awareness-Week.

As October comes to a close, so does the monthly observance known as National Disability Employment Awareness Month. This year’s theme selected by the Office of Disability Employment Policy was “Advancing Access and Equity.” According to the Autism Society, adults with Autism are represented in every field of employment.

In this Q&A article featuring Dr. Amy Latta, a psychologist advisor for Magellan Healthcare, we explore the question – is Autism a disability?  Dr. Latta shares her thoughts on this question below.

Q: Is autism considered a disability (from social, legal, and medical viewpoints)?

Dr. Latta: The medical and legal perspectives both view Autism as a disability. The disability is created when the individual’s impairments (social communication and social interaction, as well as restricted interests, behaviors, or activities) interfere with daily functioning.

In contrast, a social perspective views the individual with Autism as “neurodivergent”  or having a brain style that is simply different from the average or “neurotypical” person in society.  From this perspective, Autism is not a disability. The disability is created by society’s lack of acceptance of an individual with a different or “neurodivergent” brain style. Within this framework, as society becomes more inclusive of persons with Autism and adapts better to their needs, the disability fades.

Q: How do you discuss neurodivergence with a child with autism?

Dr. Latta: If you ask a group of children to draw a person enjoying something fun, do you think all the pictures will look the same? Would anyone’s drawing be the “right” drawing or the “wrong” drawing? That is neurodivergence. It means everyone’s brain functions differently. There is no right or wrong way.

Q: Please briefly outline state government disability benefits people with autism can take advantage of.

Dr. Latta: Social Security Administration’s (SSA) administers the Social Security Income (SSI) program, which provides financial assistance to children and adults with Autism. In order to meet eligibility for SSI, there are income limits and medical requirements (e.g., symptoms of Autism need to be severe enough).

Q: How does getting disability benefits differ for children and adults (especially for parents with teens about to turn 18 – do they need to go through the process of conservatorship before the 18th birthday or will their child need to show financial responsibility, such as a job or paying rent, to get the full amount of disability)?

Dr. Latta: A child (under age 18) with Autism may qualify for Social Security Income (SSI) if the symptoms of Autism are severe enough and the parents’ income does not exceed the income limit. The income limit increases with each additional child under age 18 in the family.

Once a child with Autism turns 18, the parents’ income is no longer counted (even if the child is living at home) in the calculation for SSI benefits.

If a child is going to turn 18 and needs help making life decisions as an adult, the family may want to consider providing support to the child after age 18 through guardianship, conservatorship, or power of attorney. Guardianship and conservatorship are more involved legal processes so the family will want to start this process six months before the child turns 18.

Guardianship: A trusted adult is court-ordered by a judge to make decisions on behalf of the individual. There are full and partial guardians. A full guardian can make decisions about all areas of an individual’s life. A partial guardian can make decisions about select areas of an individual’s life.

Conservatorship: A trusted adult is court-ordered by a judge to make decisions about financial affairs only.

Power of Attorney: Is a legal document that authorizes a trusted adult to make decisions about the individual’s property, finances, or medical care. Under a POA, the individual still retains the right to make decisions on his or her behalf.

For more than 80 years, organizations have turned to employee assistance professionals to support their employees and people leaders dealing with issues that threaten personal wellbeing or hinder workplace productivity. Today’s most trusted expert is the Certified Employee Assistance Professional (CEAP), who is multifaceted and has a sharp focus on the Employee Assistance Program (EAP) core technology to guide their work. Here’s how and why Magellan believes obtaining a CEAP certification can benefit your professional development and help organizations receive top-tier EAP services.

What Makes Employee Assistance Professionals Unique

Fostering employee engagement and wellbeing is associated with a positive workplace culture, helps retain and attract talented employees, and contributes to higher productivity. Employer organizations have long relied on the unique blend of expertise possessed by experienced Employee Assistance (EA) professionals to support and advance their programs. Skilled EA professionals are knowledgeable in organizational culture, mental health, workplace policy, program promotion, and crisis management. They possess the ability to interact with and support all levels of the organization.

On any given day, EA professionals intervene with individual employees and family members in managing life’s challenges; furnishing opportunities for people leader development; conducting program promotion activities; and addressing organizational impacts such as preventing and coping with workplace violence, critical incident support, and crisis management. Unlike other helping professionals who often play a client–advocate role, EA professionals recognize and are bound by the principle of their dual-client relationship and maintain neutrality as well as confidentiality. EA professionals’ distinct expertise and adherence to the dual-client philosophy sets them apart from other types of helping professionals.

The Value of CEAP Certification

The Certified Employee Assistance Professional (CEAP) certification is the only EA professional credential that demonstrates mastery of the concepts and skills required by competent EA professionals. CEAP certification is a recognizable commitment to excellence and demonstrates the EA professional’s unique body of knowledge and alignment with the EAP core technology.

Voluntary certification establishes professional credibility by demonstrating the following:

• Observance of quality and industry standards
• Well-trained in your area of expertise
• Commitment to continuous professional development
• Personal drive and motivation to excel in the Employee Assistance profession

The CEAP certification process provides an evaluation of existing knowledge and skills while concurrently providing professional development. The required knowledge modules cover essential EAP components, updated industry information, exposure to international EAP, policy issues along with relevant legal issues, EAP clinical assessments, marketing, training, supervision, and program management for EAPs.

The CEAP is the gold standard in the field of employee assistance. It is the only credential that confirms proficiency in the concepts and skills required by competent EA professionals, and it is why Magellan Federal seeks to hire professionals with this designation and offer free certification for our staff. We believe that the CEAP empowers our professionals to provide exceptional EAP services to the government, our ultimate goal.

How to Become a CEAP

There are multiple pathways to becoming a CEAP, depending on your education and work experience. Many CEAPs are masters-level counselors, but there are other roles in the EA profession that do not require a counseling degree. For example, account executives, program managers, human resource professionals, and union stewards benefit from CEAP certification in their roles.  All candidates seeking initial certification should visit the Employee Assistance Professional Association (EAPA) website for more information.

The opioid epidemic is a significant public health problem in the United States. In 2021, over 75% of drug overdose deaths involved an opioid.[1] Between 2010 to 2019, drug overdose mortality rates have increased by 53% among U.S. military veterans.4 Opioids include prescription opioids, heroin, and synthetic opioids. About 150 individuals die each day from synthetic opioids. 2

Fentanyl is a synthetic opioid that has been associated with a significant number of overdoses in the U.S. It is considered to be “up to 50 times stronger than heroin and 100 times stronger than morphine”; thus, even small amounts of fentanyl can be deadly. 2 Pharmaceutical fentanyl has been prescribed for severe pain after surgery and with medical conditions such as cancer pain. Pharmaceutical fentanyl can be given as a patch, shot, or lozenge. Illegally manufactured fentanyl is found in liquid or powder form and is commonly mixed with other illicit substances or hidden to look like over-the-counter medications. Fentanyl is linked to a high number of overdoses and deaths. Between 2017 and 2021, fentanyl was involved in 52% of overdose cases in the military.5

Combating the Epidemic: Prevention and Treatment

The risk of overdose increases significantly when drugs are contaminated by or combined with fentanyl. Since it is difficult to taste, smell, or see fentanyl in other drugs, an individual may not know that fentanyl is present. Fentanyl test strips, used to detect whether fentanyl has been mixed with another drug, are available and can help prevent overdose. However, caution should be taken since these strips may not detect all forms of fentanyl, including carfentanil.2

Fentanyl is addictive and binds to the body’s opioid receptors in the brain, which control emotions and pain. Like natural opioids, fentanyl’s effects include drowsiness, confusion, difficulty breathing, unconsciousness, overdose, and death.3

How to Respond to an Overdose and Stay Informed

Individuals who use opioids as prescribed, those who abuse them, and persons in the general public should be aware of the signs of overdose as life-saving measures, such as halo one, are available. Signs and symptoms of an opioid overdose include small, constricted pinpoint pupils, loss of consciousness, slow or weakened breathing, cold or clammy skin, and discoloration of skin. When encountering someone who has overdosed, contact 911 immediately and administer naloxone when available.2

We recommend that persons using any form of opioids, and those who are likely to have contact with individuals using opioids, carry naloxone, which is now available over the counter and can be obtained at a pharmacy, through mail order, or through community risk reduction programs. Training for administering naloxone and learning about the opioid overdose epidemic is available, and additional information can be found through the VA’s Opioid Overdose Education and Naloxone Distribution Program (OEND), state or county health departments, GetNaloxoneNow, the CDC, and the American Red Cross.

The Military Health System and Defense Health Agency provide resources for opioid overdose education and naloxone distribution, including information for patients and caregivers. Additional toolkits and naloxone distribution videos are also provided by the U.S. Department of Veterans Affairs.

Resources

1. Centers for Disease Control and Prevention (CDC). “Understanding the Opioid Overdoes Epidemic”. Last modified June 17, 2021, https://www.cdc.gov/opioids/basics/epidemic.html
2. Centers for Disease Control and Prevention (CDC). “Fentanyl Facts”. Last modified September 6, 2023, https://www.cdc.gov/stopoverdose/fentanyl/index.html
3. National Institute on Drug Abuse (NIH). “Fentanyl DrugFacts”. Last modified June 2021. https://nida.nih.gov/publications/drugfacts/fentanyl#:~:text=Naloxone%20is%20a%20medicine%20that,require%20multiple%20doses%20of%20naloxone
4. Bennett, Alex S et al. “U.S. Military veterans and the opioid overdose crisis: a review of risk factors and prevention efforts.” Annals of medicine 54,1 (2022): 1826-1838. doi:10.1080/07853890.2022.2092896. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9262363/
5. Myers, Meghann. Military Times. “Fentanyl deaths among troops more than doubled from 2017 to 2021”. Last modified February 15, 2023, https://www.militarytimes.com/news/your-military/2023/02/15/fentanyl-deaths-among-troops-more-than-doubled-from-2017-to-2021/

While sleep may appear to be a reward or special treat for some, it is a vital biological process that is necessary for optimal functioning.Without proper sleep, the body cannot adequately process new information, create memories, rid itself of toxic waste, restore energy, balance hormone secretion, and repair cells.  Inadequate length and/or quality of sleep can lead to both mental and physical challenges. (Nunez & Lamoreux, 2023)

Our Built In Sleep Cycle

Our master biological clock regulates physical, mental, and behavioral changes that follow a 24-hour cycle.  This process is referred to as a circadian rhythm.  Sleeping at night and wakefulness during the day is an example of the circadian rhythm.  Day light alerts the body to send messages to the brain to release hormones that promote attention, awareness, and energy.  Conversely, in the evening, hormones that produce relaxation and sleep are released.  Because the circadian rhythm is deeply rooted in our biological systems, it is difficult to sleep during the day and stay awake at night.  Even when the length of sleep is adequate, frequent awakenings and the absence of deep sleep may occur when one attempts to sleep during the day (Suni & Dimitriu, 2023).

When Life Gets in the Way of Our Built in Sleep Cycle

Individuals who work nights, early mornings, rotating shifts, or irregular hours lose one to four hours of sleep per day, as they experience problems falling asleep and staying asleep (insomnia) during non-work hours (Pacheco & Rehman, 2023). A stressful job such as a police officer (Ma et al., 2015), healthcare worker(Stimpfel, 2020) or active-duty military (Troxel et al.), coupled with non-traditional work hours, compound the problem.  One of the most often reported complaints of military members returning from deployment is a sleep disturbance.

Sleep deprivation and sleep disruption may result in consequences that negatively impact health and day-to-day functioning. Furthermore, there is a bi-directional association between sleep problems and illness, meaning that sleep problems may cause or increase symptoms of illness and illness may cause or increase sleep problems. (Medic, Willie, & Hemeis, 2017).

Short Term consequences of sleep problems consist of but are not limited to:

• Emotional distress
• Mood changes
• Problems with decision making and memory
• Problems in work performance
• Increased negative reactions to stressful situations
• Physical complaints (e.g., low level pain, cold symptoms).
• Weight gain

Potential long term consequences may include:

• Depression and anxiety
• High blood pressure
• High cholesterol
• Digestive problems
• Heart conditions
• Diabetes

Tips for Promoting Better Sleep

Many individuals do not have the luxury of changing jobs or life circumstances to resolve sleep problems.  But there some simple things you can do to increase the probability of better sleep even if your daily waking/sleeping routines are not synchronized with your natural circadian rhythm (Shriane, Rigney Ferguson, 2022).

Try making simple modifications to your daily schedule.  Some of the ideas listed below may fit better into your lifestyle than others, and some may be more effective for you than others (Suni & Dimitriu, 2023; Lammers-van der Holst et al., 2020; health.mil., 2023).

• Before sleeping, set your thermostat to a cool temperature (no higher than 68 degrees).
• Wear sunglasses on your way home from working a night shift if you plan to sleep when you arrive home. Sunlight tells your body it is time to wake up.
• Block out as much light as possible using dark shades on windows, eye masks, and turning off computers that may be emitting light.
• Block out as much noise as possible. Turn off TVs and other mobile devices, close doors, and use ear plugs.
• Spend a few minutes winding down and clearing your mind before trying to sleep.
• Avoid caffeine (coffee and energy drinks), and nicotine (cigarettes) at least 6 hours before trying to sleep.
• Avoid alcohol intake. Even though alcohol has a calming effect, it negatively impacts the quality of sleep.
• If possible, take prescribed medications at times when side effects, such as stimulating effects) won’t interfere with sleep.
• Be careful with over the counter supplements. Melatonin, a popular supplement may actually worsen sleep problems if taken at the wrong time or wrong dose.  Seek out a sleep professional for advice before using it.
• Do not eat a large meal immediately prior to sleep. The work involved in digestion may reduce sleep quality.
• Moderate exercise relieves muscle tension and promotes relaxation. Several hours before attempting to sleep, move around and stretch.

If you experience challenges falling or staying asleep for a prolonged period, and your sleep problems are causing distress and problems with daily functioning, contact your health care provider.  Sleep problems may signify other health issues.  Your health care provider can explore and address the root causes with you, suggest options that may reduce sleeping challenges, and help you get back on track.

References

Health.mil. (n.d.). Sleep Tips for Sift Workers.  https://www.health.mil/Military-Health-Topics/Centers-of-Excellence/Psychological-Health-Center-of-Excellence/Real-Warriors-Campaign/Articles/Sleep-Tips-for-Shift-Workers

Lammers-van der Holst, H. M., Murphy, A. S., Wise, J., & Duffy, J. F. (2020). Sleep tips for shift workers in the time of pandemic. Southwest J Pulm Crit Care., 20(4), 128–130. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7189699/

Ma, C.C., Andrew, M.E., Fekedulegn, D., Gu, J.K., Hartley, T.A., Charles, L.E., Violanti, J.M., & Burchfiel, C.M. (2015) Shift work and occupational stress in police officers.  Safety and Health at Work, 6(1) 25-29. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4372186/

Medic, G., Wille, M, Hemels, ME.  (2017) Short- and long-term health consequences of sleep disruption.  Nature and Science of Sleep.  9, 151-161. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5449130/

Nunez, K & Lamoreuz, K.  (2023) What is the purpose of sleep? https://www.healthline.com/health/why-do-we-sleep

Pacheco, D. & Rehman, A.  (2023) Shift work disorder. What it is, what causes it, and its potential complications.   https://www.sleepfoundation.org/shift-work-disorder

Sleep Health Foundation. (2023). Healthy sleep practices for shift workers. https://www.sleephealthfoundation.org.au/?view=article&id=1141:healthy-sleep-practices-for-shift-workers&catid=98

Stimpfel, A.W. (2020) Shift work and sleep disruption: Implications for nurses’ health.  American Nurse.  https://www.myamericannurse.com/shift-work-and-sleep-disruption-implications-for-nurses-health/

Suni, E. & Dimitriu, A.  (2023). Circadian rhythm.  What it is, what shapes it, and why it’s fundamental to getting quality sleep.   https://www.sleepfoundation.org/circadian-rhythm

Troxel, W.M., Shih, R.A., Pedersen, E.R., Geyer, L., Fisher, M.P. Fisher, Griffin, B.A., Haas, A.C., Kurz, J., Steinberg, P.S. (2015). Sleep in the military: Promoting healthy sleep among U.S. servicemembers. Rand Health Quarterly, 5(2), 19. https://www.rand.org/pubs/research_reports/RR739.html

Learn how to prepare your family and community

Every September, the United States observes National Preparedness Month as a reminder of the significance of proactive planning and community engagement in the face of adversity. This initiative calls for individuals, families, and communities to assess their readiness and take steps to prepare for emergencies in their homes, businesses, schools, and communities. National Preparedness Month encompasses prevention, protection, response, and recovery efforts to prepare the United States for all threats – whether they are natural or man-made disasters.

The concept of preparedness extends far beyond stockpiling canned goods. It involves a holistic approach encompassing mental, physical, and logistical readiness. At the individual level, being prepared means having a well-thought-out plan that addresses each person’s and family’s unique needs. This includes knowing how to contact loved ones during a crisis, understanding the emergency procedures of workplaces and schools, and having essential supplies readily available.

National Preparedness Month was established in the aftermath of the tragic events of September 11, 2001. In response to the9/11 attacks, the Federal Emergency Management Agency (FEMA) and the Department of Homeland Security (DHS) collaborated to establish a nationwide campaign aimed at raising awareness about emergency preparedness. FEMA’s “Ready” campaign was launched in 2003 as a national public service campaign to educate and empower Americans to prepare and respond to emergencies.

Tips to Prepare for an Emergency

Ready.gov (for Spanish, see Listo) asks individuals to do four things:

1. Stay informed about the different type of emergencies that could occur and their appropriate responses.
2. Make a family emergency plan.
3. Build an emergency supply kit.
4. Get involved in your community by taking action to prepare for emergencies.

Each year, National Preparedness Month focuses on a specific theme that highlights an aspect of preparedness and resilience. These themes are selected to address evolving challenges and empower individuals and communities with the tools and knowledge needed to navigate emergencies effectively. This year’s theme is Preparing Older Adults for Disaster.

Available Stress Counseling Services

Magellan Federal has proudly been providing stress counseling services to FEMA since 2001. Stress counseling is on-demand disaster-driven behavioral health stress counseling services to support FEMA employees while providing critical disaster response. Services include one-on-one counseling, employee management consultation, Psychological First Aid, assessment and referral, crisis intervention, program briefings, wellness talks, psychoeducational grief groups, and walkabouts. Since 2021, Magellan Federal has provided stress counseling services to over 40 disasters and 16,000 individuals.

Through awareness, education, and action, National Preparedness Month empowers communities to come together to share resources, knowledge, and support. Together, we can build a more resilient and secure future for ourselves and our communities. For more information about emergency preparedness and to start building your own emergency plan, visit Ready.gov.