Equine therapy reduces staff stress and anxiety at military hospital

ByJanetA.Aker

MHS Communications

Military facility animals—whose job is to de-stress staff and patients at hospitals and clinics—comeinallshapesandsizes.

At the Naval Medical Center San Diego (NMCSD), miniature horses are one more resource to aid in coping with stress and optimizing the staff’s daily performance in anunconventional,yeteffective,way.

Simply by being there, these tiny, shaggy creatures(about30incheshighand250-300 pounds)areshowingtheyarejustascapable ofreducingstressandtheanxietyinstaffand patients as facility dogs used elsewhere at militarymedicalfacilitiesandtheUniformed ServicesUniversity’smedicalschool

The miniature horses—and sometimes mini-donkeys—are extremely popular at NMCSD Themilitaryfacilityanimalswere actually called to work during the height of the COVID-19 pandemic when medical demand was at its highest among overworkedandemotionallyvulnerablestaff

Their owner, Judy Lee Beckett, from a ranch outside San Diego took all necessary publichealthandsafetyprecautions,includingtheuseofpersonalprotectiveequipment and physical distancing so the horses could still come to NMCSD’s courtyard during lunchhours.

“The health and wellness of our team of health care professionals is a top priority at NMCSD,” said the hospital’s director, U.S. Navy Capt. Kimberly Davis “Walking through the courtyard and encountering these miniature horses adds sunshine to anyone’sday.”

She added: “The therapeutic effect of these animals on both staff and patients is significant. The volunteer support has been greatly appreciated, especially during COVID-19whenweallbenefitedfromfresh airandafundistraction.”

Ifthepandemicprovedonething it’sthat doctors,nurses,andmedicalstaffneedtobe inahealthyplace,emotionally,tobeeffective fortheirpatients

Othermilitaryequinetherapyproponents have seen the value of interactions with horses and recovering service members, such as a program with full-size horses at Fort Campbell in Kentucky Beckett also uses full-size horses for service member, staff, and family recovery at her ranch and has had an established relationship with NMCSDsince2008

Forbothmini-andfull-sizecreatures,the horses’ ability to draw people out of themselves simply by their presence and gentlenessremainsamuch-awaiteddrawthathas become a ritual for many on the NMCSD’s grounds and has even extended beyond its gates to the nearby naval fleet concentrationarea

Researchers have learned that horses and humans tend to align their physiologicalresponsestoemotionalstimulation.It’s called “mirroring.” A similar phenomenon occurs with other animals: Research has shown that people’s blood pressure drops simply by petting a dog or cat, while the levelsoftheso-called“feelgood”hormones oxytocinanddopamineincrease.

“There is something truly magical about these horses’ ability to empathize with us without being able to utter a single word,” saidKimKobayashiElliott acertifiedtherapeuticrecreationspecialistatNMCSD,who advocates for the program and has worked withBeckettformanyyears

“The importance of just taking time out of your day to stop and pause, and really lookaroundyou,toappreciatethehorses,is prettyamazing,”shesaid.

“Animals have a way of unconditionally accepting you. Also people feel more at ease, Elliott said “They can tell an animal anything, right? They don’t break secrets They’re not into politics But we’re also trying to promote healthy recreation and experiences for staff and their families That’swhattheseanimalsdoforus.”

To learn about TRICARE’s coverage of hippotherapy, an exercise program that offers a person with a disability a means of physical activity that aids in improving balance, posture, coordination, the developmentofapositiveattitude,andasenseof accomplishmentthroughuseofahorseand a physical or occupational therapist, visit: https://www.tricare.mil/CoveredServices/ IsItCovered/Hippotherapy

ByArmyCaptGarrettBoyer

Editor’s note: Boyer is an active-duty psychologist at Fort Stewart-Hunter Army Airfield in Georgia In his commentary below,hesharesastoryofacombatveteran to encourage others to seek mental health help if needed. Names have been changed toprotectconfidentiality

I once met a soldier from Texas named Dan.Hedidwellincollegeandwascommissioned by the U.S. Army through the ROTC programinthespringof2001

The next January, he said goodbye to his loved ones and headed to Afghanistan for a 12-month deployment. His unit had many close calls but were fortunate not to have manycasualties

Six years later, Dan was a company commander and was tasked to deploy for anothertour,thistimeforninemonths

He recalled a same sense of angst he felt onthefirstdeployment

“Maybe it will be like that one,” Dan thought “Maybe nothing too bad will happenthistimeeither.”

Thatwasnotthecase.Onhisfirstday,Dan and his company were hit by improvised explosive device blasts and small-arms fire. Two soldiers died. The next two days grew consecutively worse. He and his unit were involved in a great many firefights on that tour—nearly one a day. Dan was one of the fewfortunatesoldierswhoavoidedphysical injuries during that tour; but by the end, he wasimpactedbytheconflictandnumberof subsequentcondolencelettershesenttothe familiesofsoldiers WhenDangothome,hewasnotthesame.

Thoughphysicallypresent, hismindwas thousands of miles away Even with closed eyes,hecouldstillseebloodandflashesfrom rocket attacks The chaotic sounds of war playedloudlyinhisnightmares Dan had post-traumatic stress He experienced survivor’s guilt. Dan became depressedandanxious Hebegantoshutout fromtheworld—spendinglesstimewithhis lovedonesanddrinkingmoretocope.

It was worse when he left the U.S. Army His whole identity was wrapped up, not justinmilitaryservice,butinthemoraland mentalwoundsheendured.

I asked him why he did it, “Why join the Army? Why go back to Afghanistan for a second deployment? He did not have to do it,right?”

Hisanswerstruckme

“I wanted to go,” Dan said. “I had something worth fighting for and worth dying for.”

He believed in the mission. He appreciated the ideals of an American life He wanted others in the world to prosper For him,thiswasworthdyingfor.

Dan survived combat, but he ultimately succumbed to his traumatic stressors and laterdiedbysuicide

Hisstorymaybecommonamongcombat veterans Over the past few decades, our society has become increasingly aware of the emotional weight these individuals bear In a 2020 report, the Department of VeteransAffairsOpensmentalhealth.va,gov stated that suicide was the 13th leading cause of death among veterans overall and the second leading cause of death among veteransunderage45 Theironyisthatthey defendedthenationandacceptedtheriskof dyingonforeignsoil,onlytodiebytheirown handathome

Amid the many threats to our service members, post-traumatic stress, survivor’s guilt, depression, anxiety, and substance abusearefoestheymustfightlongafterthey hanguptheiruniforms

Dan had a cause worth dying for That samecauseisworthlivingfor.

Combatveteransaresomeofthetoughest peoplethereare.However,workingthrough trauma requires a different toughness One mustrecallexperiencesfromtheworstdays oftheirlifeandmentallyprocessthosetraumas Itishard,scary,andtimeconsuming Manyveteransthinkitiseasiertorepress badmemories Theythinkadrinkmaytake someoftheedgeoff ormarijuanawillcalm thestorm.Thesecopingstrategiestoooften causethemtospiraloutofcontrol.

In hard moments, it is more helpful for veterans to make positive, life-affirming choices by seeking help—lean on a coun- selor, family and friends, or their faith; seek out support and assistance from the variety of mental health resources offered by the VA and the Military Health System; or simplypickupthephonetocalltheVeteran &MilitaryCrisisLineandtalktoaqualified responder any time, any day. The mission going forward is to work through trauma and get to a point where the memories of combat do not impede the ability to live a full, abundant life Surely, that is a cause worthlivingfor

This story gives an opportunity for us to remind veterans—both past and those currently serving—that their sacrifices are worth living for. We can show our appreciation for their service by living our best lives Do something nice for a neighbor Get involved in your child’s school. Thank a service member and a veteran and their familieswhenyouseethem Salutetheflag.

And remember that you live in a nation where we are willing to do what it takes so we can be free to live a good life That’s worthdyingfor,andworthlivingfor

Resources For anyone experiencing a mental health crisis,needsimmediateassistance,orsimply totalktosomeone confidentialhelpisavailable24/7

„ The Military & Veteran Crisis Line text-messaging service, and online chat providefreesupportforallservicemembers, including members of the National Guard and Reserve, and all veterans, even if they are not registered with the Department of Veteran’s Affairs (VA) or enrolled in VA healthcare „ Call:988andpress1

„ Text:838255 „ Chatonlineatveteranscrisisline.net

„ Military OneSource is a 24/7 gateway totrustedinformationforservicemembers and families that provides resources and confidentialhelp Call800-342-9667orvisit www.militaryonesource.mil.

„ The Psychological Health Resource Center is available 24/7 for service members veterans and family members with questions about psychological health topics. Trained mental health consultants can help you access mental health care and community support resources in your local area.Call1-866-966-1020,startalivechat,or visitwww.health.mil/PHRC.

„ The inTransition Program has 20 FAQs that are a helpful introduction to the program. You can call 800-424-7877 or at 800-748-81111 in Australia, Germany, Italy, Japan, and South Korea only You can also email the program directly at: dha.ncr.j-9. mbx.inTransition@health.mil.

„ The MilitaryHealthSystem, DOD, and VAhavemanymentalhealthresourcesavailable to help any service member, families, or veteran beneficiaries who are struggling withmentalhealthchallenges ReadMental Health is Health Care for a complete list of resources for immediate assistance or to makeappointments