Seeking the Military Suicide Solution: Recent Episodes

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About Today’s Guest:

Jamie Mustard is the world’s leading authority on perception in the physical world. Steeped in the worlds of technology, product engagement, and the creative arts, Jamie consults with leading companies, CEOs, creative artists, etc., getting their messages, products, brands and ideas to STAND OUT to their desired audiences.

This is the science and art of getting heard and being memorable in iconic fashion. A graduate of the London School of Economics, Jamie’s work is an explanation of the ‘economics of attention’ based on the primal laws and neuro-scientific research on human perception called BLOCKS™, which explain why anything STANDS OUT and endures in the mind (or fails to). In his bestselling and O.W.L Award-winning book, The ICONIST: The Art and Science of Standing Out, he uses case studies in business and pop culture, in addition to his extensive scientific research, to explore how BLOCKS™ solve one of our most crucial problems: Being made invisible.

He has spoken, educated and inspired others with his work ubiquitously including, Cisco, Intel, Symantec, Adidas, Pacific Northwest College of Art and TEDx . Jamie’s ICONIST work has spanned some of the world’s leading companies, technologies, artists, designers, creatives, non-profits and the globe. In his vibrant multimedia speech presentations, he gives audiences the power of capturing attention to those who are feeling stifled by an over-messaged culture. When we can get attention at will, we can motivate and inspire others, adapt faster, get buy-in, improve organizational culture, generate demand, increase productivity and ultimately be more fulfilled as organizations and individuals.

Links Related to This Episode:

The Iconist Website

The Iconist Book

Join our Facebook Group:

Seeking the Military Suicide Solution on Facebook

Shauna's latest book: Warrior: How to Support Those Who Protect Us

Duane's latest book: Military in the Rear View Mirror: Mental Health and Wellness in Post-Military Life

How to Leave a Podcast Review

Leaving a podcast review at iTunes isn't intuitive. But positive ratings are hugely important: they help the podcast get discovered by new people. Please spend 5 minutes of your time to leave a review using one of the methods below.

How to leave a podcast review using Apple’s Podcast app

1. Navigate to Seeking the Military Suicide Solution on Apple Podcasts on your iPhone or iPad.

2. Click "Listen on Apple Podcasts"

3. Scroll down and click or tap "Write a Review." Enter your iTunes password to login.

4. Rate the podcast using 1 to 5 stars.

5. Submit a brief honest review.

Bonus: get a thank-you note

Your feedback is greatly appreciated. When you leave a review, drop us a line at info@veteranmentalhealth.com and you'll get a message with the warmest appreciation, and a bonus gift!

For Android users, Google Podcasts does not allow for ratings or reviews, but you can certainly let us know how you think we're doing on Spotify, Stitcher, or iHeartRadio

Many thanks,

Duane and Shauna

★ Support this podcast ★

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About Today’s Show:

Duane and Shauna reflect on the themes that emerged from the collective series, which include:

• Coordination and Collaboration, featuring MSG Tom Cruz
• Public Health Approach, featuring Dr. Matt Miller
• Risk Factors/Warning Signs featuring USMC Veteran David Bachmann
• Reaching out to support, featuring MG(R) Mark Graham
• Reducing stigma, featuring Kim Ruocco

Other themes that emerged from the conversations include:

• Identification of Individuals at Risk
• Data
• Research
• Lethal means
• Treatment
• Community intervention
• Suicide survivor
• Importance of connectedness

Join our Facebook Group:

Seeking the Military Suicide Solution on Facebook

Shauna's latest book: Warrior: How to Support Those Who Protect Us

Duane's latest book: Military in the Rear View Mirror: Mental Health and Wellness in Post-Military Life

How to Leave a Podcast Review

Leaving a podcast review at iTunes isn't intuitive. But positive ratings are hugely important: they help the podcast get discovered by new people. Please spend 5 minutes of your time to leave a review using one of the methods below.

How to leave a podcast review using Apple’s Podcast app

1. Navigate to Seeking the Military Suicide Solution on Apple Podcasts on your iPhone or iPad.

2. Click "Listen on Apple Podcasts"

3. Scroll down and click or tap "Write a Review." Enter your iTunes password to login.

4. Rate the podcast using 1 to 5 stars.

5. Submit a brief honest review.

Bonus: get a thank-you note

Your feedback is greatly appreciated. When you leave a review, drop us a line at info@veteranmentalhealth.com and you'll get a message with the warmest appreciation, and a bonus gift!

For Android users, Google Podcasts does not allow for ratings or reviews, but you can certainly let us know how you think we're doing on Spotify, Stitcher, or iHeartRadio

Many thanks,

Duane and Shauna

★ Support this podcast ★

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About Today’s Guest:

Chris Jachimiec is a recently retired member of the United States Air Force. Over the course of his 20 year career he served in multiple military leadership roles in Nevada, Germany and Korea and is a veteran of the war in Afghanistan. He was named the Air Combat Command First Sergeant of the year in 2016.

In July 2017, he lost his brother, Lance Corporal Adam Jachimiec, United States Marine Corps, to suicide after a courageous battle with Post Traumatic Stress. As a Wounded Warrior himself, Chris dedicates his life to finding and utilizing multiple pathways to recovery from mental health issues, grief and trauma. Chris is a Warrior Games Athlete and distinguished member of the Governors and Mayors Challenge teams in Nevada and Las Vegas. He has recently been named the first PREVENTS Ambassador for Nevada and is working with Senator Jacky Rosen on legislation for veterans issues.

Links Mentioned in this Episode:

Nevada's Mayors and Governors Challenge

Join our Facebook Group:

Seeking the Military Suicide Solution on Facebook

Shauna's latest book: Warrior: How to Support Those Who Protect Us

Duane's latest book: Military in the Rear View Mirror: Mental Health and Wellness in Post-Military Life

How to Leave a Podcast Review

Leaving a podcast review at iTunes isn't intuitive. But positive ratings are hugely important: they help the podcast get discovered by new people. Please spend 5 minutes of your time to leave a review using one of the methods below.

How to leave a podcast review using Apple’s Podcast app

1. Navigate to Seeking the Military Suicide Solution on Apple Podcasts on your iPhone or iPad.

2. Click "Listen on Apple Podcasts"

3. Scroll down and click or tap "Write a Review." Enter your iTunes password to login.

4. Rate the podcast using 1 to 5 stars.

5. Submit a brief honest review.

Bonus: get a thank-you note

Your feedback is greatly appreciated. When you leave a review, drop us a line at info@veteranmentalhealth.com and you'll get a message with the warmest appreciation, and a bonus gift!

For Android users, Google Podcasts does not allow for ratings or reviews, but you can certainly let us know how you think we're doing on Spotify, Stitcher, or iHeartRadio

Many thanks,

Duane and Shauna

★ Support this podcast ★

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About Today’s Guest:

Dr. Bridget Matarazzo is a Clinical Research Psychologist and the Director of Clinical Services at VA’s Rocky Mountain MIRECC for Suicide Prevention and an Associate Professor in the Department of Psychiatry at the University of Colorado School of Medicine. She completed her Pre-Doctoral Internship at the Denver VA Medical Center and obtained a PsyD in Clinical Psychology from the University of Denver in 2010. She is a licensed clinical psychologist in the state of Colorado.

Dr. Matarazzo is passionate about applying implementation science research to promote the dissemination and implementation of evidence-based suicide prevention strategies to enhance care for Veterans. She partners closely with colleagues in the VA Office of Mental Health and Suicide Prevention to develop and implement national suicide programs and initiatives. Her team uses evidence-based implementation strategies to provide technical assistance, training and quality assurance/improvement to support these programs. One such project is VA’s Suicide Risk Identification Strategy (Risk ID), which is the nation’s largest population-based screening and evaluation initiative. Another is VA’s REACH VET program, which utilizes predictive analytics to identify and support Veterans at increased risk for suicide.

Additionally, Dr. Matarazzo is deeply committed to supporting providers who deliver suicide prevention care to Veterans. She is Co-Director of VA’s Suicide Risk Management Consultation Program, which supports VA and community providers serving Veterans at risk for suicide. Her team provides consultation, resources and training to support those doing such incredibly important work. #NeverWorryAlone

Dr. Matarazzo’s clinical interests are in suicide risk assessment and management for Veterans at high risk for suicide and PTSD treatment as a certified Cognitive Processing Therapy provider. She is also a member of the Rocky Mountain MIRECC Training Committee and provides supervision to Post-Doctoral Fellows and Psychology Interns.

Links Mentioned in this Episode:

VA’s Suicide Risk Management Consultation Program

Rocky Mountain MIRECC

Join our Facebook Group:

Seeking the Military Suicide Solution on Facebook

Shauna's latest book: Warrior: How to Support Those Who Protect Us

Duane's latest book: Military in the Rear View Mirror: Mental Health and Wellness in Post-Military Life

How to Leave a Podcast Review

Leaving a podcast review at iTunes isn't intuitive. But positive ratings are hugely important: they help the podcast get discovered by new people. Please spend 5 minutes of your time to leave a review using one of the methods below.

How to leave a podcast review using Apple’s Podcast app

1. Navigate to Seeking the Military Suicide Solution on Apple Podcasts on your iPhone or iPad.

2. Click "Listen on Apple Podcasts"

3. Scroll down and click or tap "Write a Review." Enter your iTunes password to login.

4. Rate the podcast using 1 to 5 stars.

5. Submit a brief honest review.

Bonus: get a thank-you note

Your feedback is greatly appreciated. When you leave a review, drop us a line at info@veteranmentalhealth.com and you'll get a message with the warmest appreciation, and a bonus gift!

For Android users, Google Podcasts does not allow for ratings or reviews, but you can certainly let us know how you think we're doing on Spotify, Stitcher, or iHeartRadio

Many thanks,

Duane and Shauna

★ Support this podcast ★

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About Today’s Guest:

Michael Sugrue began his law enforcement career in the United States Air Force as a Security Forces Officer in 1998. As a Security Forces Officer, Michael specialized in Law Enforcement, Global Force Protection, Anti-Terrorism, Nuclear Security, Foreign Air Field Assessments and Air Base Ground Defense.

Michael served in a variety of assignments including: Flight Leader, Flight Commander, Senior Watch Officer, Chief of Command Post and Chief of Security Forces.

Michael served all over the United States, Europe, the Middle East and South America. He was also a Security Forces Phoenix Raven with the unique identifier of #1173. Michael honorably separated from the Air Force as a Captain in 2004.

Immediately after the Air Force, Michael was hired by the Walnut Creek Police Department where he served in a variety of assignments including: Patrol Officer, Driver Training Instructor, FieldTraining Officer, SIU Detective, Undercover CA DOJ Narcotic Task Force Agent (Contra Costa County), Public Information Officer and Patrol Sergeant.

Michael was awarded the Walnut Creek PD Distinguished Service Medal in 2014 for his heroic and life saving actions during a Fatal Officer Involved Shooting in 2012.

Michael ultimately medically retired in 2018. He is now a Peer Volunteer at the West Coast Post Trauma Retreat (WCPR) and an Ambassador for Save A Warrior (SAW).

Michael is a dedicated advocate for awareness, prevention, education, training on Post Traumatic Stress Injury (PTSI) and First Responder Suicide Prevention. Michael continues to speak at law enforcement agencies all over the United States.

Links Mentioned in this Episode:

Follow Michael on LinkedIn

Join our Facebook Group:

Seeking the Military Suicide Solution on Facebook

Shauna's latest book: Warrior: How to Support Those Who Protect Us

Duane's latest book: Military in the Rear View Mirror: Mental Health and Wellness in Post-Military Life

How to Leave a Podcast Review

Leaving a podcast review at iTunes isn't intuitive. But positive ratings are hugely important: they help the podcast get discovered by new people. Please spend 5 minutes of your time to leave a review using one of the methods below.

How to leave a podcast review using Apple’s Podcast app

1. Navigate to Seeking the Military Suicide Solution on Apple Podcasts on your iPhone or iPad.

2. Click "Listen on Apple Podcasts"

3. Scroll down and click or tap "Write a Review." Enter your iTunes password to login.

4. Rate the podcast using 1 to 5 stars.

5. Submit a brief honest review.

Bonus: get a thank-you note

Your feedback is greatly appreciated. When you leave a review, drop us a line at info@veteranmentalhealth.com and you'll get a message with the warmest appreciation, and a bonus gift!

For Android users, Google Podcasts does not allow for ratings or reviews, but you can certainly let us know how you think we're doing on Spotify, Stitcher, or iHeartRadio

Many thanks,

Duane and Shauna

★ Support this podcast ★

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About Today’s Guest:

Dr. Kudler received his M.D. from Downstate Medical Center in Brooklyn, trained in Psychiatry at Yale and is Adjunct Associate Professor at Duke. He has received teaching awards from the Duke Department of Psychiatry and Behavioral Sciences, the American Psychiatric Association and the American Psychoanalytic Association.

From 2002 to 2010, Dr. Kudler coordinated mental health services for a three state region of the U.S. Department of Veterans Affairs (VA) and from 2000 through 2005 co-chaired VA’s Special Committee on PTSD which reports to Congress. He founded the International Society for Traumatic Stress Studies’ (ISTSS) PTSD Practice Guidelines taskforce and has served on the ISTSS Board of Directors. He co-led development of the joint VA/Department of Defense Guideline for the Management of Posttraumatic Stress and serves as advisor to Sesame Street’s Talk Listen Connect series for military families.

From 2006 to 2014, he co-led the North Carolina Governor’s Focus on Returning Military Members and their Families. In 2012, he was appointed to the North Carolina Institute of Medicine. From 2004 to 2014, Dr. Kudler was Associate Director of the VA's Mid-Atlantic Mental Illness Research, Education, and Clinical Center (MIRECC) which focuses on Deployment Mental Health. From 2010 to 2013, Dr. Kudler was also Medical Lead for the VISN 6 Rural Health Initiative. In July, 2014, he joined VA Central Office in Washington DC where he serves as Chief Consultant for Mental Health Services.

Links Mentioned in this Episode:

Dr. Kudler's research and background

Join our Facebook Group:

Seeking the Military Suicide Solution on Facebook

Shauna's latest book: Warrior: How to Support Those Who Protect Us

Duane's latest book: Military in the Rear View Mirror: Mental Health and Wellness in Post-Military Life

How to Leave a Podcast Review

Leaving a podcast review at iTunes isn't intuitive. But positive ratings are hugely important: they help the podcast get discovered by new people. Please spend 5 minutes of your time to leave a review using one of the methods below.

How to leave a podcast review using Apple’s Podcast app

1. Navigate to Seeking the Military Suicide Solution on Apple Podcasts on your iPhone or iPad.

2. Click "Listen on Apple Podcasts"

3. Scroll down and click or tap "Write a Review." Enter your iTunes password to login.

4. Rate the podcast using 1 to 5 stars.

5. Submit a brief honest review.

Bonus: get a thank-you note

Your feedback is greatly appreciated. When you leave a review, drop us a line at info@veteranmentalhealth.com and you'll get a message with the warmest appreciation, and a bonus gift!

For Android users, Google Podcasts does not allow for ratings or reviews, but you can certainly let us know how you think we're doing on Spotify, Stitcher, or iHeartRadio

Many thanks,

Duane and Shauna

★ Support this podcast ★

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About Today’s Guest:

Danica Thomas is the widow of US Army SSG Allen Thomas. In March of 2010, her husband was severely injured in Afghanistan and brought to Walter Reed. Danica was pregnant with their first daughter. She became a caregiver overnight and quickly learned they had a very long road to recovery. They were stationed back at Fort Bragg in August 2010, where he would rehabilitate and transition to medical retirement at the Warrior Transition Battalion and Womack. They had their first daughter in October. Danica experienced the hard trials and errors of being a new mom and caregiver, as well as Army wife. They welcomed a second daughter in the Spring of 2013. Tragically in the late Summer of 2013, her husband lost his long battle to suicide. As a widow and mother of two, she has now made it a mission to work closely within the Military community. Danica has put her heart into helping other Caregivers and Wounded Veterans like her husband.

Links Mentioned in this Episode:

Danica's Story: Life After Suicide

Join our Facebook Group:

Seeking the Military Suicide Solution on Facebook

Shauna's latest book: Warrior: How to Support Those Who Protect Us

Duane's latest book: Military in the Rear View Mirror: Mental Health and Wellness in Post-Military Life

How to Leave a Podcast Review

Leaving a podcast review at iTunes isn't intuitive. But positive ratings are hugely important: they help the podcast get discovered by new people. Please spend 5 minutes of your time to leave a review using one of the methods below.

How to leave a podcast review using Apple’s Podcast app

1. Navigate to Seeking the Military Suicide Solution on Apple Podcasts on your iPhone or iPad.

2. Click "Listen on Apple Podcasts"

3. Scroll down and click or tap "Write a Review." Enter your iTunes password to login.

4. Rate the podcast using 1 to 5 stars.

5. Submit a brief honest review.

Bonus: get a thank-you note

Your feedback is greatly appreciated. When you leave a review, drop us a line at info@veteranmentalhealth.com and you'll get a message with the warmest appreciation, and a bonus gift!

For Android users, Google Podcasts does not allow for ratings or reviews, but you can certainly let us know how you think we're doing on Spotify, Stitcher, or iHeartRadio

Many thanks,

Duane and Shauna

★ Support this podcast ★

View Details

About Today’s Guest:

Amy Taft is the wife of retired Navy Senior Chief Petty Officer Ward Taft. Together they have 2 girls and live in Jacksonville, NC. Amy is the founder of Third Star Foundation, an organization that provides ongoing support to children who live in a house with a veteran or service member that has sustained an injury or wound as a result of their time in service. Amy founded the organization after witnessing her own children go through drastic behavior changes after their father returned home from combat with a moderate brain injury. Her goal is to allow children to meet other peers that have a shared experience and give them the tools they need to express their emotions in a healthy way. Amy also wants to bring awareness to child suicide and the devestating effects that isolation has on children. Amy spent 7 years as a classroom teacher just outside Marine Corps BaseCamp Lejeune and currently serves as the Sr Director of Education for the COMMIT Foundation. Amy was also part of the inaugural GW Bush Institute Veteran Stand To Leadership Program. To learn more about Third Star Foundation, email amy@thirdstarfoundation.org

Links Mentioned in this Episode:

The Third Star Foundation

Join our Facebook Group:

Seeking the Military Suicide Solution on Facebook

Shauna's latest book: Warrior: How to Support Those Who Protect Us

Duane's latest book: Military in the Rear View Mirror: Mental Health and Wellness in Post-Military Life

How to Leave a Podcast Review

Leaving a podcast review at iTunes isn't intuitive. But positive ratings are hugely important: they help the podcast get discovered by new people. Please spend 5 minutes of your time to leave a review using one of the methods below.

How to leave a podcast review using Apple’s Podcast app

1. Navigate to Seeking the Military Suicide Solution on Apple Podcasts on your iPhone or iPad.

2. Click "Listen on Apple Podcasts"

3. Scroll down and click or tap "Write a Review." Enter your iTunes password to login.

4. Rate the podcast using 1 to 5 stars.

5. Submit a brief honest review.

Bonus: get a thank-you note

Your feedback is greatly appreciated. When you leave a review, drop us a line at info@veteranmentalhealth.com and you'll get a message with the warmest appreciation, and a bonus gift!

For Android users, Google Podcasts does not allow for ratings or reviews, but you can certainly let us know how you think we're doing on Spotify, Stitcher, or iHeartRadio

Many thanks,

Duane and Shauna

★ Support this podcast ★

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About Today’s Guests:

Michael Kanaan was the first chairperson of artificial intelligence for the U.S. Air Force, Headquarters Pentagon. In that role, he authored and guided the research, development, and implementation strategies for AI technology and machine learning activities across its global operations. He is currently the Director of Operations for Air Force / MIT Artificial Intelligence. In recognition of his fast-rising career and broad influence, the author was named to the 2019 Forbes "30 Under 30" list and has received numerous other awards and prestigious honors--including the Air Force's 2018 General Larry O. Spencer Award for Innovation as well as the US Government's Arthur S. Flemming Award (an honor shared by past recipients Neil Armstrong, Robert Gates, and Elizabeth Dole). Kanaan is a graduate of the US Air Force Academy and previously led a National Intelligence Campaign for Operation Inherent Resolve in Syria and Iraq.

Links Mentioned in this Episode:

Air Force / MIT Artificial Intelligence Accelerator

Michael's book: T-Minus AI: Humanity’s Countdown to Artificial Intelligence and the New Pursuit of Global Power

Join our Facebook Group:

Seeking the Military Suicide Solution on Facebook

Shauna's latest book: Warrior: How to Support Those Who Protect Us

Duane's latest book: Military in the Rear View Mirror: Mental Health and Wellness in Post-Military Life

How to Leave a Podcast Review

Leaving a podcast review at iTunes isn't intuitive. But positive ratings are hugely important: they help the podcast get discovered by new people. Please spend 5 minutes of your time to leave a review using one of the methods below.

How to leave a podcast review using Apple’s Podcast app

1. Navigate to Seeking the Military Suicide Solution on Apple Podcasts on your iPhone or iPad.

2. Click "Listen on Apple Podcasts"

3. Scroll down and click or tap "Write a Review." Enter your iTunes password to login.

4. Rate the podcast using 1 to 5 stars.

5. Submit a brief honest review.

Bonus: get a thank-you note

Your feedback is greatly appreciated. When you leave a review, drop us a line at info@veteranmentalhealth.com and you'll get a message with the warmest appreciation, and a bonus gift!

For Android users, Google Podcasts does not allow for ratings or reviews, but you can certainly let us know how you think we're doing on Spotify, Stitcher, or iHeartRadio

Many thanks,

Duane and Shauna

★ Support this podcast ★

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About Today’s Guest:

Colonel Robert “Rob” Swanson retired from active duty after serving nearly 35 years. Since retirement, he completed an Executive MBA from the Shidler School of Business and has been actively involved as keynote speaker, senior mentor and advisor for the award-winning Fight For Each Other suicide prevention program in Hawaii.

Prior to retirement, Colonel Swanson was Chief, Weather Strategic Plans and Interagency Integration Division, Directorate of Weather, Deputy Chief of Staff, Operations, Headquarters U.S. Air Force, Washington, D.C. The Division plans weather, climate and space environmental support for the Air Force Weather functional area and oversees integration of technology and weather into C4I and modeling systems.

Links Mentioned in this Episode:

USAF Article on Personal Resiliency

Task and Purpose Article

Join our Facebook Group:

Seeking the Military Suicide Solution on Facebook

Shauna's latest book: Warrior: How to Support Those Who Protect Us

Duane's latest book: Military in the Rear View Mirror: Mental Health and Wellness in Post-Military Life

How to Leave a Podcast Review

Leaving a podcast review at iTunes isn't intuitive. But positive ratings are hugely important: they help the podcast get discovered by new people. Please spend 5 minutes of your time to leave a review using one of the methods below.

How to leave a podcast review using Apple’s Podcast app

1. Navigate to Seeking the Military Suicide Solution on Apple Podcasts on your iPhone or iPad.

2. Click "Listen on Apple Podcasts"

3. Scroll down and click or tap "Write a Review." Enter your iTunes password to login.

4. Rate the podcast using 1 to 5 stars.

5. Submit a brief honest review.

Bonus: get a thank-you note

Your feedback is greatly appreciated. When you leave a review, drop us a line at info@veteranmentalhealth.com and you'll get a message with the warmest appreciation, and a bonus gift!

For Android users, Google Podcasts does not allow for ratings or reviews, but you can certainly let us know how you think we're doing on Spotify, Stitcher, or iHeartRadio

Many thanks,

Duane and Shauna

★ Support this podcast ★

View Details

About Today’s Guests:

Kim Donohue has worked for the Nevada Department fo Veteran Services as the Suicide and Homelessness Prevention Program Manager and Organizational Integrator since January 2018. Kim has been actively participating in the SAMHSA Mayor's Challenge Teams, which is a suicide prevention initiative that fights against suicide among service members, veterans, and their families since the inauguration in January 2018. In December of 2018, Governor Sisolak designated Kim to lead the Governors Challenge team and continue efforts towards preventing suicide on a state-wide level.

Prior to working for NDVS, she taught early childhood education. Kim spent over five years living in Ireland and Great Britain, establishing European offices in England and the Middle East for an International Engineering Software Company.

Links Mentioned in this Episode:

Nevada Mayor's and Governor's Challenge to Prevent Veteran Suicide

Join our Facebook Group:

Seeking the Military Suicide Solution on Facebook

Shauna's latest book: Warrior: How to Support Those Who Protect Us

Duane's latest book: Military in the Rear View Mirror: Mental Health and Wellness in Post-Military Life

How to Leave a Podcast Review

Leaving a podcast review at iTunes isn't intuitive. But positive ratings are hugely important: they help the podcast get discovered by new people. Please spend 5 minutes of your time to leave a review using one of the methods below.

How to leave a podcast review using Apple’s Podcast app

1. Navigate to Seeking the Military Suicide Solution on Apple Podcasts on your iPhone or iPad.

2. Click "Listen on Apple Podcasts"

3. Scroll down and click or tap "Write a Review." Enter your iTunes password to login.

4. Rate the podcast using 1 to 5 stars.

5. Submit a brief honest review.

Bonus: get a thank-you note

Your feedback is greatly appreciated. When you leave a review, drop us a line at info@veteranmentalhealth.com and you'll get a message with the warmest appreciation, and a bonus gift!

For Android users, Google Podcasts does not allow for ratings or reviews, but you can certainly let us know how you think we're doing on Spotify, Stitcher, or iHeartRadio

Many thanks,

Duane and Shauna

★ Support this podcast ★

View Details

About Today’s Guests:

David Bachmann is a Marine Corps Infantry combat veteran. He served with E Co, 2nd Battalion 7th Marines from 2001-2005. After being discharged from the Marine Corps he began to ride and build motorcycles. He currently resides in Texas where he raises cattle and Quarter horses. David is active in an ongoing healing movement developed by Marines that brings the Tribe of veterans together throughout the year for warrior reunions. He has also been an invited suicide prevention speaker at Marine reunions.

Links Mentioned in this Episode:

Article highlighting USMC Peer Support Retreats

Join our Facebook Group:

Seeking the Military Suicide Solution on Facebook

Shauna's latest book: Warrior: How to Support Those Who Protect Us

Duane's latest book: Military in the Rear View Mirror: Mental Health and Wellness in Post-Military Life

How to Leave a Podcast Review

Leaving a podcast review at iTunes isn't intuitive. But positive ratings are hugely important: they help the podcast get discovered by new people. Please spend 5 minutes of your time to leave a review using one of the methods below.

How to leave a podcast review using Apple’s Podcast app

1. Navigate to Seeking the Military Suicide Solution on Apple Podcasts on your iPhone or iPad.

2. Click "Listen on Apple Podcasts"

3. Scroll down and click or tap "Write a Review." Enter your iTunes password to login.

4. Rate the podcast using 1 to 5 stars.

5. Submit a brief honest review.

Bonus: get a thank-you note

Your feedback is greatly appreciated. When you leave a review, drop us a line at info@veteranmentalhealth.com and you'll get a message with the warmest appreciation, and a bonus gift!

For Android users, Google Podcasts does not allow for ratings or reviews, but you can certainly let us know how you think we're doing on Spotify, Stitcher, or iHeartRadio

Many thanks,

Duane and Shauna

★ Support this podcast ★

View Details

About Today’s Guests:

Dr. Jeffrey Allen Smith, PhD: Dr. Smith is an Associate Professor of American History and Chair of the History Department at the University of Hawaii at Hilo. He has published historical analyses of military mental health, psychology, and suicide in academic journals and commentaries on his research in the New York Times, Time, and Washington Post; and has been quoted in U.S. News & World Report, NBC News, Reuters, Stars and Stripes, and other media outlets.

Dr. Michael Doidge, PhD: Dr. Doidge Dr. Doidge is a contract historian working for the Department of Defense, where he writes on the history of U.S. military medicine. His work on the history of suicide in the military has been published in the Journal of the American Medical Association and the Washington Post. The views expressed are the author’s alone and do not represent the official position of the Department of Defense, or the U.S. Government.

Links Mentioned in this Episode:

JAMA Journal Article on Historical Aspects of Military Suicide

Visual Chart: Suicides Rates Among Active-Duty Personnel in the US Army, 1843-2017

Washington Post article: Can historical analysis help reduce military deaths by suicide?

Military Times article: Historic data on military suicide shows no clear link with combat operations

Join our Facebook Group:

Seeking the Military Suicide Solution on Facebook

Shauna's latest book: Warrior: How to Support Those Who Protect Us

Duane's latest book: Military in the Rear View Mirror: Mental Health and Wellness in Post-Military Life

How to Leave a Podcast Review

Leaving a podcast review at iTunes isn't intuitive. But positive ratings are hugely important: they help the podcast get discovered by new people. Please spend 5 minutes of your time to leave a review using one of the methods below.

How to leave a podcast review using Apple’s Podcast app

1. Navigate to Seeking the Military Suicide Solution on Apple Podcasts on your iPhone or iPad.

2. Click "Listen on Apple Podcasts"

3. Scroll down and click or tap "Write a Review." Enter your iTunes password to login.

4. Rate the podcast using 1 to 5 stars.

5. Submit a brief honest review.

Bonus: get a thank-you note

Your feedback is greatly appreciated. When you leave a review, drop us a line at info@veteranmentalhealth.com and you'll get a message with the warmest appreciation, and a bonus gift!

For Android users, Google Podcasts does not allow for ratings or reviews, but you can certainly let us know how you think we're doing on Spotify, Stitcher, or iHeartRadio

Many thanks,

Duane and Shauna

★ Support this podcast ★

View Details

About Today’s Guest:

Scott Perry was elected as the U.S. Representative of the 4th Congressional District (York, Adams and Cumberland Counties) in 2013. He earned re-election in 2018, and due to congressional redistricting, now serves the 10th Congressional District (Dauphin, Cumberland and York Counties). Congressman Perry presently serves on the House Committees on Transportation & Infrastructure, and Foreign Affairs. He previously served three terms as a State Representative in the Pennsylvania General Assembly.

Scott began his military career in 1980. He attended basic training at Fort Dix, NJ, and graduated Advanced Individual Training at Fort Belvoir, VA, as a technical drafting specialist. He graduated as the president of his Officer Candidate School class, and was commissioned a Second Lieutenant in the Field Artillery branch. He soon branch-transferred to Army Aviation, where he earned qualifications in almost every rotary-wing aircraft in the Army inventory (Huey, Cayuse, Kiowa, Cobra, Chinook, Apache and Blackhawk), and the Instructor Pilot rating. Scott commanded at the company, battalion and brigade levels; notably, Lieutenant Colonel Perry commanded the 2-104th General Support Aviation Battalion, which deployed to Iraq from 2009-2010, and during which he flew 44 combat missions. In 2011, he was promoted to the rank of Colonel, and became Commander of the Fort Indiantown Gap National Training Site. Scott was selected for promotion to the rank of Brigadier General in 2014, and was honored to serve as the Assistant Division Commander of the 28th Infantry Division – the Army’s oldest, actively-serving Division. After serving in his final military position as Assistant Adjutant General, Joint Forces Headquarters, Pennsylvania National Guard, Perry retired on 1 March 2019, after nearly 40 years in uniform. Scott is a graduate of the US Army War College, where he earned a Master’s Degree in Strategic Studies.

Scott’s service to the community has included serving as the chairman of the Carroll Township Planning Commission, and as a member of the township Source Water Protection Committee. He was chairman of the Dillsburg Area Wellhead Protection Advisory Committee and he served on the Dillsburg Revitalization Committee. He was active in the Jaycees and was the regional director for the state organization. He’s a member of Dillsburg Legion Post #26, Dillsburg VFW Post #6771, Lions Club International, Army Aviation Association of America, the NRA, and numerous other associations.

Links Mentioned in this Episode:

Congressman Perry's Web Site

Join our Facebook Group:

Seeking the Military Suicide Solution on Facebook

Shauna's latest book: Warrior: How to Support Those Who Protect Us

Duane's latest book: Military in the Rear View Mirror: Mental Health and Wellness in Post-Military Life

How to Leave a Podcast Review

Leaving a podcast review at iTunes isn't intuitive. But positive ratings are hugely important: they help the podcast get discovered by new people. Please spend 5 minutes of your time to leave a review using one of the methods below.

How to leave a podcast review using Apple’s Podcast app

1. Navigate to Seeking the Military Suicide Solution on Apple Podcasts on your iPhone or iPad.

2. Click "Listen on Apple Podcasts"

3. Scroll down and click or tap "Write a Review." Enter your iTunes password to login.

4. Rate the podcast using 1 to 5 stars.

5. Submit a brief honest review.

Bonus: get a thank-you note

Your feedback is greatly appreciated. When you leave a review, drop us a line at info@veteranmentalhealth.com and you'll get a message with the warmest appreciation, and a bonus gift!

For Android users, Google Podcasts does not allow for ratings or reviews, but you can certainly let us know how you think we're doing on Spotify, Stitcher, or iHeartRadio

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Duane and Shauna

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About Today’s Guest:

Peter M. Gutierrez, Ph.D. is a licensed Clinical Psychologist at the VA VISN 19 Mental Illness Research Education Clinical Center (MIRECC). Dr. Gutierrez's clinical training was in child and adolescent psychology, with an emphasis on serious psychopathology and suicide. He is Professor of Psychiatry at the University of Colorado School of Medicine. He has been studying suicide, focusing on screening, assessment, and intervention for over 20 years.

Dr. Gutierrez is a Past-President of the American Association of Suicidology (AAS). He was the 2005 recipient of the AAS Shneidman Award for outstanding contributions in research in suicidology and the 2014 recipient of the Roger J. Tierney Award for Service. He is an Associate Editor for the journal Suicide and Life-Threatening Behavior, a consulting editor for Archives of Suicide Research, and regularly reviews for other psychology, psychiatry, and specialty journals. Dr. Gutierrez is a member of the MIRECC psychology fellowship training committee, provides supervision and mentoring for psychology pre-doctoral interns, and MIRECC psychology fellows. He has provided numerous VA trainings and conference presentations on issues related to clinical care of Veterans at high risk of suicide, the interplay of TBI, PTSD and suicide, and related topics.

Dr. Gutierrez is co-Director, with Dr. Thomas Joiner at Florida State University, of the DOD funded Military Suicide Research Consortium. He and Dr. Joiner are joint recipients of the 2018 Military Health System Research Symposium (MHSRS) Outstanding Research Accomplishment (Team/Academia) Award and the American Psychological Association (APA) Division 19 Society of Military Psychology’s 2018 Charles C. Gersoni Military Psychology Award.

Links Mentioned in this Episode:

Rocky Mountain MIRECC Home Page

Join our Facebook Group:

Seeking the Military Suicide Solution on Facebook

Shauna's latest book: Warrior: How to Support Those Who Protect Us

Duane's latest book: Military in the Rear View Mirror: Mental Health and Wellness in Post-Military Life

How to Leave a Podcast Review

Leaving a podcast review at iTunes isn't intuitive. But positive ratings are hugely important: they help the podcast get discovered by new people. Please spend 5 minutes of your time to leave a review using one of the methods below.

How to leave a podcast review using Apple’s Podcast app

1. Navigate to Seeking the Military Suicide Solution on Apple Podcasts on your iPhone or iPad.

2. Click "Listen on Apple Podcasts"

3. Scroll down and click or tap "Write a Review." Enter your iTunes password to login.

4. Rate the podcast using 1 to 5 stars.

5. Submit a brief honest review.

Bonus: get a thank-you note

Your feedback is greatly appreciated. When you leave a review, drop us a line at info@veteranmentalhealth.com and you'll get a message with the warmest appreciation, and a bonus gift!

For Android users, Google Podcasts does not allow for ratings or reviews, but you can certainly let us know how you think we're doing on Spotify, Stitcher, or iHeartRadio

Many thanks,

Duane and Shauna

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About Today’s Guest:

Marine Corps Sgt. Maj. Bryan Battaglia is the former Senior Enlisted Advisor to the Chairman of the Joint Chiefs of Staff, and was the senior non-commissioned officer in the U.S. Armed Forces. In this role, he served as the principal military advisor to the Chairman and the Secretary of Defense on all matters involving joint and combined total force integration, utilization, health of the force and joint development for enlisted personnel.

The first Marine to be appointed Senior Enlisted Advisor to the Chairman, Battaglia served as the most senior ranking non-commissioned officer of the United States Armed Forces and principal military advisor to the Chairman of the Joint Chiefs of Staff, Generals Martin Dempsey and Joseph Dunford, and to Secretaries of Defense Leon Panetta, Chuck Hagel, and Ashton Carter on all matters involving the joint and combined total force integration, utilization, health of the force and joint development for enlisted personnel and families.

Battaglia was honorably retired from the United States Marines on 31 August 2016, having served nearly 37 years of active duty service.

Read more about Sergeant Major Battaglia's service here

Links Mentioned in this Episode:

Total Force Fitness Framework

Join our Facebook Group:

Seeking the Military Suicide Solution on Facebook

Shauna's latest book: Warrior: How to Support Those Who Protect Us

Duane's latest book: Military in the Rear View Mirror: Mental Health and Wellness in Post-Military Life

How to Leave a Podcast Review

Leaving a podcast review at iTunes isn't intuitive. But positive ratings are hugely important: they help the podcast get discovered by new people. Please spend 5 minutes of your time to leave a review using one of the methods below.

How to leave a podcast review using Apple’s Podcast app

1. Navigate to Seeking the Military Suicide Solution on Apple Podcasts on your iPhone or iPad.

2. Click "Listen on Apple Podcasts"

3. Scroll down and click or tap "Write a Review." Enter your iTunes password to login.

4. Rate the podcast using 1 to 5 stars.

5. Submit a brief honest review.

Bonus: get a thank-you note

Your feedback is greatly appreciated. When you leave a review, drop us a line at info@veteranmentalhealth.com and you'll get a message with the warmest appreciation, and a bonus gift!

For Android users, Google Podcasts does not allow for ratings or reviews, but you can certainly let us know how you think we're doing on Spotify, Stitcher, or iHeartRadio

Many thanks,

Duane and Shauna

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About Today’s Guests:

Michael Richardson: As the independence services and mental health vice president for the Wounded Warrior Project®(WWP), Michael Richardson is responsible for the Independence Program (IP) and Long-Term Support Trust (LTST), as well as the Combat Stress Recovery Program (CSRP).

Michael began his military service in 1981 as a 17-year-old private and retired 32 years later in 2013 as a medical service corps lieutenant colonel. During Michael’s career, he had numerous combat and operational deployments to Iraq, Kuwait, Kosovo, and Bosnia. Of note, during his last 15-month deployment to Iraq, Michael served as the Iraq theatre medical regulating officer and was responsible for the coordination of all patient movement within and departing from Iraq.

Michael holds a master’s degree in public administration (health) from the University of Missouri-Kansas City and a bachelor’s in economics from the University of Hawaii. He resides in Jacksonville, Florida, with his wife, Beth, who is an active-duty military police officer.

Dr. Roger Brooks: Roger Brooks is a Senior Program Initiatives and Integration Specialist of Mental Health at Wounded Warrior Project® (WWP). He received his undergraduate degree from the University of the Incarnate Word and his graduate degree from the University of Notre Dame.

Roger previously served as the chief clinical officer for a mental health facility. He has also served as the co-director for a trauma studies program and director for the Laboratories for the Psychological research of Ethno-cultural aspects of Trauma.

Links Mentioned in this Episode:

WWP's Warrior Care Network

Join our Facebook Group:

Seeking the Military Suicide Solution on Facebook

Shauna's latest book: Warrior: How to Support Those Who Protect Us

Duane's latest book: Military in the Rear View Mirror: Mental Health and Wellness in Post-Military Life

How to Leave a Podcast Review

Leaving a podcast review at iTunes isn't intuitive. But positive ratings are hugely important: they help the podcast get discovered by new people. Please spend 5 minutes of your time to leave a review using one of the methods below.

How to leave a podcast review using Apple’s Podcast app

1. Navigate to Seeking the Military Suicide Solution on Apple Podcasts on your iPhone or iPad.

2. Click "Listen on Apple Podcasts"

3. Scroll down and click or tap "Write a Review." Enter your iTunes password to login.

4. Rate the podcast using 1 to 5 stars.

5. Submit a brief honest review.

Bonus: get a thank-you note

Your feedback is greatly appreciated. When you leave a review, drop us a line at info@veteranmentalhealth.com and you'll get a message with the warmest appreciation, and a bonus gift!

For Android users, Google Podcasts does not allow for ratings or reviews, but you can certainly let us know how you think we're doing on Spotify, Stitcher, or iHeartRadio

Many thanks,

Duane and Shauna

★ Support this podcast ★

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About Today’s Guest:

Joseph Bartozzi is the President and CEO of the National Shooting Sports Foundation, the trade association for the firearm and ammunition industry, as well as the Sporting Arms and Ammunition Manufacturers Institute, the standard setting organization for the firearm and ammunition industry.

Joe is an attorney licensed to practice in Connecticut and Maine, and also is a licensed member of the bar of the United States Supreme court. In addition, he serves on the board of Connecticut chapter of the American Red Cross.

Links Mentioned in this Episode:

NSSF Suicide Prevention Web Page

Safe Firearm Storage Toolkit

Join our Facebook Group:

Seeking the Military Suicide Solution on Facebook

Shauna's latest book: Warrior: How to Support Those Who Protect Us

Duane's latest book: Military in the Rear View Mirror: Mental Health and Wellness in Post-Military Life

How to Leave a Podcast Review

Leaving a podcast review at iTunes isn't intuitive. But positive ratings are hugely important: they help the podcast get discovered by new people. Please spend 5 minutes of your time to leave a review using one of the methods below.

How to leave a podcast review using Apple’s Podcast app

1. Navigate to Seeking the Military Suicide Solution on Apple Podcasts on your iPhone or iPad.

2. Click "Listen on Apple Podcasts"

3. Scroll down and click or tap "Write a Review." Enter your iTunes password to login.

4. Rate the podcast using 1 to 5 stars.

5. Submit a brief honest review.

Bonus: get a thank-you note

Your feedback is greatly appreciated. When you leave a review, drop us a line at info@veteranmentalhealth.com and you'll get a message with the warmest appreciation, and a bonus gift!

For Android users, Google Podcasts does not allow for ratings or reviews, but you can certainly let us know how you think we're doing on Spotify, Stitcher, or iHeartRadio

Many thanks,

Duane and Shauna

★ Support this podcast ★

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About Today’s Guest:

Matt Mishkind, PhD, has focused his career on two focal points: military health care and organizational development. He began his military health career with the Deployment Health Clinical Center (DHCC) at Walter Reed Army Medical Center in Washington, DC. He also served as one of the original staff members tasked with developing the National Center for Telehealth and Technology (T2) located on Joint Base Lewis-McChord, Washington State. While at T2, Dr. Mishkind helped lead the development of several technology-based initiatives to improve behavioral health access across the Department of Defense. His particular focus was on developing telehealth programs for remote and otherwise isolated populations. Both DHCC and T2 are part of the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE).

Dr. Mishkind has 20 publications primarily focused on improving access to behavioral health care for military populations. He is also certified as a Senior Professional in Human Resources. Dr. Mishkind has also held positions focused on organizational development. Most recently, he served as team lead for training and human capital initiatives at the Bureau of Reclamation within the United States Department of Interior.

Links Mentioned in this Episode:

Johnson Depression Center

Defense Health Agency Connected Health

Join our Facebook Group:

Seeking the Military Suicide Solution on Facebook

Shauna's latest book: Warrior: How to Support Those Who Protect Us

Duane's latest book: Military in the Rear View Mirror: Mental Health and Wellness in Post-Military Life

How to Leave a Podcast Review

Leaving a podcast review at iTunes isn't intuitive. But positive ratings are hugely important: they help the podcast get discovered by new people. Please spend 5 minutes of your time to leave a review using one of the methods below.

How to leave a podcast review using Apple’s Podcast app

1. Navigate to Seeking the Military Suicide Solution on Apple Podcasts on your iPhone or iPad.

2. Click "Listen on Apple Podcasts"

3. Scroll down and click or tap "Write a Review." Enter your iTunes password to login.

4. Rate the podcast using 1 to 5 stars.

5. Submit a brief honest review.

Bonus: get a thank-you note

Your feedback is greatly appreciated. When you leave a review, drop us a line at info@veteranmentalhealth.com and you'll get a message with the warmest appreciation, and a bonus gift!

For Android users, Google Podcasts does not allow for ratings or reviews, but you can certainly let us know how you think we're doing on Spotify, Stitcher, or iHeartRadio

Many thanks,

Duane and Shauna

★ Support this podcast ★

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About Today’s Guest:

Michelle Villarreal Zook is currently an economics impact researcher evaluating programs within the federal government. She previously served as a commissioned officer in the United States Air Force, flying as an air battle manager with the 960th Air Command and Control Squadron out of Tinker Air Force Base, OK. As squadron executive officer and chief of the orderly room, she oversaw all administrative and personnel requirements for an operational line squadron of 300 officers and enlisted personnel in theater critical operations, leading a team of nine airmen in over 30 organizational programs, and advising command staff. Additionally, she served as 552d Operations Group executive officer, working on a team to assist the group commander and four deputy group commanders in leading and directing mission essential operations for 1200 personnel.

After leaving the Air Force, she earned her Master of Arts in Public Policy and joined the district staff of then freshman Congressman John Ratcliffe. As his constituent services manager and veterans’ affairs policy lead, she led a casework team for over 100 federal agencies, ensuring the more than 735,000 constituents of Texas’s Fourth District received representation and any benefits they were entitled to. She also provided recommendations to the legislative director regarding veterans and defense legislative matters, while managing the congressman’s service academy selection board and serving as the district’s federal disaster response coordinator. Despite all this and being selected for the Bush Institute’s Inaugural Veterans Leadership Program, her two children still feel the need to backseat drive and tell her she’s doing everything wrong. In her spare time, she runs, reads too many mystery novels, coaches girls’ lacrosse, scribbles in notebooks, yells at the Dallas Stars (particularly Jamie Benn), and nags her kids to clean their rooms.

Links Mentioned in this Episode:

Michelle on LinkeIn

Michelle's Women Veteran Authors project

Redefine Your Mission Web site

Join our Facebook Group:

Seeking the Military Suicide Solution on Facebook

Shauna's latest book: Warrior: How to Support Those Who Protect Us

Duane's latest book: Military in the Rear View Mirror: Mental Health and Wellness in Post-Military Life

How to Leave a Podcast Review

Leaving a podcast review at iTunes isn't intuitive. But positive ratings are hugely important: they help the podcast get discovered by new people. Please spend 5 minutes of your time to leave a review using one of the methods below.

How to leave a podcast review using Apple’s Podcast app

1. Navigate to Seeking the Military Suicide Solution on Apple Podcasts on your iPhone or iPad.

2. Click "Listen on Apple Podcasts"

3. Scroll down and click or tap "Write a Review." Enter your iTunes password to login.

4. Rate the podcast using 1 to 5 stars.

5. Submit a brief honest review.

Bonus: get a thank-you note

Your feedback is greatly appreciated. When you leave a review, drop us a line at info@veteranmentalhealth.com and you'll get a message with the warmest appreciation, and a bonus gift!

For Android users, Google Podcasts does not allow for ratings or reviews, but you can certainly let us know how you think we're doing on Spotify, Stitcher, or iHeartRadio

Many thanks,

Duane and Shauna

★ Support this podcast ★

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About Today’s Guest:

Akshay Nanavati is a Marine veteran, speaker, adventurer and entrepreneur. His new book "Fearvana" is an actionable guide on how to leverage fear to accomplish anything. The Dalai Lama said “Fearvana inspires us to look beyond our own agonizing experiences and find the positive side of our lives.”

Links Mentioned in this Episode:

Fearvana Web Site

Fearvana Book on Amazon
Responding to Grief and Trauma course on PsychArmor

Join our Facebook Group:

Seeking the Military Suicide Solution on Facebook

Shauna's latest book: Warrior: How to Support Those Who Protect Us

Duane's latest book: Military in the Rear View Mirror: Mental Health and Wellness in Post-Military Life

How to Leave a Podcast Review

Leaving a podcast review at iTunes isn't intuitive. But positive ratings are hugely important: they help the podcast get discovered by new people. Please spend 5 minutes of your time to leave a review using one of the methods below.

How to leave a podcast review using Apple’s Podcast app

1. Navigate to Seeking the Military Suicide Solution on Apple Podcasts on your iPhone or iPad.

2. Click "Listen on Apple Podcasts"

3. Scroll down and click or tap "Write a Review." Enter your iTunes password to login.

4. Rate the podcast using 1 to 5 stars.

5. Submit a brief honest review.

Bonus: get a thank-you note

Your feedback is greatly appreciated. When you leave a review, drop us a line at info@veteranmentalhealth.com and you'll get a message with the warmest appreciation, and a bonus gift!

For Android users, Google Podcasts does not allow for ratings or reviews, but you can certainly let us know how you think we're doing on Spotify, Stitcher, or iHeartRadio

Many thanks,

Duane and Shauna

★ Support this podcast ★

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About Today’s Guest:

Rick Trimp, MBA, is an experienced health and education executive. He leads LivingWorks with a vision of community-based health impact made possible through layered, integrated training programs combined with transformative technology.

Prior to joining LivingWorks, Rick led the Northern Alberta Institute of Technology (NAIT)’s School of Health and Life Sciences as Dean. Before that, he provided executive leadership to Alberta Health Services, Canada’s first and largest province-wide health service, first as Vice President of Province-Wide Clinical Support Programs and Services and then as Interim President and CEO.

Rick began his career as a physical therapy technician with the United States Navy and went on to work in healthcare operations throughout Canada and the United States. His focus on fostering and expanding strategic partnerships has enabled him to draw communities and partner organizations together to magnify their health and education impacts. Rick is passionate about suicide prevention and establishing grassroots, community-based approaches that create lasting changes in population health.

Links Mentioned in this Episode:

LivingWorks Suicide Prevention and Intervention Training Website

Join our Facebook Group:

Seeking the Military Suicide Solution on Facebook

Shauna's latest book: Warrior: How to Support Those Who Protect Us

Duane's latest book: Military in the Rear View Mirror: Mental Health and Wellness in Post-Military Life

How to Leave a Podcast Review

Leaving a podcast review at iTunes isn't intuitive. But positive ratings are hugely important: they help the podcast get discovered by new people. Please spend 5 minutes of your time to leave a review using one of the methods below.

How to leave a podcast review using Apple’s Podcast app

1. Navigate to Seeking the Military Suicide Solution on Apple Podcasts on your iPhone or iPad.

2. Click "Listen on Apple Podcasts"

3. Scroll down and click or tap "Write a Review." Enter your iTunes password to login.

4. Rate the podcast using 1 to 5 stars.

5. Submit a brief honest review.

Bonus: get a thank-you note

Your feedback is greatly appreciated. When you leave a review, drop us a line at info@veteranmentalhealth.com and you'll get a message with the warmest appreciation, and a bonus gift!

For Android users, Google Podcasts does not allow for ratings or reviews, but you can certainly let us know how you think we're doing on Spotify, Stitcher, or iHeartRadio

Many thanks,

Duane and Shauna

★ Support this podcast ★

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About Today’s Guest:

Mr. Tony Kurta performed the duties of Deputy Under Secretary of Defense for Personnel and Readiness. Mr. Tony Kurta assumed the duties of Deputy Assistant Secretary of Defense for Military Personnel Policy on September 8, 2014.

A member of the Senior Executive Service, he was responsible for recruiting, retention, compensation, travel, and the related human resource management for the 1.4 million Active Duty military members of the U .S. Armed Services

A native of Columbia Falls, Montana, he graduated with merit from the U.S. Naval Academy in 1981, earned an M.A. in National Security Studies from Georgetown University, is a distinguished graduate of the Air Command and Staff College, and was a National Security Fellow at the John F. Kennedy School of Government at Harvard University.

Mr. Kurta’s career includes over 32 years on active duty as a Navy Surface Warfare Officer, during which he commanded USS Sentry (MCM 3), USS Guardian (MCM 5), USS Warrior (MCM 10), USS Carney (DDG 64), Destroyer Squadron Two Four and Combined Joint Task Force, Horn of Africa (CJTF-HOA). As CJTF-HOA, his command included Active and Reserve officers and enlisted, Navy, Army, Marines, Air Force, Special Operations, National Guard, inter-agency and coalition personnel. Shore assignments included: Chief, Special Actions Division on the Joint Staff; Director, Surface Officer Distribution Division (Pers-41) at the Navy Personnel Command; Director for Policy, Resources and Strategy for U.S. Naval Forces Europe and Africa; and Director, Military Personnel Policy (N13) on the OPNAV Staff. Mr. Kurta retired from the Navy in 2013 as a Rear Admiral.

He has also served as a Senior Leader in the Department of the Navy from December 2013 through September 2014 as the Director of Navy Flag Officer Management and Development where he was responsible for flag officer community management and executive development.

His awards include the Distinguished Service Medal, Defense Superior Service Medals, Legions of Merit, Meritorious Service Medals, and various other awards and unit commendations.

Links Mentioned in this Episode:

Rear Admiral Kurta's LinkedIn Profile

Join our Facebook Group:

Seeking the Military Suicide Solution on Facebook

Shauna's latest book: Warrior: How to Support Those Who Protect Us

Duane's latest book: Military in the Rear View Mirror: Mental Health and Wellness in Post-Military Life

How to Leave a Podcast Review

Leaving a podcast review at iTunes isn't intuitive. But positive ratings are hugely important: they help the podcast get discovered by new people. Please spend 5 minutes of your time to leave a review using one of the methods below.

How to leave a podcast review using Apple’s Podcast app

1. Navigate to Seeking the Military Suicide Solution on Apple Podcasts on your iPhone or iPad.

2. Click "Listen on Apple Podcasts"

3. Scroll down and click or tap "Write a Review." Enter your iTunes password to login.

4. Rate the podcast using 1 to 5 stars.

5. Submit a brief honest review.

Bonus: get a thank-you note

Your feedback is greatly appreciated. When you leave a review, drop us a line at info@veteranmentalhealth.com and you'll get a message with the warmest appreciation, and a bonus gift!

For Android users, Google Podcasts does not allow for ratings or reviews, but you can certainly let us know how you think we're doing on Spotify, Stitcher, or iHeartRadio

Many thanks,

Duane and Shauna

★ Support this podcast ★

View Details

About Today’s Guest:

Tom Cruz is an Active Duty Master Sergeant in the United States Army with over 25 years of service. He has deployed in support of Operation Joint Guardian, Operation Iraqi Freedom and Jordan. He has lived experience with suicide prevention and awareness resulting from an attempt in 2010 to take his life. Since his attempt, he became a huge advocate of more awareness and prevention for Veterans. Tom has taken his skills to social media, where he assisted in pioneering two organizations to identify and assist Veterans with mental health issues, suicidal ideations, relationship issues, financial concerns and other Veteran specific issues. With his own recovery breaking the stigma within the military on career status, family life and security clearance myths, he has pushed to bring holistic means to Veterans to the road of recovery.

Tom has been widely sought by military units, military bases, DoD organizations, National Suicide Organizations and the White House for his expertise on Veterans issues and social media. He is Master Resilience Trained Level One, an Applied Suicide Intervention Skills Training (ASIST) Instructor, Question, Persuade, Refer (QPR) trained, and an Army Suicide Intervention (SI) trainer. He is also the Program Director for Suicide and Awareness with Veterans Counseling Veterans, advisor to Animal Rescue & Veteran Support Services, panel member of Center of Innovation on Disability and Rehabilitation Research with University of South Florida, and subject matter expert with White House and Office of the Surgeon General. Tom received the Substance Abuse and Mental Health Service Administration (SAMHSA) 2017 Voice Award Consumer/Peer/Family Leadership Award for his work to ensure America’s military and veteran communities have access to the mental health and substance use treatment and services they deserve

Links Mentioned in this Episode:

Tom Cruz on Twitter

Join our Facebook Group:

Seeking the Military Suicide Solution on Facebook

Shauna's latest book: Warrior: How to Support Those Who Protect Us

Duane's latest book: Military in the Rear View Mirror: Mental Health and Wellness in Post-Military Life

How to Leave a Podcast Review

Leaving a podcast review at iTunes isn't intuitive. But positive ratings are hugely important: they help the podcast get discovered by new people. Please spend 5 minutes of your time to leave a review using one of the methods below.

How to leave a podcast review using Apple’s Podcast app

1. Navigate to Seeking the Military Suicide Solution on Apple Podcasts on your iPhone or iPad.

2. Click "Listen on Apple Podcasts"

3. Scroll down and click or tap "Write a Review." Enter your iTunes password to login.

4. Rate the podcast using 1 to 5 stars.

5. Submit a brief honest review.

Bonus: get a thank-you note

Your feedback is greatly appreciated. When you leave a review, drop us a line at info@veteranmentalhealth.com and you'll get a message with the warmest appreciation, and a bonus gift!

For Android users, Google Podcasts does not allow for ratings or reviews, but you can certainly let us know how you think we're doing on Spotify, Stitcher, or iHeartRadio

Many thanks,

Duane and Shauna

★ Support this podcast ★

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About Today’s Guest:

Mathew “Frag-o” Bergendahl, MS, NCC, LPC graduated from South Dakota State University with a Masters Degree in Counseling in the Agency Setting back in 2015. Prior, he earned his Bachelors of Science in Psychology from Blackhills State University. Mathew is a former Air Force Security Forces member enlisting from 1999-2005 and spent his enlistment being deployed to Kuwait, Saudi Arabia, Qatar, Oman, and Iraq.

Mathew started working for the Department of Veterans Affairs in 2010 as an Office Manager for the Rapid City, SD Vet Center and was promoted to Readjustment Counseling Therapist once he completed his Masters degree. Mathew currently holds a Licensed Professional Counselor in the state of South Dakota, and is a member of the National Board of Certified Counselors. Mathew started donating his time to Stack Up as a Therapeutic adviser for the Stack Up Overwatch Program (StOP) early this year and currently serves as the Overwatch Program Manager.

Links Mentioned in this Episode:

StackUp.org

StackUp Overwatch Program (StOP)

Join our Facebook Group:

Seeking the Military Suicide Solution on Facebook

Shauna's latest book: Warrior: How to Support Those Who Protect Us

Duane's latest book: Military in the Rear View Mirror: Mental Health and Wellness in Post-Military Life

How to Leave a Podcast Review

Leaving a podcast review at iTunes isn't intuitive. But positive ratings are hugely important: they help the podcast get discovered by new people. Please spend 5 minutes of your time to leave a review using one of the methods below.

How to leave a podcast review using Apple’s Podcast app

1. Navigate to Seeking the Military Suicide Solution on Apple Podcasts on your iPhone or iPad.

2. Click "Listen on Apple Podcasts"

3. Scroll down and click or tap "Write a Review." Enter your iTunes password to login.

4. Rate the podcast using 1 to 5 stars.

5. Submit a brief honest review.

Bonus: get a thank-you note

Your feedback is greatly appreciated. When you leave a review, drop us a line at info@veteranmentalhealth.com and you'll get a message with the warmest appreciation, and a bonus gift!

For Android users, Google Podcasts does not allow for ratings or reviews, but you can certainly let us know how you think we're doing on Spotify, Stitcher, or iHeartRadio

Many thanks,

Duane and Shauna

★ Support this podcast ★

View Details

About Today’s Guest:

Barbara Van Dahlen, Ph.D., named to TIME magazine’s 2012 list of the 100 most influential people in the world, is the president of Give an Hour. A licensed clinical psychologist who has been practicing in the Washington, D.C., area for over 20 years, she received her Ph.D. in clinical psychology from the University of Maryland in 1991. Concerned about the mental health implications of the wars in Iraq and Afghanistan, Dr. Van Dahlen founded Give an Hour in 2005 to enlist mental health professionals to provide free services to U.S. troops, veterans, their loved ones, and their communities.

Working with other nonprofit leaders, Dr. Van Dahlen developed the Community Blueprint, a national initiative and online tool to assist communities in more effectively and strategically supporting veterans and military families. Give an Hour has implemented the Blueprint approach in two demonstration sites and continues to lead community collaboration projects.

In June of 2019, she was named the Executive Director of the Task Force to create the President’s Roadmap to Empower Veterans and End a National Tragedy of Suicide (PREVENTS).

Links Mentioned in this Episode:

PREVENTS Web Site

Public Health Approach Overview

PREVENTS Road Map

Within REACH Public Awareness Campaign

Join our Facebook Group:

Seeking the Military Suicide Solution on Facebook

Shauna's latest book: Warrior: How to Support Those Who Protect Us

Duane's latest book: Military in the Rear View Mirror: Mental Health and Wellness in Post-Military Life

How to Leave a Podcast Review

Leaving a podcast review at iTunes isn't intuitive. But positive ratings are hugely important: they help the podcast get discovered by new people. Please spend 5 minutes of your time to leave a review using one of the methods below.

How to leave a podcast review using Apple’s Podcast app

1. Navigate to Seeking the Military Suicide Solution on Apple Podcasts on your iPhone or iPad.

2. Click "Listen on Apple Podcasts"

3. Scroll down and click or tap "Write a Review." Enter your iTunes password to login.

4. Rate the podcast using 1 to 5 stars.

5. Submit a brief honest review.

Bonus: get a thank-you note

Your feedback is greatly appreciated. When you leave a review, drop us a line at info@veteranmentalhealth.com and you'll get a message with the warmest appreciation, and a bonus gift!

For Android users, Google Podcasts does not allow for ratings or reviews, but you can certainly let us know how you think we're doing on Spotify, Stitcher, or iHeartRadio

Many thanks,

Duane and Shauna

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Sue joined Combat Stress in 2016 as the first female Chief Executive in the charity’s 100-year history. Since her arrival, the charity has increased its profile and contributes actively to veterans’ mental health and particularly military trauma healthcare. Sue has set out a new strategic direction in the face of growing demand for military trauma treatment and a changing NHS landscape.

Sue joined Combat Stress following a decade as Director of Welfare and latterly Director of Operations at The Royal British Legion (TRBL). At TRBL she commissioned the first UK veterans’ population mapping studies and initiated and led the early stages of the Armed Forces Covenant campaign and a string of other successful parliamentary policy campaigns. During her 10-year tenure she transformed TRBL's service footprint across UK, opened its 16 high street Pop In Centres and tripled its services. Prior to joining TRBL she held a series of leadership roles at Scope, the UK cerebral palsy charity including a year's secondment to Department of Health on a community care task force preparing local councils for implementing the 2001 Health & Community Care Act.

Sue has served on MoD and NHSE committees and was a Cobseo Non-Executive Director representing Combat Stress. She is currently serving on a steering group board of a veterans’ sector emerging leaders programme hosted by Clore Social and Forces in Mind Trust. She also serves as a consortia member on the Veterans’ Gateway Strategy Board. Sue is a former lay member on NHS England Armed Forces Clinical Reference Group, partner member of MoD Defence Recovery Partnership Board, Royal Commonwealth Ex-Services League Welfare Committee, World Veterans Association Medical Advisory Committee and trustee of several veterans’ charities.

Sue holds a BA Hons from Exeter University and an MBA from Aston Business School and is EQM qualified.

Links Mentioned in this Episode:

Combat Stress.org Web site

Join our Facebook Group:

Seeking the Military Suicide Solution on Facebook

Shauna's latest book: Warrior: How to Support Those Who Protect Us

Duane's latest book: Military in the Rear View Mirror: Mental Health and Wellness in Post-Military Life

How to Leave a Podcast Review

Leaving a podcast review at iTunes isn't intuitive. But positive ratings are hugely important: they help the podcast get discovered by new people. Please spend 5 minutes of your time to leave a review using one of the methods below.

How to leave a podcast review using Apple’s Podcast app

1. Navigate to Seeking the Military Suicide Solution on Apple Podcasts on your iPhone or iPad.

2. Click "Listen on Apple Podcasts"

3. Scroll down and click or tap "Write a Review." Enter your iTunes password to login.

4. Rate the podcast using 1 to 5 stars.

5. Submit a brief honest review.

Bonus: get a thank-you note

Your feedback is greatly appreciated. When you leave a review, drop us a line at info@veteranmentalhealth.com and you'll get a message with the warmest appreciation, and a bonus gift!

For Android users, Google Podcasts does not allow for ratings or reviews, but you can certainly let us know how you think we're doing on Spotify, Stitcher, or iHeartRadio

Many thanks,

Duane and Shauna

★ Support this podcast ★

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As the National Guard Bureau J-1 Warrior Resilience & Fitness Division Chief, Captain Matthew Kleiman, MSW, LCSW, BCD, synchronizes Air and Army National Guard well-being, resilience, and suicide prevention efforts across the 54 states, territories, and DC. He also serves as the Director of Psychological Health for the Chief of the National Guard Bureau.

He was detailed to the U.S. Coast Guard (USCG) from 2010-2016 as the Chief of USCG’s Behavioral Health Services. Prior to that, he was the principal advisor in the Office of Health Affairs to senior leadership at the Department of Homeland Security on resilience and behavioral health policies across the organization.

CAPT Kleiman is a commissioned officer in the United States Public Health Service. He began his active duty career over 20 years ago as an Air Force clinical social worker.

Links Mentioned in this Episode:

National Guard Warrior Resilience and Fitness Division

Response/Recovery (RE) Leadership Integrated Engagement Framework (RELIEF)

Join our Facebook Group:

Seeking the Military Suicide Solution on Facebook

Shauna's latest book: Warrior: How to Support Those Who Protect Us

Duane's latest book: Military in the Rear View Mirror: Mental Health and Wellness in Post-Military Life

How to Leave a Podcast Review

Leaving a podcast review at iTunes isn't intuitive. But positive ratings are hugely important: they help the podcast get discovered by new people. Please spend 5 minutes of your time to leave a review using one of the methods below.

How to leave a podcast review using Apple’s Podcast app

1. Navigate to Seeking the Military Suicide Solution on Apple Podcasts on your iPhone or iPad.

2. Click "Listen on Apple Podcasts"

3. Scroll down and click or tap "Write a Review." Enter your iTunes password to login.

4. Rate the podcast using 1 to 5 stars.

5. Submit a brief honest review.

Bonus: get a thank-you note

Your feedback is greatly appreciated. When you leave a review, drop us a line at info@veteranmentalhealth.com and you'll get a message with the warmest appreciation, and a bonus gift!

For Android users, Google Podcasts does not allow for ratings or reviews, but you can certainly let us know how you think we're doing on Spotify, Stitcher, or iHeartRadio

Many thanks,

Duane and Shauna

★ Support this podcast ★

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Tina Atherall, DSW, LMSW, brings to PsychArmor her vast experience and leadership in the military non-profit community and academia. In 2006, she co-founded Hope For The Warriors, an organization dedicated to serving combat wounded servicemembers and their families. Scaling a grass-roots effort to a national platform, she worked extensively with various levels of military leadership, agencies, corporations, and communities educating and advocating for critical support for those who have served and their families. She has embedded her career in the field of social work innovation and leadership and obtained her Doctor of Social Work (DSW) from the University of Southern California. Her recent work focuses on the 12 Grand Challenges for Social Work to eradicate social isolation specifically the challenges of military family social isolation. As an adjunct faculty, her love for PsychArmor began while utilizing the PAI educational videos to enhance teaching social work practice with military and their families to Masters of Social Work students in New York City.

As PsychArmor’s new CEO, Tina will continue the mission of bridging the military-civilian divide. She has fresh ideas to strengthen PsychAmor’s pivotal role as the “go to” place for employers, healthcare providers, educators, volunteers, municipalities, service providers, government workers, caregivers and communities to learn about how to better serve our military Veterans.

Links Mentioned in this Episode:

PsychArmor Institute Suicide Training Portfolio

Join our Facebook Group:

Seeking the Military Suicide Solution on Facebook

Shauna's latest book: Warrior: How to Support Those Who Protect Us

Duane's latest book: Military in the Rear View Mirror: Mental Health and Wellness in Post-Military Life

How to Leave a Podcast Review

Leaving a podcast review at iTunes isn't intuitive. But positive ratings are hugely important: they help the podcast get discovered by new people. Please spend 5 minutes of your time to leave a review using one of the methods below.

How to leave a podcast review using Apple’s Podcast app

1. Navigate to Seeking the Military Suicide Solution on Apple Podcasts on your iPhone or iPad.

2. Click "Listen on Apple Podcasts"

3. Scroll down and click or tap "Write a Review." Enter your iTunes password to login

4. Rate the podcast using 1 to 5 stars.

5. Submit a brief honest review.

Bonus: get a thank-you note

Your feedback is greatly appreciated. When you leave a review, drop us a line at info@veteranmentalhealth.com and you'll get a message with the warmest appreciation, and a bonus gift!

For Android users, Google Podcasts does not allow for ratings or reviews, but you can certainly let us know how you think we're doing on Spotify, Stitcher, or iHeartRadio

Many thanks,

Duane and Shauna

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Dr. Karin A. Orvis, a member of the Senior Executive Service, is the Director of the Defense Suicide Prevention Office in the Office of the Under Secretary of Defense for Personnel and Readiness. In this capacity, Dr. Orvis is responsible for policy, oversight, and advocacy of the U.S. Department of Defense (DoD) suicide prevention programs. Her current portfolio spans the full spectrum of suicide prevention, intervention, and postvention efforts including policy, program development and evaluation, data surveillance, research, and outreach and engagement. In this position, and in her prior DoD roles, she strategically leads multidisciplinary, interservice/interagency teams in designing, implementing, and evaluating DoD-wide policies and programs in support of over 2M service members and over 2.5M military family members worldwide.

Dr. Orvis brings nearly 20 years of progressively broader experience spanning the federal government, academia, and private sector. Prior to her current assignment, Dr. Orvis served as the Acting Principal Director of Military Community and Family Policy, where she was responsible for the policy, oversight, and advocacy of military community quality-of-life programs for service members and their families. Dr. Orvis also previously served as the Director of the Transition to Veterans Program Office, where she was instrumental in redesigning the DoD Transition Assistance Program, which ensures that service members are ‘career ready’ and prepared to transition from active duty to civilian life.

Other prior DoD positions include the Director of Evaluation and Assessment for the Transition to Veterans Program Office and the Program Manager of the Basic Research program at the U.S. Army Research Institute. Dr. Orvis transitioned to the federal government after spending four years as a University Assistant Professor at Old Dominion University. Dr. Orvis has also worked with the private sector on programs related to employee training, leader development, staffing, and organizational effectiveness. Her work has been published in journals such as Leadership Quarterly, Military Psychology, Journal of Applied Psychology, Journal of Business and Psychology, and the International Journal of Training and Development.

Dr. Orvis holds a Doctorate and a Master of Arts in Industrial/Organizational Psychology from George Mason University, and a Bachelor of Science in Psychology from Michigan State University. She has received various awards throughout her career including the Office of the Secretary of Defense Medal for Exceptional Civilian Service, Office of the Secretary of Defense Award for Excellence, Department of the Army Commander’s Award for Civilian Service, and American Society for Training and Development Dissertation Award.

Links Mentioned in this Episode:

Defense Suicide Prevention Office Web site

Join our Facebook Group:

Seeking the Military Suicide Solution on Facebook

Shauna's latest book: Warrior: How to Support Those Who Protect Us

Duane's latest book: Military in the Rear View Mirror: Mental Health and Wellness in Post-Military Life

How to Leave a Podcast Review

Leaving a podcast review at iTunes isn't intuitive. But positive ratings are hugely important: they help the podcast get discovered by new people. Please spend 5 minutes of your time to leave a review using one of the methods below.

How to leave a podcast review using Apple’s Podcast app

1. Navigate to Seeking the Military Suicide Solution on Apple Podcasts on your iPhone or iPad.

2. Click "Listen on Apple Podcasts"

3. Scroll down and click or tap "Write a Review." Enter your iTunes password to login.

4. Rate the podcast using 1 to 5 stars.

5. Submit a brief honest review.

Bonus: get a thank-you note

Your feedback is greatly appreciated. When you leave a review, drop us a line at info@veteranmentalhealth.com and you'll get a message with the warmest appreciation, and a bonus gift!

For Android users, Google Podcasts does not allow for ratings or reviews, but you can certainly let us know how you think we're doing on Spotify, Stitcher, or iHeartRadio

Many thanks,

Duane and Shauna

★ Support this podcast ★

View Details

Betsey Mercado became involved in Objective Zero after seeing the positive influence that intervention had on veterans in crisis. Betsey has committed herself to making a difference in the lives of Soldiers, veterans, and their families. Her experience working with military spouses and leading multiple Family Readiness Groups supporting active duty units gives her a unique perspective that she brings to the Objective Zero team. She volunteers her time to assist with development of the Objective Zero mobile app, maintain the website, and manage Objective Zero’s administration. Betsey holds a Bachelor of Arts in Business Administration.

Links Mentioned in this Episode:

Objective Zero Foundation Web site

Join our Facebook Group:

Seeking the Military Suicide Solution on Facebook

Shauna's latest book: Warrior: How to Support Those Who Protect Us

Duane's latest book: Military in the Rear View Mirror: Mental Health and Wellness in Post-Military Life

How to Leave a Podcast Review

Leaving a podcast review at iTunes isn't intuitive. But positive ratings are hugely important: they help the podcast get discovered by new people. Please spend 5 minutes of your time to leave a review using one of the methods below.

How to leave a podcast review using Apple’s Podcast app

1. Navigate to Seeking the Military Suicide Solution on Apple Podcasts on your iPhone or iPad.

2. Click "Listen on Apple Podcasts"

3. Scroll down and click or tap "Write a Review." Enter your iTunes password to login.

4. Rate the podcast using 1 to 5 stars.

5. Submit a brief honest review.

Bonus: get a thank-you note

Your feedback is greatly appreciated. When you leave a review, drop us a line at info@veteranmentalhealth.com and you'll get a message with the warmest appreciation, and a bonus gift!

For Android users, Google Podcasts does not allow for ratings or reviews, but you can certainly let us know how you think we're doing on Spotify, Stitcher, or iHeartRadio

Many thanks,

Duane and Shauna

★ Support this podcast ★

View Details

Kate Hendricks Thomas, PhD is a behavioral medicine researcher and Master Certified Health Education Specialist. She studies evidence-based mental fitness and peak performance and is the author of several books. Kate is passionate about education and teaches for George Mason University’s Department of Global and Community Health.

Her TEDx speeches provide a glimpse into Dr. Kate’s unique ability to make science accessible and actionable for everyday audiences.

Dr. Kate’s background as an academic researcher, storyteller, and U.S. Marine Corps veteran positions her to communicate credibly to a variety of audiences.

She is a writer and researcher at heart, and has authored over 100 scientific publications and presentations. Her behavioral health research, published in journals like Best Practices in Mental Health, the Journal of Environmental Psychology, and Military Behavioral Health, has been praised as “masterful” and “constructive.” She writes for a diverse array of popular blogs and newspapers – her social commentary has been featured on NPR and BBC and published in The Hill and in The Washington Post.

Links Mentioned in this Episode:

Dr. Hendricks-Thomas' Web site

Invisible Veterans: What Happens When Military Women Become Civilians Again

Stopping Military Suicides: Veteran Voices to Prevent Deaths

Join our Facebook Group:

Seeking the Military Suicide Solution on Facebook

Shauna's latest book: Warrior: How to Support Those Who Protect Us

Duane's latest book: Military in the Rear View Mirror: Mental Health and Wellness in Post-Military Life

How to Leave a Podcast Review

Leaving a podcast review at iTunes isn't intuitive. But positive ratings are hugely important: they help the podcast get discovered by new people. Please spend 5 minutes of your time to leave a review using one of the methods below.

How to leave a podcast review using Apple’s Podcast app

1. Navigate to Seeking the Military Suicide Solution on Apple Podcasts on your iPhone or iPad.

2. Click "Listen on Apple Podcasts"

3. Scroll down and click or tap "Write a Review." Enter your iTunes password to login.

4. Rate the podcast using 1 to 5 stars.

5. Submit a brief honest review.

Bonus: get a thank-you note

Your feedback is greatly appreciated. When you leave a review, drop us a line at info@veteranmentalhealth.com and you'll get a message with the warmest appreciation, and a bonus gift!

For Android users, Google Podcasts does not allow for ratings or reviews, but you can certainly let us know how you think we're doing on Spotify, Stitcher, or iHeartRadio

Many thanks,

Duane and Shauna

★ Support this podcast ★

View Details

Major General (retired) Mark Graham is currently serving as the Senior Director, Rutgers UBHC National Call Center. Included in his duties is Director, Vets4Warriors and several other programs. MG Graham retired from the US Army on August 1, 2012 after almost thirty-five years of service. His final position was as the Director (G-3/5/7) U.S. Army Forces Command, Fort Bragg, North Carolina. In this position, he oversaw the plans, operations and training for Army forces (active and reserve component) stationed in the Continental United States and ensured conventional forces were prepared for worldwide deployment and combat.

MG Graham and his wife, Carol, are tireless champions of military and civilian efforts to promote mental health and suicide-prevention awareness, and to eliminate the stigma surrounding mental health care. To honor the memory of their sons, 2LT Jeff Graham who was killed by an IED in Iraq in February 2004, and their son Kevin a Senior Army ROTC cadet who died by suicide in June 2003 while studying to be an Army Doctor at the University of Kentucky, the Grahams established the Jeffrey C. and Kevin A. Graham Memorial Fund to provide the “Question, Persuade, Refer” suicide prevention program at the University of Kentucky. The Grahams were instrumental in establishing the Jeffrey and Kevin Graham Memorial Endowed Lectureship in Psychology for the study of depression and suicide prevention at Cameron University, in Lawton, Oklahoma. Additionally, they support the ongoing efforts of the Pikes Peak Suicide Prevention Partnership, Colorado Springs, Colorado (El Paso County), through the “Jeffrey and Kevin Graham Support Services”. The Graham’s story is featured in the award-winning book, “The Invisible Front: Loss and Love in an Era of Endless War”, by Yochi Dreazen.

Links Mentioned in this Episode:

Vets4Warriors Web site

Join our Facebook Group:

Seeking the Military Suicide Solution on Facebook

Shauna's latest book: Warrior: How to Support Those Who Protect Us

Duane's latest book: Military in the Rear View Mirror: Mental Health and Wellness in Post-Military Life

How to Leave a Podcast Review

Leaving a podcast review at iTunes isn't intuitive. But positive ratings are hugely important: they help the podcast get discovered by new people. Please spend 5 minutes of your time to leave a review using one of the methods below.

How to leave a podcast review using Apple’s Podcast app

1. Navigate to Seeking the Military Suicide Solution on Apple Podcasts on your iPhone or iPad.

2. Click "Listen on Apple Podcasts"

3. Scroll down and click or tap "Write a Review." Enter your iTunes password to login.

4. Rate the podcast using 1 to 5 stars.

5. Submit a brief honest review.

Bonus: get a thank-you note

Your feedback is greatly appreciated. When you leave a review, drop us a line at info@veteranmentalhealth.com and you'll get a message with the warmest appreciation, and a bonus gift!

For Android users, Google Podcasts does not allow for ratings or reviews, but you can certainly let us know how you think we're doing on Spotify, Stitcher, or iHeartRadio

Many thanks,

Duane and Shauna

★ Support this podcast ★

View Details

Keita Franklin, LCSW, PhD, is the Chief Clinical Officer at Psych Hub, the Co-Director of the Columbia Lighthouse Project at Columbia University and consults with Leidos Health Group. In her capacity as Psych Hub’s Chief Clinical Officer, she serves as a key member of the executive team overseeing the development and production of all clinical content for Psych Hub’s ever-expanding repository of educational videos and informational materials. A nationally-recognized expert, Dr. Franklin, ensures all clinical content is on the cutting edge of the intersection between health care and information technology. Key to Psych Hub’s goal of revolutionizing how mental health care education and training is delivered, Dr. Franklin leads the esteemed Psych Hub clinical team, ensuring all Psych Hub products are evidence-based and trauma-informed.

Before joining Psych Hub, Dr. Franklin served as a senior executive at both the Department of Veteran Affairs and the Department of Defense. In these roles, Dr. Franklin served as the principal advisor to Department leadership for all matters on suicide prevention, and she is widely credited with leading a transformative, enterprise-wide shift from a crisis intervention posture to an upstream, broad public policy approach focused on continuous surveillance and early prevention. Dr. Franklin was also responsible for leading a multi-disciplined team of experts in advancing evidence-based prevention practices for over 20 million Veterans and reaching our Nation’s heroes wherever they live, work, thrive, and receive care. A poised and articulate communicator of strategic messaging, Dr. Franklin has been frequently asked to testify before committees in both the U.S. House of Representatives and U.S. Senate and led numerous caucus roundtable discussions with members of Congress.

While serving as a senior executive within the Department of Defense, Dr. Franklin was responsible for suicide prevention policy, programs, and oversight. During her tenure, she conducted a first-of-its-kind comprehensive, program review and authored new DoD policy directives and instructions, optimizing higher headquarter guidance for all military service branches. She also chaired several DoD senior leader committees charged with developing solutions for vexing mental health issues impacting our service members and their families.

Links Mentioned in this Episode:

Psych Hub

Join our Facebook Group:

Seeking the Military Suicide Solution on Facebook

Shauna's latest book: Warrior: How to Support Those Who Protect Us

Duane's latest book: Military in the Rear View Mirror: Mental Health and Wellness in Post-Military Life

How to Leave a Podcast Review

Leaving a podcast review at iTunes isn't intuitive. But positive ratings are hugely important: they help the podcast get discovered by new people. Please spend 5 minutes of your time to leave a review using one of the methods below.

How to leave a podcast review using Apple’s Podcast app

1. Navigate to Seeking the Military Suicide Solution on Apple Podcasts on your iPhone or iPad.

2. Click "Listen on Apple Podcasts"

3. Scroll down and click or tap "Write a Review." Enter your iTunes password to login.

4. Rate the podcast using 1 to 5 stars.

5. Submit a brief honest review.

Bonus: get a thank-you note

Your feedback is greatly appreciated. When you leave a review, drop us a line at info@veteranmentalhealth.com and you'll get a message with the warmest appreciation, and a bonus gift!

For Android users, Google Podcasts does not allow for ratings or reviews, but you can certainly let us know how you think we're doing on Spotify, Stitcher, or iHeartRadio

Many thanks,

Duane and Shauna

★ Support this podcast ★

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SMSgt Erin Esquer serves as the First Sergeant for the 74th Aerial Port Squadron, Joint Base San Antonio (JBSA) Lackland, Texas. SGMSgt Esquer is the advisor to the Commander, providing guidance for all enlisted matters concerning morale, fitness, and the welfare of unit members.

SGMSgt Esquer entered the Air Force in November 2007 and graduated from the Health Services Management Apprentice Course at Shephard Air Force Base Texas in March 2008. She deployed in support of ENDURING FREEDOM as Duty Controller with the 775th Expeditionary Aeromedical Evacuation flight (EAEF) as well as the 10th Expeditionary Aeromedical Evacuation Squadron (EAES). She also deployed as a First Sergeant for the 380th Expeditionary Logistics Readiness Squadron (ELRS). Prior to her current position as First Sergeant, SMSgt Esquer was a Health Services Management Craftsman (4A071) for the 349th Aeromedical Evacuation Squadron, Travis AFB, CA.

SMSgt Esquer also serves the United States Air Force as a civilian for the 349th Air Mobility Wing, working as the Wing Exercise Program Manager for the Inspector General Inspections team at Travis AFB, CA.

Links Mentioned in this Episode:

Veteran Voices Local Television Show on Facebook

Join our Facebook Group:

Seeking the Military Suicide Solution on Facebook

Shauna's latest book: Warrior: How to Support Those Who Protect Us

Duane's latest book: Military in the Rear View Mirror: Mental Health and Wellness in Post-Military Life

How to Leave a Podcast Review

Leaving a podcast review at iTunes isn't intuitive. But positive ratings are hugely important: they help the podcast get discovered by new people. Please spend 5 minutes of your time to leave a review using one of the methods below.

How to leave a podcast review using Apple’s Podcast app

1. Navigate to Seeking the Military Suicide Solution on Apple Podcasts on your iPhone or iPad.

2. Click "Listen on Apple Podcasts"

3. Scroll down and click or tap "Write a Review." Enter your iTunes password to login.

4. Rate the podcast using 1 to 5 stars.

5. Submit a brief honest review.

Bonus: get a thank-you note

Your feedback is greatly appreciated. When you leave a review, drop us a line at info@veteranmentalhealth.com and you'll get a message with the warmest appreciation, and a bonus gift!

For Android users, Google Podcasts does not allow for ratings or reviews, but you can certainly let us know how you think we're doing on Spotify, Stitcher, or iHeartRadio

Many thanks,

Duane and Shauna

★ Support this podcast ★

View Details

Terri Tanielian is a senior behavioral scientist and a nationally recognized expert on veteran mental health. Her areas of interest include military and veterans health policy; military suicide; military sexual assault; psychological effects of combat, terrorism, and disasters. She has led multiple studies to assess the needs of veterans and to examine the readiness of private healthcare providers to deliver timely, high quality care to veterans and their families. She has also examined community based models for expanding mental health care for returning veterans and their families.

As the former director of the RAND Center for Military Health Policy Research, she spent a decade overseeing RAND’s diverse military health research portfolio. She was the co–study director for a large, non-governmental assessment of the psychological, emotional, and cognitive consequences of deployment to Iraq and Afghanistan entitled Invisible Wounds of War: Psychological and Cognitive Injuries, Their Consequences, and Services to Assist Recovery. She was also the co-director for RAND’s study Hidden Heroes: America’s Military Caregivers, the first representative study of military caregiving in the United States.

Tanielian has published numerous peer-reviewed articles and reports. She was a member of the planning committee for the 18th, 22nd, and 26th Annual Rosalynn Carter Symposium on Mental Health Policy, which focused on mental health needs and recovery following September 11, Hurricane Katrina, and deployment to Iraq and Afghanistan, respectively. She serves on the National Academy of Medicine’s Standing Committee on Health Threats and Resilience. She earned her M.A. in psychology from American University.

Read more about Terri Here

Links Mentioned in this Episode:

Terri’s Email Address: TerriT@rand.org

Rand publications on military, veteran, and family member mental health

Rand publications on suicide prevention

Terri's congressional testimony

Terri Tanielian on Twitter

Join our Facebook Group:

Seeking the Military Suicide Solution on Facebook

Shauna's latest book: Warrior: How to Support Those Who Protect Us

Duane's latest book: Military in the Rear View Mirror: Mental Health and Wellness in Post-Military Life

How to Leave a Podcast Review

Leaving a podcast review at iTunes isn't intuitive. But positive ratings are hugely important: they help the podcast get discovered by new people. Please spend 5 minutes of your time to leave a review using one of the methods below.

How to leave a podcast review using Apple’s Podcast app

1. Navigate to Seeking the Military Suicide Solution on Apple Podcasts on your iPhone or iPad.

2. Click "Listen on Apple Podcasts"

3. Scroll down and click or tap "Write a Review." Enter your iTunes password to login.

4. Rate the podcast using 1 to 5 stars.

5. Submit a brief honest review.

Bonus: get a thank-you note

Your feedback is greatly appreciated. When you leave a review, drop us a line at info@veteranmentalhealth.com and you'll get a message with the warmest appreciation, and a bonus gift!

For Android users, Google Podcasts does not allow for ratings or reviews, but you can certainly let us know how you think we're doing on Spotify, Stitcher, or iHeartRadio

Many thanks,

Duane and Shauna

★ Support this podcast ★

View Details

Sarah and Mike Verardo have become a national face for severely wounded combat Veterans andtheir Caregivers. They’ve appeared on numeroustelevision programs and news outlets over the past several years to push for Veterans Affairs healthcare reform.

Sarah has dedicated her life to both the care and recovery of her husband, and supporting Caregivers and our wounded heroes nationwide. She is a national spokesperson for Caregivers in the country, serving as an Alumni Fellow with the Elizabeth Dole

Foundation. She also has a significant background in both public relations and fundraising, and is a respected national voice, regularly featured on conservative national programs and talk shows. She continues her service through The Independence Fund as a highly effective advocate for Veterans and Caregivers, working directly with members of the United States House and Senate.

Links Mentioned in this Episode:

The Independence Fund

Operation Resiliency

Join our Facebook Group:

Seeking the Military Suicide Solution on Facebook

Shauna's latest book: Warrior: How to Support Those Who Protect Us

Duane's latest book: Military in the Rear View Mirror: Mental Health and Wellness in Post-Military Life

How to Leave a Podcast Review

Leaving a podcast review at iTunes isn't intuitive. But positive ratings are hugely important: they help the podcast get discovered by new people. Please spend 5 minutes of your time to leave a review using one of the methods below.

How to leave a podcast review using Apple’s Podcast app

1. Navigate to Seeking the Military Suicide Solution on Apple Podcasts on your iPhone or iPad.

2. Click "Listen on Apple Podcasts"

3. Scroll down and click or tap "Write a Review." Enter your iTunes password to login.

4. Rate the podcast using 1 to 5 stars.

5. Submit a brief honest review.

Bonus: get a thank-you note

Your feedback is greatly appreciated. When you leave a review, drop us a line at info@veteranmentalhealth.com and you'll get a message with the warmest appreciation, and a bonus gift!

For Android users, Google Podcasts does not allow for ratings or reviews, but you can certainly let us know how you think we're doing on Spotify, Stitcher, or iHeartRadio

Many thanks,

Duane and Shauna

★ Support this podcast ★

View Details

Cheree Tham holds a Master’s Degree in Social Work from the University of Alabama and is a Licensed Clinical Social Worker (LCSW). She is the Principal Investigator (PI) with America's Warrior Partnership for Operation Deep Dive (OpDD). OpDD is a community based study of veteran suicide, asphyxiation, drowning, death by law enforcement and single driver high speed car accident. Her experience has been in program development and administration of programs with a wide range of populations, targets and services. She is responsible for planning, oversight, management, and supervision of all programs and services provided to and initiatives with military-affiliated constituencies. Her position functions at a strategic and tactical level to develop and maintain mission-driven, sustainable programs, services, and initiatives consistent with America's Warrior Partnership’s mission and model of Community Integration.

Links Mentioned in this Episode:

America's Warrior Partnership

Operation Deep Dive

Bob Woodruff Foundation COVID19 Impact Study

Join our Facebook Group:

Seeking the Military Suicide Solution on Facebook

Shauna's latest book: Warrior: How to Support Those Who Protect Us

Duane's latest book: Military in the Rear View Mirror: Mental Health and Wellness in Post-Military Life

How to Leave a Podcast Review

Leaving a podcast review at iTunes isn't intuitive. But positive ratings are hugely important: they help the podcast get discovered by new people. Please spend 5 minutes of your time to leave a review using one of the methods below.

How to leave a podcast review using Apple’s Podcast app

1. Navigate to Seeking the Military Suicide Solution on Apple Podcasts on your iPhone or iPad.

2. Click "Listen on Apple Podcasts"

3. Scroll down and click or tap "Write a Review." Enter your iTunes password to login.

4. Rate the podcast using 1 to 5 stars.

5. Submit a brief honest review.

Bonus: get a thank-you note

Your feedback is greatly appreciated. When you leave a review, drop us a line at info@veteranmentalhealth.com and you'll get a message with the warmest appreciation, and a bonus gift!

For Android users, Google Podcasts does not allow for ratings or reviews, but you can certainly let us know how you think we're doing on Spotify, Stitcher, or iHeartRadio

Many thanks,

Duane and Shauna

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Kim Ruocco, MSW, the Vice President of Suicide Prevention and Postvention for TAPS, is an internationally known subject matter expert who uses her education, personal experience and information gathered from thousands of survivors to help others more fully understand suicide. Over the past decade, Ms. Ruocco has developed a best-practice, comprehensive, peer-based program that offers comfort and care to all those who are grieving the loss of a service member to suicide. In addition to her postvention work, Ms. Ruocco contributes to suicide prevention efforts in military as well as civilian organizations. She holds a B.A. in Human Services and Psychology from the University of Massachusetts and a Masters degree in Clinical Social Work from Boston University. She is the surviving widow of Marine Corps Major John Ruocco, who died by suicide in 2005.

Links Mentioned in this Episode:

Tragedy Assistance Program for Survivors

TAPS Suicide Postvention Program

The following two 90-minute Postvention courses can be viewed for free thanks to funding from the Boeing Foundation:

Suicide, Grief, and Trauma - Supporting Veterans and Families of the Fallen

Grief to Growth: A Roadmap to a Healthy Grief Journey

The following three courses are free to access courtesy of the NFL Foundation

Postvention: Healing After Suicide Loss

Finding Stability After Suicide Loss

Grief and Trauma

Join our Facebook Group:

Seeking the Military Suicide Solution on Facebook

Shauna's latest book: Beyond the Military: A Leader's Handbook for Warrior Reintegration

Duane's latest book: Military in the Rear View Mirror: Mental Health and Wellness in Post-Military Life

How to Leave a Podcast Review

Leaving a podcast review at iTunes isn't intuitive. But positive ratings are hugely important: they help the podcast get discovered by new people. Please spend 5 minutes of your time to leave a review using one of the methods below.

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1. Navigate to Seeking the Military Suicide Solution on Apple Podcasts on your iPhone or iPad.

2. Click "Listen on Apple Podcasts"

3. Scroll down and click or tap "Write a Review." Enter your iTunes password to login.

4. Rate the podcast using 1 to 5 stars.

5. Submit a brief honest review.

Bonus: get a thank-you note

Your feedback is greatly appreciated. When you leave a review, drop us a line at info@veteranmentalhealth.com and you'll get a message with the warmest appreciation, and a bonus gift!

For Android users, Google Podcasts does not allow for ratings or reviews, but you can certainly let us know how you think we're doing on Spotify, Stitcher, or iHeartRadio

Many thanks,

Duane and Shauna

★ Support this podcast ★

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About Today’s Guest:

Dr. Nicholas (Nick) Polizzi is the Governmental Action Officer for the inTransition program and the Real Warriors Campaign at the Defense Health Agency’s Psychological Health Center of Excellence (PHCoE). Prior to joining the PHCoE in April 2019, Dr. Polizzi served as the lead clinical trainer and primary contract support for Navy Medicine’s Behavioral Health Integration Program (BHIP). Prior to this, Dr. Polizzi served as the Deputy Chief Psychologist at the DoD’s Deployment Health Clinical Center’s Primary Care Behavioral Health Directorate where he provided tri-service integrated care support. From 2010-2013 Dr. Polizzi helped to stand up the Navy BHIP program while providing subject matter expertise to Navy Medicine’s Wounded, ILL & Injured program. Dr. Polizzi earned his doctorate of philosophy and Master’ degree in Educational Psychology from the University of Georgia, a Master’s of Education from Marymount University, and a bachelor’s of arts from Washington & Lee University.

Links Mentioned in this Episode:

Real Warriors Campaign Web site

inTransition Program

Real Warriors on Facebook

Real Warriors on Twitter

Real Warriors on YouTube

Join our Facebook Group:

Seeking the Military Suicide Solution on Facebook

Episode Sponsor:

milMedia Group

Shauna's latest book: Beyond the Military: A Leader's Handbook for Warrior Reintegration

Duane's latest book: Military in the Rear View Mirror: Mental Health and Wellness in Post-Military Life

How to Leave a Podcast Review

Leaving a podcast review at iTunes isn't intuitive. But positive ratings are hugely important: they help the podcast get discovered by new people. Please spend 5 minutes of your time to leave a review using one of the methods below.

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1. Navigate to Seeking the Military Suicide Solution on Apple Podcasts on your iPhone or iPad.

2. Click "Listen on Apple Podcasts"

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4. Rate the podcast using 1 to 5 stars.

5. Submit a brief honest review.

Bonus: get a thank-you note

Your feedback is greatly appreciated. When you leave a review, drop us a line at info@veteranmentalhealth.com and you'll get a message with the warmest appreciation, and a bonus gift!

For Android users, Google Podcasts does not allow for ratings or reviews, but you can certainly let us know how you think we're doing on Spotify, Stitcher, or iHeartRadio

Many thanks,

Duane and Shauna

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About Today’s Guest:

Mark Divine is a retired Navy SEAL Commander, New York Times Best-Selling Author, Founder / CEO of SEALFIT and Unbeatable Mind, founder of multiple million-dollar businesses, lifetime Martial Artist, Ashtanga Yoga teacher, and host of the Unbeatable Mind podcast

At twenty-six he graduated as Honor Man (#1-ranked trainee) of SEAL BUD/S class number 170. Mark served for nine years total on active duty and eleven as a Reserve SEAL, retiring as Commander in 2011. His leadership of teams was so effective the government tasked him with creating a nationwide mentoring program for SEAL trainees. Not only did it increase the quality of SEAL candidates, it reduced BUD/S attrition rate up to five percent.

Through Mark’s teaching, entrepreneurial endeavors and travel to foreign countries, he noticed the power of mental toughness, emotional resilience, intuitive leadership and a healthy spirit for anyone wanting breakthrough performance. They weren’t solely for combat or restricted to the business world or one culture. He’d watch them transform lives in people from every background, nation and belief system. So he wrote and self-published his first book, Unbeatable Mind, in 2011 and launched its at-home study program.

Links Mentioned in this Episode:

Unbeatable Mind Podacast

Commander Divine's Author Page on Amazon

Courage Foundation Web site

Join our Facebook Group:

Seeking the Military Suicide Solution on Facebook

Episode Sponsor:

milMedia Group

Shauna's latest book: Beyond the Military: A Leader's Handbook for Warrior Reintegration

Duane's latest book: Military in the Rear View Mirror: Mental Health and Wellness in Post-Military Life

How to Leave a Podcast Review

Leaving a podcast review at iTunes isn't intuitive. But positive ratings are hugely important: they help the podcast get discovered by new people. Please spend 5 minutes of your time to leave a review using one of the methods below.

How to leave a podcast review using Apple’s Podcast app

1. Navigate to Seeking the Military Suicide Solution on Apple Podcasts on your iPhone or iPad.

2. Click "Listen on Apple Podcasts"

3. Scroll down and click or tap "Write a Review." Enter your iTunes password to login.

4. Rate the podcast using 1 to 5 stars.

5. Submit a brief honest review.

Bonus: get a thank-you note

Your feedback is greatly appreciated. When you leave a review, drop us a line at info@veteranmentalhealth.com and you'll get a message with the warmest appreciation, and a bonus gift!

For Android users, Google Podcasts does not allow for ratings or reviews, but you can certainly let us know how you think we're doing on Spotify, Stitcher, or iHeartRadio

Many thanks,

Duane and Shauna

★ Support this podcast ★

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About Today’s Guest:

Howard Somers, M.D., and Jean Somers, are the parents of CA Army National Guard SGT Daniel Somers. Daniel took his life in June, 2013, after suffering for nearly a decade with Post Traumatic Stress, Traumatic Brain Injuries, and Gulf War Syndrome subsequent to serving in Operation Iraqi Freedom. Daniel’s condition was exacerbated by his experiences with the Phoenix VA Mental Health Department. He left an eloquent and heart breaking suicide note.

Since Daniel’s death, Jean and Howard have dedicated themselves to improving the care that the VA provides to our Veterans, especially in the area of Mental Health. They have developed initiatives to improve the transition process and increase general awareness among our service members “support network.” The idea for Operation Engage America is based on their own experiences with locating resources to help themselves and Daniel through the military-to-civilian transition experience and realizing that many other veterans and their families had similar problems. Howard and Jean have met with leaders in the VA, Executive Branch, Congress and the Department of Defense, and have testified before the House Committee on Veterans Affairs.

Howard was born and raised in NYC, and practiced urology in Phoenix for 28 years. Jean who is from Canton, Ohio, is a paralegal and worked in the financial side of healthcare for 30 years. She was Howard’s practice manager for the last 12 years of their careers. They currently reside in the San Diego area.

Links Mentioned in this Episode:

Operation Engage America

Howard and Jean on Twitter

Howard and Jean's testimony before the House Committee on Veterans Affairs

Join our Facebook Group:

Seeking the Military Suicide Solution on Facebook

Episode Sponsor:

milMedia Group

Shauna's latest book: Beyond the Military: A Leader's Handbook for Warrior Reintegration

Duane's latest book: Military in the Rear View Mirror: Mental Health and Wellness in Post-Military Life

How to Leave a Podcast Review

Leaving a podcast review at iTunes isn't intuitive. But positive ratings are hugely important: they help the podcast get discovered by new people. Please spend 5 minutes of your time to leave a review using one of the methods below.

How to leave a podcast review using Apple’s Podcast app

1. Navigate to Seeking the Military Suicide Solution on Apple Podcasts on your iPhone or iPad.

2. Click "Listen on Apple Podcasts"

3. Scroll down and click or tap "Write a Review." Enter your iTunes password to login.

4. Rate the podcast using 1 to 5 stars.

5. Submit a brief honest review.

Bonus: get a thank-you note

Your feedback is greatly appreciated. When you leave a review, drop us a line at info@veteranmentalhealth.com and you'll get a message with the warmest appreciation, and a bonus gift!

For Android users, Google Podcasts does not allow for ratings or reviews, but you can certainly let us know how you think we're doing on Spotify, Stitcher, or iHeartRadio

Many thanks,

Duane and Shauna

★ Support this podcast ★

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About Today’s Guest:

Rajeev Ramchand, PhD is the inaugural Craig Newmark Fellow at the Bob Woodruff Foundation. He comes to the Foundation after serving as Senior Vice President for Research at the Cohen Veterans Network where he established the organization’s research agenda and laid the foundation for conducting research within the network.

Prior to CVN, he worked for 12 years as a behavioral scientist at the RAND Corporation. At RAND, he conducted research on an array of topics including military and veteran mental health, military and veteran caregivers, adolescent delinquency, the impact of disasters on community health, and violent extremism. He has also conducted many studies on suicide and suicide prevention in military, veteran, and civilian populations. This includes epidemiologic studies on risk factors for suicide, evaluations of suicide prevention programs, environmental scans of organizational responses to suicides, and has developed tools to help organizations to evaluate their own programs. While at RAND, he received two RAND Gold Medal Awards for his research on suicide prevention and one Presidential Award, RAND’s highest honor, for his work on military and veteran caregivers.

Dr. Ramchand has authored nearly 100 peer-reviewed publications. His research has been funded by the National Institutes of Health, National Institute of Justice, Department of Defense, Department of Veterans Affairs, and private foundations. He has been interviewed by and published op-eds in various media outlets and has provided expert testimony before the United States Congress and California State Senate.

Dr. Ramchand received his B.A. in economics from the University of Chicago and his Ph.D. in psychiatric epidemiology from the Johns Hopkins Bloomberg School of Public Health.

Links Mentioned in this Episode:

Bob Woodruff Foundation

Research articles published by Dr. Ramchand

Join our Facebook Group:

Seeking the Military Suicide Solution on Facebook

Episode Sponsor:

milMedia Group

Shauna's latest book: Beyond the Military: A Leader's Handbook for Warrior Reintegration

Duane's latest book: Military in the Rear View Mirror: Mental Health and Wellness in Post-Military Life

How to Leave a Podcast Review

Leaving a podcast review at iTunes isn't intuitive. But positive ratings are hugely important: they help the podcast get discovered by new people. Please spend 5 minutes of your time to leave a review using one of the methods below.

How to leave a podcast review using Apple’s Podcast app

1. Navigate to Seeking the Military Suicide Solution on Apple Podcasts on your iPhone or iPad.

2. Click "Listen on Apple Podcasts"

3. Scroll down and click or tap "Write a Review." Enter your iTunes password to login.

4. Rate the podcast using 1 to 5 stars.

5. Submit a brief honest review.

Bonus: get a thank-you note

Your feedback is greatly appreciated. When you leave a review, drop us a line at info@veteranmentalhealth.com and you'll get a message with the warmest appreciation, and a bonus gift!

For Android users, Google Podcasts does not allow for ratings or reviews, but you can certainly let us know how you think we're doing on Spotify, Stitcher, or iHeartRadio

Many thanks,

Duane and Shauna

★ Support this podcast ★

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About Today’s Guest:

Kacie Kelly oversees and manages policy, operational, and programmatic efforts on veteran health and well-being for the George W. Bush Institute Military Service Initiative, which includes the Warrior Wellness Alliance. She manages strategic efforts to promote the partnerships, collaboration, and alignment among organizations that are so crucial to fostering the health and well-being of post-9/11 Veterans.

Prior to this role, Kacie served as the National Director for Public-Private Partnerships in the U.S. Department of Veterans Affairs Office for Suicide Prevention where she was responsible for developing a comprehensive and integrated public health approach to prevent suicide among the 14 million Veterans not engaged in VA healthcare. Throughout her 15-year career with VA, she led innovative programs to serve more Veterans and their families through strategic partnerships within government and across public and private sectors. In addition, she has had leading roles to promote military culture competence in the community, outreach efforts to reduce stigma associated with seeking mental healthcare, and to enhance provider proficiency in evidence-based mental health care. She earned her Master of Health Sciences (MHS) at Louisiana State University and has a Graduate Certificate in Women in Public Policy and Politics from the University of Massachusetts - Boston. Kacie has also been an active volunteer in the New Orleans community where she served as a Commissioner on the BioDistrict Board of New Orleans and on the Board of Directors for the American Red Cross.

Links Mentioned in this Episode:

Warrior Wellness Alliance

Beyond war and PTSD: The crucial role of transition stress in the lives of military veterans

Kacie Kelly on Twitter

Join our Facebook Group:

Seeking the Military Suicide Solution on Facebook

Episode Sponsor:

milMedia Group

Shauna's latest book: Beyond the Military: A Leader's Handbook for Warrior Reintegration

Duane's latest book: Military in the Rear View Mirror: Mental Health and Wellness in Post-Military Life

How to Leave a Podcast Review

Leaving a podcast review at iTunes isn't intuitive. But positive ratings are hugely important: they help the podcast get discovered by new people. Please spend 5 minutes of your time to leave a review using one of the methods below.

How to leave a podcast review using Apple’s Podcast app

1. Navigate to Seeking the Military Suicide Solution on Apple Podcasts on your iPhone or iPad.

2. Click "Listen on Apple Podcasts"

3. Scroll down and click or tap "Write a Review." Enter your iTunes password to login.

4. Rate the podcast using 1 to 5 stars.

5. Submit a brief honest review.

Bonus: get a thank-you note

Your feedback is greatly appreciated. When you leave a review, drop us a line at info@veteranmentalhealth.com and you'll get a message with the warmest appreciation, and a bonus gift!

For Android users, Google Podcasts does not allow for ratings or reviews, but you can certainly let us know how you think we're doing on Spotify, Stitcher, or iHeartRadio

Many thanks,

Duane and Shauna

Episode Transcript:

Duane France (00:00):

Welcome to episode eight of the Seeking the Military Suicide Solution podcast brought to you by the military times. I'm Duane France.

Shauna Springer (00:07):

And I'm Doc Shauna Springer.

Kacie Kelly (00:09):

And we'd like to thank you for taking the time to learn more about suicide in the military affiliated population. I'd also like to thank our sponsors, milMedia Group. milMedia Group is a proven web design and digital media agency specializing in supporting organizations focusing on the military population. Find more about them at www.milmediagroup.com.

Duane France (00:36):

Thanks again to everybody for joining us to listen to an honest conversation about service member veteran and military family suicide. Do you want more folks to find the show? Make sure to give us an honest rating and review on your podcast player of choice. We'd also like you to join our Facebook group moderated by fellow combat veteran Dee James. You can find the group and the show notes by searching for Seeking the Military Suicide Solution on Facebook. As we continue this series looking at suicide in the military affiliated population, we want to highlight a number of groups that are working to bring folks together in collaboration. That's what our guest today is talking about. Shauna, what can you tell us about today's guest?

Shauna Springer (01:11):

Yes, Kacie Kelly has spent 17 years working in the field of suicide prevention. While she was at the VA, she spearheaded efforts to disseminate cognitive processing therapy and prolonged exposure therapy throughout the VA system. Efforts which led to the training of 20,000 mental health professionals to become certified providers of CPT cognitive processing therapy in one year alone. She currently leads efforts at the George W. Bush Warrior Wellness Alliance, an ambitious initiative that aims to knit together the efforts of veterans serving mental health organizations with peer support based veteran service organizations and peer support based community organizations.

Duane France (01:55):

Yes, I'm glad that we're able to have Kacie come on the show. As many listeners might know, I'm involved with Kacie in the Bush Institute, through the veteran leadership program, and really think that the stuff that they're doing, the Warrior Wellness Alliance to bridge some gaps is some good stuff. So we'll get into the conversation and come back afterwards to pull out some key points.

Duane France (02:27):

The Warrior Wellness Alliance, really, for the last several years has been taking the lead on a lot of different things including suicide prevention. So from your point of view, what do you see that's working when it comes to preventing suicide in the military community?

Kacie Kelly (02:40):

Well, I think we're really starting to see a shift in how much people are talking about suicide. At one point in my career, my now 17 year career, you know, people who are even afraid to say the word suicide. And I think that we have reached an inflection point where people are so frustrated that the numbers aren't changing and are really recognizing that perhaps that veterans might have an opportunity to change the trajectory of the suicide crisis that we have in this country.

Duane France (03:12):

Not just for veterans and military families, but for our country overall. And one of the things that I think has helped with that is the Bush Institute. We've started really sharing our philosophy in that suicide prevention is not crisis intervention only. It is really about promoting a life worth living and the things that are working are not only evidence-based mental health care, but those other activities and programs that promote community and help veterans find purpose after the military and organizations such as The Mission Continues and Team Red, White, and Blue, and the Wounded Warrior Project, that continue to help veterans find their peers and find purpose and community after they've taken off the uniform.

Duane France (04:09):

Yeah, I agree. The idea that the conversation is starting now. Ultimately that's how this project had emerged. And Military Times got on board because so many people are, are interested. I mean we've been here for the last 15 years or so talking about it, but now the time for action is upon us and, and I agree there is a lot more discussion about it. And I think we're ready to move beyond just awareness.

Kacie Kelly (04:38):

I agree Duane and we're seeing some of that with the policy changes that we're seeing come to fruition. Both within the Department of Veterans Affairs and with some leadership coming out of the White House with the PREVENTS executive order and another executive order that came out before PREVENTS that was really focused on the transition period. That executive order we're actually now seeing, put into practice and that the VA has just kicked off one of the outcomes of that original executive order where they are proactively calling transitioning veterans at, the first call is at the 90 day mark. And that's something that people have been advocating for for many years that is now finally coming to fruition. And I'm really pleased to see that action being taken by the department and by our political leaders.

Kacie Kelly (05:36):

However, I think there's a lot more that we can do. I think that one of the reasons that the Bush Institute started the Warrior Wellness Alliance is because we believe that the VA and our government officials cannot do this alone. We know that the large majority of veterans actually don't go into the VA for a variety of reasons. And that supporting veterans mental health and supporting thriving veteran communities is really everyone in our country's responsibility. You know, less than 1% of our country defend our values and our freedoms and our country really needs to get their head around the fact that this is not a VA issue. This is not a DOD issue. This is an American issue and we should be proud to support military families on a daily basis.

Duane France (06:22):

You know, and I think that's a mind shift that a lot of people, maybe they're starting to have, but really need to have. And this is actually something that came out with my conversation with Barbara Van Dahlen was that for a long time we think suicide prevention is something we do to somebody. Like you said, it's this crisis intervention piece, but really it's something we do with somebody and with each other.

Kacie Kelly (06:45):

Exactly. Again, the Bush Institute started the Warrior Wellness Alliance with an effort to connect more veterans to effective mental health care that exists around the country. It is the only collective of organizations at the scale that seats veteran peer leaders at the same table with clinical subject matter experts. And my charge in leading the Alliance has really been to empower them to work collaboratively and equally as a collective. And even though of the 14 organizations, they all have their own mission, their own primary responsibility to get their own organization's job done, they have come together and recognized that there was so much more power in our collective and that even if mental health and suicide prevention was not their primary mission, they were dealing with it as a secondary or tertiary mission anyway. And so I'm really excited that we're to a place where we're taking this concept and this philosophy into action and we are kicking off pilots of a process that we have worked together to generate that actually functionally connects nonclinical organizations to clinical organizations and provides a mechanism for our peer networks to be able to refer themselves or to refer their buddy when they see them struggling to effective mental health care. In a way that does not put them in a position that makes them feel like they have any liability or that overextends what they feel their capacity is.

Kacie Kelly (08:27):

As far as training. We really have worked to understand their operations. While we are excited about the three pilot regions, what I'm most excited about in kicking them off is that this is just the beginning. The intention is that we will learn, we will refine and then be able to give this new knowledge and this process that has been developed to others and scale it on a national basis.

Duane France (08:50):

And I think that, and as you mentioned, we'd been doing this for so long, I think maybe that identifies what one of the things that isn't working is that each of us doing something individually isn't solving the problem. Right? I mean, we all complain and tear our hair out about these silos and these turf Wars and stuff like that. And like you said, this is why the Warrior Wellness Alliance was created was to bridge that gap. But is that one of the things that isn't working when it comes to suicide prevention?

Kacie Kelly (09:19):

Yeah, I think that while there are variety of things that aren't working that need to be improved, but one of the things specifically that, that we have learned in the Alliance and that I think we will be able to share is this barrier of we just have limited mental health care in this country. We have limited quality mental health care in this country. We also have this mindset of expecting veterans to come into the healthcare system. With the Alliance, we're, we're combating both of those challenges and both of those barriers. In this process, we have sort of created a way for nonclinical organizations to access quality, mental health care when they need to. We all know that there's nothing about this that's easy. And I'm just really thankful that at the table with me through the Alliance, we have so many brilliant experts.

Kacie Kelly (10:20):

And the brain capital in our Alliance I think is really what's going to make us feel successful. So I would say there are three things that we're really addressing through the Alliance that are barriers to suicide prevention and barriers to more people accessing quality care. One is the negative perception issue. The "reaching out for help means I'm weak" by working through our peer networks and sort of sending a message that their strength and power and shared experience and that we really want you to thrive. It's not just about surviving, it's about thriving. We're targeting that negative perception, that stigma issue. The second is the navigation to quality care. You know, once someone is willing to raise their hand and say, okay, I'm struggling, I need some help.

Kacie Kelly (11:14):

I don't know what it is. It's really hard to get access to something that would be a good experience. And so through these pilots, we've created this easy button, if you will, that we'll be testing and refining. And then the third thing that that is much bigger, and the Alliance alone cannot tackle this, is the fact that we have limited quality mental health care in this country. So one of the ways that we are planning to combat that is through technology, through coming together to really shine a bright light as a collective, that this is an issue that more people need to be focused on. And then to be positioning ourselves to get those nonclinical resources into folks hands at a community level so that people who maybe aren't social workers or psychologist or psychiatrist will know what to do and know how to take action and feel competent that when they take action to help their buddy that they will get the care that they need.

Duane France (12:16):

Kacie and I talk about the impact of leaving the military and the challenges of transition to post-military life.

MilMedia Group (12:32):

Hi, I’m Alyssa Mosher. I’m a local army spouse, daughter, sister and a proud team member of milMedia. I’m here at our headquarters at the great Fort Hood, Texas. MilMedia is a military affiliated team that wants to serve you the way that you served our country. With mostly military retirees, veterans and families as our staff, we understand the military mindset. milMedia is the one place that prioritizes your goals above all else, which you will see from our incredible customer service. With over 25 years of experience, we work with everyone from startups, small businesses, entrepreneurs and nonprofits. milMedia group is the digital division of Top Sarge Business Solutions that specializes as a web design and digital marketing platform. So visit our website today for a free website analysis so that you can sit back, relax, and let us give you the perfect online presence to hear more about what milMedia is doing and will continue to do, call me today at (254) 554-0974 or visit our website. That’s milMediagroup.com So call me whenever you’re ready.

Duane France (13:41):

Yes. And this is, again, looking at the gaps, and you've mentioned it a couple of different times, but this, you know, the idea that all of the peer organizations are over here on this side of the chasm and all the clinicians are over there on that side of the chasm and never the twain shall meet. Right? It's like, you know, the chocolate and the peanut butter and nobody knows they work together. And that's what the pilot program...well, the Warrior Wellness Alliance overall, but the pilot program is aiming to do in these three target regions is to bridge that gap almost literally.

Kacie Kelly (14:17):

Yeah. Literally. It's exciting. And you know, I think that there will be a lot of things that we will learn and we'll learn them really quickly. But you know, the number that sort of strikes me is, is that while we know that the large majority of veterans come home and transition and go on to contribute as leaders in our communities around the country and, and in corporations, we also estimate that at least 250,000 Post 9/11 on any given day are struggling with some sort of invisible wounds of war. And there's no simple rapid or reliable way for them to confidently refer themselves or to refer appear to effective mental health care and quality mental health care. And I think that while we are focused on referral to effective mental health care, that many of the byproducts are going to be in uniting these organizations around a singular mission that will ultimately lead to not just reduction of disease and reduction of the sort of challenges associated with invisible wounds of war, but will also be an opportunity for these organizations and the Alliance to unite around a shared mission and to continue to thrive in this community that we have developed called the Alliance.

Duane France (15:52):

You know, and I really appreciate that identification, maybe that delineation and, and as you will know, it's not even as easily delineated. You know, a couple of years ago a friend of mine, he was a deputy sheriff in the local veterans court. And he said, how long have you been out? And I said, well, I've been out for three years. And he was like, Oh, you've had a great transition. Well, it's not felt like that from my standpoint, right? Because it's not always blue skies and puppy dogs and rainbows. And so even those non 250 that aren't struggling with an invisible wound of war, maybe necessarily sort of the idea that we're all two paychecks away from poverty, we're all two really big incidents from really needing to connect with somebody.

Kacie Kelly (16:36):

Yeah. Well, Duane, you know, I also like to remind folks that mental health and that transition is not only a veteran issue. While there are certainly things that our our military face that are different than and not even comparable to the rest of our population. Change is hard. Change is hard for everyone. And whenever that is a traumatic event or a career change or geographical relocation it is to be expected that there will be some challenges associated with those transitions. And I think sometimes that we, we forget that some of this is just normal and it's life. It's okay to not be okay is the, the latest phrase I've heard. Because, you know, I think that we forget that when there are challenges, there's also growth, right?

Kacie Kelly (17:44):

And I just always try to push back when folks try to put veterans sort of in this like corner that they're so different, because in my experience, I have learned more about leadership and more about strength and courage and vulnerability frankly from the veterans that are in my life. And I actually think that what our veteran community is doing related to advancing proactive public health approaches to helping their veteran communities thrive, whether it's through the enrichment program at TRB, or the shared mission of the Mission Continues or our own team 43 that's really sort of taught us, taught the Bush Institute about the power of competitive sport and recovery and the power of community through competitive sport. I think all of those social determinants, those sort of preventative activities are really what's going to be the secret sauce when we crack the nut on on suicide prevention. I think we, we as a country have completely missed the boat in how we've thought about suicide prevention and mental health care and thinking that it was isolated to a healthcare setting. I think there's so much more that we have to learn and so much more opportunity for us outside of the healthcare system.

Duane France (19:16):

I seem to be saying this almost every interview and I might start to edit it out because the listeners are going to hear it over and over. But if I as a mental health counselor had the solution in my community, had the solution, the problem would be solved, right? It's not just an us problem. What are some actions, steps that people can take? It's great to think about this and beyond, you know, pushups and hashtags, but what are some action steps and actual things that people can do to maybe make a difference in their lives, in their community?

Kacie Kelly (19:48):

So the first thing, when I get this question, I always try to remind people that asking sincerely how someone is doing and waiting to listen has so much power. And that is something that every one of us can do. And I think we take it for granted because we are all so busy doing our life. And I think technology, this is an area and I'm a huge fan of technology. I think this is an area where technology has, has created an additional barrier. So I would just, I think, strongly encourage listeners to not undervalue the power of looking someone in the eye or picking up the phone and sincerely asking how they were doing and letting them know that you were there to grab a cup of coffee or to go for a run or something.

Kacie Kelly (20:42):

I think the other thing that is a pet peeve of mine is when people are interested and wanting to do something about raising awareness about the suicide epidemic in our country. They often time raise the numbers, right, highlight the problems. And I strongly encourage implore every one of you that are willing to take that action. And thank you for taking that action to raise awareness about this problem, to also make sure that you include some resources that are available. Because the last thing we want to do if someone really is starting to feel down or just start thinking about suicide is to continue to reinforce how bad the problem is without actually letting them know that someone is there and that there are resources that are available. So those are, I think those are my two biggest suggestions.

Duane France (21:40):

My...it brings in mind thinking, you know, if you've got a bunch of stray dogs running around just pointing how many stray dogs are out there isn't solving the problem. It's how do we coordinate our efforts to reduce the stray dog population.

Kacie Kelly (21:53):

Yeah, exactly. Duane . And unfortunately I've been on the other side of it where when we were reviewing tragic situations where we have learned that people decided to take their life and you know, as a result of feeling like there was really no hope. Because of people raising the numbers. And I think the final thing I would just offer, we've talked a bunch about the Alliance, but if folks would like to get involved with any of our Alliance organizations please check out www.bushcenter.org/wwa. You can find opportunities to connect with peer networks that are in the Alliance. You can also find opportunities to learn more about effective mental health care organizations around the country. And what we're going to continue to build out the website. So I would encourage you to check back. You can also follow me on Twitter at Kacie A Kelly, I'm sure Duane will send out some contact information and follow up to this. I just really thank you for allowing me the opportunity to join you today and share a little bit about what we are doing with the Warrior Wellness Alliance to try to help be a part of the solution and create a country where more veterans are able to thrive and continue to lead our country the way they so passionately want to.

Duane France (23:30):

I really enjoyed the conversation with Kacie . Again, as I've mentioned in the intro and a number of different times, I've known her I if for a couple of years now actually in our mutual interaction at the Bush Institute and I really do believe what they're doing as far as making that bridge between the organizations that have veterans participating like Rubicon and stuff, and then mental health professionals. I think it's a noble goal. So what did you think about our conversation?

Shauna Springer (23:56):

Well, first off, Kacie is absolutely on the money when she points out that even though many of the pure based veteran's service organizations didn't start with the central mission of preventing veteran suicide, this has become a secondary or tertiary purpose for many of them. Team Rubicon, a disaster relief organization started and led by veterans, is a perfect example of this. Team Rubicon's founders originally conceived of TR as a way to tap the unique skills of veterans to become a highly capable, adaptable disaster relief organization. The suicide of beloved Marine and founding member Clay Hunt prompted deep grief and a time of soul searching among TRS founders. And they emerge from this grief with a realization that Team Rubicon's central mission would be the support of veterans through giving them purpose, which can be lifesaving for some members as a rank and file gray shirt within Team Rubicon, I've been deployed twice as part of disaster response operations in Northern California.

Shauna Springer (24:56):

Being on these operations has given me a window into the comradery between service members that can be so hard to put into words. At the end of the day, we gather around a fire pit huddled together by the glow of the fire. The conversation quickly turns intimate. Fellow gray shirts, sharing their grief in losing fellow veterans to suicide. How they themselves have battled with their own demons and how the mission of Team Rubicon has been lifesaving to them in the context of this mental warfare. It's critical to stand with these organizations. Live saved isn't well captured by research, but I've personally witnessed this outcome repeatedly because of organizations like Team Rubicon.

Duane France (25:34):

Yeah, I am a huge fan of whatever we call them, the new age VSOs or what have you. The way I sort of describe it, and have had this conversation with folks from Team Rubicon and RWB, and things as well as the VFW and the Legion is that you know, the VFW and the Legion sort of give veterans what they need. They do a lot of legislative activity. They do a lot of obviously supporting for benefits and meeting the needs of veterans and their families. The new VSOs can really be seen as giving veterans what they want. Right? I want to go exercise, I want to engage in that. So I go to team RWB. I want to, you know, run through the woods with the chainsaw. So it's Team Rubicon. I want to do community stuff. So it's a, the Mission Continues and at the same time, that also meets both of them meet a deeper need of connecting to other veterans just as what you're talking about, which can definitely keep somebody from going into a suicidal crisis.

Shauna Springer (26:37):

I know you were kidding. And I know that team Rubicon would never let their sawyers, who are the people with the chainsaws go running through the woods with them.

Duane France (26:45):

It is a post-military version of something...I used to say running through the woods with muddy boots and rifles. I was speaking metaphorically, not literally, don't run with chainsaws, kids. Do not try this at home.

Shauna Springer (26:58):

We joke around a lot about putting out a TR calendar where people would be just with the chainsaw and nothing else and selling that and we would never do it, you know, but I was joking around with some of the guys and women about that kind of a funny fundraiser. Which will never happen. Okay. The second thing that I pulled out is this: I absolutely agree with Kacie that life is full of transitions and that veterans are some of our strongest, bravest, most adaptable citizens. And knowing her heart for veterans, I'm sure she would agree that transition from the military is a uniquely vulnerable time. Research informs us that the majority of first suicide attempts occur within the initial phase following discharge. In fact, to my mind when many of our strongest and bravest citizens are hitting a wall, we should get curious about why this is the case.

Shauna Springer (27:50):

My sense is that current transitional programs view the needs of transitioning veterans as being somewhat like job seekers who need to find their next paid job. Yet those who serve in the military are not like coworkers. They're a family, and the needs of transitioning veterans go far beyond the need to find new employment. That turns often tell me that they feel invisible like ghosts trying to navigate through a culture that has values that are completely different from their own values. This is essentially why Jason Roncoroni and I wrote Beyond the Military to unpack the psychological, cultural and relationship dimensions of transition that we are not talking about and to build a program that will allow veterans to confidently navigate the minefield of transition. Columbia University researchers, Meghan Mobbs and George Bonanno have also done some great research on transition. They publish a very thoughtful article that will include as a further resource in the link to the show notes for this episode.

Shauna Springer (28:48):

Here's a quote that I really liked from their article. :During transition, service members may struggle with unresolved or prolonged grief and bereavement over fallen comrades, loss of their previous military identity, nostalgia for the order and purpose to characterize their service experiences, a sense of moral injury, confusion about military and civilian differences and changing masculine roles". In the final analysis, this is whereI land. military transition is a uniquely stressful experience. And armed with the right psychological insights and the right support, our warriors are uniquely capable of not just surviving but thriving beyond the military. What did you think Duane ?

Duane France (29:28):

No, I obviously I agree having gone through it myself. And it's interesting, I think that we're having this conversation along with the Warrior Wellness Alliance one. In that, back on the other podcast, I had the director of team RWB, JJ Pinter, on the show and he and I talked about the fact that the military really sees transition as transactional. Right? You know, give me your experience. I will return you a resume. Give me your wardrobe. I will teach you how to dress for success. Give me your interview skills and I will help you hone them. Right? So it's very much a give and take. Whereas in JJ's point, it needs to be much more transformational in that we need to change the mindset. I've written before on how to apply Prochaska and DiClemente stages of change. And we're getting into the mental health mumbo jumbo here.

Duane France (30:20):

But the stages of change model, if I am not ready to change my mind, the Army doesn't care, it puts me out anyway. Right? So if I'm in precontemplation stage, they want me to take action. And so we do have to make that shift. And then what...and Meghan Mobbs is a friend...and what Megan and her colleague have talked about is transition stress, moving beyond the medical model of mental health where it's PTSD and TBI, and even substance abuse where there are diagnoses for these, but moving beyond the medical model for mental health to more of a wellness model and these other things like purpose and meaning, moral injury needs fulfillment family, which you're very familiar with relationships. There's no diagnosis for repeated disrupted relationships. But yet that is a significant part of the challenges in post-military life.

Shauna Springer (31:11):

Absolutely. Couldn't agree more. I have so many patients whose relationships ended even solid relationships or had all kinds of relationship-based chaos during the transition period. Which is part of what makes me feel that it, it really is a uniquely vulnerable time for relationships and for personal wellness. But there are ways that we can navigate this if we understand sort of psychological underpinnings of it. And you wrote about some of that too in Military in the Rear View Mirror. You definitely took on some of those things that people don't talk about enough.

Duane France (31:46):

Yeah. And I've often said that one of my secrets of success is that I didn't come home to an empty house. That was one of my very, very important aspects of the support from my wife and, and we've been married for well over 20 years. And so that is a definitely a great point. And, and being able to yes, transitions and changes in life occur. I've got kids going from high school to college and then they'll go from college to the workforce, but it is unique from the military to post-military life.

Duane France (32:19):

Really really appreciate everybody checking out the conversation that we just had a make sure to check out the show notes for this show veteranmentalhealth.com/stmss08. You can get the links to everything that we talked about on this episode, as well as finding the show notes on military times.com. As a reminder, you can ask us questions or let us know what you thought about the show by going to our Facebook group, moderated by the outstanding Dee James by searching, seeking the military suicide solution on Facebook.

Duane France (32:44):

While you’re at it, check out our sponsors, milMedia Group. They’re a web design and digital media agency with over 25 years of experience in supporting service members, veterans and their families. They specialize in working with startups, small businesses, entrepreneurs, nonprofits and city, state and local governments. As a veteran owned business, they’re uniquely qualified to work with those that want to reach an audience in the military and veteran space. Do you have a dream or a vision they can help you bring it to life and get it in front of your audience? You can contact them at (254) 554-0974 or find them online at www.milmediagroup.com

Shauna Springer (33:19):

Just a reminder that the guests and reflections on this show are for informational purposes only and should not be considered professional advice. While Duane and I are mental health professionals, we are not your mental health professionals. We always recommend that you discuss these things with the licensed clinician.

Duane France (33:37):

You can find out more about the work that Shauna’s doing by checking out her latest book, Beyond the Military, a Leader’s Handbook for Warrior Reintegration, and the work that I’m doing with my latest book, Military in the Rear View Mirror. Both are available on Amazon and we’ll have links to those in the show notes. and always remember, you can connect with the veteran crisis line by calling (800) 273-8255 and pressing one, chat online with them at veterancrisisline.net or texting, 838255. Thanks again for joining us to talk about Seeking the Military Suicide Solution and make sure to follow Military Times on social media to keep up with the latest shows. Join us next time for another great episode and until then, remember, you’re not alone. Ever.

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About Today’s Guest:

Kayla M. Williams is a Senior Fellow and Director of the Military, Veterans, and Society Program at Center for a New American Security. She previously served as Director of the Center for Women Veterans at the Department of Veterans Affairs, where she was primary adviser to the Secretary on department policies, programs, and legislation affecting women veterans. Kayla spent eight years at RAND researching servicemember and veteran health needs and benefits, international security, and intelligence policy.

Ms. Williams was enlisted for five years as an Arabic linguist, serving in the 101st Airborne Division (Air Assault). She authored the memoirs Love My Rifle More Than You: Young and Female in the U.S. Army and Plenty of Time When We Get Home: Love and Recovery in the Aftermath of War. Kayla graduated cum laude with a BA in Literature from Bowling Green State University and earned an MA in International Affairs from American University. She is a member of the Department of Labor Advisory Committee on Veterans’ Employment, Training, and Employer Outreach; a former member of the Army Education Advisory Committee and VA Advisory Committee on Women Veterans; and a 2013 White House Woman Veteran Champion of Change.

Links Mentioned in this Episode:

CNAS State Veteran Benefit Finder

VA Vet Center Locator

Join our Facebook Group:

Seeking the Military Suicide Solution on Facebook

Episode Sponsor:

milMedia Group

Shauna's latest book: Beyond the Military: A Leader's Handbook for Warrior Reintegration

Duane's latest book: Military in the Rear View Mirror: Mental Health and Wellness in Post-Military Life

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Many thanks,

Duane and Shauna

Episode Transcript:

Duane France (00:00):

Welcome to episode seven of the Seeking the Military Suicide Solution podcast brought to you by the Military Times. I'm Duane France.

Shauna Springer (00:07):

And I'm Doc Shauna Springer.

Duane France (00:09):

And we'd like to thank you for taking the time to learn more about suicide in the military affiliated population. I'd also like to thank our sponsors, milMedia Group. milMedia Group is a proven web design and digital media agency specializing in supporting organizations focusing on the military population. Find more about them at www.milmediagroup.com.

Duane France (00:37):

Thanks again to everybody for joining us to listen to a conversation about service member veteran and military family suicide. Really appreciate how people have started to find the show and share it. If you want more folks to find the show, make sure to give us an honest rating and review on your podcast player of choice. We'd also like you to join our Facebook group moderated by fellow combat veteran Dee James. You can find the group in the show notes or by searching, "Seeking the Military Suicide Solution" on Facebook. And one of the things that we've heard is that a lot of listeners don't just want to hear from mental health professionals and today's guest isn't, but she has a lot of expertise when it comes to this subject. Shauna, what can you tell us about today's guest?

Shauna Springer (01:14):

Yes, so Kayla Williams is an Iraq war veteran who serves as Director of the Military Veterans in Society program at Center for a New American Security. I asked Kayla why suicide matters to her on a personal level, and she said this: when she was in Iraq, a woman in her unit died by suicide. She and this soldier had just spoken a few days before the death. Like many leaders who care about their soldiers, Kayla spent a lot of time wondering whether she missed the signs or could have said or done anything different that might've encouraged her fellow soldier to get help. She also shared that she has struggled with suicidal ideation herself on more than one occasion and also with trying to find the right response when her husband, another veteran, has expressed similar feelings. Kayla is an elegant writer who has given deep thought to this topic. We're happy to host her on today's episode.

Duane France (02:09):

Yes, the lived experience. We've also often talked about the fact that those of us who served have a number and that number is the number that we have lost to suicide. And sometimes that number is bigger even than the number of people that we lost in combat. And that's going to continue to grow. So I really appreciate Kayla's transparency and vulnerability and we'll get into the conversation. We'll come back afterwards to pull out some of the key points.

Duane France (02:45):

As a combat veteran yourself as a veteran spouse, dual military and all the work that you've done really over the last 15 years, from your point of view, what have you seen that is effective when it comes to ending in the military population?

Kayla Williams (03:01):

That's a great question. I think looking at the data, we have to admit that VA is getting something right because, while we've seen overall growth in the rate of suicide, that growth rate has been lower or even flat among veterans who use VA for their healthcare. We know that's true for women veterans in particular. So obviously VA has at least some protective effect. One thing that I noticed in several of the VA medical centers that I've been to personally is that they are willing to try to address the issue of gun safety. So the Pittsburgh VA where I used to go for care, they just had bowls of gun locks sitting out on counters to just make it really easy and simple to get a gun lock to enhance the safety of those who do own firearms. And because of the lethality of firearms, that is a really big deal. And anything that can help folks who choose to own firearms be safer when they're in crisis is a good thing. I think also that, like anecdotally, the power of personal connections is really important. Feelings of isolation can be incredibly detrimental. And having a close and supportive network of peers can be protective. And anything that can enhance that, organizations that can help folks get together, spend time with each other can potentially be really beneficial as well.

Duane France (04:37):

You know, that's a couple of great points. And and definitely the question about lethal means safety and firearm safety is something a lot of people want to kind of keep their hands off of. But it is part of what this issue is. I mean, you and your former role at the VA working with the center for women veterans, the women veterans suicide rate using firearms is higher, maybe nearly double what it is, the non-military female rate. I mean, it's critical. We don't like to talk about it, but it's the elephant in the room. It's there.

Kayla Williams (05:08):

That's absolutely right. And again, I'm not saying people shouldn't have guns. I'm a vet. I carried a weapon every single day for a year when I was in the Middle East. I'm very comfortable with having firearms and having access to firearms. But that doesn't mean that I can't, you know, say really honestly, that we know that because of that lethality and the comfort level that veterans have with firearms, we are significantly more likely to die by suicide that involves use of a firearm. So we have to be able to talk about it in a way that doesn't raise people's hackles and make them think that we're talking about taking away guns. We're not talking about taking away guns. We're talking about finding safe ways to store firearms and finding ways that, if somebody thinks to themselves, you know, I may be reaching a crisis point that they can find a safe place to store their guns temporarily until the crisis has passed.

Kayla Williams (06:09):

So in some States, that may mean that there needs to be like a law change that makes it possible to, you know, hand over your firearm to a friend temporarily. It may mean trying to find partnerships with gun ranges or stores or you know, other places where somebody could say like, Hey, I'd like to leave my firearm here for awhile and lock it up. Because, and this is one of the tough things. There's, there's this huge misconception that once someone decides to die by suicide, that it's going to happen no matter what. And there's nothing we can do. And that's just not true. The data is really pretty clear that restricting access to lethal means is very effective. You see bridges that put up chain link fences so people can't jump.

Kayla Williams (07:02):

Somebody shows up finds the fence, they don't go look for another bridge. They go home. Putting medications in blister packs, so you have to individually pop out every pill that is effective. Anything that slows people down, that puts a barrier between them and the lethal means that they are looking into at that moment drives down the rate of suicide. It's often this impulsive decision, you know, and made within an hour of making the decision that actually is taken. And so slowing that down and giving people the opportunity to to rethink and to, you know, maybe reach out to a loved one or reach out to a crisis line or get help in some way is really important. So we definitely have to talk about lethal means. And in our community in particular, firearms is a big one. So let's make it easier for people to get gun locks, to store their firearms safely, to feel comfortable going to a friend and saying, "Hey, can you hold onto this for awhile? I think I'm better off not having it around right now."

Duane France (08:06):

So the idea of the things that are working right, you know accessing care at the VA if it's available to you and you know, the frequency or working with some kind of treatment. Even the peer to peer and things like that. That's what's working. But maybe what might not be working is the messaging or, you know, you just absolutely busted one of the myths when it comes to suicide and means preference. What do you see that's not working when it comes to veteran suicide? Like it, before we started talking for 15 years, you first wrote your book in 2005, you'dve been talking about these issues and really banging this gong and it, and it hasn't seemed to change. In some ways it might seem to be getting worse.

Kayla Williams (08:46):

Some of the things that I find really frustrating include that pundits and sometimes even journalists and politicians aren't using best practices and talking about these issues. So it's been pretty well documented that there is a contagion effect. In many communities you'll see clusters of suicides. And so when we're talking about individuals who have died by suicide, there are some evidence based practices about the types of language to use or not use. And people just don't follow those. There are guidelines and include things, too. Like not calling it an epidemic. Not saying that rates are skyrocketing, not using inflammatory language in general, but you still see that. We think we know that it's really important that whenever you're going to be talking about or writing about suicide that you talk about and include information on how to reach out, which I'm sure that you'll be doing here, including the crisis line somewhere and making sure that folks know that there are places they can turn to if they are in crisis.

Kayla Williams (09:54):

So I think all of that is an ongoing sense of frustration for me that folks are continuing to not abide by those best practices. And another source of frustration for me is that, you know, I've talked a little bit about firearms. So if somebody's already made this choice, other lethal means, restricting access is important. The other direction that I think we should try to go is way, way left of boom, and addressing some of the issues that I think could be contributing to an overall sense of distress and unhappiness that seems to pervade our society. Like we're talking about suicide in the mil/vet community where it's been rising faster than another segments of society, but it's going up in all segments of society. The growth rate in suicide among 10 to 14 year olds has been dramatic.

Kayla Williams (10:48):

Like that is terrifying to me. My son is nine. Like, I didn't think I would need to worry about it that young, but you know, there is something going on in our broader society that that we should be trying to address. I don't have data on what I'm going to say next. This is just more of an anecdotal feeling, but my sense is that, you know, we have rising income inequality. We have you know, an environment that's really stressed. We have this ongoing trend of people, it seems like, spending less time with each other in person, face to face. I just feel like in a lot of segments of society, we're seeing hopelessness and loneliness and trying to address some of those issues where folks can live lives of purpose and meaning where they believe that they're doing work that makes a difference in the world and that they're connected to their communities and their family members. I think those could be really protective as well. But those are hard problems to tackle and they extend far beyond our community. But I think, again, no data on this, but I feel like that is important.

Duane France (12:00):

Oh, you're absolutely right. And you're a definitely singing my song and a former colleague of yours, Rajeev Ramchand, and he is coming on the show, and he says, yes, suicide awareness. But it would be a very bleak world if we just walked around thinking everyone that we come in contact with is about to take their own life. The goal is really to increase wellness rather than prevent suicide. And this, you know, always thinking that somebody in crisis. It can create a very negative view.

Duane France (12:32):

After the break, Kayla and I talk about how difficult it might be to implement and measure more upstream interventions that keep people from experiencing a suicidal crisis in the first place.

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Duane France (14:03):

That seems to be a gap that exists is, I mean, even talking about suicide, suicide is a symptom of an underlying issue to be resolved. It's not a problem to be solved itself. Is that one of the gaps that you see is just the lack of awareness of getting left to the boom?

Kayla Williams (14:19):

I think lack of awareness but also a sense of confusion or helplessness about what to do. Right? And how do you get funding for programs that feel that nebulous, you know? I think that's another challenge for folks who want to look at this. It's, we're in a time when I think legitimately, for many reasons, folks want to see evidence based programs. They want to see something that that you can see a noticeable change in numbers. You can have metrics, you can track outcomes and, and something that is aiming to change some more fundamental aspects of our society that's going to take years or decades to pay off. And you're not going to necessarily be able to see a nice clean metric to show that it's effective. And I'm not sure that we even know, you know, what, what would work?

Kayla Williams (15:10):

People, I hear people talk about wanting to get left of boom, but I'm not sure that folks know how to do that or what to do. Perhaps that's one of the reasons that VA can be beneficial is that VA, if you get into the VA system there are actually a lot of types of support within VA across it's different administrations and types of programs that you're not going to get from standard health insurance or at a standard doctor's office, right? If you ask and sometimes have to ask again, but you can get connected with not just medical care, not just mental health care, but in a growing number of VA medical centers have like medical, legal partnerships. So you can get linked up with pro bono legal services. If you have legal problems, you can get help with financial issues if you get disability compensation or access to your GI bill. Right? So these other things that are getting at your overall quality of life. I'm not saying the VA's always perfect and certainly it's a very difficult and frustrating system to navigate at times. But perhaps that's one of the other things that can make a difference. I feel like, I wish I had the answer for you. I'm sure everybody does, but I don't know that there is, like if there was one clean, simple answer, we would have already implemented it. Right,

Duane France (16:25):

Right. Exactly. And this is something that, that actually Shauna and I, you know, say is, if we, the mental health professionals, had the solution, the problem would be solved by now. If the employment folks had the solution, the problem would be solved. Right. And so that's really the premise of this series is to say, you know, each of us has an aspect of the answer. And if we combine them then maybe we will get a larger answer. You know, the whole being greater than the sum of its parts. The idea of, you know left to the boom in this wellness stuff. And not everything works for everybody. I'm not a yoga guy, but I've got a lot of friends who are. I'm a meditation guy. It is similar but very different. I'm not a massage guy, but I will swear by float therapy, I do it at least once a month. That's my kind of massage and it just makes me feel good. Right? I feel relaxed and good after I'm done. And it's hard to quantify an evidence based practice, that feeling of feeling good.

Kayla Williams (17:20):

Right? Right. My husband does a fly fishing with Project Healing Waters and that's really beneficial for him. I think both in terms of the socialization, being out around other humans and other veterans in particular and also being in nature right? Like on the water surrounded by trees and also the meditative aspect, I think of casting a line, right? Like the, the repetitive motion and the peacefulness that can come with casting. And then also, you know, he ties flies and feeling pride in accomplishing something and doing something and being good at it and doing, you know, complicated work. All of those things I think are helpful in their own ways. But as you say, hard to necessarily quantify,

Duane France (18:06):

Yes, from a clinical standpoint, the neurological development that comes with the concentration of tying flies and even a fly fishing in the constant motion. I mean we in the clinical space knows what works and we know that in the same way that the concentration in golf helps neurological development and things like that. You know, there is a scientific basis for why these things work. The same thing for float therapy or massage, meditation when it comes to calming down the amygdala and increasing prefrontal lobe and things like that.

Kayla Williams (18:34):

I feel like every week I see some new headline that's like "bee keeping helps veterans," "scuba diving helps veterans" and I'm like, yes. Getting out of your house and doing something, preferably with other humans, helps. Right. It isn't necessarily the one specific thing, it's what you're talking about that comes along with any of those activities,

Duane France (18:58):

You know? And maybe that leads into, you know, what can be done, what action steps can people take. This raising awareness or, even, you know, as you're talking about the reporting issues, which is really more like shouting fire in a theater and not really effective. But still all of this awareness, we've been banging the gong of awareness for years. What action steps can individuals take or maybe we take as a community to really make a difference.

Kayla Williams (19:24):

One of the things that I still see as a really big need in our community are organizations that can help service members, veterans and military families navigate the available resources because there are so many resources and the eligibility requirements for them vary dramatically. The way to apply can really vary dramatically. And when you're struggling, that process can be incredibly overwhelming. So for organizations to come together in a collective impact model or in some type of physical location or informal collaboration. So that if somebody comes in and you know, they express that they are having distress in one area of their life and then as it comes to light, they're actually having challenges across several different areas that they can get their needs met across a variety of areas from one starting point. Right? With coordinated care. And I mean care in a really broad sense there.

Kayla Williams (20:28):

I think that's helpful and important. You see some organizations starting to do this in various cities. I think Combined Arms in Houston is a good example. I think also Code of Support with their Patriot Link software is another good model that seems to be showing some real promise. So, you know, folks are trying different ways to do this, expanding those efforts and making sure that they they exist, you know, across communities I think is really gonna be important. And to me, something that shows a lot of promise to make sure that we don't have people slipping through the cracks in one area when they reached out in any way to try to get some needs met.

Duane France (21:11):

I absolutely agree. I describe it to my clients and, and even to others in my local community and elsewhere, starving at the feast, right? We have this amazing buffet of all of these different things. It's like the largest buffet in the world, but yet people are still starving in the middle of it because like you said, the barriers that exist. But also the barriers of, you know, leaders eat last, right? I'm just going to keep letting someone else, you know, it take advantage of the resources. They need it more than I do. I've got my 10 fingers and toes and so on. And so eventually you just have a bunch of thirsty horses that want to drink water, but they don't know where to start.

Kayla Williams (21:48):

Yup. Yup. Also mention, some of the work that we've done recently that may be of interest to your listeners. We identified and coded every state level benefit across the country. We found 1,800 I'm sorry, we found 1,814 discrete benefits offered by States. So service members, veterans and military families. It's more than I even expected. There's a lot of variation. There are a lot of States that offer discounts on recreational activities. So we're talking about the benefit of, you know, going outside, getting into nature and doing some activities. There are a lot of States offer reduced price or free fishing licenses or hunting licenses. Virginia also has peer support specialists that are offered at the state level, paid for by the state. And if my kids start to struggle because of my service or my husband's service, the state of Virginia will pay for my kids to get mental health care.

Kayla Williams (22:47):

And as you know, VA, that's something VA can't do. So the fact that the state is willing to step in and help with that. And again, talking about these stressors that go across life domains, if you're worried about your kids, that's another huge stressor. So encourage people to, when they're thinking about this buffet, as you call it, remember that States are another source of available benefit and support and they have a lot of huge variation between States and what's available. And with our new state benefit finder, folks can go online or on their desktop or on their phone and search by type of benefit type of beneficiary or state to find out what they may qualify for.

Duane France (23:27):

That's excellent. And I'm a definitely going to make sure that that's included in the show notes. As well as following my own advice is to see what...because even as I'm helping veterans here in Colorado, I'm certain I probably don't even know of all of the state benefits here. So we'll definitely recommend listeners take that step. Kayla, I really appreciate you coming on the show today.

Kayla Williams (23:50):

Thanks. It's my pleasure. In case you don't have it handy, just want to remind everyone the crisis line is (800) 273-8255, veterans press one. And I'll also put in a plug for Vet Centers. I don't know if you've had anybody from a Vet Center on to talk, but I feel like those are an under...they're a resource for veterans that not enough veterans know about that Vet Centers are more at the peer type support because such a high percentage of them are fellow veterans.

Duane France (24:29):

You know, when I first started thinking about people who could come on the show to talk about suicide, Kayla was one of the first ones that I talked about. I've had the opportunity to interact with her in a number of different occasions. What did you think about what we talked about?

Shauna Springer (24:42):

I thought it was another great interview from somebody who really brings authenticity to the conversation that comes from not only expertise but also lived experience. One of the things that I especially notice was that Kayla expressed frustration that people in the media and sometimes in political roles often fail to use best practice approaches in talking about suicide. And she gave the example of describing suicide as an epidemic or rates as skyrocketing. I've been thinking a lot about this too. Because in many of the suicide related briefings, talks and trainings and media pieces that I've heard, the all too common lead in is to start by raising a cry of alarm usually by citing a disturbing statistic. Now, I have no doubt that the intentions of the speaker are all for the good. I think this is designed to get people's attention in a world where our attention is terribly fragmented, but it occurs to me that if we wanted to engineer a way to increase complacence by habituating people to these statistics, this would be the way to go about it.

Shauna Springer (25:47):

Not that everyone is doing this in any organized, purposeful way, and they surely want the opposite outcome. But for the past couple of years, I've argued against this approach because I've also witnessed the impact of this strategy on those who have been impacted by suicide loss. For example, this last summer, I joined a group of Marines who came together to grieve the loss of their fallen, whether due to combat or suicide. In this gathering occurred during a time when there was a flurry of news reports about recent suicides in the military and veteran population, and I will always remember how many of the Marines in that circle expressed and showed such frustration and helplessness in regard to this barrage of news reports about veteran suicide. They told me that it feels so demoralizing and drives this false and damaging narrative of the broken veteran. So my thought is, at what point is our desire to bring awareness doing more harm than good? From my perspective, warriors need to hear that they are irreplaceable assets who can come back from war and contribute in meaningful ways. And I think the question for all of us to consider is this, how do we balance acknowledging the pain that suicide causes without leading people to feel helpless and hopeless, when in fact there's so much we can do to prevent suicide in many cases?

Duane France (27:10):

You know, this is a...actually, I'm not sure if listeners who have listened this far to have really picked up on it, but we're not using the numbers, right? We're not saying 22 or 20, or 17, or 17 and 6 or you know, 14 and...I mean this is one of the things is it goes beyond the numbers. I think couple episodes ago, Cecily had really, you know, she very clearly said not to talk about the numbers but brought up a statistic, but it's more than just the statistic. It's more than just a number. That's the awareness piece and part of the public health approach is to define the problem and people are using the statistic to define the problem. But moving beyond that is, how do we identify risk and protective factors? And that's what we're trying to do here.

Shauna Springer (27:55):

Right. Because in the last couple of years I've really switched to, you know, the messaging that one loss is the loss of one irreplaceable person to those that loved that individual. So really one is too many. And so zooming in on the impact of suicide for those who are affected by it rather than kind of increasing a sense that this problem has no solution, which isn't true, there are things we can do to prevent suicide. The other thing that she pointed out kind of at the end of her interview, which I really wanted to pick up on was Vet Centers are often overlooked as potential resources. I really wanted to emphasize this point. We're going to add in the show notes for this episode, a Vet Center locator, but many of the veterans I've worked with have been surprised to learn about the range and the depth of services offered at Vet Centers.

Shauna Springer (28:49):

They are typically smaller, more approachable treatment clinics that are often largely staffed by veterans, as Kayla mentioned. They offer general readjustment counseling as well as peer support groups, including often combat trauma support groups and they have specialized programming for people who have had military sexual trauma and those who are grieving a military loved one. They also do events and bring the veteran community together in social ways. For example, here where I live in my community, the Vet Center hosts weekend workout sessions and has a veteran led softball team. What is your Vet Center offer, Duane?

Duane France (29:28):

One thing it offers is an opportunity to not be in the big VA. Vet Centers or out in the community, righ? As you were talking about this and even as Kayla had mentioned, I am a huge proponent of Vet Centers in that it's an easy and comfortable way for veterans to access outpatient mental health, right? So when people think about, you know, going to see the wizard or seeing the shrink at the VA, it's not all about medications. That's a misconception is, Vet Centers don't do medications, they just do outpatient readjustment counseling. There was a study back in 2018, the evaluation Department of Veterans Affairs Mental Health Services, the National Academy of Sciences, and they identified that the Vet Centers, if we can make behavioral health clinics more like Vet Centers, more veterans would actually use behavioral health in the VA. And so it's not just going in some little narrow room with the doc. It's going to a comfortable place, almost a living room atmosphere in the waiting room and stuff like that. I mean we describe our clinic as a civilian Vet Center because it is designed and very much the same way.

Shauna Springer (30:37):

Yeah. I think a lot of times people think of the VA as the big medical centers and that centers are the VA. People don't know that VA Vet Centers are a whole series of clinics that began largely because of, frankly, Vietnam veterans standing up and advocating for this. The original history of it was that the Vet Centers were, as you said, designed to be in the community setting and a more streamlined, approachable way to get into care. In fact, the original tagline I'm told is "help without the hassle." And so they started by the advocacy of Vietnam Veterans who wanted these more approachable clinics and they're still around and they're offering a tremendous depth of services in different places and they're just an overlooked resource for many people.

Duane France (31:27):

Yeah. And as Kayla mentioned, a lot of the clinicians that are hired by the Vet Centers are veterans themselves. I mean, that is a priority focus when they're looking at staffing clinicians, master's levels and PhDs and even interns working there, that having military background, A veteran doesn't need much recent to avoid therapy and the Vet Center is really do reduce a lot of those reasons.

Speaker 5 (31:44):

We really appreciate everybody checking out the conversation that we just had a make sure to check out the show notes for this show veteranmentalhealth.com/stmss07. You can get the links to everything that we talked about on this episode. as well as finding the show notes on military times.com. As a reminder, you can ask us questions or let us know what you thought about the show by going to our Facebook group, moderated by the outstanding Dee James by searching, seeking the military suicide solution on Facebook.

Duane France (32:19):

While you're at it, check out our sponsors, milMedia Group. They’re a web design and digital media agency with over 25 years of experience in supporting service members, veterans and their families. They specialize in working with startups, small businesses, entrepreneurs, nonprofits and city, state and local governments. As a veteran owned business, they’re uniquely qualified to work with those that want to reach an audience in the military and veteran space. Do you have a dream or a vision they can help you bring it to life and get it in front of your audience? You can contact them at (254) 554-0974 or find them online at www.milmediagroup.com

Shauna Springer (32:53):

Just a reminder that the guests and reflections on this show are for informational purposes only and should not be considered professional advice. While Duane and I are mental health professionals, we are not your mental health professionals. We always recommend that you discuss these things with the licensed clinician.

Speaker 5 (33:11):

You can find out more about the work that Shauna’s doing by checking out her latest book, Beyond the Military, a Leader’s Handbook for Warrior Reintegration, and the work that I’m doing with my latest book, Military in the Rear View Mirror. Both are available on Amazon and we’ll have links to those in the show notes. and always remember, you can connect with the veteran crisis line by calling (800) 273-8255 and pressing one, chat online with them at veterancrisisline.net or texting, 838255. Thanks again for joining us to talk about Seeking the Military Suicide Solution and make sure to follow Military Times on social media to keep up with the latest shows. Join us next time for another great episode and until then, remember, you’re not alone. Ever.

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About Today’s Guest:

Joseph R. Chenelly was appointed national executive director of the nation’s fourth largest veterans service organization in May 2016. In this capacity, he administers the policies of AMVETS, supervises its national headquarters operations and provides direction, as needed, to state and local components. Joe previously served as AMVETS’ national communications director.

Joe Chenelly is the first veteran of combat operations in Afghanistan and Iraq to lead one of the nation’s four largest veterans service organizations’ staffs.

A native of Rochester, N.Y., Joe enlisted in the U.S. Marine Corps in 1998, serving with the 1st Marine Division, and was honorably discharged as a Staff Sergeant in April 2006. He is a combat veteran of Operation Enduring Freedom and Operation Iraqi Freedom, having served in Afghanistan, Pakistan, Iraq, Kuwait, East Timor and the Horn of Africa.

Joe became a veterans advocate, a journalist, and a political adviser after his time in uniform. He covered military and veterans matters on staff with Leatherneck magazine, the Military Times newspapers, USA TODAYand Gannet News, reporting on operations in the Middle East, Southwest Asia, Africa, as well as disaster relief in the United States.

Joe was named one of the 100 “most influential journalists covering armed violence” by Action on Armed Violence in 2013. He was the first U.S. Marine combat correspondent to step into enemy territory after September 11, 2001, as a military reporter in Pakistan and Afghanistan. He also reported from the front-lines with American and allied forces in Kuwait and Iraq as that war began. He was on the ground for the start of both Operation Enduring Freedom and Operation Iraqi Freedom.

Joe served as AMVETS’ national communications director in 2005-2007, and for eight years as assistant national director for communications for the Disabled American Veterans (DAV) in Washington, D.C., leading grassroots efforts through social networking and new media.

He has also served as president of Social Communications, LLC, and as a public affairs officer director for the Department of Navy. Joe is an alumni of Syracuse University and Central Texas College. He resides in Fairport, N.Y., with his wife Dawn, a service-connected disabled Air Force veteran, and their five children.

Links Mentioned in this Episode:

AMVETS Web Site

The VET HEAL Suicide Prevention Training Course

Firearms Access: A Loaded Topic Part 1

Join our Facebook Group:

Seeking the Military Suicide Solution on Facebook

Episode Sponsor:

milMedia Group

Shauna's latest book: Beyond the Military: A Leader's Handbook for Warrior Reintegration

Duane's latest book: Military in the Rear View Mirror: Mental Health and Wellness in Post-Military Life

How to Leave a Podcast Review

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How to leave a podcast review using Apple’s Podcast app

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2. Click "Listen on Apple Podcasts"

3. Scroll down and click or tap "Write a Review." Enter your iTunes password to login.

4. Rate the podcast using 1 to 5 stars.

5. Submit a brief honest review.

Bonus: get a thank-you note

Your feedback is greatly appreciated. When you leave a review, drop us a line at info@veteranmentalhealth.com and you'll get a message with the warmest appreciation, and a bonus gift!

For Android users, Google Podcasts does not allow for ratings or reviews, but you can certainly let us know how you think we're doing on Spotify, Stitcher, or iHeartRadio

Many thanks,

Duane and Shauna

Episode Transcript:

Duane France (00:00):

Welcome to episode six of the Seeking the Military Suicide Solution podcast brought to you by the military times. I'm Duane France.

Shauna Springer (00:07):

And I'm Doc Shauna Springer.

Duane France (00:09):

And we'd like to thank you for taking the time to learn more about suicide in the military affiliated population.I’d like to thank our sponsors, milMedia Group. milMedia Group is a proven web design and digital media agency specializing in supporting organizations focusing on the military population. Find more about them at www.milmediagroup.com.

Duane France (00:35):

Thanks again to everybody for joining us to listen to an honest conversation about service member veteran and military family suicide and thank you for the response to the show. We're getting a lot of great feedback. If you want to give us more feedback rate and review the show on your podcast player of choice, we'd also like you to join us on our Facebook group, moderated by fellow combat veteran Dee James. You can find the group on the show notes or searching seeking the military suicide solution on Facebook. I'm excited to bring today's guest on the show because I think it demonstrates the importance of this issue at the highest national level. Shauna, what can you tell us about today's guest?

Shauna Springer (01:10):

So Joe Chenelly, he is the executive director at AMVETS national headquarters, but behind his public role is a man who is a servant leader. Our first conversation could have gone on for hours. Joe is a Marine who served as a combat correspondent with several back to back deployments and Joe knows the pain of suicide loss all too well. He sustained multiple losses including eight Marines that he served with in Iraq and Afghanistan and his mother who died by suicide 10 years ago as well as many others in the vast network of veterans He serves his role at AMVETS. Joe and his team have taken the late night calls from veterans in crisis. They're doing in the trenches work to keep their brothers and sisters in the fight. Joe has a perspective that's uniquely valuable and it's such an honor post him on the podcast today.

Duane France (01:55):

Yeah, I agree. Joe is definitely outspoken about the need for this. And it's really great, and AMVETS is not the only one of the big six that is doing this. Hopefully to have more conversations to come. But glad to be able to have a different voice, a unique voice on the show. So we're going to get into the conversation and come back afterwards to pull out some of the key points.

Duane France (02:27):

I really appreciate the role that AMVETS is playing in the, the veterans service organization space to address. the suicide epidemic, not just in veterans but their families and things like that. So I'm interested to hear from your point of view, what you see is actually working when it comes to preventing suicide in our population.

Joe Chenelly (02:49):

Duane, I really appreciate you having me on for a conversation, suicide prevention, addressing the mental health crisis, not just among veterans, but you know, really generally in at this point Is our top priority. And we think one of the biggest needs are off the bat is having a national conversation about this. You know, a chance to get on here with you and talk about this is really important. You know, the VA does have quality mental health care. And we do see, you know, pretty good results with what they're providing. But we know they can't do it alone. What is working out there that we see is a lot of this alternative therapy, but we're seeing what happens at the local levels is what's most effective in whether it's yoga at AMVETS or one of the other veterans posts or at the hospitals or just at someone's yoga clinic. And I'm just using yoga as one example of many. And we see these warrior retreats showing tremendous promise.

Joe Chenelly (03:48):

Unfortunately, they're not getting enough opportunity yet to be able to prove themselves. You know, everything has to be evidence-based. And we agree that things need to be able to be proven, but they have to be given the opportunity to prove themselves. And you know, a lot of times that requires funding. It requires observation by, you know, the so called experts out there, things like that. You know, there's great warrior retreats out there like Save a Warrior and Boulder Crest and Camp Hope. And you know, I mentioned Camp Hope which started in Missouri. You know, that's a very different take on the way some of the other therapies are out there. It's all peer-to-peer and we believe peer-to-peer is probably the most effective way to address this. And so we've launched a training program that we built and it's on our website and we have a pretty aggressive goal of hitting 10,000 of our members in the next few months trained on this program.

Joe Chenelly (04:46):

This is really how to identify what's happening, how to mitigate the risks and identify when triggers are happening and how to connect their fellow veterans with the resources that they need. The story is pretty commonly told to us about veteran who is suicidal or in serious crisis and they stop into a post. Sometimes it's supposed to be their one last stop is "I'm going to go in and have, I have a couple beers and then go home and kill myself." And they go in there and they end up talking to their fellow veterans. Find something that they didn't realize that they're not alone. That there are other people out there who care about them, that there is help. Unfortunately, far too many don't get that. And sometimes we know when people do exactly that they go into a post or somewhere else, so some other type of community space and they don't find what they need or those that they're in there interacting with don't recognize what's happening and they do end up killing themselves.

Duane France (05:49):

And that's...absolutely. I as a mental health professional, but I'm sort of a super peer, right? I was a vet and then I became a clinical mental health counselor. There's not enough of us in the field provide that clinical sort of connection. And, and I agree there is a gap between the clinicians and then, you know, maybe what's working on the ground. But you're talking about the HEAL training, right? That was clinically informed. I mean like, you know, clinicians paired with AMVETS to put that together.

Joe Chenelly (06:18):

That's correct. And we do have we clinicians on staff here with AMVETS now at our national headquarters and they work with a lot of other agencies out there and built this training program. It's an online training module. It takes about 20 minutes. It's actually pretty difficult. When we first launched it, you know, obviously this has been a big part of my life for a long time.

Joe Chenelly (06:41):

So I decided I wanted to test the test and I decided to cruise through it, kind of just skip through the different periods of instruction and just go right to the individual quizzes and the final test and I failed it. Which I thought was a good sign that this program really brings something new to the table. And we're also going out and we are doing training now. We'll be launching a nationwide training effort next year where we're doing in person training throughout the country, wherever veterans go. We're going to start with our largest posts. But we'll be filling...There's other other VSOs just come in and conduct that training as well. We don't care who it is or where, who's getting credit for anything like that. As long as they're saving lives. Those people that, you know, our staff is training.

Duane France (07:28):

And that's great. You know, and this is one of those things, I actually was having a conversation with somebody the other day and we're doing some community based work here in El Paso County and Colorado Springs. And the discussion was about, you know, who has the mandate, does this organization have the mandate to take this forward? And my point is, well it's laying on the ground so somebody has got to pick up the ball and run with it. Right. And I think that's one thing and I've noticed over the last several years that AMVETS has really tried to do is that this ball has been surprisingly, it's been sitting on the ground for so long that you picked it up and run with it. And like you said, this is something that you have been dealing with for quite a while. So that's what works. The peer support is what works. But what are you seeing that isn't working? That maybe some of the things that people think what I'm doing is effective, but it doesn't seem to be working.

Joe Chenelly (08:07):

Shure. We, we could start with with dollar signs, right? We have $9 billion has been spent by the VA year after year. And in the last 10 years we've lost more veterans to suicide than we lost in all of Vietnam. We're trying to do the same thing over and over again. And you know, again, back to that at the beginning of our conversation here, there are things that are working in the VA, but it's hard to have that have any impact if you have a large number of veterans who are, some of the veterans were in most need of treatment of counseling, things like that. They're not going to the VA. There's different reasons.

Joe Chenelly (08:53):

Although it's hard for us to decipher for sure. Because the VA says they don't have certain data, like they don't know how many of we know we'll use this 20 a day number of the 20 veterans who die. Statistically speaking per day, 16 of them are not currently receiving treatment from the VA. We don't know how many of those 16 went to the VA, didn't like what they experienced, didn't go back or how many just don't have access to it. Because of either their local VA is very busy or because their local VA's isn't all that local. You know, a lot of veterans who are experiencing mental health issues, they are unable to leave their house or maybe they don't feel comfortable to drive things like that. We don't really know why they're not going to VA. But we know they're not getting there or tthey don't trust the VA.

Joe Chenelly (09:43):

Maybe they don't trust the government. You know, there's been a lot of reasons out there, well publicized reasons of why people don't trust the VA. So the bottom line is expecting the VA to be the catchall and the one lone entity responsible for saving these veterans, for providing these veterans where they need is unrealistic and it's simply not working. So we spend billions and billions of dollars a year and the suicide rate is going up, not down spending is going up. Suicide. The suicide rate is not going down. We're not getting a return for our investment as tax payers. You know, it's not my job to try to look out for the taxpayer here, but you know, that's the reality here is that we're not getting what we need from that. You know, that's why we're very supportive of efforts in Congress to be able allow the VA to provide resources to local entities, whether that's the alternative therapy whether it's peer to peer support, whether it's local, clinical help, whatever it is, we want to push that locally.

Joe Chenelly (10:47):

The VA needs community partners. We all do. We realize that we also don't think with the Department of Defense doing is working. Really about the problem starts way back in the Department of Defense. And I mean in the very beginning, I don't think they're doing the appropriate or enough scanned enough screening when people are coming into the military, provide the type of transition assistance that they need. And we've addressed a ton...back during the Obama administration, they poured a ton of money to improve the transition from the military back into civilian life or into veterans life. And you know, there's a ton of resources out there when in reality, veterans or service members are still sprinting through that process to get out. The Department of Defense needs to own this issue. And now we know there's a lot of active duty military who are killing themselves. So clearly they're failing, the Department of Defense is failing. You know, our men and women in uniform in that way. And when they get out, it becomes VA's problem instantly. And you know, that's I don't care what's fair or not. Life's not fair, but it's right. And It's not going to, it's not going to address this, this crisis

Duane France (11:54):

After the break, Joe and I talk about the importance of collaboration between government agencies, the medical and mental health community and organizations like AMVETS supporting the military population nationally.

milMedia Group. (12:18):

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Duane France (13:26):

This is a conversation I've had with people that, in the community, you know, and obviously maybe this was much more on social media, but you know, it's either the DOD's problem or it's the VA's problem, right? They need to fix it. And that third stool, like you said, community partners, people in the community don't even think that it's their responsibility. Right? You know, that's...I don't put out fires. That's a fire department's job. Well, I do what I can to prevent fires so that I don't have to call the fire department, but people don't consider that. Whenever we talk about suicide, it's the DOD problem or the VA's problem.

Joe Chenelly (14:10):

It's America's problem. It's everybody. Everybody needs to chip in on this thing. It's the only way we're going to come close to solving it.

Duane France (14:10):

So that's the classic definition of insanity, right? Keep trying the same thing over and over again expecting different results. And I often say I as a mental health provider, we...this community, the mental health community doesn't have the solution because if we did, the problem would be solved. And so that's one of the issues is what's not working. I'm not saying any more than you're saying is that clinical interventions don't work. They do for the people they work with. And then these other things. But what gaps are there? I mean, you're, you're having this conversation at the national level. We started talking a little bit before about the, the drum beat that AMVETS is trying to hit, but what else is needed? What gaps are there that we need to fill?

Joe Chenelly (14:52):

Yeah, I think we need broader collaboration within the government and from the government, within the medical community and with the nonprofit community or the nongovernmental agencies. President Trump last year signed an executive order called PREVENTS that directs all of his cabinet members to work together on this. Very supportive of that concept, we need to get the brightest minds in this country working on this issue. And if you look at maybe the department of energy, not an entity that we've engaged with in the past for this crisis, who can really analyze what things are happening and we think they can figure out some new solutions. You know, this is all about thinking outside the box and looking at new ways to address this. We can go to the department of commverce. The Department of Commerce has more data than anybody else in the United States. We're all always talking about the lack of data to be able to use as we plan.

Joe Chenelly (15:50):

Things like that. You know, clearly HUD and HHS you know, they have a ton of informaiton, a ton of resources ,expertise at their fingertips and you know, to bring them all together in one way. I think it can be very important. But with the health industry, with the non governmental agencies you know, they're engaged in silos right now and the basic, what can you do? It's always about what can you do? It's how can we work together. And I think we're gonna get there. But that's, that's a big part of our message here of what we're missing right now. That there's a lot of resources that are stronger if they're used together.

Duane France (16:32):

You know, that's interesting when you talk about that. Obviously we all talk about these silos and turf battles and stuff like that. But it wasn't like that we were in the military, right? I was in logistics for 22 years. Right. So I definitely know that the behind the scenes stuff didn't get the bullets in the guns to the guys in front. Right. So, you know, you didn't just rely as an infantry men or as a combat medic, you didn't just rely on other combat medics or other infantry men. You built a team. I mean ultimately that's what the special forces is built around is this finding people who are very skilled in one particular area and putting them together, but it doesn't seem to...that doesn't seem to translate to post-military life for veterans organizations.

Joe Chenelly (17:14):

That's a great example of what we need to learn from. I haven't thought about that way before. But you're right, that's a hopefully breaking it down in a way that your listeners, but you know, just as importantly, our government officials can understand. That's great.

Duane France (17:28):

You know, so in, in those or I see the same gaps, right? How, why are we not in the same room talking about the same thing. Everybody doing connectivity. Let's get in the room and, and again, this analogy that listeners are hearing this over and over again, but we're all digging holes, but nobody is telling us where to dig or how to dig or at what depth or what direction, right? So this coordination piece, we're trying all of this stuff. What kind of actions, cause this is a thing, right? You know, the 20th day, 22 a day, 17 a day, pushups. You know, we're beyond the awareness point. We know about the problem. How do we move beyond awareness to actually taking action? What can listeners actually do when it comes to suicide prevention?

Joe Chenelly (17:50):

Depends on their, their level of of desire to participate. You know, we're encouraging everyone to take the training that we have offered out there or if there's others who are offering the training, but to be able to find out what you individually can do first and foremost, figure out how you can identify things. And it's not as simple as these little business cards that the VA passes out of, you know, if people are giving away their things or if they're talking about suicide.

Joe Chenelly (18:38):

So a lot of people who don't have those really outward highly visible things but then it's not just knowing that as well, it's learning how to help them mitigate the risks. Firearms. A big deal. You know, when we look at the means by which most veterans are taking their lives, it's firearms. We are not advocating for taking away anyone's firearms. We know if a veteran feels that he or she may lose their firearms because they went and self-identified that they needed some help, they're probably not going to do that. You know, so to understand that issue and understand the right way to talk with people about that, how do ensure that they really know that you're there for them or that there are others who are there for them. I think the other thing here is to continue to push your lawmakers into understanding.

Joe Chenelly (19:25):

We can't keep doing the same thing over and over again and expect different outcomes. And to pressure them to make sure they know that you expect them to engage with those who are trying to find outside the box ideas here. Try to leverage best practices that maybe have worked in other things. We talk a few times now about these community partners, building these community partners. That's how our government addressed veterans homelessness with a lot of success in the last presidential administration. They put grants out to the local levels and we saw homeless numbers drop dramatically. It worked. And we think that kind of engagement, the local levels so that that's stuff that we want. We need everybody to be pushing their lawmakers on, whether it's informing them or just encouraging them,. You know, it's risky. And we have a lot of lawmakers who are afraid of taking that risk of, you know, putting several billion dollars into a program that might not work. And we acknowledge it might not work. But we also can acknowledge that what we're doing now isn't working.

Duane France (20:30):

You know, I often use the veteran homelessness example as well. We have, I have a partner here in my community who is one of the SSVF grant recipients. And again, it's one of those things of, as veterans go. So Gord nation, if we can figure out how to solve veteran homelessness in this very identifiable small group and what interventions will get them off the streets, we can then apply that to the national issue or the community based issue. Same thing with suicide is if we can figure out how to engage this particular demographic, which is representative across socioeconomic factors and geographic factors. But if we can figure out how to address suicide in this population, we can then take those same techniques and apply it to the nation at large.

Joe Chenelly (21:20):

You're absolutely right. And that was a conversation I had with the White House staff just yesterday. Of course, they're responsible for the entire country, not just the veterans population. We know the veterans population is suffering a particularly high suicide rate, but really the entire country is facing the suicide epidemic. And when you're not breaking down veterans or non veterans, we're talking about a suicide in the United States every 15 minutes. I mean, a huge number. Veterans, you know, have been leading from the front forever and finding ways to help the rest of the country. And that's what we can all do here by helping address this at the veterans level.

Duane France (21:58):

No, I absolutely agree. I'm definitely gonna make sure that the, the HEAL training, your website and you have a great instructional video that I see here. I'm gonna make sure that that's in the show notes and and I really appreciate you coming on the show today.

Joe Chenelly (22:12):

Yeah, thank you Duane, this has been great. Appreciate it. Appreciate everything you're doing. You're outreach, especially out there on Twitter. Now we hear through your podcast and your blogs really making difference. We're very grateful for you.

Duane France (22:34):

You know, I really enjoyed that conversation with Joe. I think he had a lot of good points

Shauna Springer (22:38):

I did too. He made the comment that a number of programs and retreats that are highly impactful may not get the support they deserve because we're so focused on evidence based treatments. As a psychologist who has been a researcher. It's a balance, I suppose. On the one hand we need to guard against, you know, wildly irresponsible, damaging interventions or things that are a waste of time and money. But sometimes I wonder if we've gone too far in terms of resourcing only the things that have research backing. Specifically, I'm thinking about being in a number of sacred circles of warriors. Reunions that they've pulled together with little to no outside funding. And during these weekends I've honestly witnessed more transformative change than in most of the other settings I've worked with. I had a one particular reunion with about two dozen Marines and I asked for emergency funding from a large foundation that gives money out for veterans and they said, Nope, it doesn't have the research backing.

Shauna Springer (23:36):

So no funding for this. And we did it anyway. And I wanted to read some feedback that I got from one of the Marines after that weekend because it makes the point rather than me just saying it, I wanted to read some excerpts from the letter he sent. Hello ladies. I wouldn't admit it in front of those other goofballs, but I needed that. That reunion could not have come at a better time. The therapy you provided was far more successful than any of the other methods I've experienced. Couldn't believe how not forced that felt it was not in an office or any other setting that feels not therapeutic and sterile. There's something to be said for how beneficial it is to place your subjects in a safe environment they're comfortable with. I think counseling and grief programs should be conducted for units, groups that already know each other.

Shauna Springer (24:23):

There's an unbreakable bond. We can skip the hours and days of breaking down individual barriers to establish a working comfort level. The location was perfect. Woodsy, quiet, hard to find secure. To close. I was completely blown away by how well coordinated organic and therapeutic this was. The model of therapy that you are utilizing should be given a hard look by other organizations with the same goal. I can't express how much I needed that in my life from the bottom of my heart. Thank you. And we didn't ask for that letter it was probably twice that long. I thought it was super insightful and really funny actually. But it makes the point that some of the most impactful things that we're doing are precisely the things that are so sacred that we're just not going to be able to bring, you know, questionnaires and surveys into them. And so I just wanted to get your thoughts on that as well, Duane, because I think Joe makes such an important point here.

Duane France (25:18):

No, I agree, and definitely the funding is around PTSD and TBI. Right? You know, that's where the money is. And so that's where we design the research around, right? We have the medical model of mental health when it comes to, we have evidence base for depression and substance abuse of course, and TBI and PTSD. But what about that lack of purpose and meaning? That's much more existential. Moral injury is now emerging in developing some evidence, but that's exactly right. And I think this is one of the challenges that we've had is separating the medical community or the mental health community that needs to be quantifiable and measurable to when the apple falls from the tree, I can tell it's gravity,

Shauna Springer (26:00):

Right? And when enough Marines or warriors or soldiers or airman say this was profoundly impactful, more than anything I've ever done, then the foundations should be listening to them. They ought to have a vote and a voice. I think in terms of what gets funded. But it is a balance. You know, we don't want to do something that's wildly irresponsible. So there needs to be some oversight and some structure. But I just think sometimes we've erred on the side of reifying research and evidence based practice. The other thing that Joe commented on was the perception that firearms will be taken away as a barrier to starting treatment. And this is an obstacle to care for so many veterans. So a few years ago I was talking with a Marine named Brian Vargas and I asked him this question, what do you think veterans really think when clinicians like me who have not served in the military ask veterans about their firearms?

Shauna Springer (26:56):

And he said, well, I know what I think and I can find out what other veterans think if you want. So at the time, Brian was working toward a degree in social work at Berkeley and he was using tools like survey monkey. So he pulled together a poll and sent it out to the veteran community. And about a week later he returned with the results. It was responses from about 70 veterans enrolled at three different local colleges out here in California. It was one veteran asking other veterans to share what they really think. So here's what we learned. When Brian asked them if they would tell a new clinician the truth about owning firearms over half said probably not or definitely not. Moreover, over half said that they would probably drop out of treatment if a clinician, they did not know well were to ask them if they own a firearm.

Shauna Springer (27:42):

So I wonder if this sounds familiar to any of the veterans or clinicians who are listening to this podcast today. You know, despite our good intentions, what if asking questions about firearm ownership, what if the questions we're asking about firearm ownership or actually backfiring? Leading veterans to avoid seeking help in the first place? What if our questions in our approach are a major barrier to many veterans who would otherwise engage in care? These are the thoughts that have led me to develop trainings and talks about the psychology of approaching this conversation in a respectful strategic way. In the show notes for this episode, we'll post a link to a free to access television program that I did, which hosted a refreshingly honest conversation about firearms.

Duane France (28:26):

You know, I always say that a veteran doesn't need much reason to avoid therapy. So any reason is a good reason...

Shauna Springer (28:33):

Yeah, they're scanning for a reason to never come back

Duane France (28:37):

And not to make light of this, but this is a very accurate reason to avoid getting care. This is a...I describe it as a fear of being taken something taken away, not just the guns, but here at, at Fort Carson and Peterson Air Force, Base of fear of their security clearance being taken away. But it's this fear of something being taken away from me and not exploring that fear, not verifying whether that's true or not can keep somebody from getting the help they need.

Shauna Springer (29:05):

Yeah. It's a loaded conversation and it requires a thoughtful strategic approach rather than just diving into, you know, are you a risk for suicide and do you own firearms? We really need to have a strategic, humble approach to how we ask these questions in the first place.

Duane France (29:22):

No, I agree. I think that having...learning how to have the conversations, we're able to sit with uncomfortable conversations in other spaces, but when it comes to these very maybe politically charged or maybe emotionally charged situations, it's hard to do that.

Shauna Springer (29:37):

Right, right. Yep. This is, yeah, it brings in a lot of emotional and so it's really just very tricky, but there are ways to have the conversation. So that's why I wanted to post that show because there's a couple of specific examples I give in the last segment about how we can talk about this respectfully.

Duane France (29:55):

Yeah, I, I absolutely agree. And as we've been saying, this is a conversation we're going to have to have. We can't talk about suicide in the military affiliated population without talking about firearms. It's simply cannot happen simply because of the number of deaths by suicide.

New Speaker (30:13):

And I appreciate everybody for taking the time to check out the show. You can find the show notes for this show veteranmentalhealth.com/stmss06. You can get the links to everything that we talked about on this episode. And you can also find the show notes on military times.com. I’d like to thank our sponsors, milMedia Group. They’re a web design and digital media agency with over 25 years of experience in supporting service members, veterans and their families. They specialize in working with startups, small businesses, entrepreneurs, nonprofits and city, state and local governments. As a veteran owned business, they’re uniquely qualified to work with those that want to reach an audience in the military and veteran space. Do you have a dream or a vision they can help you bring it to life and get it in front of your audience? You can contact them at (254) 554-0974 or find them online at www.milmediagroup.com

Shauna Springer (31:14):

Just a reminder that the guests and reflections on this show are for informational purposes only and should not be considered professional advice. While Duane and I are mental health professionals, we are not your mental health professionals. We always recommend that you discuss these things with a licensed clinician

Duane France (31:32):

You can find out more about the work that Shauna’s doing by checking out her latest book, Beyond the Military, a Leader’s Handbook for Warrior Reintegration, and the work that I’m doing with my latest book, Military in the Rear View Mirror. Both are available on Amazon and we’ll have links to those in the show notes. and always remember, you can connect with the veteran crisis line by calling (800) 273-8255 and pressing one, chat online with them at veterancrisisline.net or texting, 838255. Thanks again for joining us to talk about Seeking the Military Suicide Solution and make sure to follow Military Times on social media to keep up with the latest shows. Join us next time for another great episode and until then, remember, you’re not alone. Ever.

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About Today’s Guest:

Dr. Eugene Lipov is board certified in Anesthesiology and Pain Management and has been practicing in the field of pain medicine since 1990. He completed Northwestern Medical School in 1984, Anesthesia Residency at University of Illinois in 1989, and Advanced Pain Training in 1990.

Dr. Lipov pioneered adaption of a sympathetic block in the neck called Stellate Ganglion Block (SGB) for treating Post-Traumatic Stress Disorder (PTSD) and hot flashes. Considering current efficacy of PTSD treatment is under 30 percent, using pharmaceuticals and psycho therapy, SGB’s success rate of 85 percent is a major game-changer.

So far, he and his team have treated over 200 veterans. Their foundation has covered the cost of treatment and travel of 100 veterans. They have also treated several hundred civilian patients with diagnosis of PTSD from all over the world. They have successfully treated military-related PTSD, Military Sexual Trauma (MST), PTSD due to being a first responder, non-military sexual trauma, pediatric sexual trauma, and PTSD from other traumatic events.

Additionally Dr. Lipov treats pain patients at Advocate Illinois Masonic Medical Center, and at his private practice, Advanced Pain Center.

Links Mentioned in this Episode:

List of Mayor's and Governor's Challenge Partners

Dr. Lipov's websites:

www.sgbptsd.com

Erase PTSD Now

Episode Sponsor:

milMedia Group

Shauna's latest book: Beyond the Military: A Leader's Handbook for Warrior Reintegration

Duane's latest book: Military in the Rear View Mirror: Mental Health and Wellness in Post-Military Life

How to Leave a Podcast Review

Leaving a podcast review at iTunes isn't intuitive. But positive ratings are hugely important: they help the podcast get discovered by new people. Please spend 5 minutes of your time to leave a review using one of the methods below.

How to leave a podcast review using Apple’s Podcast app

1. Navigate to Seeking the Military Suicide Solution on Apple Podcasts on your iPhone or iPad.

2. Click "Listen on Apple Podcasts"

3. Scroll down and click or tap "Write a Review." Enter your iTunes password to login.

4. Rate the podcast using 1 to 5 stars.

5. Submit a brief honest review.

Bonus: get a thank-you note

Your feedback is greatly appreciated. When you leave a review, drop us a line at info@veteranmentalhealth.com and you'll get a message with the warmest appreciation, and a bonus gift!

For Android users, Google Podcasts does not allow for ratings or reviews, but you can certainly let us know how you think we're doing on Spotify, Stitcher, or iHeartRadio

Many thanks,

Duane and Shauna

Episode Transcript:

Duane France (00:00):

Welcome to Episode Five of the Seeking the Military Suicide Solution podcast brought to you by the Military Times. I'm Duane France.

Shauna Springer (00:07):

And I'm Doc Shauna Springer.

New Speaker (00:08):

And we'd like to thank you for taking the time to learn more about suicide in the military affiliated population. I'd like to thank our sponsors, milMedia Group. milMedia Group is a proven web design and digital media agency specializing in supporting organizations focusing on the military population. Find more about them at www.milmediagroup.com.

New Speaker (00:34):

Thanks again to everybody for joining us to listen to the conversation about service member veteran and military family suicide. Our guest today is Dr. Eugene Lipov Shauna, what would you like to tell us about Gene?

Shauna Springer (00:45):

Yeah. So Dr. Eugene Lipov is a board certified physician in anesthesiology and pain management who's been practicing in the field of pain management since 1990. He's an assistant professor of surgery at University of Illinois, completing medical school at Northwestern in 1984, was an anesthesia residency at university of Illinois in 1989, and advanced pain training in 1990. But Dr. Lipov, more than anything is a pioneer and he's really pioneered the adaptation of a sympathetic block in the neck called stellate ganglion block, SGB, as it's known for treating post traumatic stress. In the book Outliers. Malcolm Gladwell talks about this idea of the 10,000 hour rule, and he says that the key to achieving world-class expertise in any skill is to a large extent, a matter of practicing the correct way for over around 10,000 hours. And by that definition, Dr. Lipov is a master three or four times over when it comes to this.

Shauna Springer (01:50):

So he's been doing SGB over the course of his 30 years in the field and since he adapted it for use with PTS, he's done hundreds of stellate ganglion block procedures over 14 years with those who have served in the military. So because of this, his methods and his understanding are really light years ahead of anyone else in the field. In the past year, I've personally referred about 20 patients to him. And as you know, Duane, I'm not really a true believer by nature, but I have to say what I've observed is really compelling. His treatment with stellate ganglion block has transformed the lives of everyone I've referred to him. And he's literally saved the lives of a few of my prior patients. There are several who have called me in a state of suicidal crisis who are now feeling lasting relief from their symptoms, who view the future in a totally different way, much more hopeful now. So this may be one of the most important conversations we host on this podcast. But I'm excited to get into it. And you know, I really like brave people and so I'm honored that Dr. Lipov Is joining us for this conversation.

Duane France (03:00):

Well, I agree. As I often say to people is you know, suicide is not the problem to be solved. It's the symptom of an underlying issue. And for many veterans who are in a place of suicidal crisis, those underlying issues are suffering with things like post traumatic stress and the increased anxiety and the hypervigilance and things like that. And so Dr. Lipov is not someone who would normally be on a list of suicide prevention experts. He would be on this list of people that are treating one of the conditions that leads to suicide. This is what we wanted to do is bring somebody on the show that, look, this is a novel, unique intervention that is actually working that this can be one piece of the puzzle. So really appreciated my conversation with Gene. Let's get into that and we'll come back afterwards to pull out some of the key points.

Duane France (04:00):

I know about the neurological basis for PTSD. Obviously it is as much neurological, as it is psychological and the work that you have done really addresses the neurological aspect of PTSD using stellate ganglion block. So really to get started, I guess if you can give us sort of an understanding of what it is and maybe how it works.

Eugene Lipov (04:23):

Sure. Well, thank you very much for having me. One. So I think it's very hard to separate psychologic from biologic because if the brain is not there, there's no psychologic anything. And then that's why working with amazing people like Dr. Springer, it's really great to be able to have people evaluate and make the correct diagnosis. And after we do the physiological intervention to do the follow up and really to be able to help them get to the ultimate goal, which is functioning to the pre trauma state, I believe. So if I may, I'd like to tell you what I believe PTSD is and what it's not. So what it's not as this amorphous nonspecific issue. While if you look at the physiologic aspect of what happens is when somebody is traumatized being military or non-military, then body produces something called NGF nerve growth factor, which promotes sprouting or increased growth of sympathetic fibers, which is fight and flight fibers.

Eugene Lipov (05:30):

As the longest that condition's maintained, people have increased norepinephrine that are on the brain and norepinephrine kind of activates the body or the brain. Specifically, the part that seems to be overactivated is called them Amygdala on the right side. Amygdala is the anger and fear center of the brain. So functional MRIs or biologic scan and assess can can demonstrate that, which is really cool because you can actually help diagnose a biologic change in the brain. And then I think if people understand that it's much easier to come to grips with PTSD is it's not a weakness of the soul or something like that. It's actual biologic change and you can do psychological support, but sometimes it's just not enough. And that's when they do stellate ganglion block on the right side and it seems to reduce the sympathetic overgrowth. It's called pruning...neuroscience likes those terms..and then it seems to reduce too much sympathetic fight and flight system or activations, norepinephrine drops and then people feel markedly better within 10, 15 minutes of a procedure, which is amazing to see. I never get tired of the same and the response can last for years. That's kind of in a nutshell what we are doing.

Duane France (06:43):

Yeah, and that's great. I often, usually when I meet with a veteran client for the first time, I describe thi, the neurological, the biological aspect of PTSD. And for many of the clients, it's the first time they'd heard about it. Right. You know, it's they've been told for years that it's, it's all in your head, meaning you're making it up, not, it's all in your head, the fact that it's in your brain. But really describe this the, the amygdala, the hippocampus. I describe that as sort of the gas pedal. But then our prefrontal lobe is sort of the governor that keeps the RPMs from going too high and, and really the hyperactivity of the lower part of the brain and the amygdala and that's basically what caused a lot of the distress symptoms, the emotional symptoms, as you said, the anger and fear or anxiety and the hypervigilance and things like that. So that's how I sorta describe it to my clients. Would that be accurate?

Eugene Lipov (07:40):

I think you're exactly right on because, it's kind of interesting, one of the people who follows my work, he gave me a story about a SEAL or a Special Ops operator, and that he had horrible experience out in the field. And then he was taking some very strong medication, atypical antipsychotics, and that's kept him pretty sleepy and tired. Not too bad, but he was able to function. So he had the stellate ganglion block and then he fell asleep driving the car. So that's exactly, I use the same terminology. You have the gas pedal, which is the amygdala and you have the break, frontal cortex. But in this case it was also the medication. So when he took the foot of the gas pedal, the brake was too much and that's why he fell asleep. Exactly the same thing. So I agree with that.

Duane France (08:29):

PTSD...the show obviously is about seeking the suicide solution, but suicide is a lagging indicator of an underlying problem. And for a lot of service members, but even family members who may have secondary traumatic stress and things like that. The the stellate ganglion block and the stellate ganglion block is something that, you know, helps reduce the trauma, which then in turn helps reduce suicidal ideation. Have you seen that?

Eugene Lipov (08:59):

Very, very much. If I may, I would say it doesn't help reduce the trauma. It helps reduce the after effects of trauma. Would you agree with that? You can't change the trauma. It has alreayd happend.

Eugene Lipov (09:11):

So I'd like to give you an example of one person kind of, to me it's all about examples. You know, you're old when you have a story about everything. So one of the guys we treated, he came in and he was in Vietnam, he was on a national show with me in 2012. He came in and he was very distraught and in fact I was having an opening in our Institute and he wouldn't come in because there were too many people. A lot of people with severe because the, as you probably know, they're agoraphoic and they're very anxious in crowds. And so he came in and then he said, do you mind doing procedures? So I did the procedures. So he later said, I was actually thinking of suicide before I needed a procedure.

Eugene Lipov (09:56):

Right after you did it, I didn't want to do that anymore. And the reason that happens is because I gave a speech in American Psychiatric Association in 2015 and that for that I research what causes suicidal, what are the trends that lead to suicide? And it seems to be two things. And I'd like to know your experience. One is they have severe sleep difficulties and two, over reactivity to stimuli. And that's what [SGB] actually works on the best. Overreactivity and sleep dysfunction really drives people crazy because you don't sleep well enough, you never feel right by yourself. And then this guy, Raleigh had 40 years of psychotherapy for zero. So my point to him, you know, somewhere you have to stop and have some really good trauma informed psychotherapists, but I'm sure nobody is going torecommend 40 years of therapy that does not work. Somewhere you just got to go. He had two injections.

Duane France (10:48):

And I think that's key. You know, like you said, at some point we have to figure out something that doesn't work. And that's where we're at, especially with suicide is we keep throwing things at it. And the same old problems, you know, maybe we, we know the numbers of two years ago. But if we're doing the same thing today that we were doing in 2018, then we're going to get 2018 numbers in 2020. So yes, it is trying to figure out how to do something different. And the SGB is exactly that. You know, yes, I absolutely do see that insomnia is a significant factor. Sleep deprivation...and we were trained for it in the military, right? You know this, we were proud of being able to operate on minimal sleep for an extended period of time, but that doesn't necessarily translate to post-military life.

Duane France (11:38):

So that is a sort of a life factor that impacts it. The way that I always describe suicide to my clients is that it's an attempt to stop pain: physical pain, obviously those individuals in extreme physical, chronic pain. Emotional pain, the depression, the anger, the anxiety, moral pain, right? But, and so it's, it is an attempt to stop pain and more explicitly and attempt to stop suffering. And for many service members and their families, they think that's the only way to stop the suffering. But from my understanding, that's what SGB does, is it reduces the symptoms and relieves the "pain". And in some ways I think very literally. So that suicide's no longer an option.

Eugene Lipov (12:24):

Well kind of, so let me, let me get my perspective. Being a pain physician. I'm very sensitive to the term pain. So we have a nonprofit Erase PTSD Now, and I'm not trying to certainly push that, but you know, our subtitle is stop the misery. It's not necessarily pain, it's the misery of existence. So the service members, military and non-military that people have been treated basically they have a very similar report. My life is just pure misery and there is no hope. So to me suicide actually is lack of hope. I think especially military service members can deal with a lot of pain, but if they know that there's nothing else to do, they keep doing the same thing and making everybody around them miserable, they're miserable. What's the point of living once you lose hope? That's a big issue. And then to me, the great thing about stellate ganglion block,, it works in about 20 to 30 minutes. So people walk in and they walk out totally differently. The family members, significant others see a difference. And the other part that's really cool about it, compliance is not a problem for us. Somebody comes in, they get treatment, they feel different, and success rate is, and let's say 80%, which is pretty high compared to the regular stuff. But if you look at that, the compliance is a big problem, right? Conventional therapeutics. Here is a significant difference. So that's kind of my answer,

Duane France (13:49):

You know and it's a great point. And I think that you have just caused me to modify my terminology because yes, that, that is even more correct. It's the way to stop the misery whereas, you know, and being nonmedical but clinical, obviously applying "pain," the term pain, but you're exactly right and it's misery. And it's the absence of hope that this will never stop.

Speaker 6 (14:14):

Hi, I’m Alyssa Mosher. I’m a local army spouse, daughter, sister and a proud team member of milMedia. I’m here at our headquarters at the great Fort Hood, Texas. MilMedia is a military affiliated team that wants to serve you the way that you served our country. With mostly military retirees, veterans and families as our staff, we understand the military mindset. milMedia is the one place that prioritizes your goals above all else, which you will see from our incredible customer service. With over 25 years of experience, we work with everyone from startups, small businesses, entrepreneurs and nonprofits. milMedia group is the digital division of Top Sarge Business Solutions that specializes as a web design and digital marketing platform. So visit our website today for a free website analysis so that you can sit back, relax, and let us give you the perfect online presence to hear more about what milMedia is doing and will continue to do, call me today at (254) 554-0974 or visit our website. That’s milMediagroup.com So call me whenever you’re ready.

Duane France (15:33):

It would be a stretch to say that you restore hope, but by relieving these symptoms hope is restored

Eugene Lipov (15:40):

So well. So I'll tell you what my patients are telling me. So it does offer hope. And in fact, some people don't have a stellate ganglion block, which is kind of counterintuitive. But they say, you know, this is our last hope. What happens if it doesn't work? Because we tell people it doesn't work on everyone, right? So we're not saying this certainly, we're gonna, you know, hope restore is way too big of a term. But to me, I think especially men, look at anything like why? You know, Einstein said expecting different results when doing the same thing is insanity, right? So somebody knows you're going to do the same thing. How could you have hope? Because you already tried this. So he had to try something totally different. And at least to me, it gives a lot of hope that there is a good chance it's going to work for you and you don't have to...

Eugene Lipov (16:24):

The other part is that you don't have to tell people, well, wait another six months. And unfortunately medication takes months to years to work, if ever. Right?. And that's a very different dynamic here. So that's why I like that, being a man as like, you know, I'd like to do something which helps and we're done. You don't have to talk about it, you now feel better. Now go seek appropriate psychiatric treatment. Now reintegrate with your family. Don't be an asshole, but have a great life. Right? I used to be a trauma surgeon, so I'm pretty direct.

Duane France (16:52):

Right, right. So, and it might be helpful for listeners to understand what actually stellate ganglion block is. You kind of talked about it in the very beginning. But, but what is the actual procedure? This is a medical procedure. This isn't therapy.

Eugene Lipov (17:08):

Absolutely not. Well, first of all, I'm not a psychiatrist. I don't know much about psychiatry. I'm an anesthesiologist. So typically anesthesiologist, I'm not really, we did not participate as a specialty in psychiatric care normally. However so an interesting set of circumstance, I was able to figure out that a old procedure called stellate ganglion blocks since been done since 1925 has marked effect on PTSD. So let me just walk through the procedure if I may. So the patient comes in, we do the usual evaluation, like for any medical procedure, make sure everything's fine. We put an IV in. IV is done for safety. Some people want to go to sleep, some do not. So I want to stay up for that. Again, as said, I'm very comfortable giving people sedation and other physician give it to them. The patient lies on their back.

Eugene Lipov (17:55):

When I'm on the scan, I use fluoroscopy guidance. So x-ray to figure out what are we going? Numb up the skin on the right side of the Adam's Apple. And then we place the needle to that area under guidance and then put a little dye and make sure there's no issues and put local anesthetic and what's he put in, it's called bupivacaine, the same drug that's used on pregnant women. So you know, it's pretty safe. It's been around for 50 years. So everything that's used for this procedure is old. What's new is a new indication. I was able to determine that this particular procedure has marked impact on PTSD rapidly. But I've been doing stellate ganglion blocks for 30 years. With PTSD, I've been doing it for 14 years.

Duane France (18:33):

And so it just so happened that I had a random encounter when I was in Dallas over the summer of 2019 with a Marine Corps veteran who had received a stellate ganglion block and he volunteered the fact that he had gotten SGB and he did say that it was something that had changed his life and reduced symptoms. And he also said that it helped him engage in therapy better after that. Because he said, I still had all of these different things and so he still had to manage these things in his life. And this is what I always tell clients for me is this is what maybe some medications can do. It can sort of calm the waters so you can learn the skills to be able to manage these issues. I generally understand it's the same with stellate ganglion block is it reduces the symptoms to the point where the veteran or the service member of the family member can actually go work with an individual in therapy and the therapy doesn't need to take 40 years. It can work a lot faster.

Eugene Lipov (19:34):

So I think you're absolutely right. So what we do find, is I highly suggest doing, like as I said, Dr. Springer is amazing in this. She's like a true professional in this space. So the key points, so let me compare and contrast [SBG] to regular medications, right? So you're absolutely right. So people define as people can't comply. It was going to come to behavior therapy or trauma-informed therapy. I don't know that much about it, but I do know a specialist and especially Dr. Springer. But the key point there, it reduces their over reactivity so they can comply with that. They don't get pissed off. They don't get shut down. You can actually talk about the real issues, but the difference in that and the medication, a lot of times medications, let's say you've taken benzodiazepine before your session, you're not going to remember half of the session and you'll have doubt. That's not good. You want to have somebody who's clear but not over reactive. And that's what [SGB} does. That's a different, but I agree with that. If he can calm the waters without sedating you or screw around the memory, people speak as they already have memory issues.

Duane France (20:35):

Right. And I think that's a critical part of this. And obviously you know, a lot of veterans will say, do you know the side effects of the medication and you have to take a medication to modify the side effects and those have effects. And there's sort of a crescendo effect when it comes to medication. And this, again, I see that this reduces a lot of that. So it takes a lot of the medications off the table. We do a procedure called transcranial magnetic stimulation, which is very specific for depression. It takes them off of the medications a lot. Just being off the medications, lifts the veterans' spirits,

Eugene Lipov (21:08):

Oh I agree and think TMS definitely has a place in it. And it's been used for depression for a number of years. He just, the affinity of it is different. It takes sometime to do it. And I agree with you, I highly applaud approaches which are non-medication such as RTMS, EMDR, you know, all of those. If they can reduce the patient's overreactivity, I think that is huge and it helps them.

Duane France (21:31):

So you've found yourself...as you said you've been doing this for the past 15 years and so shortly after our current conflicts began. And, and it's taken...I get the sense that it's taken you awhile to really get this information out into the mainstream and even to be recognized by medical professionals, by mental health professionals, by the community at large.

Eugene Lipov (21:53):

That is a true statement. Totally. Yes, sir. Yeah. I gave testimony in front of Congress in 2010. I had a letter of support of Senator Obama, 2007. I've applied multiple times for grants and I've been pretty rebuked Pretty good. But I think they're finally at the preface of this being available for the people who need it.

Duane France (22:13):

And so the idea, and one of the goals of this show is to identify what gaps exist. And as Doc Springer and I were talking about what gaps exist in the suicide for the military population space. We're talking psychological interventions, we're talking, you know medication interventions but you're filling a gap that exists when it comes to physiological interventions for a psychological disorder.

Eugene Lipov (22:38):

I think that's totally true. I think you're right. And then not everything is fixable by [SGB]. There's no one thing that's gonna fix everything. But I think giving emotional support, having people to talk to ,supporting the spouses. And a lot of times I think you know better than I do because you're out in the trenches. But when the spouse leaves, a lot of times those patients become suicidal at that point. So supporting and understanding that is a secondary because the, as you alluded to, the significant other can have. So supporting all of that and other parts of one of my interests is to be able to treat the patient and the spouse. And I also have treated children because the entire family undergoes a severe stress because typically a father comes back and highly violent, then you can predict that everybody suffers.

Eugene Lipov (23:24):

But everybody wants it to work, not just the soldier. And that's why, you know, that's why it takes a lot of that. So all I can do is reduce symptoms but then people as yourself and Doc Springer can really navigate the complexities of family dynamics and all of that. The other part that's I wanted to mention is that I didn't realize until I looked into that 85% of men sexual dysfunctions with PTSD. I wrote a chapter on that, actually. And then turns out [SGB] tends to reverse a lot of those effects, which is a big deal. Intimacy and the relationship is a big deal as well.

Duane France (23:56):

No, you're, you're absolutely right. I was actually attending talk with Dr. Irvin Yalom and he was talking about how some clients aren't comfortable talking about death and mortality in therapy, and absolutely respect Dr. Yalom, but veterans are, are very comfortable talking about death and mortality in therapy. As a matter of fact, more comfortable talking about their mortality than they are talking about their sexual dysfunction. That is even in the therapy space something that is usually comes out, you know, weeks or months later it says, Oh, by the way, I'm having this issue as well. I didn't realize that SGB also had an impact on that.

Eugene Lipov (24:34):

Yeah. But you know, again, one of the things, I think I'm fortunate that having had amazing training in a trauma unit, and I like being direct and soldiers, especially male, are loving directness, right? So I don't ask them, it's like, Oh, do you have sexual dysfunction? How's it affecting you? Not me. It's like, Hey, you don't have to tell me, but this may actually happen. So if it happens, great. If doesn't, okay. So I get occasional phone call. "So doc, you know, you're right," and give me this wink and it's like, okay, enough said! We're good to go. I've just not a voyeur.

Duane France (25:08):

So, and like you said, you've been doing this for a number of years, how can listeners find out more about stellate ganglion block? You know, if they're interested in learning more about the procedure, learning more about you.

Eugene Lipov (25:21):

Sure. If you go into www.sgbptsd.com. Really simple.

Duane France (25:30):

That's great. And I'll make sure that the link to that is in the show notes and we'll, we'll link to some of your articles that you've written on the subject so that the listeners can go find more. Really appreciate you coming on. Absolutely. I really appreciate you coming on the show today.

Eugene Lipov (25:46):

Thank you.

Duane France (25:50):

You had known Gene for a very long time and I really appreciated you bringing him or suggesting that he come on the show. I had mentioned to you that I had heard of him. I'd heard him on a couple of other shows. Like you said, not really a true believer. I'm not somebody that believes in thisn magic bullet that, you know, the one thing that cures everything. But I really, really enjoyed my conversation with Gene.

Shauna Springer (26:16):

Yeah. And the thing is, Gene wouldn't either. You know, neither one of us would say, as I'm sure you would agree, you know, this is the solution, you know, for post traumatic stress. In fact, one of the things that is really important, I think to emphasize is that Gene Lipov, Dr. LIpov, really sees this as something that is combined with therapy, really good therapy and other treatments and yoga and meditation to really get the effect that we're seeking. And so, you know, I've really thought of this as an accelerant to really good therapy. That's how it's worked for me, for all of the patients that I've referred. It's like this, when we're chronically flooded with adrenaline, it's really hard to learn new things, to take in new insights and really apply them. Our vision literally tunnels and we're in survival mode.

Shauna Springer (27:08):

And it's not only our learning that's impacted by post traumatic stress, but also our sleep is affected. You know, our memories are poor. Our sex life can be impacted because chronic over arousal impacts all of this. So when SGB is used to treat the biological symptoms of this overarousal, there's a window of opportunity that opens up for people to really make changes in terms of how they think, how they behave and how they express themselves with those they love. So SGB and therapy can work together in a really synergistic way. And like I said, that's really how it's worked for the patients that Dr. Lipov and I have co-treated. So he believes in the value of therapy. And definitely I think, you know, what we're about, you and I, Duane is about really not siloing treatments but working across areas of expertise. And I think that people like Gene Lipov and others that bring innovation forward are going to be some of our greatest assets for suicide prevention. So I'm really glad we had him on.

Duane France (28:14):

Yeah, I think it's a great example of the collaborative nature of addressing this issue. Right. And he even said it in the show. He's not a psychiatrist, he's not a trained mental health professional. But the thing that he does impacts the psychological makeup and the challenges that some veterans face. I think I deployed with a a guy who, didn't know it, for the years that I'd known him. He was suffering with extreme, extreme back pain, right? This chronic pain. And after our deployment to Iraq, he had taken some medical leave. He had gotten some vertebrae replaced, right? He'd gotten the vertebrate fusion. He came in...like, I didn't recognize him. Like his face looked different and I was...he looked literally years younger because he wasn't dealing with the chronic pain, but I didn't know him before that. And it was almost an amazing transformation. And that's an example of, it's very hard to address what's going on if you're in this extreme chronic pain or if you have, you know, gastric issues or whatever. If we work with the medical community to address those issues in the whole veteran or whole individual concept...well this is just the same thing. It just happens to be in the brain, not in the back or the belly.

Shauna Springer (29:35):

Right. I mean it's so interesting that you talked about him looking so different because that was another thing that I really wanted to hit on that you know, Dr. Lipov talked about how people feel remarkably better, markedly better, you know, in the minutes after they received this procedure and how he never gets tired of seeing that even doing, you know, many hundreds of cases. And you know, sometimes we see this in therapy like when someone reaches a new insight that changes everything for them, how they see the past, the present, the future and their face changes. And it's really hard to put it into words, but, but you hit on that and I did want to kind of hit on this as well because SGB doesn't work for everyone. And I'm saying that based on, you know, 75% to 85% of those treated according to research have the outcome that we're seeking, but for the cases that I've referred, it's worked for all of them.

Shauna Springer (30:34):

100% hit rate for the cases I've referred. So probably about 25 in total. And what's interesting is that even with such a small sample size of 25 cases, there's remarkable consistency in what people say without having talked to each other in that moment of relief when their face changes. So the majority of them will say, it usually starts with, "it's weird, but..." And then they will say one of the following things: they'll say, it feels like I have a thousand pound weight that's just been lifted off my chest. Or they'll say, it feels like the first time that I've been in my body for many years. Or they'll say, it feels like I can see and feel things more acutely than I did before. Or they'll say, I felt relaxed. And then the next day they'll say, I slept for the first time inmany, many years. So it's independent patients that haven't talked to each other and they have this transformation. And that's why it's really hard, even as a person who doesn't run towards, you know, being a true believer to not be swayed by witnessing that kind of an outcome repeatedly from different people that I've known really well, that are not the kind of people that would, you know, spin a tale of how they're doing after years of suffering. So yeah, it's really interesting.

Duane France (31:57):

And those things are the things that, you know, can exacerbate a suicidal crisis, right? The insomnia. If I'm not sleeping, if I feel burdened, right. Or if I feel like, you know, I'm not in my own body or I'm not comfortable in my in my environment, you know, all of those things lead to the place where suicide can happen. And so, you know, this is not a treatment for suicide. This is a treatment very specifically for post traumatic stress. Again, I imagine that the 25 veterans that you referred very specifically met the diagnostic criteria for PTS. It wasn't somebody who was told they have PTS, but it's really major depressive disorder or something like that. These were people who were diagnosed and had the hyperactivity. And so for the people that have this condition, this works and I think it's a great match.

Shauna Springer (32:49):

That's actually my theory as to why, you know, I have the sort of hit rate for those cases. It's a very small sample size like I said, but I know them. I personally assess them and so I knew, you know, who would be a good fit for this treatment. And you know, he, Dr. Lipov actually doesn't do this like anybody else in the field, he actually is innovator around his methods. So he's doing a two block procedure, a sequential block in two different places. And all of the combat veterans that I've referred have needed this. Where the first one didn't do the trick and the second one was really required. So I'm already kind of thinking with him around, you know, how, why it is that maybe two are needed and he has a deep understanding of the physiology of this. And you know why that makes sense physiologically. But yeah, exactly. It's it's just the right fit for this treatment makes a huge difference.

Duane France (33:49):

Oh, that's great. And again, I really appreciate you introducing me to Gene, right? Just the conversation that I had with gene. It was, it was great. Obviously, you know, some people might've heard me having some insights. I've really thought a lot about that. The anesthesiologist giving me a short lesson on pain which has caused me to change some of my terminology. But it was a really great conversation and I appreciate you connecting me with him.

Duane France (34:16):

And I appreciate everybody for taking the time to check out the show. You can find the show notes for this show veteranmentalhealth.com/stmss05. You can get the links to everything that Gean and Shauna and I talked about on this episode. And you can also find the show notes on military times.com.

Duane France (34:34):

I'd like to thank our sponsors, milMedia Group. They’re a web design and digital media agency with over 25 years of experience in supporting service members, veterans and their families. They specialize in working with startups, small businesses, entrepreneurs, nonprofits and city, state and local governments. As a veteran owned business, they’re uniquely qualified to work with those that want to reach an audience in the military and veteran space. Do you have a dream or a vision they can help you bring it to life and get it in front of your audience? You can contact them at (254) 554-0974 or find them online at www.milmediagroup.com

Shauna Springer (35:09):

Just a reminder that the guests and reflections on this show are for informational purposes only and should not be considered professional advice. While Duane and I are mental health professionals, we are not your mental health professionals. We always recommend that you discuss these things with a licensed clinician

Duane France (35:26):

You can find out more about the work that Shauna’s doing by checking out her latest book, Beyond the Military, a Leader’s Handbook for Warrior Reintegration, and the work that I’m doing with my latest book, Military in the Rear View Mirror. Both are available on Amazon and we’ll have links to those in the show notes.

Duane France (35:41):

and always remember, you can connect with the veteran crisis line by calling (800) 273-8255 and pressing one, chat online with them at veterancrisisline.net or texting, 838255. Thanks again for joining us to talk about Seeking the Military Suicide Solution and make sure to follow Military Times on social media to keep up with the latest shows. Join us next time for another great episode and until then, remember, you’re not alone. Ever.

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About Today’s Guest:

Cicely Burrows-McElwain is the Senior Public Health Advisor, Military and Veteran Affairs Liaison, National Policy Liaison Branch, Division of Regional and National Policy/ Office of Policy, Planning, and Innovation (OPPI), Substance Abuse and Mental Health Services Administration (SAMHSA). Cicely currently works to advance veteran outcomes through government department collaboration to address the mental health and substance use needs of military members and veterans and their families.

She has over 18 years of experience working in rural behavioral health systems in local, state and federal programs. Now prior to joining the team at SAMHSA, she served as a clinical social worker for the VA in veterans integrated service network five in the VA Maryland healthcare system. Cecily is an adjunct lecture for Salisbury university social work department where she teaches courses on rural social work and disaster mental health.

Links Mentioned in this Episode:

List of Mayor's and Governor's Challenge Partners

Suicide Prevention Resource Center

CDC Resource: Preventing Suicide: A Technical Package of Policy, Programs, and Practices

Service Members, Veterans, and their Families Technical Assistance (SMVF TA) Center

Real Warriors Campaign

VA's S.A.V.E. Training (introduction to suicide prevention)

Episode Sponsor:

milMedia Group

Shauna's latest book: Beyond the Military: A Leader's Handbook for Warrior Reintegration

Duane's latest book: Military in the Rear View Mirror: Mental Health and Wellness in Post-Military Life

Using an app makes subscribing and listening to podcasts (both ours and others) so much simpler. Just subscribe to Seeking the Military Suicide Solutionwithin your app and it will automatically update every time a new episode is released. You can also find all of the podcast players here.

Episode Transcript:

Duane France: (00:00) Welcome to episode four of the Seeking The Military Suicide Solution Podcast brought to you by the Military Times. I'm Duane France.

Shauna Springer: (00:07) And I'm doc Shauna Springer.

Duane France: (00:09) And we'd like to thank you for taking the time to learn more about suicide in the military affiliated population. I'd like to thank our sponsors, milMedia Group. milMedia Group is a proven web design and digital media agency specializing in supporting organizations focusing on the military population. Find more about them at www.milmediagroup.com

Duane France: (00:35) Hey everybody. Welcome back to the show. Once again and as always, really appreciate you joining us to listen to an honest conversation about service member veteran and military family suicide. Our guest today is Cicely Burrows-McElwain. Shauna?

Shauna Springer: (00:49) So Cecily Burrows-McElwain serves as a military and veterans affairs liaison for SAMHSA where she focuses efforts on strengthening cross agency collaboration between organizations like the VA, the department of health and human services, and the department of defense in meeting the behavioral health needs of service members, veterans, and their families. She has over 18 years of experience working in rural behavioral health systems in local, state and federal programs. Now prior to joining the team at SAMHSA, she served as a clinical social worker for the VA in veterans integrated service network five in the VA Maryland healthcare system. Cecily is an adjunct lecture for Salisbury university social work department where she teaches courses on rural social work and disaster mental health.

Shauna Springer: (01:39) In speaking with Cecily, it's quickly evident that her work is not just a job. One sign of her dedication is that she engages in volunteer efforts that serve our nation's defenders, Cecily volunteers, for example, as a First Lieutenant in the Maryland military department's defense force as a clinical social worker with the 10th Medical Regiment. As we'll see in her interview, she's passionate about advancing collaborations that results in positive community level outcomes. It's a pleasure to have her join us as we kick off the initial episodes of seeking the military suicide solution.

Duane France: (02:15) It absolutely is. A Cicely as a friend, is a colleague, and I'm really excited to be able to bring this interview to the listeners. We'll get into the conversation and then we'll come back afterwards to pull out a few key points.

Duane France: (02:38) You're the VA/DOD liaison for SAMHSA. So you have a very sort of high level strategic view of suicide prevention. It's not the only part of your job, but, but that's a big part of it.

Cicely McElwain: (02:51) Yeah, you're absolutely right. What I get to do is really play a coordination role between the work that we do here at SAMHSA, the work that, kind of the larger partnership within all of the department of health and human services does around suicide prevention and bringing those resources, subject matter experts, et cetera to our partners at DOD and VA. And it's really a great kind of macro level viewpoint as you mentioned, but it allows for a perspective that really, for me, being a public servant, really reinforces my meaning as being in this kind of a role because we're able to kind of identify how these federal departments, these large organizations can really make a difference for communities. And so it's been a real honor to do this job.

Duane France: (03:40) I mean it's hard to balance sometimes because it is such a very personal and even local issue. The things that are gonna work in Colorado Springs aren't going to work in San Antonio and they're not going to work...Heck, even the things that work in Baltimore not going to work in DC. And so a, , talking about what works, what is working from your point of view, how do you balance that sort of macro level with the need for community involvement?

Cicely McElwain: (04:07) That's a great question Duane. And I think it's one thing that actually my agency at SAMHSA has done very well on a number of issues related to behavioral health. But in particular when it comes to suicides, there was this understanding that, because this is such a personal issue that touches so many lives, because we have a recognition that there's no community that's not impacted by this. The recognition has been the best way to go about getting action on this huge issue is to get communities involved at the grassroots level up. And so SAMHSA has done, for years now, policy academies to try to work with communities and identifying the issues that are facing them and in particular identifying the needs of our military and veteran families.

Cicely McElwain: (04:53) And we've done this with , all of the States and territories over the last decade or so, but in particular, the last two years we've partnered with the VA and their office of suicide prevention to do something called the mayors and governors challenge, which I know you've been a part of and I think a lot of your listeners may have at some point, but if they haven't, hopefully they will be soon. So the answer is really, what works is it's taking this responsibility to act and care for one another to the local community. And we're doing that through taking what we call a public health approach to suicide prevention.

Duane France: (05:28) And so the Mayor's Challenge, and like you said, we in Colorado, we're part of the Governor's Challenge, but there's correct me if I'm wrong, but I think it's what, 14 or, or maybe 18 cities or communities that are involved with the Mayor's Challenge. And so this is support from the federal level providing, like you said, technical assistance and sort of how to come together and how to build a coalition at the community level and diverse communities like Mecklenburg, North Carolina,Houston, even, Montana, certain cities in Montana, so a wide range of not just city communities, right. , Baltimore and DC and Colorado Springs, but rural communities which is a total nother issue.

Cicely McElwain: (06:17) Yeah, it was a great program that really kind of was VA's effort to kind of build off of their success with their homeless challenge. And we went with a Mayor's Challenge effort to start to really see what it would be like to engage local communities. Actually, we hit 24 different sites with what we called the Mayor's Challenge, but it ended up for a few communities being more of a community County level effort that got underway. And we had a great mix of both urban and rural areas that were able to take this challenge on. As you mentioned, some of the cities out in Montana folks here in the East coast, Virginia a number of different communities that came together and really were able to, with the support of their mayors or their County executives to put together a team.

Cicely McElwain: (07:05) And the unique components to this is, , while we may say there's key leadership positions that are required to come to the table, local communities can also identify the core champions within their local communities that are going to be able to go back and take these plans and put them into action. And so really what as the federal support system to this we do is bring together subject matter expertise, a good model of strategic framing around action planning and coalition building. And then communities take that to their local communities to really start to hone in on where their goals are. What are those action steps look like? How do we get the right people to the table? And really through kind of a collective impact model can, can grow their own unique brand of action for the community that meets their needs the best.

Duane France: (07:57) See, and I think that...and, we've heard the criticism of, it can't be this top down force fed model that everybody does the same thing because, as we're talking about not all of the communities are the same. The resources in, , Charlotte, North Carolina may not be as robust or maybe more robust than in another community. And so it's one of these things where I'm not having this prescribed, "these are the steps that you take with suicide prevention" because as you said, each community is unique.

Cicely McElwain: (08:32) You're absolutely right. What we've found really if we're talking about kind of an area that we could bolster, if we had kind of our magic wand, it would really be that infrastructure around suicide prevention for all of our States and communities. So while a number of our public health issues, and suicide really is a public health issue for our nation, have some infrastructure built into the way that we kind of address those issues at the local level through health departments and through state department level organizations that get funding and kind of filters out. Suicide prevention has been one of those areas that while everyone agrees it's a very impactful and serious issue, the funding has not necessarily kind of been uniformed in any way or, or done in a way that allows for communities to really do good planning with kind of a full time dedicated person to coordinate this effort.

Cicely McElwain: (09:26) It doesn't mean they don't exist. They absolutely do. And they do some amazing work on the community side. But the infrastructure is really, I think, one area where we could kind of as a nation, take a look at that. And and say, Hey, how could we do that a little bit better to make sure that communities have someone to really help roll this work out. We've had major success in getting communities to address the issues of their military and veteran families. I think everyone recognizes what a value an asset our military and veteran families are. And so when we were starting to hear numbers from the VA, startling numbers around rates that were eclipsing their civilian counterparts by one, one and a half, 2%, we were able to get folks to take notice and say, Hey, what's that about?

Cicely McElwain: (10:12) What can I do? How can I make a difference? We have a amazing toolkit that I would encourage communities and folks that are interested in taking a look at that came out of the CDC, but it was really a federal and subject matter expert designed tool called the preventing suicide technical package that really describes how communities can take a public health approach to suicide prevention. And what's so unique about this is if you take a look at some of these strategies, everyone has a role to play in at least one of these strategies, and it doesn't matter if it's the youngest child in your family that wants to maybe give back and kind of recognize some of the service that people have provided to their nation or if it's the clinician that's thinking about how they can kind of give back to their community through their clinical expertise.

Cicely McElwain: (10:58) There's a number of strategies that are out there that can really make communities recognize that each kind of unique gift that you have to give back is something that's going to be valuable in creating a healthy system for individuals that are at risk. So those strategies in particular kind of take a look at strengthening economic support, looking at accessing delivery of suicide care. So that's more on the clinical level. Looking at protective environments, promoting that connectedness piece, which if all of the strategies when we talk about our veteran population, I think looking at how we promote connectedness for veterans and their families is one of the things that's a real secret to supporting them through these tough times when they may be most at risk. And then teaching coping skills, identifying support for those individuals who are at risk and then making sure that we lessen harms and prevent future risks.

Cicely McElwain: (11:47) So all of those, while maybe kind of abstract and their thoughts right now come down to community action, which are really tangible steps. Like how do we make sure folks know how to access the benefits that they earned through their service?, Different resources within communities, local chambers of commerce that may have specialized programs and training all the way to looking at how we make sure that veterans and community members know where they can go to seek services for mental health care. So there's a lot that can be done. And I think what we're seeing is if we can kind of empower communities to take a role in whatever area that they feel comfortable and then train them if they're willing to be trained, in some of the great steps that we know have been proven to work, the we can achieve success together.

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Duane France: (13:51) In my experience, this is one of the gaps. As you mentioned, there's things that we know work, the technical package, we'll have a link to that in the show notes, but that's a tool, right? That is something that is based in research. It's based in clinical and community based experience. But that tool isn't effective unless there's somebody in the local community who can pick up and use that tool effectively. Right? And that's what you're talking about is not having the infrastructure in the communities. [I'll toot Colorado's horn here for a little bit. In that we have had a dedicated state office of suicide prevention paid full time for a number of years, 15, I think. But not every community has that. And so that's what you're talking about is we have the knowledge, we know what works based on the research and what we can do to stop suicide in our population. But we don't have people on ground to actually implement that.

Cicely McElwain: (14:50) Right. Absolutely. So as you shared, you come from a state that's very rich in these resources. A lot of this has been state infrastructure that's been built up. It's been folks like yourself that are champions within the local community saying, Hey, how do we start this? , and, and maybe sometimes it's rubbing two sticks together to make things, kind of gain some momentum. But if we could try to identify, through some evaluation of the work that's being done in those communities where they've really made strides, like Colorado and others, what we're able to do then is to make suggestions. And we're in a situation right now, as some of your listeners probably have already heard, about the unique opportunity through executive order 13861, the PREVENTS initiative, which is known as the President's Roadmap to Empower Veterans and End the National Tragedy of Suicide. Through PREVENTS, these departments, my own and others included, are really looking at what are those gaps that we could potentially identify and support at the federal level to ensure that communities are able to provide this kind of care for citizens nationwide.

Cicely McElwain: (16:01) And so we're learning from communities that are doing a great job, that have been innovative, that have adopted some of these strategies. We're learning from the Mayors and Governors Challenge communities on how they've been able to take some of these strategies and make them work. Hearing from community members, hearing from veterans and family members about how the connectivity piece through veteran service organizations has really changed their life. It's opening up this idea that maybe in the past has been kind of a closed off paradigm thinking that suicide really is an issue for folks living with severe mental illness or living with other issues. This is talking about going upstream and looking at what are the other components so that we can kind of ensure that individuals hopefully don't get to that point or if they do that the system is not excluding them from actually getting where they need to be.

Cicely McElwain: (16:52) And what we found is that communities need and want assistance in identifying where those barriers are because they want to fix it. There's no one that goes out in the morning and says, I want to keep people from getting well. Right? The goal and kind of the beauty of, of what our nation is about is really kind of helping people be independent, helping individuals find their own path and be successful in that. And so when a community can see the role that they can play in saving lives, this collective impact of all of us working in whatever sector that we are, whether it's the employer that has a huge role to play in creating a safe work environment, whether it's the family member that individuals are coming home to, being there and knowing the right questions to ask and how to approach someone that they're concerned about. All of those things kind of take some time and education, but they're not out of the reach of individuals. Once that education, training, technical can be shared, it really does empower us to make a difference for not only the veterans in our lives, but for all of our community members.

Duane France: (17:57) And I think that's the, like you said, the magic, that happens is, everyone is doing their individual effort. The employment folks are helping folks get jobs and those are things that are...that's suicide prevention. I do, if I'm a homeless veteran or homeless military family advocate, I do homelessness prevention and prevent suicide or I help people get jobs and prevent suicide. And so there needs to be that clinician at the table and the folks that take people on fishing trips because sort of that "a burden shared is a burden lessened." And the growth is exponential rather than just the incremental efforts that we might get just from from our individual efforts. So, and I'm definitely going to, as I mentioned, I'm going to have the the preventing suicide technical package in the show notes. I'm going to include a list. I think there's a map of Mayor's Challenge cities so that if listeners are in a Mayor's Challenge community that they can reach out and connect. I'm actually going to have some of the Mayor's Challenge community leaders on the show. But what are some actions steps that listeners can take to actually get involved or do something at their community level?

Cicely McElwain: (19:14) That's a great question and thanks for encouraging folks to learn a little bit more about those challenges. One thing I can share officially is that this year in particular, VA and SAMHSA are going to be launching a Governor's Challenges through 28 more States. So we have that first initial seven that you have been a part of through the state of Colorado. But we've identified the fact that the state level infrastructure is such that it allows for really amazing opportunities of collaboration to get underway. And so we have just yesterday sent out, and I don't know when folks are listening to this, so it'll be a little dated. But we have just sent out our first round of invitations to 14 States to get them to the table and really help get the local government feel to look at how they can play a role in helping save lives.

Cicely McElwain: (20:09) We know that and let's just, for the one time use the numbers out there, that 14 of the veterans that we know die by suicide are not connected to the VA. And so this is why it's so critical that we turn to our community members, and say "you have a role to play."This for me is personal. It starts at home. If people are sitting there and they're thinking, Oh, I have to download a link or I have to think about this. Really it's beyond that. It's, do you know the veterans to the right and left of your home? Who are the veterans within your own family? Who are the family members that support those veterans that may need a touch base? Start by looking at the folks that you touch within your local community, your faith based communities the, the workplace and identify if there's anyone that you can make that personal connection with.

Cicely McElwain: (20:55) We know that personal connections, we know that caring contacts in the general sense versus the sense of just an aftercare model really do make a difference. And so I encourage folks to start thinking from that perspective, from the individual out, and then start drawing those larger circles of what your organization can do. What your , your own kind of profession can do. You, yourself being a counselor. , how critical it's been to kind of make sure that people that carry this licensure and have this important role have some cultural competency in serving your fellow veterans. And so one of the things that I like to say is kinda just take some time. Think about what your own individual strengths are. If you match those up to some of the strategies that we know are out there that are successful see where there's maybe an area of resources.

Cicely McElwain: (21:45) There's lots of free resources and trainings in this space. SAMHSA has the suicide prevention resource center or sprc.org with loads of information and training that are at your fingertips. Also our service member veterans and their families technical assistance center that does all of the coordination through the interagency agreement we have with VA on the Governors and Mayors challenges. The samhsa.gov website has a link for our service members, veterans and their families TA center. And we want folks to go there and know that that resource is there for them to pull down information. So I guess start with yourself. No, you don't have to pay for this information. It's out there. The federal systems and departments have some amazing resources in particular within DOD. The Real Warriors campaign is one that I suggest folks take a look at on the VA side. We have some amazing resources through their office, suicide prevention. There's great trainings available through partners like PsychArmor with their S.A.V.E. Course that VA provided to them. I just think there's so much out there that if you can find the one area around suicide prevention that even sparks an interest for you, there's an amazing opportunity that awaits and in the way of being able to kind of learn more and take it to that next level.

Duane France: (22:59) That's really great. I, I appreciate that. What I used to say was, I'm not going to be able to change the. Army, but I can definitely impact my corner of it. I can take care of my soldiers and so on, so I can influence what's immediately around me. And if everybody starts to influence something that's immediately around them, then that's going to sort of spread like the inkblot on the page. And eventually we'll turn the corner.

Cicely McElwain: (23:25) You got it. It's pretty amazing. It's not a situation where we oftentimes think about this unless our lives are touched by it. It's just kind of how it is. We tend to kind of turn away from the things that are uncomfortable for us, but when it comes to suicide prevention, when you think about the alternatives of helping individuals to live full lives, that really kind of ensure that communities have a role to play, that people feel connected in a way that allows them to thrive. That's what is possible when we take a public health approach on an issue like this. And I think if people can walk away knowing that they have a role to play, if they're willing to do so, it's an amazing way for them to continue their service and to really support those who have served.

Duane France: (24:07) Oh, that's great. I really appreciate....like, of course, I appreciate you and the work that you're doing, but I appreciate you coming on the show today.

Cicely McElwain: (24:14) Thank you. It's been an honor to be with you.

Duane France: (24:23) Like I said before, it was great to be able to talk to Cecily. Cecily and I talk somewhat often. But definitely in her role as the liaison between SAMHSA and the VA/DOD. She's doing a lot of great work. I'm interested to hear what you thought about some of the things she had to say in the interview.

Cicely McElwain: (24:43) Yeah, I thought it was a great interview and one of the things that was clear to me is how Cecily and Dr. Craig Bryan really picked up on a common theme of shifting towards a more public health approach. Both Dr. Bryan and Cecily, certainly as providers who have practiced and worked with veterans believe that behavioral health is critical and that treatment works. But at the same time, Cicely and her team are part of the movement to shift the paradigm away from this solely mental health approach. As she put it. I think, , we all have a role to play. She gave an example of a child who honors military service members and also talked about clinicians who serve on the front lines of care as the range of people that have a role to play. What did you think, Duane?

Duane France: (25:28) No, I think exactly the same thing. Just the, the uniqueness of, and for listeners, we didn't plan this right?. So, Cicely and Craig and none of our guests have spoken to the other guests, and Shauna and I really believe that there's going to be these kinds of themes that are going to emerge over and over and over again, which is really, I think going to hit that counterpoint. And this is one of those examples of we're going to hear a lot about shifting from just the pure mental health model or the sole community model and creating something that's conjoined. So, yeah, I think that was a great point.

Cicely McElwain: (26:05) Yeah, right. I mean, another thing that really stuck out for me is thinking about what technical assistance means. So in her role, Cecily provides technical assistance to communities at the community mental health level and other community organizations. What does that actually mean though? I think that's one of those terms that could help us to get some specific examples in mind of what that means. And I mean, you know as well as I do what some of those specific examples are. I think of it as being kind of the connective tissue between the government and other agencies that partner with the government as well as skill sets that maybe relate to helping communities understand how data can inform their efforts. For example, where the gaps in service may exist and there are other technical assistance pieces that that also are included in that. Can you think of another few specific examples?

Duane France: (27:01) Yeah. I have been as part of the community work that we're doing here. We have been a recipient of some of that technical assistance. Through the state of Colorado. And one of the things is, like you said, connecting but connecting to resources that communities might not be available. For example we conducted a two day policy Academy, so how do we develop policies in our state and our communities? And they brought in subject matter experts on different aspects of a suicide prevention. So being able to connect us with people like Dr. Richard Stone was there from the VA and a number of different people who are doing things that communities don't necessarily have readily available access to, but yet could very much benefit from.

Duane France: (27:54) And then they actually had brought a team out here to Colorado Springs and helped me conduct sort of a brainstorming session with a number of, wide range. I think I had 45 or 50 different agencies there from across the spectrum in all of these different areas. And so their technical assistance center came in and helped me organize sort of this conversation that really pushed our community based suicide prevention conversation forward. So you're, you're exactly right. And I didn't even think about it because technical assistance is sort of the name. Like we know what it means, right? But then I, I take a step back and people like, well, I called tech support if my computer's not working, so what is it? And so I think it's a great point. A little jargony, but we don't even recognize that it's jargony because we're there every day.

Shauna Springer: (28:45) Well, that's it. I mean, I call the computer support tech assistance and usually they say, ma'am, is your computer plugged in? And , most of the time it is. But , that's kind of where I put it in that bucket of my mind. But the efforts that Cicely and her team are doing are successful and they're expanding to so many more States. And so they basically come in and they provide expertise and organizational capacity and connection to experts and systems that can help States really launch their efforts. So yeah. The other thing I noticed about the interview was just really wanting to highlight what she said about every population has different needs. And you said this too, Duane, you said that this is not a prescribed approach, which I totally agree is critical. That one size fits all does not work for suicide prevention. Part of our work is really seeing what the unique needs are of each subpopulation that we're serving and then addressing those in culturally appropriate ways. And so I thought maybe it'd be fun, I know that you did a lot with the Mayor's Challenge or the Governor's Challenge in the state of Colorado and I did a lot this past year with the state of Montana. So I thought it would be fun to kind of talk about different efforts in those two States as examples of how there are unique plans of action depending on who we're serving.

Duane France: (30:09) Yeah, sure. So this past year as you said, Colorado was selected as one of seven Governor's Challenge state. So many listeners may be familiar with the Mayor's Challenge, started out with the Mayor's Challenge to prevent veteran homelessness, then it became the Mayor's Challenge to prevent veteran suicide. So partnering with a number of different communities, as Cecily and I talked about. But then the Governor's Challenge is the first time that they're trying to raise it to the state level. And one of the things that we're doing in my community, so El Paso County, it's Fort Carson is here at Peterson Air Force base, the Air Force Academy a large, large population of service members and veterans and also a large number of resources. So one of the things that we're doing is we're setting up a suicide prevention task force here in El Paso County, which the County, just to the South of us is Pueblo County.

Duane France: (31:01) They're trying to do the same thing, but it's almost night and day. And we're 45 minutes away from each other, whereas Pueblo County does not have the level of infrastructure that they necessarily have. So they have to build up a lot of infrastructure on suicide prevention based on this public health model. Whereas here in El Paso County, we've got tons of resources, but it's not really organized in a certain way. And so even between two communities that are that close to each other. But even thinking about within communities in larger cities. I grew up in St Louis and addressing suicide prevention in the Central West End in St. Louis would be different than South County. Right? I mean, just there's, there's neighborhoods and communities and different, just different messages for different groups of people. The basics would all be the same, but really it has to be almost a tailored approach to population and community.

Shauna Springer: (31:55) Exactly. Exactly. And my team at Tragedy Assistance Program for Survivors, we were the subject matter experts for part of the Mayor's Challenge in Montana. And so it started with a phone call with their leadership and their point of contact folks that are excellent partners. And we said, what do you need? And so we ended up doing a couple of web-based trainings. And then we flew out. We did a grand tour of Montana. It was really beautiful. We flew into Billings and we did a half day, four hour training. It was at the Army National Guard facility and we had VA treatment providers and community health providers in the same training. So it was really that public health approach of having all of the different cross sections of providers who interact with the population be part of that same training.

Cicely McElwain: (32:46) And then we also had people connected remotely. So there were people in Helena that connected to that training in Billings. And then we drove four hours across the state, saw some bison, which was beautiful and beautiful countryside. And then in Helena the day after that we did another four hour training on best practice peer support after presenting the first day on the postvention model that TAPS has developed. So that was all really great. And then the last training we did was December 12th, we did a training on how to support clinicians who have lost a patient to suicide. Because in Montana there aren't very many clinicians for the population and everybody's really spread out. And so we really wanted to shore up the clinicians who are serving on the front lines of care in Montana. Suicide rates are high, , and the occupational hazard of losing a patient to suicide has nothing to do with one's skill in the vast majority of cases, but it can cause people to really change their whole career trajectory and maybe leave the field of professional therapy. So we're losing good people if they're not really well supported. And so that was an example of trainings that we scoped out for the Mayor's Challenge, really in response to the unique needs in that state. So I'm definitely a full supporter of kind of this non-prescriptive approach. A responsive approach is what I think we really need.

Duane France: (34:13) No, I agree. I've got a colleague who who often and repeatedly says that it is a national problem with a local solution, but the folks at the national level, the research shows what works. We just need to be able to have a smorgasbord of options so that communities can take one from column a and one from column b that works in their community rather than this, everything for everyone works all the time, which we know for the last 10 years hasn't worked.

Cicely McElwain: (34:41) Right. Exactly. Couldn't have said it better.

Speaker 7: (34:44) So everybody makes sure to continue to stay tuned to listen to more episodes about Seeking The Military Suicide Solution. Make sure to check the show notes at www.veteranmentalhealth.com as well as finding the show notes on military times.com. While you’re at it, check out our sponsors milMedia group. They’re a web design and digital media agency with over 25 years of experience in supporting service members, veterans and their families. They specialize in working with startups, small businesses, entrepreneurs, nonprofits and city, state and local governments. As a veteran owned business, they’re uniquely qualified to work with those that want to reach an audience in the military and veteran space. Do you have a dream or a vision they can help you bring it to life and get it in front of your audience? You can contact them at (254) 554-0974 or find them online at www.milmediagroup.com

Shauna Springer: (34:56) Just a reminder that the guests and reflections on this show are for informational purposes only and should not be considered professional advice. While Duane and I are mental health professionals, we are not your mental health professionals. We always recommend that you discuss these things with a licensed clinician.

Duane France: (35:12) You can find out more about the work that Shauna’s doing by checking out her latest book, Beyond the Military, a Leader’s Handbook for Warrior Reintegration, and the work that I’m doing with my latest book, Military in the Rear View Mirror. Both are available on Amazon and we’ll have links to those in the show notes.

Duane France: (35:27) and always remember, you can connect with the veteran crisis line by calling (800) 273-8255 and pressing one, chat online with them at veterancrisisline.net or texting, 838255. Thanks again for joining us to talk about Seeking the Military Suicide Solution and make sure to follow Military Times on social media to keep up with the latest shows. Join us next time for another great episode and until then, remember, you’re not alone. Ever.

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About Today’s Guest:

Dr. Matt Miller is currently the Acting Director for Suicide Prevention, Office of Mental Health and Suicide Prevention for the Department of Veterans Affairs. He was appointed the permanent Director of the Veterans Crisis Line on July 23, 2017. Dr. Miller joined the VA in January of 2012 as the Chief of Mental Health at the Saginaw VAMC in Saginaw, Michigan. He has been detailed to the national mental health office as a Technical Assistance Specialist and as Senior Consultant for National Mental Health Technical Assistance. Before coming to VCL, Dr. Miller served as Deputy Chief of Staff for the Saginaw VAMC, with responsibility and oversight of facility-wide access and quality, assisting Saginaw with achieving and maintaining a 5-star ranking by facility complexity in the nation on SAIL. Within his role as Director of the VCL, Dr. Miller has been privileged to be a part of a team that has created and implemented a third call center in Topeka, KS, has increased total staffing to 900+ FTE becoming the world’s largest crisis call center, has achieved a 96 percent reduction in Rollover calls to the backup call center, has developed an industry-leading Quality and Training program, has achieved certification via nationally-recognized oversight organizations, and has innovated cutting edge research projects in the field of suicide prevention.

Dr. Miller received his PhD from Michigan State University, East Lansing, and his MPH from the University of Michigan, Ann Arbor. He completed a professional clinical psychology internship via the United States Air Force (USAF), Wright Patterson Medical Center, Wright Patterson Air Force Base, Ohio. Thereafter, he was assigned to Vance Air Force Base in Enid, Oklahoma, as Chief of Mental Health. Miller was awarded “Officer of the Year” representing the 71st Medical Group in 2003; in the same year, he was awarded the USAF “Cutting Edge Award” for program development and outcomes addressing and treating Complicated Airsickness Management for Pilots.”

Links Mentioned in this Episode:

VA Office of Mental Health and Suicide Prevention

2019 National Veteran Suicide Prevention Annual Report

Episode Sponsor:

milMedia Group

Shauna's latest book: Beyond the Military: A Leader's Handbook for Warrior Reintegration

Duane's latest book: Military in the Rear View Mirror: Mental Health and Wellness in Post-Military Life

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Episode Transcript:

Duane France: (00:00) Welcome to episode three of the Seeking the Military Suicide Solution Podcast brought to you by the military times. I'm Duane France.

Shauna Springer: (00:07) and I'm doc Shauna Springer.

Duane France: (00:09) and we'd like to thank you for taking the time to learn more about suicide in the military affiliated population. I'd also like to thank our sponsors, milMedia group. Milmedia group is a proven web design and digital media agency specializing in supporting organizations focusing on the military population. Find out more about them at milmediagroup.com

Duane France: (00:38) Thanks again to everybody for joining us to listen to an honest conversation about service member veteran and military family suicide. The response to the concept of the show has been outstanding. It's generating a lot of conversation and that's what we're trying to do. Our guest today is Dr. Matt Miller, Acting Director for Suicide Prevention for the Department of Veterans Affairs. Shauna?

Shauna Springer: (01:00) Today we're pleased to bring Matt Miller onto the show. As Duane said, his official role as Acting Director for Suicide Prevention for the Department of Veterans Affairs, but like other guests, this is not a job. It's personal. The back story is this: many years ago, Matt Miller was the only psychologist on Vance air force base in Enid, Oklahoma. In this role, he was in charge of mental health for the entire base. He led all efforts related to suicide prevention, family advocacy, substance abuse treatment, and critical incident response services. He also became part of the inner circle of major John Ruocco. By all accounts, John was the kind of guy that lit up a room, a decorated Cobra pilot. He was someone who had more than 75 combat missions under his belt and John was a rock for many people, including Matt Miller. John was also someone that never fully revealed the depth of his hidden pain, even to those who love him most. When John died by suicide in February, 2005 the grief that initially engulfed those closest to him later fueled an explosion of posttraumatic growth. John's wife, Kim Ruocco, who will be featured on a future episode of Seeking the Military Suicide Solution, has led efforts to develop and refine what is now the leading postvention model in the country. And Matt Miller went on to become the director of the veteran's crisis line and is now the acting national director for suicide prevention for the department of veterans affairs.

Duane France: (02:32) Yeah, it's really great to hear Matt's background and like we've talked about even in the introductory episode, you know, the reasons why people come to this work are often very personal and that's definitely the way it was with Matt. So let's get into the conversation and we'll come back afterwards to pull out some of the key points.

Duane France: (03:01) The work that you're doing now and the work that you've done before focusing on suicide in the veteran population with the VA. What do we know that works with preventing suicide in the veteran population?

Dr. Matt Miller: (03:16) Hmm. We know...that's a question that we all are constantly asking in the context of such an important issue where lives are truly on the line on a daily basis. In terms of what we know works. We know that a public health approach to suicide prevention is evidence-based and work. A public health approach means that...kinda consider it like an equation, where you have an equal sign and on the right hand side of the equal sign you have public health approach. So really then what's on the left hand side of the equal sign, there's two things. Number one, there's clinically based interventions and then number two, there's community based intervention. And they, those two clinically based interventions and community based interventions are joined by a plus sign. So clinically based interventions plus community based interventions equals a true public health approach.

Dr. Matt Miller: (04:33) If you altered the left hand side of that equation and were to say, for example, clinical clinically based interventions minus community based interventions, you would not have public health approach on the other side of the equal sign. If you were to remove the equation and simplify it, let's say, and simply put that clinically based interventions equal a public health approach or community based interventions equal a public health approach, you would not have a true public health approach. So what we're learning works the direction that we're learning and verifying that we need to head with the critically important issue of suicide prevention is the clinically based interventions plus the community based interventions together and within a integrated plan, strategy, and delivery system such as the VA. Now in terms of what works and what we're seeing here within each of those two important components...

Dr. Matt Miller: (05:57) Our 2019 annual suicide prevention report provides some insight, for example, under a clinically based intervention we see from the 2019 report based upon 2017 data that there has been a decrease in the suicide rate for veterans diagnosed with a depressive disorder and receiving VHA care. I asked the team if they could convert that rate of decrease into a calculated figure for lives saved from the 2016 data to this 2017 data based upon the rate decrease. So they came back to me and they said, Matt, this translates to 87 lives saved from 2016 to 2017 of individuals, veterans, diagnosed with depression and in VHA care. 87 lives saved. That's significant. That tells us that evidence based care can be effective and is effective and can save 87 lives if not more when implemented in evidence-based manner. .

Dr. Matt Miller: (07:20) So that's an anchor of hope that we hang on to and as a data point in terms of that, which is a fact of. We also know that if you take a look, it gets a little mathy, but if you take a look at the slope of increase for suicide among veterans and you were to compare the slope, the increase, for veterans in VHA care versus veterans, not in VHA care, the slope, the rise is significantly different between veterans in VHA care and veterans, not in VHA care. And it's much lower for veterans in VHA care versus not. Specifically, there's about a 1% slope rise, if you will, for veterans in VHA care compared to over 11% for veterans not in VHA care. So all of this to say, Duane, and all of this to get back to the point that under the heading of clinically based interventions, we know that there are things that work that we continue then to press forward with and find new ways to implement now in 2019 going into 2020 under the clinically based interventions heading

Dr. Matt Miller: (08:33) Under the community based intervention setting. We know from our clinic practice guidelines issued by the VA and DOD and a national leading collaborative effort that lethal means safety is a very effective tool on the population, community based level for suicide prevention. So that's something that we look to move forward and have developed a toolkit for safe firearm storage in the community that represents a partnership between us, the American Foundation for Suicide Prevention and the National Shooting Sports Foundation. So there's a couple of specific points, I think, in reference to your very good question,

Duane France: (09:27) You know, I really appreciate that visualization because I'm thinking about other public health dilemmas and how that would translate. So when it comes to smoking cessation, nobody doubts whether or not there is a clinical approach, a medical approach really. But a clinical approach plus a community approach. Let's say with a reduced drunk driving that's not necessarily a medical thing. And so it's not really a clinical approach required. But the unique aspect of suicide because it's psychological and it impacts the community, the two things are combined and so it's much more in line with something like smoking cessation or reducing obesity or heart risks cardiac risk.

Dr. Matt Miller: (10:16) Yeah, there's parallels there. But let's even go back. Let's go back to the driving while intoxicated example that you nicely cited. We can take a look at that across community and clinical. So on the community based intervention levels, you can have very effective public messaging campaigns that highlight the impact of driving while intoxicated on the individual's lives and on the community as a whole. And, and everyone listening right now can think probably and see some of those images from those campaigns. On the clinical side, you can think, well, there may be individuals who have a substance use disorder and they would benefit from evidence-based alcohol addiction, alcohol dependence or alcohol abuse treatment. And as they engage in that treatment, yes, it will positively impact that which we're doing more broadly with regard to decreasing driving while intoxicated incidents and impact. But if you were to just rely on the clinically based interventions to address this, you wouldn't impossibly cover the entire spectrum that you need because every situation doesn't necessarily entail alcohol dependence or an alcohol abuse disorder. Sometimes it does and therefore it's important to have that treatment available and evidence based. But it also involves a community approach of messaging to everyone in the community, whether you may be working through an alcohol use or abuse problem or not.

Duane France: (12:15) After the break, Matt and I talk about why the public health approach to suicide is different than the public health approach to things like DUIs or heart disease.

milMediaGroup: (12:37) Hi, I'm Alyssa Mosher. I'm a local army spouse, daughter, sister and a proud team member of milMedia. I'm here at our headquarters at the great Fort Hood, Texas. MilMedia is a military affiliated team that wants to serve you the way that you served our country. With mostly military retirees, veterans and families as our staff, we understand the military mindset. milMedia is the one place that prioritizes your goals above all else, which you will see from our incredible customer service. With over 25 years of experience, we work with everyone from startups, small businesses, entrepreneurs and nonprofits. milMedia group is the digital division of Top Sarge Business Solutions that specializes as a web design and digital marketing platform. So visit our website today for a free website analysis so that you can sit back, relax, and let us give you the perfect online presence to hear more about what milMedia is doing and will continue to do, call me today at (254) 554-0974 or visit our website. That's milMediagroup.com So call me whenever you're ready.

Duane France: (13:46) That puts me in mind, perhaps the question, and maybe we won't answer it in this short of time, but why is it different than when it comes to suicide? Because in the community, the minute somebody says suicide, it becomes something for the experts to do. It's not something for the barista or the mechanic or the plumber,

Dr. Matt Miller: (14:02) Which is exactly, exactly, Duane, what we're trying to change. If you take a look at our Be There campaign and you take a look at what we talked about extensively during the month of September and suicide prevention month, you just hit the nail on the head on our theme. Our theme under Be There was everyone has a role to play with suicide prevention. A good example of this I think is some work being done by a colleague of ours out in Oregon. And what they found at the local community level when they really dove into some things regarding what's happening with suicide in our community, they found the last 24 to 48 hours of individual's lives prior to suicide. They commonly in that area visited animal shelters and hotels. And you say, well, why animal shelters? Well, they were arranging plans and care for their beloved pets.

Dr. Matt Miller: (15:09) Why hotels? They were often going there as a location so that they weren't in a home setting, impacting their family or loved ones in a more perceived adverse way. So based upon that data, a team deployed training and gatekeeper training for suicide prevention at animal shelters locally and at local hotels, teaching individuals in those settings, individuals on the front lines, they're not clinical psychologists, they're not primary care physicians. They're good people working at animal shelters in hotels, teaching them how to recognize warning signs, teaching them what to do when they recognize these warning signs and then engaging based upon that information. It's one of the few counties in our nation that's actually seen a decrease in suicide. So that gets to the point and reinforces exactly what we're trying to accomplish with Be There. Now, some may say, Matt, you're abdicating your responsibility here. You're trying to put suicide prevention on the front line individuals while people like you aren't doing what they need to do.

Dr. Matt Miller: (16:30) I say, I agree. That's why we have, and that's the importance of the additive model of the public health approach. It's important that you do have those clinically based interventions available and access to those clinically based interventions. But you know what, although there's a relationship between depression and suicide, there's not always a relationship between suicide and depression. So you need to be able to have the clinically based interventions that address depression, that address substance use disorder that address relationship problems and issues. But you also need to have the community based intervention approach where all of us are looking out for each other and all of us are ready to engage. When we see something.

Dr. Matt Miller: (17:27) Duane, I give an example, a personal example of this from my own life. It's a little bit of an apples to oranges comparison, but I'll share it. I often tell of a time where I have my four daughters and we were out for dinner and we were at a restaurant, it was called Smoking Charlie's at the time. And we were sitting there and all of a sudden I heard some coughing over my shoulder behind me. And one of my daughters who was sitting across from me said, daddy, is that guy choking? I turned around and I looked, and there was a man standing at his table and he had all the hallmark signals and signs of choking. He was coughing, he was holding and grasping his throat. He was leaning over, he had the look of desperation on his face. And I, my first thought was, I hope someone does something about that.

Dr. Matt Miller: (18:28) And my second thought was, Matt, you could do something. You could do the Heimlich. And then my next thought was, what if I screw it up? What if I don't do it right? What if I don't help? And so this time that I was thinking and churning on these issues, someone stood up, someone administered the Heimlich maneuver on this individual and they dislodged the potato chip that this individual was choking on and this individual lived. I stepped back from that, as ashamed I am of that example. I think it provides an illustration of the role we can all play. I don't need to be a cardiologist, I don't need to be a pulmonologist to administer the Heimlich maneuver for someone at Smoking Charlie's who's choking on a potato chip. I can be the person beside them that simply engages the Heimlich maneuver and saves a life. And in that same way, the community and everyone therein has a role to play with, "See something, do something." Yeah. Do we not need pulmonologists? Do we not need cardiologists? Do we not need EMS to show up and still do a followup check to make sure the individuals, okay? Yes! We need all of that. So that illustrates the community plus the clinical coming together in a lifesaving daily way,

Duane France: (19:53) You know, so that...and obviously the thing that works is the connection between the community and clinically based practices, again, needing both of those to balance the equation. And that's also illustrating the gap that occurs because we don't have that connection. We as clinicians...and I'm saying it often on the show and I'm gonna say it often in my community, if we had the solution then the problem would be solved by now, but we're not the first one in contact, right? The, the EMS was not the first person that come in contact the gentleman in the restaurant. You know, so that illustrates both what's working and and the gap and even, you know, maybe what actions people can take is to, you know, learn and be educated on the signs and symptoms. But for listeners, what's not working, right? There's something that people, you know, think that is effective or is working, that's not working when it comes to preventing suicide.

Dr. Matt Miller: (20:50) Hmm. Oh, I think what's not working is a over-reliance on, to the exclusion of the other, an over-reliance on clinically based interventions to the exclusion of community based interventions and conversely and over-reliance on community based interventions to the exclusion of continuing to attend to that which we can do and furthering clinically based intervention. What's also not working is when there's no plus sign between the clinically based and the community based. As you said, they're not talking or coordinating together. There's a gap, there's no plus sign unifying them. That scenario is going to get us to, is going to keep us at a point where suicide prevention then as a whole is not working for our nation. And we see that historically. Suicide is not a veteran specific issue. It is an issue that impacts veterans in a meaningful way. It is an issue that we must continue to find ways to turn around and address but it occurs within a larger context of our United States population. Our brothers and sisters, wherein suicide is on a rise across our nation as a whole. It's been rising since 1999. It's the 10th leading cause of death in adults, but it's become the second leading cause of death in individuals age 10 to 22. So this is a broader issue that merits a national level discussion and the VA can lead the way within that in terms of veterans, veteran care and that which we're doing to unify the clinical and the community.

Duane France: (22:48) Oh, I absolutely agree. I think one of the things that I've often said is you know, as veterans go, so go our nation not that veterans need to be taken care of, but you know, it is a microcosm, but if we can figure out how to address veteran homelessness, then we can apply those techniques to homelessness in the community. But with the veteran population, essentially it can be a test bed, but that's what you're talking about is if we can help solve this corner of what the issue is, then that's going to impact the issue overall.

Dr. Matt Miller: (23:19) Yes. Yeah. In some ways we are the canary and we are going into places here that are dark that no one has been. And we are testing things here in the name of saving lives. Someone's got to do it. And I'm proud to be a part of the VA team on a community that is doing this.

Duane France: (23:43) Yes. And I absolutely agree and I thank you and your team. There's a lot of great work coming out of the office of suicide prevention. Like you said, your, your lethal means safety work especially between AFSP and the National Sports Shooting Foundation. Great stuff. And, and I really think that we're at a point where it's going to start having more momentum. I really appreciate you coming on the show today, Matt.

Dr. Matt Miller: (24:13) You know, safe messaging and talking about suicide in a way that doesn't create fear, that doesn't promote stigma but instead promotes awareness and promotes constructive engagement. That's a big part of the battle here. And what you're doing today, is being a frontline troop in that battle. You're opening up the discussion, you're de stigmatizing, you're offering suggestions for converting awareness into engagement. So the thanks are due to you, not to me. And to your audience,

Duane France: (24:48) That is a, that's definitely the goal.

Duane France: (24:59) So I had a really great time with that conversation. Matt is somebody, again, we're really working through the beginning of these shows, the list of people that I really wanted to come on and sort of set the tone of suicide prevention. And when we think about suicide prevention in the veteran military family population, of course we think about the Department of Veterans Affairs not just because of the size of it, but because of the work that's been done to the research and the interventions. And so it was great to be able to have Matt come on the show to talk about some of the things that the VA is doing when it comes to veteran suicide specifically. So Shauna, what did you think about the show?

Shauna Springer: (25:42) Yeah, I thought there were some real important insights in there. One of the important insights that stood out to me was the insight about hotels and animal shelters. I sometimes think that important insights are overlooked and are so clear in retrospect. When he talked about community level efforts and how these efforts have led to insights around high risk indicators, this felt really important to me. So specifically when he talked about how people in the suicidal mind-state often visit animal shelters and hotels before they attempt to end their lives. Now this makes total sense. I'd be willing to bet that, you know, what I say is also true for you, Duane. In my years as a frontline provider, I've had many patients tell me that the only thing keeping them alive is that they wouldn't abandon a beloved pet. So, you know, it makes sense that people are trying to ensure that their pets are not abandoned before they consider attempting suicide. It also makes sense that visits to hotels would be paired with attempts since people often want to create distance with their loved ones who might find them just after the death. So by identifying these patterns and helping staff members of animal shelters and hotels be vigilant for people who may be in distress, we may be able to prevent perfect storms from ending in lasting tragedy. And this was really exciting to hear since this kind of very practical insight is why I wanted to do this podcast with you. What did you think?

Duane France: (27:16) Yeah, I agree. And definitely that idea of, you know, suicide hotspots. Some people think about suicide hotspots as locations where people often attempt to take their life like the Golden Gate Bridge or a particular rail crossing or bridge in someone's community. But we're getting to the point and, and I'm speaking definitely here in Colorado where most communities should get to the point of, you know, the corner knows the zip codes and even to the addresses of when these these deaths by suicide and just like anything else, if you have a larger cluster of suicides in one particular area, then it would be very good to concentrate efforts in that area. And it would be different between communities. It may be hotels in Oregon. Or it may be parking lots in, you know, North Dakota, right? I mean,, it could be something different in each community. But yeah, I absolutely believe the concept is something that is intriguing and to be honest, something that we're looking to implement in our community to see where the majority of our suicides are clustered.

Shauna Springer: (28:29) Right. It's, you know, really understanding that concentration of where people are going to travel before they consider making an attempt. I think that's going to help us with the public health approach because it will help us understand who we need to really equip.

Duane France: (28:46) Yeah. You know, and I think that's equipping people who may not think they need to be equipped or it's not even a concept for them. Another thing that we have, in our community efforts here, the restaurant and bar association has reached out to our local organization saying, can you teach us suicide prevention? So who, but the bartenders, right? The bartender is the late night therapist kind of thing. But they reached out and said, can you give us help? So it is giving people those tools that they may not even realize they need or really aren't comfortable using. Anything else you got from Matt's conversation?

Shauna Springer: (29:29) Yeah. You know, speaking of restaurants, I really appreciated the personal example that Matt shared of being in the restaurant, seeing someone choking and having the immediate thought, gee, I hope somebody helps that guy. I think this is such an important point. So much of the time I think we don't intervene in situations, not because we don't care if someone lives or dies, but because we're fearful that we'll screw it up or we think we're not qualified to assist. And this kind of made me reflect on bravery. A few thoughts I wanted to share. Bravery is something that can be domain specific. For example, I've worked with a number of combat veterans who would walk into the kill zone of an ambush without flinching. They're terrified to tell their partners that they love them and they need them.

Shauna Springer: (30:15) And I've worked them through this barrier. So I know that the instinct to avoid can be overcome if someone gives it a real focused effort. Also bravery can be developed. I think through practice. For example, many people who serve in the military are initially fearful or uncomfortable about using firearms or using violence against other people. But military training helps these people overcome that avoidance instinct. And some of them become our finest soldiers and Marines and operators because they have a level of humility and restraint that others never had to begin with. So my thought is that for the public approach to suicide to really work, we have to figure out a way to overcome our initial avoidance instinct. We need to trust our gut when it calls to us and we need to move in close when we sense that someone is in a dark and hopeless place. I think this kind of bravery can absolutely be learned.

Duane France: (31:07) You know, this is actually something that I often brought up when I was doing the applied intervention skills training. And I'd asked the attendees, you know would you do anything to save the life of a fellow veteran, you know, well, yeah, of course I would, right? You know, run into a burning building. And they would say, yes. And I said, what if that includes looking them in the eye and asking them, "are you thinking of killing yourself?" And then people are like, "Oh I don't know about all that." Well and yes, bravery is bravery but are we willing to, and this and that was one of my things and that's what in things like assist and QPR and these trainings do for you is to get you used to asking those questions and just like basic training and I like that analogy but doing stressful things in non stressful situations so that you can then do those things in stressful situaitons.

Shauna Springer: (31:59) Exactly. Exactly where my mind goes to, that there's a way to habituate to being uncomfortable because it's a different domain of bravery, you know to go into a burning building or to look someone straight in the eye in the context of a relationship that's trusting and intimate in the sense of loving someone as a brother or sister and saying, are you thinking about having thoughts of ending your life right now. And holding the gaze. It's hard for people to look at each other full in the face and not ask anything even harder for them to ask about life or death matters. But we need to be doing that for a public health approach to work.

Duane France: (32:39) Yeah. And I think, again, there's that idea of what maybe came out in that first episode with Dr. van Dalen was suicide prevention is not something we do to someone. It's something we do with people, right? It's a mutual thing that we do with someone who happens to be in crisis. And that does impart a responsibility on both sides, I think. But it's a matter of a partnership. Whereas, you know, doing the Heimlich maneuver as Matt had described, that's something you do to somebody, right? You do CPR to somebody. You don't do CPR with somebody. But this is a very highly relational situation where we have to do this with each other.

Shauna Springer: (33:19) Exactly. Yep. Fully agree.

Duane France: (33:22) Yeah. I really appreciated Matt's conversation and the opportunity to, and even their willingness, the VA's willingness to come on the show and have this conversation in a very public way to be able to make a difference. So I'm really excited about how this episode will be received.

Shauna Springer: (33:43) Yeah, I think there's a lot of confusion and misunderstanding about the people behind the roles. And one of the things that was neat about this episode is to really understand where Matt is coming from and this is personal for him. And so it's not just a role in a job.

Duane France: (33:59) Absolutely. So everybody makes sure to continue to stay tuned to listen to more episodes about seeking the military suicide solution. Make sure to check the show notes at www.veteranmentalhealth.com/stmss03, where you can get links to all the things that Matt talked about in the episode. And you can also find the shows on military times.com. While you're at it, check out our sponsors milMedia group. They're a web design and digital media agency with over 25 years of experience in supporting service members, veterans and their families. They specialize in working with startups, small businesses, entrepreneurs, nonprofits and city, state and local governments. As a veteran owned business, they're uniquely qualified to work with those that want to reach an audience in the military and veteran space. Do you have a dream or a vision they can help you bring it to life and get it in front of your audience? You can contact them at (254) 554-0974 or find them online at www.milmediagroup.com

Shauna Springer: (34:56) Just a reminder that the guests and reflections on this show are for informational purposes only and should not be considered professional advice. While Duane and I are mental health professionals, we are not your mental health professionals. We always recommend that you discuss these things with a licensed clinician.

Duane France: (35:12) You can find out more about the work that Shawna's doing by checking out her latest book, Beyond the Military, a Leader's Handbook for Warrior Reintegration, and the work that I'm doing with my latest book, Military in the Rear View Mirror. Both are available on Amazon and we'll have links to those in the show notes.

Duane France: (35:27) and always remember, you can connect with the veteran crisis line by calling (800) 273-8255 and pressing one, chat online with them at veterancrisisline.net or texting, 838255. Thanks again for joining us to talk about Seeking the Military Suicide Solution and make sure to follow Military Times on social media to keep up with the latest shows. Join us next time for another great episode and until then, remember, you're not alone. Ever.

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About Today’s Guest:

Dr. Craig J. Bryan, PsyD, ABPP, is a board-certified clinical psychologist in cognitive behavioral psychology, and is currently the Executive Director of the National Center for Veterans Studies at The University of Utah. Dr. Bryan received his PsyD in clinical psychology in 2006 from Baylor University, and completed his clinical psychology residency at the Wilford Hall Medical Center, Lackland Air Force Base, TX. He was retained as faculty in the Department of Psychology at Wilford Hall Medical Center, where he was Chief of the Primary Care Psychology Service, as well as the Suicide Prevention Program Manager for Lackland AFB.

Dr. Bryan deployed to Balad, Iraq, in 2009, where he served as the Director of the Traumatic Brain Injury Clinic at the Air Force Theater Hospital. Dr. Bryan separated from active duty service shortly after his deployment, and currently researches suicidal behaviors and suicide prevention strategies, and psychological health and resiliency. He currently manages numerous federally-funded projects in excess of $10 million, to include studies testing cognitive behavioral treatments for suicidal service members, developing innovative methods to identify and detect high-risk military personnel and veterans, and disseminating effective treatments to health care providers and the public.

Dr. Bryan has published over 120 scientific articles and several books including Managing Suicide Risk in Primary Care, Cognitive Behavioral Therapy for Preventing Suicide Attempts: A Guide to Brief Treatments Across Clinical Settings, and the Handbook of Psychosocial Interventions for Veterans and Service Members: A Guide for the Non-Military Mental Health Clinician. He is the lead risk management consultant for the $25 million STRONG STAR Research Consortium and the $45 million Consortium to Alleviate PTSD, which investigates treatments for combat-related PTSD among military personnel, and has served on the Board of Directors of the American Association for Suicidology. He is considered a leading national expert on military and veteran suicide. For his contributions to military mental health and suicide prevention, Dr. Bryan has received numerous awards and recognitions including the Arthur W. Melton Award for Early Career Achievement, the Peter J.N. Linnerooth National Service Award, and the Charles S. Gersoni Military Psychology Award from the American Psychological Association; and the Edwin S Shneidman Award for outstanding contributions to research in suicide from the American Association of Suicidology.

Links Mentioned in this Episode:

National Center for Veterans Studies

Dr. Bryan on Social Media

Twitter

LinkedIn

Episode Sponsor:

milMedia Group

Shauna's latest book: Beyond the Military: A Leader's Handbook for Warrior Reintegration

Duane's latest book: Military in the Rear View Mirror: Mental Health and Wellness in Post-Military Life

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Episode Transcript:

Duane France: (00:00) Welcome to seeking the military suicide solution podcast brought to you by the military times. I'm Duane France

Shauna Springer: (00:06) And I'm doc Shauna Springer

Duane France: (00:08) And we'd like to thank you for taking the time to learn more about suicide in the military affiliated population. I'd like to thank our sponsors, milMedia group. milMedia group is a proven web design and digital media agency specializing in supporting organizations focusing on the military population. Find more about them at milmediagroup.com.

Duane France: (00:34) Thanks again to everybody who joined us to listen to an honest conversation about service member veteran and military family suicide. Our guest today is Dr. Craig Bryan from the University of Utah. Shauna, how about you tell us about our guest.

Shauna Springer: (00:47) Sure. Dr. Craig Bryan is an Air Force veteran, a board certified clinical psychologist and Executive Director of the National Center for Veteran Studies at the University of Utah. Greg and his wife Annabel met in Iraq in 2009 when both of them were engaged in military service roles. After separating from the military, at times, they've both considered going back in and their daughter posed this question to them: why would you think about going back to Iraq when you're both satisfied with your job, with your housing, with really just about everything else in your life? And so as Craig reflected on this question, he realized that the pull of returning to Iraq had a feeling of unfinished business and then he saw that this was actually an illusion. One that is maybe common to many who serve. As he put it, it's something we do to ourselves. Always thinking about what we've done and how it's not good enough even when we've done more than enough. Before we built a friendship, I admired Craig and AnnaBelle for their dedication to the mission of suicide prevention and their ability to engage in both in the trenches work with those who are suffering and their high level thought leadership. Craig and AnnaBelle are on mission to support fellow veterans. They are considered field leading experts on suicide and suicide prevention strategies. It's such a pleasure to have them on the podcast as one of our lead off interviews for Seeking the Military Suicide Solution.

Duane France: (02:07) I really appreciate that. You know, when we started putting this together, a lot of people, when I said, "who should we have on the show?" A lot of people said, Dr. Craig Bryan, he was usually top of the list. And so I'm really glad that we were able to have him on the show. Let's get into the conversation and we'll come back afterwards to pull out some of the key points.

Duane France: (02:35) From Your perspective, what is the thing that really works when it comes to preventing suicide in the military population?

Craig Bryan: (02:41) There's sort of two, I think, arms to thinking about what works in suicide prevention. One arm falls on the healthcare side of the house and then the other arm is outside of the healthcare system. And I point that out, because we know, you know, 70% of veterans who died by suicide are not actively seeking out of mental health care at the time of their death. And that seems to be true for both active duty currently serving military as well as those who are no longer in military service. And historically we have focused almost exclusively on the treatment side. And so when we look at that, I mean the sort of the good news, the hopeful news is that we have actually detected a signal, things that work within the healthcare setting. So a lot of the work that we've done in my lab for instance, looks at brief cognitive behavioral therapy for suicide prevention as well as crisis response planning. These are pretty simple, straight forward outpatient therapeutic interventions that have been shown to reduce suicidal behaviors by anywhere from 60 to 76%. Then the second arm, if we go to what can we do outside of the healthcare system, I think there are two key factors.

Craig Bryan: (03:54) A single most important is doing a much better job of focusing on safety as it relates to gun ownership. 70% of service members and veterans who die by suicide use a gun. And statistics suggest that, interestingly enough, the individuals who are most likely to use a gun to kill themselves, they tend to be men. And they actually tend to be people without a mental illness. But we know that if people were to lock up their guns, if they use safes, if they use gun locks or trigger locks, things along those lines, that's actually been shown to reduce suicide deaths by up to 50%. In many ways it's similar to, you know, we wear seatbelts when we drive a car, even though we don't intend to get into an accident. And of course none of us are actually bad drivers. Everybody else is the bad driver.

Craig Bryan: (04:46) But we buckle up anyway to be safe. And in many ways I think we need to buckle up those of us who are gun owners because sometimes things go down quickly. When we go from zero to 60, really fast and every second, every minute that slows us down in those moments can potentially save our lives. Then the last thing I'll point out for outside of the healthcare systems, I think we really need to focus on communities and quality of life issues. And what I mean by this is, we have become so obsessed with this whole like resiliency and individual pathology model where when we think about suicide, we say, well, this person didn't have enough coping skills. They were experiencing stress, things like that. But most of us understand the things that stress us out the most in life; you know, it's perhaps financial strain.

Craig Bryan: (05:37) It's, you know, having a job or work that isn't particularly meaningful. It's having all of these trainings, like these computer based trainings that we just keep getting asked to do over and over again. And then when we get stressed out and burnt out, it's, in essence, we say, "well, you're the problem. You just need better skills," when really it's in many ways the system itself that's pressuring us. And I think we've forgotten that one of the key ways that we can potentially reduce suicide is by improving quality of life or really kind of looking at how can we change the workplace, family life, our communities in a way that we help to remove or reduce the sort of constant pressure that wears people dpwn.

Duane France: (06:24) You know, that's really great. I am thinking of as a clinical mental health professional, myself and my colleagues and you and your colleagues we understand suicide prevention. We know what works, but the veteran or the military family member is not likely to come in contact with us right away. Right? We are that second stage intervention beyond the gatekeepers, beyond the pastors, beyond the law enforcement or first responders, or even beyond the family members. Right? So the ones who are maybe most familiar with these suicide interventions that work are least likely to come in contact with the veteran. Then on the other side, outside the healthcare system, the range owners, the gun shop owners who can have that influence over gun safety or the person that's working on veteran homelessness or veteran employment, they're not thinking about suicide prevention. So there's a disconnect there.

Craig Bryan: (07:13) Oh yeah. Yeah. And I think this is, this is sort of like one of my stomping points. Right now, it's been for the past few years, is that we have, we have gone so full tilt into this mental illness model of suicide prevention that everything we do, all of our warning signs, all of our recommendations are all geared around going and getting help. And but when we really look at the data, we know that at least half of those who die by suicide do not have a diagnosable mental illness. And so we're in essence telling people, "look out for these things that don't apply to half of the population" and that we're encouraging individuals to seek out treatment even though they don't necessarily have the problems or the conditions that would warrant them to seek out that treatment. But yeah, we have these sort of these non mental health individuals who actually probably play a way bigger role in suicide prevention in the same way that, you know, when we look at how we've been able to reduce traffic fatalities for instance, you know, as a result of drunk driving, we didn't like go around and tell everyone, well you need to go into counseling for substance abuse so that you don't get into a car crash and you know, kill yourself or kill someone else.

Craig Bryan: (08:27) What we did is we came up with ideas like "Friends don't let friends drive drunk". When does this matter the most? How do you prevent an alcohol related traffic fatality? It's when a bunch of friends are hanging out with each other at someone's house on the weekend and everyone's partying and having a good time. And then someone says, all right, I'm going home. And it's somebody else saying, no, you can't drive. And those are the moments that make a difference. The same applies when it comes to firearm ownership and suicide prevention of family members and friends stepping in and saying, let's not wait until someone becomes incredibly distressed and has a mental illness. There are these sort of key moments in time where we could potentially intervene with each other and say, "Hey, let me hang onto your guns for a while while you go through this tough time." It's these simple little things that actually can make such an enormous difference.

Duane France: (09:19) You know, and that's one of the things that, maybe that what might not be working is this focus solely on the mental health professionals. Because if, if you and I as clinicians, if we had the solution, then the problem would be solved already, right? We wouldn't have this issue. What are some of the things that people think that are working that's simply, you know, the research shows that just aren't?

Craig Bryan: (09:41) Yeah, I would say, perhaps the most pervasive idea about suicide prevention that doesn't really seem to hold as much water as we often assume as this notion that if you treat depression or if you treat some of these other mental health conditions, you can prevent suicide. The data actually suggests that the things that prevent suicide are, are actually different from mental illness.

Craig Bryan: (10:08) Now that's not to say that things like depression are totally irrelevant, but there's something else that seems to contribute to reductions in suicidal thoughts and behaviors. And so we know that if you just treat the depression, it helps a person to feel better but doesn't actually reduce their risk for trying to kill themselves. And so the best way that I've found a think about this is sort of like when we're driving our cars, we have an accelerator and we have a brake. The accelerators speeds us up and helps us go forward. But if you take your foot off the accelerator, you'll slow down, but you won't necessarily stop right away. That's what the brake is for. So these are two completely different systems within our car. And I think mental illness works in that same way. Mental illness, depression, you know, other problems in life are kind of like the accelerator.

Craig Bryan: (10:59) It might help move us towards suicide, but simply eliminating those things don't necessarily apply the brake. And so you can feel better as a result of therapy or treatment. But some people still continued to be at risk for suicide, which is why many of us, if you think about family members and friends, it's sort of like been this mystery for a long time of they were doing better. I don't really understand. And I think it's because we've, we've not really kind of conceptualize that maybe the brake pedal is different from the accelerator pedal. And so in essence, we've in many ways been barking up the wrong tree, I think for many, many years.

Duane France: (11:40) You know, and I think that's very important. You know, not everyone who has depression goes on to take their own life. Not everybody with anxiety or all of these, you know, not all of the common factors are there, which we can say this leads to suicide.I understand there's maybe like 20 different factors now that, especially looking at service member and veterans, that feed in one way or another to contribute to someone deciding to take their own life.

Craig Bryan: (12:05) Yeah. And I think, you know, kind of related to that, you know, one of the other sort of long held assumptions that we've had that seems to be wrong is, we've always looked for what is the right combination of those 20 factors that lead to suicide. But in reality there can be different combinations of those factors. And so there might be different sort of pathways or different trajectories or types of suicide. And so another reason we're not very effective is because we're looking for the one cause and the one solution, but maybe there are actually different solutions in different strategies. And so, perhaps something like on the treatment side, we've got now some interventions are actually really effective. Like I said, I mean the most, the most promise, I think we have a suicide prevention is actually on the therapy side, but that's not going to prevent all suicides and it never will because other people get to suicide through a very, very different mechanism and so we need to come up with a variety of options that are better suited to meet the unique combination of variables that exist.

milMedia Group: (13:24) Hi! I'm Alyssa Mosher, military spouse, Army brat, and sister of a soldier. I'm here in our headquarters of milMedia Group at the great place, Fort Hood, Texas, and I want to share our vision to put veterans to work in professional careers. We work with a variety of clients from startups to small businesses, entrepreneurs and nonprofits with web design and social media digital marketing. We want to serve you with everything from web design to digital marketing because we know that you don't have all the answers. The thing that we care about most is honoring your vision and our service members. milMedia is a military affiliated team that wants to serve you the way you served our country. With mostly military retirees, spouses and families is our staff, we understand the best way to do things is the military way. Contact me at milMedia group now at (254) 554-0974 or visit our website. That's www.milMediagroup.com

Duane France: (14:35) So that maybe we're one of the gaps are, is getting the information that we know works as clinicians. The folks at SAMHSA, the CDCs technical package to prevent suicide. The VA's a suicide prevention programs research. We know that the research works, but it's getting it into the hands of the people that can actually use it.

Craig Bryan: (14:55) I think that's part of it. Like,, we do know that there is sort of this delay between research findings and implementation of those findings. But I think a lot of it is making sure, it's sorta like understanding how seemingly contradictory research findings can perhaps not be so contradictory after all. And that's where I think sometimes a lot of confusion comes from, is you look at these studies and you know, a certain treatment works in this study, but it doesn't seem to work in that study. I think maybe part of what it comes down to is that again, some of these strategies and ideas do work under some circumstances, but I don't think as researchers you know, we've really taken that into account because it's hard. It's hard to do that. And so we can end up sort of washing out a lot of our conclusions because we're not truly capturing the actual complexity in nature of suicide.

Duane France: (15:59) And I think that goes back to the community-based aspect of it too, is what may be some of the primary in the 20 causes in one community may not be the same in another community. Here in El Paso County we're approaching probably 14 to 15% density, just veterans. But Houston for example, only has 4%, but has a greater number. Right? So what will work in El Paso County, Colorado Springs, Colorado won't necessarily work in Houston.

Craig Bryan: (16:26) Absolutely. Yeah. And, and it's, you know, those differences that we see across a community, there are different reasons that contribute to those differences. So if you look at, again, like El Paso County is a different region of the country. It's, you know, largely you know focused on army, whereas if you go to like, say, San Antonio, Texas, there's more of like an Air Force type of presence. And of course each branch of service has a somewhat different culture. You know, we have a lot in common, but we also have different ways about going about doing things. But then there are regional differences within the country as a whole. And so yeah, what works in El Paso might not necessarily be the same thing that works in San Diego. And it's one of those things where it's sort of like, it's unfortunate, right? Because it'd be nice if one thing worked everywhere. But that's just sort of a reflection of how life actually is. And it's okay. That doesn't mean that nothing ever works. It just means I think we need to be a little bit more intentional and thoughtful about trying to find the ways to take something like BCBT (Brief Cognitive Behavioral Therapy) that we know works, but how do we make sure that we tailor it and adapt it to these different communities?

Duane France: (17:42) And I think that's, in operating at the community level, that's what I've seen as a challenge is taking what we know, again, works at the national level. But then applying it to our community. Right? And we're trying to, from my observation, trying to apply interventions across the board, Irregardless of culture.

Craig Bryan: (18:03) Yeah. Yeah. And it's something that I've thought a lot about as a psychologist who does treatment research is distinguishing between the core principles and mechanisms of a particular intervention or a treatment or a program from sort of like the surface features, the packaging or the you know, the gift wrapping. And so in many cases there are these core concepts and ideas that can be sort of transported from one community to community to another.

Duane France: (18:37) So it's, you know, increasing economic stability is a factor that will keep people from getting into financial crisis or losing a job. But the way that we would implement economic security is different in a rural community than in an urban or semi-urban.

Craig Bryan: (18:55) Yeah. And, the way in which we, each of us experiences economic stability might be different. And so if we were to just come in and say, well, everybody is going to get education on, you know, like credit card management, something like that. Well that isn't necessarily going to be the way to effectively stabilize and provide financial security for every single person who feels strained. And so there, there might be a number of ways that we help people to feel more economically stable, but we shouldn't just assume that everyone is the same and everyone is stressed out for the same reason.

Duane France: (19:35) Yeah. Cause I think then we get into the transactional trap in which, you know take two financial stability classes and call me in the morning. Right? Or here, here's a resume class. So let me just get you a job.

Craig Bryan: (19:48) Yeah. Very much so. Yeah. And I think of it like, you know, for me kind of the practical impact on, you know, kind of like a mental health side is, you know, like the center that I run, we're really good at treating PTSD, suicide risk, and depression. If you're a veteran though, and we've received these calls, you know, veterans call us and they have other problems. We've had individuals, veterans diagnosed with like bipolar disorder. Or eating disorders, things like that. And you know, we say, Hey, you know, that's not our thing. You know, it's, we want to be able to help you. But it's sort of like, that's not really what we're good at. And so I don't think you're going to be well served by us and being comfortable with that. Because if all you have is a hammer, everything looks like a nail. It's like, well, if all you have is a hammer, just know what a nail looks like because that's an appropriate tool to use in that circumstance. But recognize, Hey, this isn't a nail, this is a screw. Maybe we need to find a screwdriver instead.

Duane France: (20:53) And I think that's the other piece that many of us have been working towards in the military and veteran community is making those connections is if someone does come with an eating disorder, well we may not be the place, but there's this great place at UCLA that that really does great work with military service members and eating disorders. What kind of action steps, right? You know, somebody listening to this, obviously it's two clinicians talking to each other and we've used, you know, the crazy acronyms and stuff like that, but somebody listening to this, what are some action steps that they can take to prevent suicide in their home, their community and things like that?

Craig Bryan: (21:29) Yeah, I think if, if we stick with that spirit of kind of looking at this from a community perspective and I've found it very valuable to think of suicide prevention from an injury prevention model. So what are the things that we do to prevent our loved ones, our family members from experiencing injury in general? And it involves things like, you know, removing hazards from the environment. It's, you know, all of us who have little kids, you know, we know that you can't store cleaning supplies and chemicals underneath the sink, you know, without a lock on it. And so we move things, we lock things up, we store them away to protect, you know, the people that we care about. Likewise, all of us, when we, you know, in our homes we have things like smoke detectors and carbon monoxide detectors things like that to help protect and preserve our safety and security.

Craig Bryan: (22:24) And so if we take that approach and apply it to suicide, this is where I think if we get back to the notion of do we keep large quantities of medication in the home, you know, if you're not using the medication anymore, it's expired, but yet we have lots of pills laying around that in some cases could be a potential hazard as it relates to suicide. Firearm storage is the clearest. I think that's actually the single, simplest and most effective thing we could do to prevent suicide. It's, you know, just locking up guns. You don't have to necessarily completely get rid of 'em, but just locking them up. That is we already know that's been shown to reduce suicides by 50% or more. I mean, it doesn't actually really require that much effort from us. Likewise, if you have a friend or a family member who's going through a rough patch, be the designated driver so to speak, and offer to hang on to their firearms in the same way that you would temporarily take away their keys and not let them drive.

Craig Bryan: (23:29) I think it's in the workplace as well, being sure that we express gratitude and appreciation to each other. It's something like, when I've consulted with military leaders over the years, for instance, and this is true, I think of even family sometimes and other organizations, Iask questions like, "well how often do you thank people for the work that they've done for completing tasks?" And when I hear you know, someone in an authority position saying, "well, but that's their job. They're expected to do it." It's like immediately I'm like, well, now I know what the problem is. And it's because those little things, you know, make a big difference. Think of, think of the jobs that you've had that you really enjoy. Think of the friends that you have that you care about the most. They typically express to you appreciation.

Craig Bryan: (24:18) They thank you for the little things. They back you up, they support you. They reach out to you in times of need. And even when you're not in need, they just send you a text message every once in a while and say, Hey, I was thinking about you. Hope you're doing okay. Or Hey, I read this funny article online, it reminded me of you. These are the little things that we can actually do on a day to day basis that influence and reduce the probability of a person kind of tipping over the edge when they find themselves in that momentary moment of despair.

Duane France: (24:49) You know, and that's the idea of be nice to each other. Right? And it's sort of that human piece, but that's the prevention piece. Let's keep people from getting into that suicidal crisis. And then there's that piece of the intervention piece. I really appreciate you coming on the show today. Thanks for taking the time and hopefully the listeners get some benefit out of this.

Craig Bryan: (25:11) Yeah, my pleasure. Thanks for having me.

Duane France: (25:21) It was really great to be able to talk to Craig, had a really great time. I, kinda really didn't want to cut it off. These are, again, some of these conversations that we can really have for hours and hours. What did you think about what Craig and I were talking about, Shauna?

Shauna Springer: (25:35) I thought it was a great interview. I mean, he goes into so many things that require a paradigm shift in our thinking in terms of the behavioral health emphasis that we've had as a field. You know, he makes the point that so many times people who die by suicide do not have a mental illness. So non mental health factors play a strong role and this is something that you and I both know Duane, such an important point.

Duane France: (26:01) Yeah. You know, I mean, and that was one thing that really kind of drove home for me was that you know, a financial crisis or a relationship crisis and you know, there's no diagnosis or you know, getting fired from your job. And so it may, all those things may lead to some type of anxiety, but it's sort of natural anxiety and it's just life. It's not a diagnosed mental illness,

Shauna Springer: (26:26) Right. It's just part of being human. And you know, I think so many times in the suicide prevention field we've had for many years that kind of "get thee to the doctor" model for suicide prevention. And so what Craig is sharing here is really bringing attention to the fact that there are these bigger issues in terms of life stressors and transitions.

Duane France: (26:46) Yeah, and I think this goes to, again, some of the stuff that we've talked about is that, like you said, to get thee to the doctor, but it's not just us. It's the people who are helping with employment in veterans, or military spouses or you know, people who know that the military spouse, military child is a caregiver. That it's more than just a responsibility for what we're calling "experts" like you and me.

Shauna Springer: (27:12) Right. And in fact, it's a very humbling thing. I wrote about this topic, the limitations of the professional defender model, in a chapter in my next book, which is coming out in the spring. And I talked about some recent data that was collected by the Department of Defense. It's really humbling. It said that an active duty service member who's struggling is actually more likely to turn to a military peer, a friend outside the military, parent, a spouse over a professional mental health provider. And in fact, in a list of 12 potential categories of people that an active duty service member would talk to when they're feeling stressed or overwhelmed, mental health providers are actually 10th on the list, just slightly above attorneys. You know, as a behavioral health provider I really do believe that treatment works and I believe that we need to resource a whole bunch of people to respond when those they love are in distress.

Duane France: (28:09) You know, that's a, that's definitely a great point and glad we beat out the lawyers.

Shauna Springer: (28:13) Yeah! I really liked his analogy of the injury prevention model. This really takes a public health approach and applies it to suicide prevention messaging. So just as he said, you know, how do we prevent loved ones from getting injuries? He's equating this to initiatives like wearing seatbelts or not letting friends drive drunk. These are very successful public health initiatives that have had hugely positive impacts on our behavior. So then he talks about, you know, do we keep large quantities of medications at home or I know that in Craig's work firearms are a big focus of his efforts. So, you know, talking about are these stored in ways that minimize risks of using them in ways that the owner didn't purchase them for. So in other words, many veterans own firearms because they want to use them for self protection or protection of those they love, but at a time of overwhelming stress, they can be turned on the self in a tragic turn of events. And so by thinking about this possibility in advance and approaching it from a safety focus perspective, we can ask ourselves, does the way we store a firearm align with the owner's intent or our intent as the case may be?

Duane France: (29:27) Yeah. You know, I mean, and this is a, this is something that really is on the individual. Don't talk about this very often, but my dad, after coming back from Vietnam and he was a a St. Louis city cop in the, so we don't know where PTSD from one ended and the other began. But one of the things growing up is we never had guns in our house because he saw what happened. He had so many calls that he would respond to with accidents or things like that when there were guns readily available. I mean, we obviously had different measures of protection in the house. It wasn't that we were unprotected, but it's an individual responsibility. It's a family safety responsibility, just like, not to be demeaning, but childproofing

Shauna Springer: (30:10) Well, you're coming down to the level of what the individual's values are and why they own that firearm in the first place and then how, you know, they're setting themselves up to use it in that way or not. It can be a safety issue when people are struggling or you know, at a time of overwhelming stress. And it makes a lot of sense to me, you know, intuitively to just equate that conversation to other public health initiatives that have kept people in the fight just by better safety measures, you know, in advance.

Duane France: (30:41) Yeah. You know, I think in, in even thinking back to the conversation I'd mentioned, you know, we don't even, it's not even a second thought. As soon as we get in the vehicle, we buckle up. Right? I mean, it's, I know that's the case for me. And I know that when I was growing up, it wasn't always like that, right? So we have made this shift of you know, keys in the bucket or let's take an Uber. Like, you know, so there are just things that have become part of the norm that we need to get there with suicide prevention as well.

Shauna Springer: (31:09) Yeah. I mean, at the same time, as he's saying, rightfully so, I think that it's an individual decision about how we store firearms, for example. We all play a role in kind of looking out for each other. So the public health initiative says, you know, individuals make choices. But we can influence them with the force of our love and our trust. And so at the same time, you know, there's been this focus on really, like we talked about, you know, the individual mental health provider when really it's about the tribe of individuals that surround us and how connected we are with them and how how we look out for each other in kind of a collective way.

Duane France: (31:51) I think you're absolutely right. And maybe one final thing that you you got from our conversation.

Shauna Springer: (31:57) Yeah. One of the other paradigm shifts that he talks about is, instead of simply recognizing, you know, the signs of suicide or focusing on individual resilience, maybe a shift to focusing on, again, getting away from just the individual resilience and more of those bigger level contextual factors in the social tribe that surrounds us. So it's not that, you know, these things aren't important, that behavioral health solutions, individual resilience, recognizing the signs, they're important. But I think we agree that they're not sufficient to address the issue of suicide. And so I've just, you know, one of the things I really appreciate about Craig is that he says the things that people think. He says it boldly and bravely and he makes a lot of sense and it fits with my experience as a mental health professional. I think we do need to shift the paradigm in this way. So I thought it was a great interview.

Duane France: (32:53) Yeah, I really appreciate that. And I think that again really sets a tone you know, and listeners you'll hear it through a number of these different interviews. There are some common themes and then there's something that we're going to pick up every different interview. And so hopefully we'll be able to get to a point where the message will start to change.

Shauna Springer: (33:18) Yup. I'm with you on that.

Craig Bryan: (33:20) So thanks everybody for listening to this episode of Seeking the Military Suicide Solution. Make sure to check out the show notes at www.veteranmentalhealth.com. You can get the links to all the things that Craig and I talked about in the episode as well as finding the show notes at militarytimes.com.

Craig Bryan: (33:35) I'd like to thank our sponsors, milMedia group. They're a web design and digital media agency with over 25 years of experience in supporting service members, veterans, and their families. They specialize in working with startups, small businesses, entrepreneurs, nonprofits and city, state and local governments. As a veteran owned business, they're uniquely qualified to work with those who want to reach an audience in the military and veteran community. If you have a dream or a vision that can help you bring it to life and get it in front of your audience. You can contact them at (254) 554-0974 or find them online at milmediagroup.com.

Craig Bryan: (34:09) You can find out more about the work that Shawna's doing by checking out her latest book, Beyond the Military, a Leader's Handbook for Warrior Reintegration, and the work that I'm doing with my latest book, Military in the Rear View Mirror. Both are available on Amazon and we'll have links to those in the show notes.

Shauna Springer: (34:25) Just a reminder that the guests and reflections on this show are for informational purposes only and should not be considered professional advice. While Duane and I are mental health professionals, we are not your mental health professionals. We always recommend that you discuss these things with a licensed clinician

Craig Bryan: (34:40) And always remember, you can connect with the veteran crisis line by calling (800) 273-8255 and pressing one, chat online with them at veterancrisisline.net or texting, 838255. Thanks again for joining us to talk about Seeking the Military Suicide Solution and make sure to follow Military Times on social media to keep up with the latest shows. Join us next time for another great episode and until then, remember, you're not alone. Ever.

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About Today’s Guest:

Barbara Van Dahlen, Ph.D., named to TIME magazine’s 2012 list of the 100 most influential people in the world, is the president of Give an Hour. A licensed clinical psychologist who has been practicing in the Washington, D.C., area for over 20 years, she received her Ph.D. in clinical psychology from the University of Maryland in 1991. Concerned about the mental health implications of the wars in Iraq and Afghanistan, Dr. Van Dahlen founded Give an Hour in 2005 to enlist mental health professionals to provide free services to U.S. troops, veterans, their loved ones, and their communities.

Working with other nonprofit leaders, Dr. Van Dahlen developed the Community Blueprint, a national initiative and online tool to assist communities in more effectively and strategically supporting veterans and military families. Give an Hour has implemented the Blueprint approach in two demonstration sites and continues to lead community collaboration projects.

In June of 2019, she was named the Executive Director of the Task Force to create the President’s Roadmap to Empower Veterans and End a National Tragedy of Suicide (PREVENTS).

Episode Transcript:

Duane France: (00:00) Welcome to episode one of the seeking the military suicide solution podcast brought to you by the military times. I'm Duane France

Shauna Springer: (00:07) And I'm Doc Shauna Springer

Duane France: (00:08) And we'd like to thank you for taking the time to learn more about suicide in the military affiliated population.

Duane France: (00:22) Thanks again to everybody for joining us to listen to an honest conversation about service member veteran and military family suicide. Our guest today is Barbara Van Dahlen. Shauna, how about you tell us about the guest.

Shauna Springer: (00:34) Sure. Dr. Barbara Van Dahlen is a clinical psychologist who serves as the executive director of the task force to create the President's Roadmap to Empower Veterans and End a National Tragedy of Suicide. What's called PREVENTS. Prior to spearheading the efforts of PREVENTS, Dr. Van Dahlen and founded Give An Hour in 2005 based on her concern that as a nation, we would not be ready to respond to the needs of those who have deployed to the Wars in Iraq and Afghanistan. As president of Give An Hour, Barbara led efforts to create a national network of mental health professionals who provide free services to us troops, veterans, their loved ones and their communities. Like many people who become leaders in the field, Barbara's work is not just a job. It's personal. After serving in the Pacific during world war II, her father came home with post traumatic stress. At the time, there was no concept of what PTSD is and how it can be treated like there is today. Barbara and her father were very close and she admired him for his strength, especially as he stepped into the role of being a single father for much of her childhood. So Give An Hour was established in large part because of Barbara's lived experience and the resultant clarity in her perception that we need to do a better job at supporting those who serve in our military. In today's episode, she and Duane discuss the concrete aims of the task force and her philosophical approach to the work of suicide prevention.

Duane France: (02:01) That's great. I really appreciate that. Whenever we were thinking about who the first guest should be, or lining up the guests, obviously the prevents task force where it is right now and where it's going to be going, she was definitely one of the first ones that I thought of, and that you agreed, would really be important to come on the show. So let's get into the conversation then. You and I will come back afterwards to pull out some of the key points.

Duane France: (02:33) So the PREVENTS Task Force, I've been hearing about it for a couple of years, obviously it's been in the works. President Trump signed the executive order back in March and now it's a thing. So if you can give us maybe a little bit of an overview of what the PREVENTS Task Force is.

Dr. Van Dahlen: (02:50) Sure. So maybe this will help frame why this is such an extraordinary issue, at least from my perspective and why I was so honored to take the position. So I was aware as many people in our community, those of us who are working to support military veterans, you know, related to this work, suicide prevention, mental health in general. I read the, the executive order in March when it was signed. I was actually then at that point the president of Give an Hour, the organization I ran for 15 years that I founded, I was asked to read it by a news outlet that wanted me to comment on it. And so I read it and I thought, this is extraordinary. We have never seen an effort from the federal government focused on addressing a challenge, a societal challenge like suicide. So that was my reaction.

Dr. Van Dahlen: (03:48) I was like, Oh my gosh. And the opportunity to pull together across agencies was just as I said, extraordinary. And so little did I know a couple months later I was called and asked whether I would consider running the task force becoming the executive director. And I was, you know, I said I was honored. And so, so began my journey with this work. The executive order, PREVENTS is the acronym, stands for the President's Roadmap to Empower Veterans and End a National Tragedy of Suicide. And both of those pieces doing are really important. Why? Because people who are empowered, people who feel like they have purpose, they have mission, people like that are much less likely to die by suicide. And we can talk more about that. The other half of that acronym, end a national tragedy of suicide, suicide is not just a concern in our military and veteran community.

Dr. Van Dahlen: (04:48) Suicide is on the rise in our nation. And in fact, suicide is now the second leading cause of death for people aged 10 to 35. 10. 10 year olds. And so this is an opportunity. Yes, our goal with some of the parts in particular, some of the funding that will eventually flow, so the research is very, very focused on veterans, but that's not all we're focusing on. This is an opportunity actually for our veterans and our military community to lead the way as we tackle suicide broadly. So this effort is an all hands on deck. It is about interagency coordination, collaboration. It's about working with our community partners, diving deep into our communities to ensure that we knit together efforts that are currently there. The last thing I'll say is that a piece of this work, and for me, perhaps the biggest piece, this is a public health approach. We've never done this before. We have never tried to address suicide on this massive scale from a public health approach.

Duane France: (05:57) Right. And, and that's what I find interesting about this. It's all out there. All the resources are out there, but it's more of a facilitation role rather than, you know, somebody taking the lead. You know, we're all digging holes, but nobody's telling us where to dig the holes or how effectively to dig them together.

Dr. Van Dahlen: (06:18) Yes. Well, and I think to your point, the public health approach, you know, people use that phrase, but not everyone knows what it means. And really, the focus of public health, we've seen it, you know, over decades that when we take on a challenge and issue and we applied this notion of it's public health issue as opposed to only trying to find those people who are at high risk, that's a part of this. But for too long we have tried to find the needles in the haystack, those veterans those service members in this case, in this community who are struggling, who are hurting, who were suicidal. If we could have done that, we'd be done. We'd all, we'd be going, okay, anybody who's got, you know, suicidal ideation, come on in. It doesn't work that way.

Dr. Van Dahlen: (07:12) So rather than continuing to look for the needles, we're not focusing on the haystacks. That doesn't mean we aren't still looking for [people at risk]. And that's a part of this, of a public health approach. You start with a sort of an inverted triangle, you know, that's the way I visualize it. At the top, you have the widest part of the triangle and the messaging and the efforts and the awareness and the education, and the call to action. That's for everyone. Meaning everyone in our country. Veterans, non-veterans, active duty. That's why we're working with DOD and, and all of the agencies. It's inter-agency. So we start with that broad population. We've got to tackle suicide broadly. Then in the middle of the triangle you have people who are at greater risk, those who have, and we know what those risk factors are. We know that there are a number of risk factors that are not all mental health related, some have to do with financial stress and collapse.

Dr. Van Dahlen: (08:06) Others have to do with chronic pain or substance use and addiction. And there, there are obviously as well mental health risk factors, you know, if depression runs in someone's family or if they've experienced trauma, repeated trauma or if they are dealing with post traumatic stress. So that that's that middle band and we definitely are targeting and want to both understand how to reach people, how to help them, how to bring hope back into their lives so that they do not fall into the tip of that triangle. Those are the people who are at very high risk. People who have attempted before, perhaps multiple times. People who are chronically struggling with severe depression, who have chronic substance use, serious illness. We have that tip. So public health approach is really going after in this case, preventing suicide by doing all these things.

Dr. Van Dahlen: (09:05) Research is a huge part of this, but it's not research for research sake. This is not about creating more studies that will just become, you know, thick reports that sit on someone's shelf. This is on creating what we're calling a research ecosystem. How do we gather research that is out there in disparate places? How do we integrate data? How do we share data? And again, I'm talking now not only within the government but also in the private sector. Looking at health insurers, as they're part of this conversation. Looking at big technology companies. Most importantly, how do we take all this data, crunch it, and then translate it into knowledge that can be applied at the community level? Because that's where we want to be at the community level, ensuring that community efforts, organizations have the tools, the knowledge, and then we're going to track it all to make sure that we can demonstrate what's working and we can then adjust if we find something that isn't working,

Duane France: (10:11) That's great. It's something as you said, we've, we've needed for a very long time and it's been a big gap. I love a theory as much as the next clinician but I'm more interested in the practical application of that theory. I really liked that visualization of the, the upside down triangle and that needle in the haystack is in that, that, that bottom point, going back to what you had said about empowerment it's interesting because it comes to my mind that suicide prevention is something that is done to someone, not by someone that we try to prevent suicide to those people in the point rather than try to get everybody to do it.

Dr. Van Dahlen: (10:51) Yes. And try to lift people up so they never get there. So as a child psychologist, I'm always thinking about development prevention, early intervention because we don't want people to be at that hopeless dark place where it's much harder, much harder for them to recover from that place. If we reach them earlier with basic knowledge and information that helps them understand what they are experiencing and that it means something and it is not something to feel ashamed of or guilty about or that they need to hide from others. One of the messages that you are going to be hearing a lot coming out of PREVENTS is that we all have risk factors. Every single one of us, we have risk factors for a number of conditions. It's part of being human. We all have risk factors for suicide. Some of us have more, some of us have many.

Dr. Van Dahlen: (11:43) That doesn't mean we're suicidal at any given point in time, but if we know our risk factors, then we're much better able to, to reach out, to engage in protective activities ensuring that we're connected to people, ensuring that we are taking good care of our emotional health and wellbeing. So there's going to be a lot of messaging coming out. Last thing I want to say about that is, I hope this sort of resonates with people, everyone who dies by suicide, at some point in that person's life, they were not suicidal. And our job is to make sure that we get the right information and tools into the hands of people at that point because waiting until they're at the, you know, crisis point, for many people it's, it's too late and we may not be able to pull them back. That's why the preventive acronym is so, so powerful, so accurate.

Everyone who dies by suicide, at some point in that person's life, they were not suicidal. And our job is to make sure that we get the right information and tools into the hands of people at that point

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Duane France: (12:59) You know, something I often tell my clients is, we don't prepare for the storm when the storm is imminent, we prepare for things. People in Miami prepare for hurricanes, hopefully decades in advance. And so, you know, the idea of let's stop it before it starts. The best way to stop smoking is to never start smoking. Looking at another, you know, public health issue. And also knowing that if I have risk factors for cancer, if I do start smoking, that's going to increase those chances.

Dr. Van Dahlen: (13:31) Yes, absolutely. And so, you know, there's a lot of these pieces of this conversation that are, “yes, you know, wow, this is so complex.” Indeed it is. But there are also a lot of things that are very simple, in a way, that everyone can do. Everyone can work on talking more openly about the challenges that we all face. Everyone can work on reaching out to somebody who they know is struggling and you don't have to have the answers. You don't have to be a mental health professional. You can be there for someone else. You can say, I see that you're hurting, I see that you're struggling. I want to be part of this solution. I want to help. You know, this is something I'll also, that we talk about a lot on my team as we're building this massive effort.

Dr. Van Dahlen: (14:21) And there are over a hundred people who've been working on the PREVENTS building this roadmap. And we often talk about if I developed cancer, if I got a diagnosis of cancer, my husband would be at my side every step of the way at doctor's appointments, figuring out treatment options, figuring out things to do to ensure, you know, that I was keeping my spirits up as we were searching for a cure, as I was going through whatever treatments. People would be bringing casseroles to the house they'd be taking care of my kids. We don't do that around mental health challenges and, and there's really no good reason why. The shame and the guilt that has as you know, developed, and, and it's not to blame our society because this is, this is a global phenomenon. We don't like to feel vulnerable and, and we can't see this kind of illness or this kind of injury the way we can see or look on a scan and see cancer, but we have to change that. And that's where everyone can play a role in preventing suicide.

Duane France: (15:24) Yes, I've seen the same thing. This is something I think NAMI has really said this isn't a casserole. And kind of situation. But you're talking about the roadmap. And so I'm interested in hearing, part of the PREVENTS is to establish this roadmap. You've been getting a lot of input, like you said, from a wide range of people. So I'd like to hear more about the roadmap aspect.

Dr. Van Dahlen: (15:48) So this will literally we're, we're constructing it and putting it together now it, it will be delivered to the president's desk on March 5th. Like a journey, you know, this is really a plan, how do we get from here to there? And there are several pieces of this journey that, you know, we need to be focused on. One is the big public health effort that we were just talking about. What does that look like? So creating a national campaign that will be very similar to big campaigns that we've seen that have made huge impact on our culture. Things like friends, don't let friends drive drunk, buckle up for safety. These kinds of calls to action that are very easy for people to get. So a lot of the big public health piece that's part of this roadmap, part of the plan.

Dr. Van Dahlen: (16:41) Building this research ecosystem. How do we partner both inter-agency partnerships, which, people may assume…or maybe they don't…no, they probably don't. They may assume that agencies work easily together and it's not because agencies necessarily don't want to. It's just, it's challenging. It's difficult. So part of this work is going to be intentionally focused on inter- agency collaboration. Another piece of the roadmap will focus on workplace and professional development. We want to make sure that our corporations are ensuring programs are adopted that focus on emotional health and wellbeing. Again, public health, we want to make sure that it's about everyone so that when people are struggling, veterans are struggling, those veterans who are in the workforce, who the VA doesn't touch, we want to make sure that their companies are supporting not only them, but their entire workforce. And oh, by the way, we believe that our veterans will lead the way we were already seeing it.

Dr. Van Dahlen: (17:36) We're already talking to many of our veterans service organization partners. They're excited because once again, we need those who have served to continue to serve in this way for each other and for the broader community. So the workplace, that's an important area of focus. We're also talking about safety. Safety around lethal means because we know that access to lethal means increases suicide. We know that. And so this is one of the areas that some people are understandably concerned about, you know, they're worried about, is this only about gun restriction? The answer is no, it's not. It's about safety. We all, we know that things like trigger locks, gun safes, saves having voluntary storage of weapons when people are at high risk. We know that looking at bridges and how do we ensure that we are smart around bridges. There've been good studies that have found that if there's a bridge in a community that people are, are jumping from and you put up barriers and nets that they don't go to other bridges.

Dr. Van Dahlen: (18:39) I mean, it's just interesting what we've learned about how people make these decisions. So that safety issue is critical. And then partnerships, you know, we are building a huge number of partnerships because we can't do this alone, even though PREVENTS, has access to a massive a number of potential partners, again within government, outside of government. But we also want to ensure that wherever possible we can facilitate other partnerships that grow efforts in communities. And then finally the community work. Eventually, we are crafting a proposal…we're not in the work of, my office is not in the work of lobbying for any specific legislation…we were tasked with creating a proposal that is a standard that can be held up to say, this is what legislation can look like, that will help drive funding into communities to support this type of work. So you'll have, you know, how we start out on this journey. You'll see the big public health campaign, some of these partnerships, the research ecosystem being built, the grant funding, starting to get finalized and flowing. And lots and lots and lots of convenings and gatherings and elevating and amplifying as we work to change the culture of our country, which is a big task, but very doable.

Duane France: (20:00) I agree. And again, you had mentioned it before that if everything that everyone was doing individually would solve the problem, the problem would be solved by now. And so I think that right now there is this national effort. There's more awareness. Really applaud your efforts. I appreciate your participation and obviously your continued service because that's really what this is about is it's not another effort just to do stuff, and then, like you said, just sit on a shelf somewhere.

Dr. Van Dahlen: (20:31) Absolutely. And a couple of things if I might, Duane, to close, one of the things I didn't mention, but I'd like to also note our office and, and, and I have been out in communities already. We visited in Texas. We were in Arizona just last weekend. I was in Tennessee, Johnson city, Tennessee doing great work. We're, we're on the road, we're doing town halls. We're asking people to come together. And that's really key too that people understand. We are looking, we want to make sure that we are, we're working with tribal communities. That's partly why we were out in Arizona. At some point I'll be up in Alaska visiting, you know, we, we see this as this, this opportunity to save lives to improve emotional health and wellbeing. And I guess what I'd like to leave with or close with: two thoughts that I hope are helpful to people and one of these, I actually took from a good friend who's a very smart epidemiologist at Harvard who said, you know, it takes about 30 things to go wrong for someone to die by suicide.

Dr. Van Dahlen: (21:41) So many things have to go wrong. It isn't just one thing. You mentioned, you know, preparing for storms. It really is not to overuse the phrase, but it is an ugly, horrible storm, perfect storm of things that go wrong that lead to that decision. Sometimes it's an impulsive act, but sometimes it is a series of things that that end with that final decision. What that means is if one of those things goes right, if somebody intervenes with one of those things, you can literally change someone's life. And finally, I think the most important thing that we can each do is push ourselves to be more open and authentic with people we care about, about our own struggles and what works for us. If we do that, if we in increase just the basic communication about these things, you open the door that could save someone's life. Thank you so much for bringing this to your audience and for all you do to ensure that those who serve their families, our veterans have a program like this to hear about these relevant topics, so thank you.

Duane France: (22:52) Yes, absolutely. Thank you.

Duane France: (23:01) It was great to talk to Barbara. As she mentioned she had been on Headspace and Timing Podcast and she and I had talked quite a bit in the past, but it was great to be able to get her point of view on the PREVENTS initiative. What did you think about what we talked about?

Shauna Springer: (23:16) I thought it was a great conversation to really frame out, you know, what is to come in terms of not only the work of the task force but what we're going to be focusing on for this podcast. I really liked the analogy, you seem to really like it as well, of the needle in the haystack. As she describes these concrete aims of the task force, she talked about how messaging and interventions within corporations need to be part of this public health approach. And I think this is critical. One of my most fulfilling training experiences in the past couple of years was to develop and film for broad dissemination, a suicide prevention training for a civilian corporation that hires a large number of veterans as well as many, many civilians. They have a workforce of 20,000 people. And doing that training for all of them all at once really hit a cross section of individuals. And this was the haystack that Barbara refers to here. And after that training, the veterans in the group said felt really good for them not to be singled out for this kind of extra suicide prevention training, but to be included as everyone else in the workforce was. So I think this conversation about corporations is going to be critical to changing the culture of the country as far as Barbara put it. What do you think Duane?

Duane France: (24:39) Yeah. You know, I definitely agree with that. The idea that, you know, we don't want to be singled out. We don't eat, you know, we just want to put our head down and go to work. Right? I mean, we don't want to be seen as one of those weird veterans in the workplace or so on. Which, really, again, is sort of the struggle of, we have this entire show, we're going to be talking about this this entire year focusing on this. And so it's a critical aspect to yes, focus on the unique cultural aspects of military when it comes to suicide. But I think you're right. It's also important to wrap that into the larger conversation.

Shauna Springer: (25:15) Yeah. And I really loved how she talked about suicide is not just an issue for those who serve in the military. You and I both agree, you know, it's a society wide issue. In my work I've definitely emphasized how we shouldn't underestimate how insidious suicidal thoughts can be given that some of our strongest, bravest citizens are dying by suicide. And I really appreciated how Barbara put it when she said that we all have risk factors for suicide. By explaining it in this way. Barbara is effectively stating that suffering is a human universal and at the same time, you know, the nature of what drives a particular person to despair is going to vary a little bit depending on who they are. So I think if we really integrate this understanding, we'll approach others suffering with that necessary measure of humility and shared compassion. And I know that you and I agree on this general approach. How do you emphasize this message in the work you do with those you serve?

Duane France: (26:18) Well, one of the things that, I often tell people and, and we've meant, we've talked about it before is that something actually the Dr. Phillip Smith of the University of South Alabama had mentioned on the other show was how suicides both common and rare. And that it's common in that all of us know someone who has maybe lost their lives or been impacted by suicide, but it's that we can go many years without experiencing that. But when I started talking about this, one of the first things I remembered was the first funeral I ever went to, I was maybe 9 or 10 years old, and it was to a cousin who had taken his own life and he wasn't in the military. Right? So it's one of these things that it's just this long-term you know, it's pervasive in everybody's life.

Duane France: (27:06) And, and like you said, it's common. The other thing that she was talking about made me think about was these, these risk factors. And I didn't bring it up in the interview, Ernest Hemingway. He had all of the risk factors, right? He was exposed to trauma, he had a substance use disorder, had depression, all of these different, you know, I mean, and if back then, whether Hemingway would have, you know, done anything about it or not, but I see that as a classic case of all of the risk factors right there. And it ended the way that it ended.

Shauna Springer: (27:41) Yeah. I mean, I remember being in high school and we had this beloved science teacher who was young and good looking. And two weeks before he died by suicide, he was actually the winner of what we called the Turkey trot, which was a cross country race that all the faculty from different schools in our division would race each other in this big event. And all their kids would come out and watch. And so everybody was cheering for him and he was just vibrant and full of health. And a favorite teacher among so many kids. Engaged to be married and he died by suicide and nobody, you know, saw it coming. And so we were called into this assembly and his fiancé was there, you know, grief stricken and it was such a shocking kind of way to be introduced to the idea that some of the people that you definitely wouldn't see or wouldn't expect to be suffering in that way can be. And so I really think it's important to realize that and really loved the way that this conversation flowed with Barbara and the thought that we all have potentially risk factors for suicide. I think that brings us to a place of humility, which is very helpful for the conversation.

Duane France: (28:56) Yeah, I think this was a great conversation with Barbara. I'm definitely looking forward to seeing what the prevents task force comes out with because this is something I think that has been needed at the national level is really sort of, again, what we're trying to do here just to broadcast. But I think that they're going to be doing some very good work.

Shauna Springer: (29:17) Yup. Very interested in seeing how it all unfolds.

Links Mentioned in this Episode:

PREVENTS Task Force Announcement

PREVENTS Executive Order

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About The Show Hosts:

Duane France, MA, MBA, LPC is the Director of Veteran Services for the Family Care Center, a private mental health clinic in Colorado Springs, Colorado. He is also the Executive Director of the Colorado Veterans Health and Wellness Agency, a 501(c)3 nonprofit professionally affiliated with the Family Care Center.

Upon retiring from the Army after a twenty-two year career, including five combat and operational deployments, Mr. France began serving as a clinical mental health counselor in 2014. He is a member of the inaugural class of the George W. Bush Institute Veteran Leadership Program, a program that supports individuals from diverse sectors across the country who are motivated to increase their impact in helping our nation's veterans.

In addition to his clinical work, he also writes and speaks about veteran mental health in a wide variety of settings. He has presented at national conferences on mental health and wellness in the military population. He has authored three books, and is the founder and host of Head Space and Timing, a blog and podcast that brings the information from the clinical community to service members, veterans, and their families. He has been published in numerous local and national media outlets, and writes an online column for Counseling Today.

Dr. Shauna Springer is a licensed psychologist and nationally recognized expert on initiatives that benefit the military community. Known as “Doc Springer”, she is a trusted advisor for a vast network of veterans, military families and fellow thought leaders. Her uniquely perceptive insights have helped thousands of warriors reconnect with their tribe, strengthen their relationships, and build lives driven by their values. Dr. Springer’s work has been featured on NPR, NBC, CBS Radio, Military Times and Marine Corps Times.

She is co-author of the best-selling book, Beyond the Military, which explores the psychological, cultural and relational aspects of military transition and provides a comprehensive roadmap for successfully navigating life after military service. In addition, she has expertise in several critical, cutting edge subjects – for example – moral injury, approaching conversations about firearm safety, the links between survivor guilt, shame, and suicidal ideation, combining therapy with Stellate Ganglion Block (an innovative treatment for post-traumatic stress), the trust gap between warriors and civilian treatment providers, and the bond between those who serve in the military and their trusted healers.

Her next book WARRIOR: How to Support Those Who Protect Us has been endorsed by Academy Award Nominee and Author of the books Tribe and War, Sebastian Junger. WARRIOR will be published in Spring 2020.

Episode Transcript:

Duane France: 00:00 Welcome to the seeking the Military Suicide Solution Podcast brought to you by the Military Times. I'm Duane France

Shauna Springer: 00:06 And I'm Doc Shauna Springer

Duane France: 00:08 And we'd like to thank you for taking the time to join us to talk about an extremely important topic, suicide in the military affiliated population.

Duane France: 00:22 So this is the introductory episode of the show and you wanted to take a few minutes to tell you a bit about us, what brought us here and why this show at this point in time. To start off with, I'll tell you a little bit about me. My name is Duane France. I said I'm a retired Army Noncommissioned Officer, combat veteran of both Iraq and Afghanistan and a clinical mental health counselor practicing in Colorado Springs, Colorado. In addition to my clinical work, I also write and speak about mental health and wellness on my blog and podcast, Head Space and Timing. In over 150 episodes of that show, the topic of suicide came up often. It started to come up so often that we decided to create this show to talk about that subject specifically. I'm joined by my cohost, Doc Springer. Shauna.

Shauna Springer: 01:06 Yes, thanks Duane. So I'm a licensed psychologist who's known as Doc Springer for my role as a trusted advisor in the military and veteran community. And in addition to spending years innovating in the area of suicide prevention, I have expertise in a number of topics that have not been well explored as yet. For example, moral injury, firearm safety conversations, and bridging the trust gap between veterans and civilian treatment providers. I've never served in the military, wouldn't want to represent that I did, but I had a pretty unconventional upbringing. That I'll talk about a little bit later in this episode that has helped veterans really feel like home to me and has really helped me feel comfortable working with those who have served in the military. I work has been featured on NPR, NBC, CBS radio, Military Times, and Marine Corps Times and I'm delighted to do this podcast series with Duane France, who I first met through the Head Space and Timing podcast. He does excellent interviews and I just thought what a thoughtful interview that was. And then when he asked me to cohost this with him, it just all kind of came together from there.

Duane France: 02:15 No, I really appreciate that. I think it was as I was thinking about the concept of this show, really wanting to bring someone on to to really, you know, parse some things out with and bounce some things off of. I really appreciated your willingness to come on and have the conversation.

Shauna Springer: 02:36 Yeah. You know, one of the things I really wanted to do in this episode is to give space for us to talk about how we came to this work. It's really important to me as we go through this process to interview guests that don't see this as just a job that really see this as a mission or a calling or something that is at least sacred work to them for some reason or another. And often there's a story behind what drives people to do this work in the first place. So I wanted to ask you, doing what brought you to this work? What's your story?

Duane France: 03:17 Everybody loves an origin story, right? Surprisingly, a pretty common question is, you know, how does a...I was not a mental health professional when I was in the army. I was actually in logistics. I made a choice 25 years ago now to to take the first thing smoking out of St Louis to be able to get out of my dad's basement and happened to be that particular MOS. And then opportunities over those 22 years I spent in the Army, I decided to do more crazy stuff like jumping out of airplanes and, you know, going to weird and exotic places like Turkey and Norway rather than changing my job. But I wasn't a mental health professional specifically. I wasn't a licensed clinician when I was in the army. When I do often say that it is somewhat similar to a Platoon Sergeant, a First Sergeant of, you know, "Hey Joe, what's going on?" And, and you know, "what's going on in your head?"

Duane France: 04:05 I always thought that I was going to be a high school teacher. Like you know, one of those English teachers or maybe a history teacher who, you know, the students could derail by asking war stories and not get any homework. And I had a Vietnam Vet teacher that we knew that if we got him talking about Vietnam, we could get out of homework. And, you know, I always saw myself doing something like that. And then some of the things in, I've talked about it, we will talk about it in future episodes as my father was a Vietnam vet as well as three of his brothers. And I saw the impact of combat on my family. My parents were divorced. And so, you know, I grew up not having, you know, parents in the same household when my dad, my father was in our life, but I saw the impact of what combat did to him and his three brothers.

Duane France: 04:59 And, and, and really growing up in that time of the 80s, the mid eighties when the wall first came up. And, and so I sort of always had this idea of, I knew what the impact would have on on combat veterans. And then 2006 was actually when I first deployed to Iraq is when I first started getting the idea that these veterans are actually going to need the same support that my father and his brothers didn't get. Right? That I could see this happening again., you know, going forward. And then through a series of serendipitous events it turned out that actually was part of a reintegration program that was being hosted by an Air Force veteran who she was a clinician at a local vet center. And and she said something to me that really kind of struck me. And she was giving her spiel, right?

Duane France: 05:55 You know, don't punch the dog and don't kick the neighbors and everything and she said, "Oh, by the way, if any of you are interested in mental health, consider a career in the clinical mental health field because there's not enough combat veterans in that space." And for me that was really sort of the spark that lit the lit the fuse that sort of got me to the point where I wanted to do clinical work and I love the clinical work that I do, but as I was doing the clinical work, I also recognized that, you know, she was right. Number one, there's not enough of us, but there's not enough connection between the clinical space and the people that are actually using or you know, as, as you had mentioned, the gap between the therapists and then the clients.

Duane France: 06:42 And so, that's really where I started getting into the speaking more and talking more. And my first suicide intervention was with my Vietnam Veteran father. He passed away in 2017, natural causes, had really great times at the end of his life. But there was a period of time in the early 2000s, even before I became a clinical mental health counselor that he was in a really rough spot and I had to do a suicide intervention over the phone. I was in Germany and I had to ask him those questions and get him the help, you know. And so for me, suicide has always been that extreme end of unresolved underlying issues. And so that's why the topic of suicide is important to me. While also really more importantly, for me, addressing what's underneath that issue, not the problem itself.

Shauna Springer: 07:43 Right, right. Yeah. Well, thank you so much for, for sharing that. I, I've always known, you know, that the work is sacred to you. It's just very clear. It really comes through. But you know, having both your military background and your father service and the lived experience of intervening with somebody you love it's now just so clear to me, you know, why this has really come together to the place where it has and where some of your insights come from as well.

Duane France: 08:16 Yeah. I really appreciate that. Is definitely you know, the ball was sitting there and I decided to pick it up. So how about you? What got you into the work that you're doing and why this topic specifically?

Shauna Springer: 08:33 Yeah, so I had actually a buddy over last night from early in my high school years, haven't seen him in over two decades. And he happened to be in town, so I got to meet him and his wife and his kiddos. And we were thinking about our early years. And like many of my friends he made the point that even by Southern California standards, my upbringing was really unusual. And it kinda started with a Pat Conroy novel that my father read called The Great Santini. It was the story of Bull Meacham who was a Marine fighter pilot who raised his kids like a drill instructor. And I think in retrospect that my dad used Conroy's novel as a parenting manual and he made no bones about talking about how much he, you know, thought that was a great book and a great philosophy for raising your kids.

Shauna Springer: 09:28 And so that's how my childhood was. It was like an extended form of bootcamp really. Everything from, you know, getting up from a very early age at five in the morning and running miles around the local track in the dark to sending us alone from the age of 10 on on service missions to foreign countries. Like my first trip was I was 10 years old, didn't know the family that I stayed with, got to know them of course. But it was to Mexico City where we ministered to people who were living in what was at that time, the second largest garbage dump in the world. So, you know, these kinds of experiences, there was a whole set of challenges that we were put through to kind of push us through our natural fears. I remember for example, when I was age six, he offered me $10 to jump off an Olympic sized diving platform.

Shauna Springer: 10:24 And it was a test of trust because I couldn't swim. So jumping off, you know, I felt sure I would die, but I jumped anyway. And he scooped me out of the pool and, and gave me this $10 bill, which was like, felt like a hundred thousand dollars to me, honestly at the time, as a kid of six, you know, you know, you could buy so much with that. So experiences just in my household and growing up really shaped me in ways that have helped me feel at home with those who serve in the military. Even though I've never served, it was actually Vietnam Veterans that started calling me Doc Springer. And that term really has meaning for me. I don't really, you know, Dr. Springer is kind of, yeah, it's the default term that we use for people with advanced degrees who have been in school for a really long time.

Shauna Springer: 11:15 It doesn't mean that you've built the trust or that you hold trust with the people that you're serving. And so when I went into the VA, I served eight years to the day and that was not by accident. It was because eight years was essentially two standard enlistments. I decided I was going to go in with that mentality that this is my way to serve those who have served in our military. And so I knew that, you know, my personality wasn't particularly suited at all to a more bureaucratic organization. But I went in there with that mentality that, no matter what, I was going to stay, you know, four years and then ended up staying eight years and honestly found a lot of really mission-driven providers that are really trustworthy and good docs as well. And came to realize that there's basically two types of providers who work with veterans.

Shauna Springer: 12:11 There's doctors and there's Docs. And the doctor is the person with the higher degree and the expertise that's recognized in the academic community. But that doesn't necessarily make them a Doc. Being a Doc, which you know, can be a social worker, a psychologist, a licensed counselor of any kind, is somebody who has a special kind of trust. And really for me, the heart of the distinction is in the role that that provider assumes with his or her patients. So here's where it kinda came from, for me. There was a special forces medic who first was on my case load first started calling me Doc and he said there are three sources of medical care in special forces. There's licensed MDs who are referred to a "Sir," medics who are unproven who are called "Medics". And finally the ones that could treat and heal you. And you knew that they were going to give you help when you needed it.

Shauna Springer: 13:09 And these were the Docs. So that's where I sort of first learned that concept and then I formed my approach to practice based on that understanding. That, you know, earning the trust and holding that trust was the most important thing for me to learn to do as a healer. And I wanted to shift the way that I approached the practice with veterans to work with them as someone with the same heart as the medics they came to trust in the military. So that's why it's such an honor when people in the military community call me Doc Springer. Dr Springer, you know, is a sort of formal designation. But like I said, it just, it doesn't mean as much to me, now that I kind of understand that from my patients. So yeah, for 10 years I've been really working closely in the military and veteran community and I'm definitely aware that service members have made lots of sacrifices that I haven't.

Shauna Springer: 14:11 Serving eight years in the VA, getting to serve in that way, by no means is the same as, you know, being far away from family, being deployed. Although deployment has peak life experiences as well. I don't mean to paint it as, you know, a trauma necessarily because it isn't for many people, but I do want to bring veterans all the way home into lives that are filled with purpose, where they're deeply connected with the people that they love, that they would have died for. And so as I've walked this path with so many veterans, I've really learned a lot about love and trust. I have learned so much about what can drive even the strongest and the bravest of us to a place of despair. And I've also, I think most importantly, learned how we can come around the dark side of the moon into a path of purpose and healing. So I'm really excited to launch this podcast with you and bring on some really interesting people and leading thinkers so that we can kind of synergize across different areas of expertise and hopefully bring something of real value that will move us all forward in the area of suicide prevention.

Duane France: 15:21 Yeah, I absolutely agree. And I think back to our conversation that you had referred to on the Head Space and Timing podcast and and I think I'd made the parallel of this sort of semi-nomadic lifestyle that you grew up to that of my own kids, right? Who don't know where they're from and, and had this, you know, it's sort of a military brat kind of existence where you're ungrounded. But you're also familiar with hardship, right? Because you know, you lived in the middle of a dump and you know, in Mexico and I lived in a middle of a dump in Iraq and a dump is a dump. Right? And maybe there's some different aspects to it, but you know, so there is some shared hardship and then again, as you'd mentioned and definitely well-respected in the field. So I'm really happy to really to be starting this project with you.

Shauna Springer: 16:13 Yeah, it's going to be great. I mean, and you first had the idea, you know, you came to me after doing the Head Space and Timing podcast for some time. Your background in logistics shows up really strong to me in terms of how you planned that one and you know, how you came to this process, but we had a vision and your vision to start with was to really get beyond just talking about statistics, to really move beyond, you know, this alarming awareness of a problem. We wanted to really bring forward conversations that would pair this awareness with meaningful action so that we could move us all forward. Can you talk a little bit about, you know, that background in terms of how you came to this idea of the Seeking the Military Suicide Solution Podcast?

Duane France: 17:03 Yeah. So again, one of the things that we're really missing is taking what you and I know as clinical mental health professionals that works, that helps people, I really love that idea of getting people around the other side of the dark side of the moon. That we know what works, right? We've seen it work with veterans, we've seen, you know, people, their lives changed. And yet there's still this large number of people that don't have that. And so that was one thing was I always saw that this was this was something, that's what the Head Space and Timing podcast was about, was to talk about mental health in general and get some of this information out to people that needed it. But really over the last 25 shows, because I went up to 150,

Duane France: 17:53 And so the Head Space and Timing podcast is on hiatus right now, but really over the last 20 to 25 shows that the Head Space and Timing podcast, I'd started getting more and more people who wanted to talk about, you know, suicide and suicide prevention. It became, it started to become a bigger and bigger issue. I started being involved in suicide prevention at my community level, at the state level here in Colorado, even at the national level. And so it was the conversation that was happening throughout 2019 and and I thought that well maybe this is time and through the Head Space and Timing podcast, how you and I met, how many of the guests who, who we're bringing on this show had met where people want to talk about it. I can't...I don't like reading journal articles for fun, right?

Duane France: 18:46 But we know there's things in there that work. And so for me, this was an idea of how do we get those people that are doing the things that work to talk about the things that work. And like you said, move beyond just the awareness piece. I can get kind of crusty. And I remember one time year and a half ago where I was a little frustrated because my local newspaper, you know, did this huge article about a veteran who was saluting flagpoles around our community for 22 minutes for 22 days. That that was the suicide awareness campaign. And like I love it that people are trying to, you know, the pushups and you know, and everything else. I really appreciate that. But once we become aware of something, well now we're aware of it. Now we know it's there. What's the next step? And that's what I think this, what I hope that this is going to do is give our listeners some actionable steps and really some frame around the conversation that we need to have around military suicide.

Shauna Springer: 19:52 Right? Because, you know, really all the awareness without the action actually promotes helplessness and hopelessness about the problem. You know, you had mentioned not wanting to read a whole bunch of journal articles all the time or most people don't. And I think that's right. And you know, you and I have both also written books. I know that, you know, you're coming out with a book called Military in the Rear View Mirror. I wrote the forward for that in support of the insights that you share in that book. I also, on Veterans Day, published with my friend Jason Roncoroni, a 400 page book on military transition called Beyond the Military: a Leader's Guide for Warrior Reintegration. And it's a really different look at transition. It's a handbook really that helps people look at the psychological, cultural, and relational aspects of military transition and really confronts the identity crisis that so many of our military service members and leaders confront when they come out of the military.

Shauna Springer: 21:00 So, you know, nobody writes books or does podcasts to make money. But they are a great way to scale insights. And so, you know, the next book that that I'm working on is going to be coming out in about six months. No, not six months to be out in like three months now in March or April. It's called Warrior: How to Support Those Who Protect us. And that's going to be, you know, 10 chapters on things that I wish I had known when I started working with this population, including a couple of chapters specifically on innovations around suicide prevention that really draw from an understanding of the military and veteran population. So this timing is, you know, perfect because I've really been steeped in that writing project and you know, thinking about these issues very intensely for some time now and looking forward to seeing, you know, what themes emerge on the podcast.

Duane France: 22:01 Yes. I agree. I really appreciate your expertise, bringing your clinical experience to the conversation. I think that this is really going to be a unique way to take what all of our colleagues are doing, but get it in the hands of people that, that really want to really want to stop this. So I really appreciate you joining me. And any last thoughts?

Shauna Springer: 22:28 Yeah, the other thing I wanted to say was how much I appreciate the partnership of the staff at Military Times. I've done a couple of pieces with them over the past year and just really felt well supported by them and proud to partner with them for this podcast that we're doing.

Duane France: 22:48 Absolutely. Well thanks everybody for listening. I really appreciate you taking the time. I look forward to giving you a lot of great information. Shauna and I already have a number of guests. Really the first three months worth are going to be or have been identified already. The goal for this show was to be a contained show. It's going to run throughout 2020. It's gonna be 50 episodes plus this one. And, and really that's going to be the limit of this. Really happy to be working with partners at Military Times to be able to distribute this to a wider audience and and really look forward to Seeking the Military Suicide Solution with you. You can find out more about the work that Shawna's doing by checking out her latest book, Beyond the Military: a Leader's Guide for Warrior Reintegration, and the work that I'm doing with my latest book, Military in the Rear View Mirror. Both are available on Amazon and we'll have links to those in the show notes.

Shauna Springer: 23:46 Just a reminder that the guests and reflections on this show are for informational purposes only and should not be considered professional advice. While Duane and I are mental health professionals, we are not your mental health professionals. We always recommend that you discuss these things with a licensed clinician

Duane France: 24:02 And always remember, you can connect with the veteran crisis line by calling (800) 273-8255 and pressing one chat online with them at veterancrisisline.net or texting 838255. Thanks again for joining us to talk about Seeking the Military Suicide Solution and make sure to follow Military Times on social media to keep up with the latest shows. Join us next time for another great episode and until then, remember, you're not alone. Ever.

Links Mentioned in this Episode

Head Space and Timing Podcast

Head Space and Timing Blog

Links to Doc Springer's work:

CBS Radio “Eye on Veterans” Interview

Endorsement of Beyond the Military by “The World’s Most Interesting Man”

Beyond the Military Amazon Page and Customer Reviews

Book Review for Beyond the Military in “Veterans Today”

Op Ed in Military Times about Beyond the Military

Author Hour interview with Jason Roncoroni and Dr. Shauna Springer

Transitions from War interview about Beyond the Military

“Holding Down the Fort” Podcast interview about Beyond the Military

Veterans Voices interview with Marine Corps Veteran about his military transition

“Firearms Access: A Loaded Topic”

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