Episode 103 Transcription

Welcome to Episode 103 of Behind The Mission, a show that sparks conversations with PsychArmor trusted partners and educational experts. My name is Duane France and each week I'll be having conversations with podcasts guests that will equip you with tools and resources to effectively engage with and support military service members, Veterans, and their families. You can find the show on all the podcast players or by going to www.psycharmor.org/podcast. 

Thanks again for joining us and Behind The Mission. Our work in mission are supported by generous partnerships and sponsors who also believe that education changes lives. Our sponsor this week is PsychArmor, the premier education and learning ecosystem specializing in military culture content. PsychArmor offers an online e-learning laboratory that's free to individual learners as well as custom training options for organizations. Find out more at www.psycharmor.org.

We most certainly could have redirected you back to this episode, which happens to be the fifth episode that we released, but thought that it was important enough to share this episode with you. Again, we've gained a lot of listeners over the past couple of years, so we wanted to bring this one forward for you to check out.  As I mentioned, this is a conversation with three subject matter experts who are doing great work in this space. 

 Dr. Heidi Kraft currently serves as the Chief Clinical Officer at PsychArmor and is a recognized expert on combat stress, stigma, and caring for the caregiver. Dr. Kraft served in the Navy for nine years as both a flight and clinical psychologist. 

 Dr. Kyle and Hunter is a U.S. Marine Corps combat Veteran serving multiple tours in Iraq as a super Cobra attack pilot. She has previously worked in Washington, DC as both a legislative staffer and firearm safety advocate. And is now a professor at the United States Air Force Academy. 

Dr. Ted Bonar is as a clinical psychologist and nationally recognized trainer and speaker, he serves on the healthcare advisory committee for psych armor. It was previously the chief of continuing education programs for the center for deployment psychology. You can find out more about them by checking out their bio in our show notes. So let's get into this replay and we'll come back afterwards to talk about some of the key points. 

[00:00:00] duane_20_01-21-2021_080024: Recently the three of you participated in a Twitch stream that was sponsored by stack-up dot org. this was a collaboration amongst a number of different partner organizations, Brady stack ups, psych armor, the clinical readiness project. And I saw this as a true cooperative effort.

clinical mental health professionals and subject matter experts who all want to make a difference when it comes to veteran suicide in general, and say, firearm storage. I'm interested to hear from each of you, why this partnership either between your organizations or between yourselves, Ted.

[00:00:29] ted_1_01-21-2021_100024: yeah. Dwayne, thanks. And it's a great question. I've been fortunate to work in this space of. Working with military and veterans for a number of years and I've and been equally fortunate to work with Heidi and the team at PsychArmor for many years about how to bring the best mental health education to providers, , working with veterans that's been my focus.

 we don't all have exactly the same mission, butthere's a Venn diagram where there's a really nice triangle between the three of us Heidi and Kai and myself, where we are all focused on, how do we get the best care to military and veterans? And my part in that has been how to send the proper message and provide the best education to mental health providers.

 and so again, I've been able to work with Heidi and PsychArmor for several years on different fronts, in different educational efforts. A couple of years ago. I started working with Kai when she was with and family fire and and of course now she's at the U us air force Academy, but that relationship developed Just very specifically about safe storage of firearms and access to lethal means in the context of suicide prevention, which became a focus of mine through my work as a suicide prevention specialist.

[00:01:47] ted_1_01-21-2021_100024: So for me, it was a natural pairing to work with both Heidi and Kira on these efforts and specifically get. involved with how to send the message of safe storage of firearms to the military and veterans community specifically to prevent suicide.

.

[00:02:04] heidi-kraft_1_01-21-2021_070024: Yeah. You know, the, the, um, I mean Sort of everything Ted said is exactly the way I think about the way that we have met each other. what has become, I think really obvious. what, like it, I think it's obvious when the three of us are together, that we are friends that we consider each other, not just colleagues, but really trusted friends.

and I think our conversations reflect that our audiences have told us that they like that about the way this works, that it does sound like we're having a conversation among people who care about each other, as well as what they're trying to get across. I thought the other really cool collaborative piece to the stackup work was the focus on, and family fires PSA, which was set up like a video game.

[00:02:49] heidi-kraft_1_01-21-2021_070024: And of course stack up is a nonprofit of veterans using gaming as a way to reach other veterans. And so it was even, I think, a further collaboration of worlds that maybe don't always interact, but it really, I think. Worked out pretty well. And going out on Twitch was new for some of us. and 

to me it felt like the future, but like a way to start to have conversations that maybe we haven't had a chance to have before.

[00:03:16] duane_20_01-21-2021_080024: and Kai, Ted being a practitioner, but also an educator and Heidi, obviously also being in mental health you come at this from a different angle as a subject matter expert and how that augments both of their experiences.

[00:03:28] kyleanne-_1_01-21-2021_080024: Yeah, absolutely. You know, in, some ways I'm a little bit of the black sheep, because I'm not a clinician or a psychologist, I'm a political science and sociologist by background and you came. Came into the suicide prevention world through the military or effectiveness lens is what first drove me into suicide prevention.

Knowing that, suicide is disproportionately impacting our active duty and veterans that are out there. And that becomes a military effectiveness problem. , cause it's not just losing the actual people, but the impact that it has on unit readiness on unit cohesion. On how we think about these now, citizens, soldiers, once they return and in my own experiences as a Marine and as someone who struggled through suicidal crises myself.

 for me, it was a blending of my academic research life, as well as my personal life and meeting folks who are on the educational and implementation side. Is the best thing from a researcher or a subject matter expert. You can find people , who really can translate and take good work and turn it into life-saving programmatic work, educational work, engagement work is so important.

, we like each other a lot, it helps with the personality side of things. But if you look at the complimentary skills that we bring. it really allows for a full life cycle of work education and you and Heidi brought up the end family fire PSA, which is I think an example of that, of a way to take this unique group skillset and talk about delivering it in a new medium.

we talk about reaching out to people where they are, the gaming community, where they are. I think this group is uniquely qualified to be able to do that. And so it's a partnership that just makes total sense.

[00:05:16] duane_20_01-21-2021_080024: No. I agree. in, in looking at it from the outside, this is a true collaboration of what we're talking about in the veteran serving community. but this is also a very specific subject. And in, in Chi, this is really a difficult subject within a difficult subject. Suicide historically has been hard to talk about.

It's been misunderstood within the complicated nature of suicide, even veteran suicide. The subject of time-based prevention lethal means safety and even more specifically firearms. Storage. This is getting to a specific aspect of suicide prevention, the military population. Why do you think that this subject in particular is one that our listeners need to be aware of?

[00:05:53] kyleanne-_1_01-21-2021_080024: So I think it's one of those things we talk about lethal means, especially among the military and veteran community. I think there's two things really as to why our audience should be concerned about this one that's broad, and that's just the fact that you suicide having access to lethal means.

Is going to increase the likelihood that someone will die when experiencing a suicidal crisis. , Ted and Heidi and I have talked a lot, you can't necessarily predict suicide in a lot of ways, but you can prevent the access to lethal beads. So we know that someone experiencing a crisis, if they're able to get help during that crisis, they're very likely to go on and live a fulfilling life.

And so there's this bit of this myth, I think out there that if somebody. Isn't a suicidal crisis. They will find whatever means necessary to take their own life. And we know that's just not true , if someone is thinking that a gun is the way I want to do it, if we break access to that gun.

It is incredibly more likely they're going to get help. So that's just number one. It's putting that out there that, someone who attempts suicide with a gun has a 90% lethality rate. Any other means is under 8% that you have. So they're removing access to that. Most lethal of means just allows time for people to get help.

But the next is to really dig into this unique relationship that military and veterans have with guns. It's not the same as the civilian community for. Many of us, the lethality of guns is not theoretical you. I think when we talk about guns being lethal among the civilian community, it is very.

Theoretical, this thought that, yeah, I know it can kill someone, but I'm really good at shooting targets type idea. I go to the range a lot. even those who hunt, who are a little more familiar with the lethality of guns, it becomes much different when it's human to human lethality. So this isn't theoretical for veterans.

They know, and it's often. That's the reason why they want to use a gun. There's also a lot of positive connotations with guns with veterans. these are tools that saved our lives as well. So it's a unique topic area. It's a hard topic area to talk about. you talk about the double lightning rods, suicide and guns, like people want to run for the Hills, but.

Really digging into understanding how we think about guns, how our relationship with guns exists and then working to develop tools to have those hard conversations in real meaningful ways is essential. And that's why I'm so glad that I've got folks who have that, that clinical and educational experience to be able to help me out with that side of it.

[00:08:17] duane_20_01-21-2021_080024: And Ted for you. This is something very meaningful for me to hear. Suicide is hard to predict, but it's not difficult to prevent and both as a practitioner yourself, but also as somebody who educates other practitioners, why is this subject important? Do you think?

[00:08:32] ted_1_01-21-2021_100024: Yeah, it's a great question. And the hard truth of it is I want to be careful how I say thismental health providers are really good at what they do and the mental health profession does know how to treat really hard things. And at the same time I'll say we as a profession, aren't well-trained enough.

On enough things. And one of the things that we're not well-trained enough on are these advanced treatments of how to prevent suicide. Part of that. And it's so important is how to have the conversation about lethal means. So mental health providers talking about lethal means, and let's talk about guns.

 how do we talk about guns with a gun owner? How do we talk about firearms with a firearm owning community and culture? So in the mental health profession, we'll talk about culture. All the time, right? We'll talk about different cultures based on race and gender and ethnicity and age and geography and language of origin and you name it right generation.

You can break up any of these into different types of cultures. And we in the mental health provider community, haven't done enough work. In my opinion, but I think other people agree with me, we haven't done enough work, understanding the firearm owning culture.

[00:09:47] ted_1_01-21-2021_100024: So how do we have the conversation? th the things that I talked about at the beginning of what she was sharing withguns being 90% effective. In suicide and yeah, that's not new. So like we knew, we know that Guns are dangerous when there's a risk of suicide, but that's not the same thing as practicing having the conversation from a cultural perspective about the importance of safe storage or the importance of a, what do we do?

Temporarily during a crisis so that somebody doesn't have easy access to that firearm. That's not the same thing as gun control. That's not the same thing as taking a firearm away from somebody. That conversation is delicate. That conversation must be handled with great care, respect, and dignity.

 Some of the things that Kai was talking about with. what firearms mean to a Marine or a veteran? that's something that requires great care, right? So for me, all of these things come together as somebody who's really, passionate about training and training other mental health professionals and Because it can feel so politically charged or culturally charged or whatever, we haven't practiced it enough.

I think that there is a phenomenal opportunity to move the conversation forward with real, tangible results towards reducing the rate of suicide. So that, that's wheremy perspective of that comes together. Like we really need to, to integrate. The fact that we know them of the high risk with the cultural piece, with the clinical practice of how do we have that conversation with the individual at risk.

[00:11:29] ted_1_01-21-2021_100024: That's where my interest has come in.

[00:11:30] duane_20_01-21-2021_080024: And I think that's very important. And Heidi, for your perspective on that, in that is Ted said, this is a delicate conversation. It's also a necessary conversation. And if the provider hasn't learned to have it delicately, it's going to be done with the baseball bat. It's going to be done abruptly.

It's going to be done harshly. and so for your role,. How does your point of view play into that?

[00:11:51] heidi-kraft_1_01-21-2021_070024: It's really interesting. I last week was walking with a friend of mine who I served in the Navy with. . She has left active duty and is working at Kaiser now and is married to a retired Marine. as many of us are.

 so we're having this conversation about her stepson. Who she's very worried about. he's feeling depressed and she's worried about him. He lives in a different state and she's talking through this with me and I asked her, does he have weapons in the house? And she said, Oh, like a whole arsenal, like a whole bunch of them, And I said, okay, tell me about it. And she said they're all in a safe. And the safe is. Bolt until the floor. And right now his mom has the only clue. And she said the reason I'm still worried is that, he's going to find another way.

And I looked at her and I said, Oh my gosh, she doesn't know this. so we started to talk about it and I said, no, actually doesn't show that. and she was shocked. And then she said to me, I'm a physician. And I had no idea that the research doesn't show that.

 could you do this training for everyone at Kaiser? And I found myself just really kind of I found myself stopping and taking a breath there for a moment and thinking this is a conversation that of course mental health professionals could be the first. The most important probably place we go, but really we could be talking to nurses and family practice docs.

[00:13:05] heidi-kraft_1_01-21-2021_070024: And th there's a lot of different touch points where if we could get people comfortable with this conversation, at least just breaking down a few of the myths in a really quick succinct and Ted said delicate way. Gosh, we could make a giant difference. I really, it hit me how much of a difference we could make.

 so from my perspective, I am a clinician and an educator. I feel like every every chance we get to educate one person that could then educate someone else is the chance to save someone's life. And it really it stopped me in my tracks. I knew this, but having that conversation made me open my eyes and think like it's right in front of me, it's everywhere.

 and it really, I think. If you fueled what was already a fire within me about this, I feel really passionate that this might be the answer that this might really turn things around. And so I feel incredibly dedicated to these two people and what they've been trying to get out and being allowed to

[00:14:05] heidi-kraft_1_01-21-2021_070024: join them in that, um,that attempt to really change the way people are talking about this. 

[00:14:12] kyleanne-_1_01-21-2021_080024: Follow up just real quickly on what Heidi just said. One thing I think that's incredibly important is this multiple touch points. You know, we talk about mental health professionals having This tool set this skill set, but one of the things that we were starting to see be born out in the data, and I've been working just quite a bit in my own County here with the data from the, coroner's office around suicide deaths, which is. horrific, but it's, it's what you have to do to get to the root of these problems is that individuals who are engaged in active mental health care actually see a much lower reduction in their, likelihood, um, individuals who don't see a much higher instance, those individuals tend to have, I mean, it's something like over 80% of those individuals who died by suicide in our.

County had a touch point with somebody else in the healthcare system very quickly, whether it was, a chronic illness or an acute injury or something, you know? So I think that can't be stressed enough that there's the mental health. Toolkit that's there, but all of these other touch points need to be able to have this.

And when we think about something like the VA, really to focus on the veteran community,it's not even just the physical health care providers. We needfinancial counselors, the job placement folks, the, you know, the childcare activists, the ones working with VA loans. I mean, cause we know all of these sort of stressors that can lead someone to think about a suicidal crisis, you know?

Job loss, a home loss, financial issues. So getting this training into more and more hands in a meaningful way is what's so important because you don't know who that. 

[00:15:50] heidi-kraft_1_01-21-2021_070024: Kai you're lesser. Right?So am I,that, that occurs to me, even as you're saying that 

we have educators and student veterans too, right? it's, we could keep. We can keep expanding the circle of places where we have the ability to intervene. 

[00:16:04] duane_20_01-21-2021_080024: And I think that's one of the critical issues. Everybody says, how do we solve this? But firearm deaths by suicide is such a significant, part of what's happening. That this is the solution. If we make an impact here, We can make a significant seismic shift in this Heidi you're part of psych Armor's team.

And PsychArmor his mission is to educate those that are serving people in the military population. That's a broad goal with a specific focus, but why do you think it was important for psych armor to be a part of this effort specifically? 

, amongst all of the other things , and for cayenne Ted, why do you think PsychArmor was a good 

partner for this 

[00:16:38] heidi-kraft_1_01-21-2021_070024: So PsychArmor has, , over 200 courses online courses that educate people who support veterans in a number of different ways. one of the portfolios I'm the proudest about is our suicide prevention, intervention, and postvention portfolio, which was sponsored by the NFL foundation. It brought together.

A variety of different experts that talked about different tools to assess and potentially intervene with suicide crises, as well as take care of suicide survivors. As we kind of moved along and these courses became live and started having people taking them. It became very clear to me that we were missing this piece. And when I had the opportunity to meet Kai, I was so moved by what she was trying to do. . But then I realized Ted and Kai had been already working together on this started to hear what they were doing.

And it became so obvious to me that this was a piece, our portfolio was really missing and that I could be part of bringing this to the portfolio. So we have been doing the speaking part together and we hope to continue to do that.

, Ted's been doing a lot of that has been doing a lot of that , and every time I talk suicide prevention, now I, I bring it in as well. and then my goal is, to actually have a couple of courses that support this as well within psych Armor's library. We really believe it's an important.

Vital critical part of the message around this. And so we want to be part of it. 

[00:18:02] duane_20_01-21-2021_080024: And Kai psych Armor's role as an organization, that's educating people in their learning management system. why do you think this was important to partner with PsychArmor about 

 The topic specifically? 

[00:18:14] kyleanne-_1_01-21-2021_080024: Well, it's, getting it in the hands of the people who need to see it the most, you know, I can, I can do research, but being able, you know, as Heidi noted, being able to actually get out and educate people who need to see this like psych armored vehicle and the trust and respect they have is an essential piece for this, So it doesn't, it doesn't get conflated as a gun control issue, as Ted said, you know, when we start talking about. Firearms and suicide. It can easily get set as like, Nope, this is a gun control issue. I'm not going to touch it with a 10 foot pole. having a vehicle like PsychArmor de politicizes everything and puts it squarely in the realm of, we are here to help , our veterans.

And it's a piece of helping the veterans. And I think , that's where, when we all talk about this too, this is , one piece of a big puzzle around veterans health, but it's an incredibly important one. 

[00:19:04] ted_1_01-21-2021_100024: Yeah, I think that, um, PsychArmor is uniquely positioned. , when you're gonna. Tackle something as big as suicide or suicide by firearm, you need a public health approach. Right. and I think that PsychArmor is uniquely positioned to, provide a broad platform. I'm going to go back to very, very basics here.

We use rough numbers, but they're they're right there. 48,000 suicides per year. Give or take and 24 plus. Thousand by firearm, 24,000 suicides a year by firearm. Every single time. I think about that number. I'm shocked and stunned and, and the enormity of it never goes away. Like it's really easy to throw out that number, that more than 50% of people that die by suicide died by firearm.

It's easy to throw that number out there, but that doesn't capture the bigness of it to me, right. To me, it's 24,000. Like we can move that number. We have to move that number. We can't talk about suicide without talking about, firearm safety. if we want to move that number and I'm not the only one that says that that's not unique to my perspective.

so I think that psych armor is uniquely qualified to carry that mission and to carry that very specific goal. Of reducing that number, into a firearm owning community of military and veterans. And it's uniquely positioned to provide specific training to mental health providers. Or medical providers or general audiences, we do need this education out there.

And like, Heidi said, it can be very basic information about breaking down some myths, and clarifying some facts about suicide and that can be, , presented. To, a broad spectrum of people that would have direct impact. And then we can also drill down, To, a broad spectrum of people that would have direct impact. And then we can also drill down, on some specific, mental and medical health provider networks and, and really improve, the types of conversations we have.

to a firearm owning community that might be at risk for suicide. we've also been really, really fortunate, not only to, the three of us partnered together, but to partner with American association of suicidology a clinical readiness project PsychArmor and family fire. Like we have some very specific trainings that are happening.

psych armor is the vehicle that, that delivers this. Right? So I, I just think that perfect to bring all of those messages through, to a place where we can, can make meaningful change and reduce that number.

[00:21:43] duane_20_01-21-2021_080024: No, I appreciate that. And obviously I appreciate each of you individually, but all of you collectively, because I do think that this is an example of the type of collaboration that we need to have. I really appreciate you all coming on the show today.

[00:21:56] kyleanne-_1_01-21-2021_080024: Thank you so much for having us and looking forward to continuing to work with my great friend, but also continuing the conversation. as we get to, to learn more and get more of this education out there.

[00:22:09] heidi-kraft_1_01-21-2021_070024: Absolutely. 

[00:22:10]ted_1_01-21-2021_100024: right. Thank you, Duane. Really appreciate it.

Once again, we would like to thank this week's sponsor, PsychArmor. PsychArmor is the premier education and learning ecosystem specializing in military culture content. PsychArmor offers an online e-learning laboratory that's free to individual learners as well as custom training options for organizations. 

 One of the problems when it comes to suicide is that it's an all too common occurrence, but it's still one that is confusing and unfamiliar to many. One of the key points that came up in this conversation is the challenge of predictability. KyleAnne identified that suicide is difficult to predict, but not to prevent. This is something that I think , maybe counterintuitive for many people. Everyone's looking for how to prevent suicide. Tell me the five signs to look for that somebody is going to take their life in the next 48 hours and I will prevent it. 

First that's not prevention. That's intervention. When someone is that close to a crisis point, the prevention efforts have already failed and crisis intervention must occur. Second, what may be the common indicators of suicide, substance use depression, financial difficulties, relationship issues. Don't always or even often result in suicide. To complicate matters. Death by suicide can occur without any of these indicators. And third, when it comes to warning signs, many think that the warning signs are easily observable the signs that someone's in a suicidal crisis. However, aren't like street signs or billboards with flashing lights. 

The signs are much more subtle than that. . They're the signs that spring is coming or that rain's going to come later today that the signs that something's changing in our community. So focusing on predicting suicide is difficult. Establishing a prevention program and the community is also difficult, but it's not impossible. 

It just requires people taking a different perspective. 

And that leads me to my second point. Another of the problems with suicide prevention is that there are some people who have had many conversations on the subject. We've researched the data. We've done deep work in the field of prevention. There are others, however, who are just getting started and understanding the subject. Common example of this is the persistence of the 22 veterans a day metric that many use to raise awareness . About veteran suicide. We don't lose 22 veterans a day. .

That number was taken from an initial research study in 2013. The research study clearly stated that this was an estimate and then it wasn't an accurate number. 

Not all the States in the nation participated in the study, including several with the largest veteran population. Not only that the number didn't just include veterans, it was based off of death certificate data. And so incorporated service members, . Both active duty and guard and reserve as well as veterans. 

We as a veteran serving community need to balance having introductory conversations about suicide in the military and veteran population with having more technical discussions about things like using a public health approach to prevent suicide and the differences between frequency of method and lethality of method. 

Both conversations are critical. The introductory conversations bring more people together to address the problem. And the advanced conversations are the ones that will produce those solutions. I think that today's conversation does a good job at finding that balance. It's a good introduction to this aspect of suicide prevention while also providing a basic understanding for the folks who are just beginning to join the discussion. 

The PsychArmor resource for this week are the courses related to suicide prevention, intervention and postvention suicide. In America it is a critical issue with high rates and service members and Veterans. Asking the right questions and feeling confident about how to help are the first steps in preventing someone from dying by suicide. PsychArmor hopes that these courses will help you be a lifeline and be there for someone in need. With generous funding from the NFL foundation. PsychArmor presents a portfolio that promises to provide vital education and information about suicide prevention, intervention, and postvention. For healthcare providers, service members, veterans, families, caregivers, and the community at large. You can find a link to these courses in the show notes.