Episode 114 Transcription

Welcome to episode 114 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 podcast 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 when all of the podcast players or by going to www.psycharmor.org/podcast. 

Thanks again for joining us on Behind the Mission. Our work and 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. 

On today's episode, we're featuring a conversation with Dr. Rajeev Ramchand, co-director of the Rand Epstein Family Values Policy Research Institute, and a senior behavioral scientist at the Rand Corporation. He has conducted research on suicide and suicide prevention, including environmental scans of suicide prevention programs, epidemiologic studies on risk factors for suicide, qualitative research with suicide loss survivors and evaluations of suicide prevention programs. In 2022, he was appointed by the Secretary of Defense to serve as a member of the Department of Defense Suicide Prevention and Response Independent Review Committee.

He has testified on suicide prevention before the United States Senate, the House of Representatives, and the California State Senate. One additional note given Dr. Ramchand's work, we're gonna be talking about suicide and suicidality in this episode. If you or anyone you know is experiencing a mental health crisis, there are ways to get help. Call or text nine eighty eight to access 24 hour confidential support to anyone in suicidal crisis or emotional distress. And if you're a Veteran and would like to be connected to the veteran crisis line, then call 9 88 and press 1.

You can find out more about Rajeev by checking out his bio on our show notes. So let's get into my conversation with him and come back afterwards to talk about some of the key points.

audioDuaneFrance,MA,M21652746203: Rae, so grateful to be able to have this conversation with you. Regular listeners are gonna recognize the detour away from my usual opening question, but given our limited time in your experience, I'd like to dig into your background in a bit of a different way.

You've been a leading voice and researcher in mental health and suicide prevention for the military population for a long time, even before the current levels of suicide were widely known. I'm curious, what is it about mental health and suicide in the military community that's made it an important issue for you to research and speak about?

audioRajeevRamchand,R11652746203: Duane, thank you so much for inviting me to talk to you today. Yeah, this is a personal commitment. I went to graduate school to get my PhD in psychiatric epidemiology to study drug abuse. And my dissertation topic was actually teenage drug use. Then I started at Rand. Cause I always wanted to do research that affected policy in one way or another.

And Rand has a drug policy research center and I wanted to work there. But I was also starting at Rand, two years after the invasion of Iraq, or two or three years after 2006, the height of the surge was about to start, and so things were kind of ramping up. And also, I had a personal connection. My brother was in the Navy. He was in the White House on September 11th. My other brother was in the Pentagon on September 11th. So I had this real kind of personal attachment to that current state of affairs, which is very different, you know, 20 years later.

But it was, it's very hard to recreate. We were very shocked and everyone wanted to do something. So when an opportunity at Rand came to contribute to the research, I jumped at it. I really jumped at the opportunity. I got involved very early on with the Famous Rand study, the Invisible Wounds of War.

And at the time I was just really trying to make sense of all these conflicting estimates of P T S D. Some were saying it's 50%, some were saying it's 5%. We're like, what is going on here? Why are we getting so many different estimates of this number? And really started to dig into it and got really interested and started talking to more veterans, more military communities, was provided with awesome opportunities by people like Terry Tenian and Sue Hossack, who are were great mentors.

Lisa J. Cox. among them, people probably are familiar with all of their names, as well really just gave me opportunities to grow and and exposure and it just kind of snowballed from there. I'm getting back into drug policy work now. We're starting to do some work on the policy of psychedelics for mental healthcare for veterans, but that we can save that for another podcast.

audioDuaneFrance,MA,M21652746203: You know, it's really interesting approaching mental health and veteran issues. At that point, 2006, you were probably just seeing the first leading wave of returning combat veterans. Really the first significant wave of combat veterans since the early nineties, but really since Vietnam and what we knew of about military and environmental health at that point was based off of Vietnam and based off of the post-Vietnam era. And then you're starting to see all of these issues, but also anticipating that in several years suicide is really gonna be an, a significant issue for the post 9/11 veterans.

audioRajeevRamchand,R11652746203: Yeah, that's right. so to step back, there was one kind of in between Vietnam and the Gulf War 2001, there was this, the whole issue of Gulf War syndrome. Do you remember the Gulf War syndrome and kind of this unexplained constellation of symptoms that service members were having who had deployed.

So there was a lot of work there that I think in many ways fed into some of the discussions we're having now. But regardless, yeah. So at the time we didn't really have, our eye on suicide as much invisible wounds of war. If you look at it, there's a few references to suicide. I had done a little bit of digging to see what the research was saying, that there was a link between P T S D and suicide.

There was, a stronger link at the time, empirically stating between depression and suicide risk, but not so much P T S D. And that's grown and there's more significant evidence now. But at the time, there wasn't. . So there was like a small paragraph. There was like, it's used in some places, but it's not the focus of invisible wounds.

But the DOD did start seeing an increasing suicide rate that they were concerned about. They asked RAND to look into, what they were doing to prevent suicide and how that reflected the, state of the evidence at the time. And so we saw, you know, areas where they were doing things really well, and areas where they were falling behind a little bit and where their efforts could be improved.

So that was our first foray into the military suicide. Then there was a congressional committee. I wasn't on that, that was established right around that time, to look at suicide in the military. But again, it was still a military issue and people have always been thinking about veteran suicide. But I think it started as a military issue. And then as these things happened, became, increasingly over time, a veterans policy issue.

audioDuaneFrance,MA,M21652746203: and I think for a lot of people the first awareness was really like that 2013 study which even when it came out stated that this is not the landscape. Everybody's really quoting that as the key. But you and colleagues that wasn't a surprise to you. That was a surprise to many when that came out. And of course the data and the research has gotten better and better since then. But really a, and I don't wanna say you saw that coming, but you saw those trends before then. 

audioRajeevRamchand,R11652746203: Yeah, it's so interesting, Duane research on military and veterans is really important. But there's significant barriers and one of the largest ones is that the military, once they're outta the military, it's like a veterans issue. And before they're veterans, it's a military issue.

So there's just there, like there is for a service member transitioning from a research perspective, I think that there's a gap. Are is the veteran community who, the people who study veterans looking at trends in the military population to see what's coming. And are veterans researchers able to look back into the military experience and say, what contributed to this, how can we do things better?

So that's an issue. and I'll we have more and more empirical evidence, and this is where I think it's most profound, that military sexual trauma contributes to suicide risk in the veteran population. So when people say of, what do you wanna do to prevent veteran suicide? Preventing military sexual trauma is suicide prevention.

DUANE: Yeah, I think that's really interesting. That idea of the cause, so to speak, is in one bucket, in, in one domain, the military, and then the effect occurs outside of that. Of course, the effect does sometimes occur in that, but in then I'm even thinking of in my own experience, I joined the military to get outta living in my dad's basement on the couch.

The military is as much a running away from something as it is running to something. So increasingly adverse childhood experiences, so sort of risk factors leading into the military, experiences in the military and all of that in one continuum. But it's really separated out, in, in these different.

audioRajeevRamchand,R11652746203: Yeah, that's right. And and I, the, I really grapple and struggle with the ACEs, the adverse childhood events data, because while absolutely you're correct, there is some evidence to suggest that those who join the military are more likely to report adverse childhood events. They're also, in many ways, really excel, they pass, they have to pass, requirements that allow them to serve in the military.

They haven't been arrested. They meet physical and, they meet all these, different requirements. So in many ways it remains a very select group, but also a group that has some history. And then when you compound that with, whether it's combat trauma, military sexual trauma, a whole host of other things, you have to be careful, as you said.

audioDuaneFrance,MA,M21652746203: Yeah, and I think that's really the challenge when we're, which came first, the chicken or the egg, like there is so many different things that go on. And so really in, in your experience in working with Rand and the work that you do, you're now currently the co-director of the Rand Epstein Family Veterans Policy Research Institute,which is really different than your previously funded research. What can you tell the audience about the institute and its goal to improve the lives of those who served?

audioRajeevRamchand,R11652746203: Yeah. Thank you. It's such a unique opportunity that we have to be part of this institute. So this was funded by a philanthropic gift from the Dan Epstein Family Foundation. And really we are there to improve veteran policy and to provide empirical support to improve the lives of those who served in the military and their families.

We take an approach that looks broadly so we're not just focused on mental health, we're focused on health, we're focused on education benefits. We're focused on employment benefits, and I think that by having that kind of multi focus, we can also look at the connections and the linkages between them.

So we're really well poised to look at some of the social determinants of health. So we had a lot of studies, for example, that we've currently funded, on homelessness and housing insecurity. So we can think about how that might contribute to some mental health challenges or suicide risk. We're looking at education benefits and how those can improve, some health outcomes for individuals, and for veterans.

So really taking a broad scope a real goal of the institute, and this has been a goal of Rand that we're really trying, pushing is not just to do the research, but to get it out in the right way. That is a challenge right now because as the amount of information that people have and Congress has and policy makers have coming to them is overwhelming.

Just the amount of information out there. So we really take pride in ensuring that we are objective, nonpartisan. That we can represent kind of rigor and quality and that, be a trusted source of information for some of these important kind of pressing questions that, again, work to improve the lives of veterans and their families.

audioDuaneFrance,MA,M21652746203: One of the things I really appreciate about the institute is one you're looking at, questions or problems that you know exist. It's not like you said before, the D O D said, come look at this situation. Or maybe the Department of the Navy or some guy said, please look at this particular problem for us.

Whereas with the institute you say, hey, I'm curious if there is something here or you've seen trends and there's something here. Nobody has asked you to look into the intersection between homelessness and suicidality, or perhaps they have, but really the institute gives the ability to dig into that, but then also not just to do the research and theorize, but how can we practically apply the research that we're developing?

audioRajeevRamchand,R11652746203: Yeah, that's exactly right. Typically the world, and it's so surprising. Not many people realize how research operates, but typically we operate in,we call a quote unquote soft money environment. Some organization comes to us and says, we would love Rand to do this research, or we think that we have an idea and we apply to an entity like the N I H.

And it's a competitive process to have a grant funded. So we have to make the case that this is important. With a philanthropic gift like the one we received, we were given the flexibility and the freedom to do research that was not sponsor driven, nor that we had to apply. And I think that really benefits us in two ways.

First, we can ask questions that we think are important, but that, either the VA or d o d or N I H or whoever is not yet asking. So I think that's one benefit. But the second benefit is agility because these other research processes can take a really long time. By the time you apply, you usually have to submit your application twice.

Then you get funding. Then you write papers, you do the analysis. So it can be like three or four years before you start generating anything from it. We can say, tomorrow, okay, go and tell, to have one of the Rand researchers start digging into something if there's available data. I mean, we have to get IRB approval and all that kind of stuff.Wwe're still working within the confines of ethical research and high quality research, but we have flexibility and that agility to really respond. And that I think really positions us well to ensure that we're informing policy and tackling kind of some of these high priority areas.

audioDuaneFrance,MA,M21652746203: And I think especially in this space when we're talking about not just as, not just mental health and wellness, but wellness broadly. The health of people is ultimately the breakdown of that health. suicide is a lagging indicator of underlying unresolved problems, whether it be the social determinants, improper housing of food deserts or socioeconomic stability.

And so what I really hear is this of everybody says getting upstream, but you need to research the upstream, these social determinants of health and the breakdown of them is what could likely lead to a suicidal crisis. So by studying homelessness in veterans, you are really looking at how can we prevent homelessness, preventing a crisis that could lead to suicide.

audioRajeevRamchand,R11652746203: Yeah, absolutely. We've been talking about going upstream for suicide prevention for a long time, but I don't wanna say without much knowledge as to what that is, but really with confusion or just some kind of, okay, yeah, we all agree we should get upstream, but what does that mean? Does that mean providing the crisis line number? Does that mean getting good sleep? Does that mean, getting treatment early? I think it means a lot of those things, but to your point, I do think that ultimately it requires addressing some of these social determinants or systemic issues that contribute to individuals kind of having crises that escalate to the point that they become suicidal crises.

audioDuaneFrance,MA,M21652746203: And I think that's really where this piece is. Here we are, 20 years later, as we're recording this after, the start of the Iraq war, right? So we're at a generation beyond, these last 20 years have been a generation of conflict for currently serving service members.

And that is broadly across a number of age ranges. And so yes, we're talking about some of how do we keep these crises from happening? But we're also still trying to address the crisis that is currently happening and the situation is currently here. And so over the past year, you and some colleagues have served on a committee that has done really that looking at what the situation really is.

Again, going back to the original, what's happened, the d o d, so you and a group of your colleagues served on the suicide prevention and response independent review committee, which was appointed by the Secretary of Defense to make recommendations to support the improvement of suicide prevention for actively serving forces, guard and reserve.

audioRajeevRamchand,R11652746203: Yeah, that was such an honor. The Secretary of Defense created this independent review committee. There were 10 of us, to really make recommendations for, where are there stones that have been unturned and, where can we really leverage resources to really address and confront head on this issue of military suicide.

So we went to, I think 13 military installations, cross services. We went to the North Carolina National Guard. We visited Korea. We went to Alaska. So we went to a lot of these installations and talked really thousands of service members and people who were working to improve the lives of service members.

And we asked, how does suicide get discussed? What are the stressors that you know, you and your peers experience most often? We talked to the most junior enlisted to the most senior ranking individuals. And a lot of what we heard, and for people who read the report, a lot of what they'll see are some of those social determinants, some of those upstream kind of interventions.

There are some mental health interventions as well and things like that, but that's what we did. I would love to tell you some of our recommendations. 

DUANE: Yeah, absolutely. I would love to dig into that and I'll make sure to link to the report. a 70 something, I think it was 71 or 72 recommendations came out of it and really, grouped in some of this. And one of the interesting things was, a lot of these aren't new recommendations. The recommendations that have been made before. And the first recommendation was do some of these recommendations have been recommended before? But yes, I would love to hear some of the key points that you took away from out of those different recommendations.

RAJEEV: Yeah, in terms of the recommendations we made for the report, there was a bunch of them, but some that I'll, some that I think are important to recognize. The first is, it is a strapped mental health workforce. We learned that most behavioral health providers we spoke to are not providing therapy or evidence-based care, they are managing crises.

There is an over-reliance on mental health. So we have some recommendations there to kind of ease the burden and hopefully instill some skills for leaders so that not every kind of flare up or disagreement results in a referral to mental health or behavioral health. So that's one recommendation is to recognize the burden currently placed on the military mental health system, we have a recommendation there about heavy drinking. I was really astounded by how much heavy alcohol use there was on installations and subsequent issues. And I think that's one of the, again, unturned stones when it comes to suicide risk, I don't think it's been addressed yet, adequately.

And so we have some recommendations there both about how alcohol's promoted on military installations and maybe thinking about constraining or changing some of the promotion, but also, how we screen for alcohol use disorders in primary care and things of that nature. Also related to that is, is some recommendations about energy drinks.

There was a lot of energy drinks being drunk among service members and soldiers. So we have some recommendations cuz if you think about it, you're drinking of this depressant and then you wake up in the morning and rely on energy drinks to make you through the day. You're doing a lot to your brain, by having these depressants and then stimulants and depressants, and then stimulants. It's hard to keep up. And so there is emerging evidence looking at kind of the problem that creates. Firearms. We have a lot of recommendations in there about firearms and we know that firearm availability increases risk of suicide.

We acknowledge that personally owned weapons are a right that service members have. But at the same time, we make recommendations about how they should be stored, the training that people should have to receive them just like the military does for motorcycles, really. Kind of ensuring that when people access and have firearms, just like when they have motorcycles, they're using them safely and storing them safely.

And I'll just say, the one other thing that we really saw was, we're facing a military recruiting crisis and members, especially the junior enlisted, are being pushed really hard. They're working a lot, and it's a hard life and there is a mentality in the military, I don't know if it was, I think it was there when you were there do more with less, right? Do more with less. Do more with less. There comes a point where you just can't do anymore with less. And so we really made recommendations to revisit that motto, to revisit that theory to say what is necessary, what's important how can we relieve some of the work related stressors that are currently being placed on these, E ones E twos, E threes, E fours, E fives.

Honestly, O ones O twos O three s, it's, we talk to everyone and everyone is overburdened and everyone is stressed out and overworked. So it's how do  really need to revisit what we're asking for these men and women to do in addition, as part of their daily routine, in addition to ensuring your and my safety and the security of our nation.

audioDuaneFrance,MA,M21652746203: No, I think that last one is a very critical one. And what even you saying that, it brings me back to, I arrived at Fort Carson, Colorado in October of 2006. I was probably number 20 in a brand new unit. Like the unit was empty, the motor pool was empty. We had three vehicles. Eight months later, we deployed to Iraq as a company of 150 people in a full stock like it was eight months of just rapid everything. Just pouring everything into the bucket. And that's exactly, and the whole idea of doing more with less, I think that's the motto of the Marine Corps actually, is literally how they live. But I think that's really the stress and that stress 2006 to 2016, to even where we are right now.

That is part of this sort of generational shift is doing that, the idea of everything's a mental health crisis, so anything sending them to the clinician, in some ways that becomes, oh, that's somebody else's problem. Oh, you're having stress. Let me have the doc deal with that. I don't have to deal with you and your financial burdens, or things like that. That's a mental health issue. I'm just gonna pass it off to the doc, and that's what they're gonna deal with. But everybody's dealing with that stress.

audioRajeevRamchand,R11652746203: Right, and the, I mean, we heard things being passed off, troubles with roommates, home sickness and things like that. And sure, like some of those could be pretty severe, but a lot of those we think could be handled by a non-licensed behavioral health provider. You know, a good leader, an empathetic leader, somebody who understands and exhibits true leadership qualities, I'll say.

audioDuaneFrance,MA,M21652746203: Absolutely. In the other piece you were talking about, and this is again going back to your original work as far as substance use, is the military is a drinking culture and even with the caffeine use, right? That is a mind altering substance, right? That is addictive but there's this, I'm not too far away. When I joined the military in the mid nineties, it was still in the era. I, my first tour was in Germany. It was a two beer lunch. As long as you had two beers at lunch, it was okay. And this was early, early nineties. But still, I'm not

audioRajeevRamchand,R11652746203: not that long.

audioDuaneFrance,MA,M21652746203: That's not that long ago. It's, that's still the culture. Of drinking to celebrate, drinking to unwind, but then you add on top of it all the stress that you were talking about before is like combat exposure, military sexual trauma and things like that. Now, alcohol is being used to regulate emotion and to be able to get to sleep and things like that.

audioRajeevRamchand,R11652746203: Or just boredom, Duane. I think that a lot of these bases we went to, there's not much to do outside to be honest. There's not much to do inside the gates on the evenings and weekends. There's not tons of offerings. Bowling, alleys, clothes early. So people are in their dorm rooms, which some of them aren't that great to start with and there's nothing else to do, so they just drink. That's a problem.

audioDuaneFrance,MA,M21652746203: Yeah. And I that definitely all of these different pieces, again, seeing it from the work that we do as far as preventing suicide, we're now trying to solve all these crises where if we make some of these recommendations, really it's more upstream work, to be able to do that.

audioRajeevRamchand,R11652746203: Yeah, that's right. We have to get upstream because if we're just constantly screening and referring, we're gonna miss a lot of individuals. And I don't know how we're gonna solve this behavioral health workforce issue. If that, if we just keep sending people, my colleague Jerry Reid tells this really great anecdote or metaphor that,you're in a, you're next to a stream and you see someone drowning and so you pull them out and you start going on your merry way, and then you see somebody else coming down the stream and so you're like, oh, I should pull this out.

How long are you gonna stay at that point, pulling people outta the stream before you start thinking what's going on up there? What's going on up, literally upstream, what's going on there? Why do people keep falling in? Can we put a fence? You know what I mean? And that's where we need to come from a, when we think about suicide prevention, we always need people to be pulling people out of the water downstream. But we need to send some people back upstream and, and think about some of those fences.

audioDuaneFrance,MA,M21652746203: Yeah, I absolutely agree. And so I, I really appreciate the opportunity to have this conversation. If people wanted to find out more, maybe about the Epstein Family Veterans Policy Research Institute or the research that you're doing, how can they do that?

audioRajeevRamchand,R11652746203: Yeah. Please go to our website, www.veteran.rand.org  And everything is there. And when you go there, make sure you click on our newsletter and sign up for our newsletter, and you'll get monthly updates and we won't sell your information to anyone. And you'll get monthly email updates, just letting you know what we have on our agenda and what's new and what's, hot . Really fun stuff. We had webinars too recently. Every other month we're doing a webinar. We just did one on, the history and the future of veterans serving nonprofits, which was really interesting, Especially as veterans becomes a more diverse group, how veterans serving organizations are keeping up and changing to meet that demand and how they collaborate with each other to push veteran policy agendas forward.

audioDuaneFrance,MA,M21652746203: Yeah, absolutely. I'll make sure that all the links to that in the show notes. Thank you so much for coming on the show today.

audioRajeevRamchand,R11652746203: thanks so much duane. 

Once again, we'd like to thank this week's sponsor. PsychArmor. PsychArmor is the premier education and learning ecosystems 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 organization. As a brief reminder, if something you heard in this episode caused concern for yourself or a loved one, there are ways to get help. Call or text nine eighty eight to access 24 hour confidential support to anyone in suicidal crisis or emotional distress. And if you're a veteran and would like to be connected to the veteran crisis line, then call 9 8 8 and press one.

I think listeners can gather that. Dr. Ramchand  and I could talk for a long time about his research. He dropped a couple of tidbits that we could probably have another conversation about. Things like the use of psychedelics for mental healthcare for veterans.

Here's a teaser. It's not exactly what you're thinking. I've been following some interesting research about Mdma assisted psychotherapy, and there is some evidence that ketamine infusions can help with neurological dysregulation, but it's not like veterans are dropping molly or popping special K and going to their therapist. It's being done in a very controlled and medically supervised way. And you heard when receive was less than committal when talking about how adverse childhood experiences may impact trauma risk and service members.

And he's right. Although both through research and anecdotally, we hear that service members and veterans are more likely to report adverse childhood experiences, there's also likely some sort of inherent resilience. People who join the military must be relatively physically healthy, substance free, and generally clean criminal records, which means that regardless of their adverse childhood experiences, there's something that kept them from being immediately impacted to such a degree so as to no longer qualify for the military. One thing I've learned when talking to research scientists, when you have an opinion, it is very advisable to have data to back up that opinion. But the primary reason we wanted to highlight Rajeev’s work was the recent recommendation report that was released by the suicide prevention and response independent review.

One thing that I would like to stress, this is not a Department of Defense internal review. This was an independent committee that was appointed by the Secretary of Defense, but not a product of the Department of Defense. And these are simply recommendations to the D O D based on the observations of the panel members.

And I can tell you from my own observation, I am professionally familiar with a number of the members of the committee, and I highly respect their opinions. And if you read the report, which I recommend, if you're interested in the subject, there are probably recommendations in there that you may not agree with.

There might even be some that you do agree with, but think that are unlikely to be adopted for whatever reason. Prevailing military culture, the need for legislative change rather than policy changes or even the current political climate. The thing is, however, that unless we consider these recommendations and many others that have been made over the years, then we're not going to advance the conversation.

Perhaps some of the recommendations in the report can serve as an awareness building exercise, getting you to think about suicide prevention in a different way. Maybe some of them are common sense, but of such common sense that we're not sure why we're not doing them already. And perhaps these are recommendations that are for the D O D, but can also be applied to the veteran community and vice versa.

So again, if you're interested in reading the recommendations, I highly encourage it if for no other reason, but to get a broader sense of what current conditions in the D O D are, from the perspective of the independent committee. So I hope you appreciated this conversation with Dr. Ramchand as much as I did. If you did, we'd appreciate hearing from you. So if you do have some feedback, let us know. Drop a review on your podcast player of choice or send us an email at inf@psycharmor.org. We're always glad to hear from listeners both feedback on the show and suggestions for future guests.

For this week's PsychArmor Resource of the Week, I'd like to share the PsychArmor’s course, Helping Others Hold On. Narrated by another member of the Independent committee Dr. Craig Bryan. Compared to the civilian population, suicide rates among the military and veterans is very high. This series of lessons, can help to give tools and tips to recognize, understand, and combat suicidal feelings in Veterans.You can find a link to the resource in our show notes. 

So thanks for taking the time to listen to this episode. Make sure to take a look at the show notes, which you can find in the podcast app, as well as on the PsychArmor website, www.psycharmor.org/podcast. While you're there, you can find hundreds of online training videos delivered by nationally recognized subject matter experts who are committed to educating the civilian community about military culture.All of these courses are free to individual learners.

You wouldn't be listening if you didn't care. And it's that curiosity and passion for supporting service members and their families that we want to encourage and increase. Come back each week for another conversation and make sure to engage with Saer on social media to let us know what you thought about the show.

I'd like to express special thanks to Operation Encore and Navy Seahawk pilot Jerry Maniscalco for our theme song, don't Kill the Messenger. This show was produced by Headspace and Timing and all rights to the show remain reserved by psych armor.

Much appreciation to the team at PsychArmor Team that makes the show happen. Carole Turner, Vice President of Strategic Communications, who keeps me on track and is an outstanding guest coordinator and support, and transcripts by Emma Atherall. Feel free to share the show. In fact, we request that you do. But make sure to let folks know where you heard it. Join us next time for another great episode, and until then, stay aware, get educated, and be well.