BTM74 Transcription

Welcome to Episode 74 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. Find the show on all 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. This episode is brought to you by PsychArmor, the premier education and learning ecosystem, specializing in military cultural content. PsychArmor offers an online e-learning laboratory that's free to individual learners as well as custom training options for organizations. You can find more PsychArmor at www.psycharmor.org. 

On today's episode, I'm having a conversation with Dr. Lynda Davis, the Former Deputy under Secretary of Defense for military community and family policy, the former Deputy Assistant Secretary of the Navy for manpower and personnel policy and the former Chief Veterans Experience Officer for the Department of Veterans Affairs. Dr. Davis has a subject matter expert on military, Veteran, family, caregiver, and survivor support. Find out more about Dr. Davis by checking out her bio in our show notes. So let's get into my conversation with her and come back afterwards to talk about some of the key points. 

DUANE: So Dr. Davis, you've had a wide range of experiences, both in the nonprofit sector, as well as important positions in the Department of Defense and the Department of Veterans Affairs. As a Veteran yourself, as a provider and a supporter of service members, Veterans, and their families, I'm sure listeners would like to hear why you've dedicated your life and your work to serving the military affiliated popular. 

LYNDA: Thank you very much, Duane. It's great to be with you and your listening audience. Many of whom I'm sure have dedicated their lives also, to service and to serving those who've served. I had the honor early in my professional career of being able to focus on and learn about men and women who were in the military services and in the reserve components.And I was so impressed with them at the ripe young age of 38. I decided to join. And, I was fortunate to be able to have some skillsets that someone was interested in and I joined the Army and became a signal officer. It changed my life. For eight years, I was able to serve alongside some of the most impressive men and women I've ever met.

And that service alongside others who have served has continued, thankfully through the rest of my career. That changed my trajectory of what I really wanted to focus on in my life. And I quickly became a mother of a soldier, then a caregiver of a soldier and an airmen and eventually the survivor of a soldier and an airmen. That again, helped inform my experience as a family member, caregiver and survivor in our military and Veteran community. So it was not what I intended to do with my life, but, sometimes while we're planning, there's a higher power that has a different call for us. So I've been very fortunate.

DUANE: No, I think that journey is very familiar. Obviously, there are those that are working with Veterans who haven't served themselves, or maybe not even have had a direct affiliation. But similar to you after my military service, there is a desire to continue to serve. But your experiences as a caregiver, like you said, as a Veteran yourself, but really you've been able to translate that experience to some very significant, high agency level positions of both Department of Defense and Department of Veterans Affairs. 

LYNDA: Yes, I've been very fortunate in that way. Of course my first introduction to a government position was as a clinician at a VA hospital. I'm doing my internships, my clinical service. And, there, I was serving our Vietnam Era Veterans. I subsequently came to Washington DC and had an opportunity to work with the Congress and the federal agencies. All of that kind of helped prepare me, I think, with the addition of the military service to be able to understand how government works and how it can work best in support of our military Veterans, families, caregivers, and survivors. So it, both of those agencies, you mentioned, I had an opportunity to be in a leadership position. And most importantly, when I found myself in that role, one, there were a lot of things that needed to get fixed. But two very,very essential, I had great teams. And most of those teams were also filled with Veterans, service members, family members, et cetera, who had walked the walk. And together we address some of the challenges.

At DOD, we had an opportunity to implement the recommendations the president's commission on wounded warriors. And that is also known as the Dole Shalala Commission. And we were able to create a whole new program that was not only DOD wide, but it worked at the VA also and in the military services.And that's basically what we know now is our wounded warrior programs and it was the federal recovery care program. Out of that understanding the importance of working closely and collaboratively with not only federal agencies, but state and local agencies, nonprofits, faith-based organizations across the country, we created the national resource directory, which still is in existence. It has vetted resources that can be searched by topic or zip code so that someone who is a family member, a Veteran or a caseworker supporting them can find out the resources they need from all sources, for anything. For instance, mental health or housing or financial assistance. So we had a wonderful experience at the VA and we really began to initiate these listening sessions. For the first time, DOD hosted a caregiver and a survivor forum listening directly to the needs that they had and we were able to make changes. So that was a great experience. And then that was followed, in a few years, by the opportunity to serve at the department of Veterans Affairs, where I was Chief Veteran Experience Officer, basically in charge of customer service. And the one thing we know about customer service is that it also starts with listening. But it's very helpful to be your own customer. And again, I had a great team, a lot of Veterans, family members, survivors, lot of committed civilians who wanted to make sure that we understood the experience of those we were serving. And that really meant for the first time applying data tools, technology and engagement strategies to capture information in ways that were used in the private sector, but hadn't been applied in government yet. So we had some very exciting opportunities to work on the journey map for instance. Understanding across the lifetime, the life cycle of the Veteran or the caregiver, for instance, what were the moments that mattered most when they were a patient at one of our hospitals, when they were applying for benefits, when they were trying to utilize a hotline or a call center. And then being able to intervene and improve those areas that matter most so that they had a positive experience and we increase their trust and utilization of the VA in areas most helpful to them.

DUANE: I think about that transition let's talk about, like over the last 30 years of both the Department of Defense and the Department of Veterans Affairs. I think about when I first became aware of the VA, was when I saw my father trying to navigate it in the eighties. And then what I knew about it when I first joined the Army in the mid nineties, early to mid nineties, I think back to maybe what people understood about both the Department of Defense and the Department of Veterans Affairs, then to where it's changed now. It's almost inconceivable in that journey and I'm really talking here about the support for service members, Veterans, and their families. It would have been inconceivable 30 years. 

LYNDA: Exactly right. Duane. Not only have the services themselves improved, our healthcare system, which is the largest integrated healthcare system in the country, is delivering highest quality care and innovative research. Including in areas like the tele-health telemedicine that we were so desperately in need of during COVID, but it's doing those in innovative and new ways that you would have never imagined,even a decade ago.

It's no longer focused on the staff at the hospital. Although the employee experience is critical to make sure that they're well-trained and equipped and prepared to address the needs of our customer, which is our best Veteran, at all. But it's really centric to the Veteran. What does the Veteran, their family caregivers and survivors need? When do they need it? How do they want to receive it? Are we doing a good job? If not, how do we change it? This is all predicated on feedback, which you know, years ago, frankly, we didn't even ask. And, if you don't know, you don't have to respond, you don't have to change anything. Then we went ahead and initiated some paper surveys once in a while.

Now we have hundreds of surveys active at the Department of Veterans Affairs that regularly ask Veteran As soon as they've had an appointment, made a call, experienced some application, what their experience was. It's not just did you like it or not like it, it leaves an opportunity for qualitative responses so that they can give comments that are analyzed with artificial intelligence and all that data is provided back to the individuals who saw them in the first place. And also the hospital director so that changes can be made in real time. And it was imperative to know that we had a commitment from the entire department.

We are not going to ask people what they need, what they want, how they did, what their experience was, unless we're committed to responding in a positive way. And that commitment is done. It's now hardwired into the code of federal regulations for the VA, that it will primarily focus in everything policy programs, practices is the customer experience that it be effective and emotionally resonant and then it generate trust. And if it isn't, we deploy service recovery, or program improvement, and that's a commitment that every single employee has made at the Department of Veterans Affairs.

So there's really lots of exciting things going on. One I really have to brag about, and there's several more that the team helped create. During COVID when Veterans were telling us, not only do they need tele-health cause they can't get in to see their doctor, but they were also unable to get to their community-based, collaboratives or one-stop centers that we hosted. We would typically have a state Department of Veterans Affairs, the VA hospital in the area, a lot of nonprofits, the local colleges, everyone get together one day to offer an outreach to Veterans and see how they could be help. Make it easy for the Veteran to get everything done in one time.

During COVID, we couldn't do those, but Veterans really found them useful. So we went online and we made those virtual. So our virtual Veteran experience action centers are now continuing across the country. We just had one in Virginia, highly successful. Hundreds of people are able to get their needs met, in one prearranged phone call where there's warm handoffs to the next agency or next provider to make sure that we get the needs met. Several other exciting things that we were able to do.

DUANE: And I think, exactly what you were talking about a little bit before, the collaborative nature of this. First you were talking about how the Department of Veterans Affairs from top to bottom is focused on the needs of the caregiver, the Veteran, the survivor.

But really you've also had the opportunity to work with a wide range of organizations, Tragedy Assistance Program For Survivors (TAPS) or The Red Cross and others. It's not just the VA top to bottom, but really it's horizontal and collaborating with a wide range of organizations, governmental, non-governmental, non-profit, for profit organizations. Why do you think it's important to have that sort of network of collaboration supporting those whose serve? 

LYNDA: Great question, Duane. We called this collaboration, the Sea of Goodwill in 2007. The chairman of joint chiefs, at the time named it, that it really was the recognition that federal agencies and military services, no matter how hard they tried would never ever be able to provide all the services that were necessary and needed by our service members, Veterans, families, caregivers, survivors.

So we needed to collaborate. And that's one of the reasons we created the National Resource Directory. So you could find out who was doing what, in a way that you could have assurance that the information was accurate. So because we rely on these non-governmental organizations and agencies, because really they're close to especially the Veterans and to our service members. So many of whom live off installation now. And they're the ones that someone will turn to, when they're often in need. Whether it's an issue with their child who has a disability or whether it's in their faith community and there's grief, whether or not they need some carpooling financial aid.

I need to find out where I go to get the best assistance for my elderly parent who I'm also caring for. So a variety of questions, we all like to go close to home. So we know we need to collaborate. And you're exactly right. I've had the honor in a variety of capacities, whether it's on the board or in an agency being able to have a memorandum of agreement, leading programs and projects to work with hundreds of, especially our military and Veteran service organizations. And recently, for instance, a great example is that the Federal Advisory Committee for Veterans' families, caregivers, and survivors that we created under my tenure with my team. That began hearing about the change in the experience of those who were survivors, because of the difference in the way the loved one, a military or Veteran had died.

Fewer combat deaths, as we all recognize and more deaths from toxic exposures which meant a prolonged illness and caregiving, and also sadly, more from suicides. So they task the Elizabeth Dole Foundation, the Tragedy Assistance Program For Survivors and the Red Cross Military and Veteran Caregivers to look into this. I was able to apply my skills in working with different organizations and also in customer experience, understanding how to survey and listen and do research. So we now have a report that will be coming out that is specifically on the experience of caregivers survivors. And it will inform not only the VA and DOD about how to anticipate and address needs, and this is not just needs of adult. There are over 2 million children and youth who are survivors and oftentimes, caregivers before their adult died. There are little hidden helpers and these children and youth, as well as the adults, we know that if they don't get the grief support that they need especially peer based emotional support that the trauma of loss on top of the challenges of caregiving can be significant, long lasting and in some cases, profoundly disabling. And these precious ones, all of them, adults and children and youth given so much in the care of their loved one. At the very least, they deserve our continued support once that person passes away.

DUANE: No, I very much appreciate that. I think that it was actually Melissa, from the Red Cross, who helped me understand my own caregiving journey with my Vietnam Veteran Father. As I mentioned, you know with him in the VA, but not just my own, but my family zone. So you mentioned having this collaborative effort.

My younger brother was a caregiver for my father and then I became my father's caregiver when I was a Veteran and we lost him to natural causes, but it wasn't always, literally going to be that way. There was a point in which we might've lost him in other ways, as you'd mentioned, and so I'm thinking about this caregiver journey and I am a former caregiver who is now a survivor. 

And so really you've talked about this caregiver to survivor concept, but also this is a project that you've been working on. I'd be interested to hear a little bit more about that as well as the work that you're doing at the Institute for Hope and Healing with the Tragedy Assistance Program for Survivors. 

LYNDA: Thank you. The caregiver to survivor project that was a collaborative of the three organizations, the Elizabeth Dole Foundation, the Tragedy Assistance Program For Survivors and the Red Cross Military and Veteran Caregiver Network, will be shared more broadly with the public, in the coming months.

There will be briefings to the Department of Veterans Affairs and Congress and our stakeholders in the community to just tell them firsthand what we heard. Caregivers say they want and need most both before their loved one dies and especially after their loved one dies. All the while recognizing that the focus is central to the grief and bereavement experience. One of the wonderful things about the collaboration on that project was the ability to have the research analytics done by the VA's Center of Excellence for Veterans and Caregivers. That was something my team and I were able to stand up while I was at the VA, it was named after Senator Elizabeth Dole, and they specifically focus on the experience of the Veteran as well as the caregiver, and now understand the essential needs that the caregiving doesn't stop, in a sense when the loved one dies, the Veteran dies. So we have a lot of good research now that's been done to look at interventions that are most helpful. One of them is essential, that is the peer based emotional support. That is offered through groups like TAPS or even, before death, through the military and Veteran caregiver network or the Elizabeth Dole foundation, to validate the importance of that.

And then to have the caregiver focus groups and survivor surveys. Tell us that yes, how essential that was. If you've lost a loved one to suicide, it has tremendous stigma associated with it. And, for all ages, the surviving family members of all ages, and to be able to share that experience with somebody else who has walked the walk, has been able to understand it truly who is nonjudgmental, but also offers hope and healing because they've survived it. They've lived through it. They are making it, and being able to make some meaning with their life. 

That's one of the things that the TAPS Institute for Hope and Healing does. It helps train professionals to understand the experience of loss with things like illness and suicide that are unique to the military and Veteran community, but also to do training for peer support, for what's unique about the experience that children and youth need for peers. For someone who has had a suicide loss, how do you create the best program for peer mentors and that kind of training. That Institute is working with professional organizations, giving continuing medical education credits, working with the VA, especially in areas like mental health. And trying to make sure that the most harrowing and negative experiences in consequence of loss and grief, are not what is the hallmark of that family's experience.

DUANE: I think in those are both some not just admirable, but also necessary programs. And again, I think it is just being able to provide that support to organizations that are helping individuals, because like you said, maybe they might not get to TAPS specifically, but as long as an organization may be familiar with that and get them to the right place.

Dr. Davis, I'm quite certain that we can talk for many more minutes and even hours. I'd like to be able to provide an opportunity for you to have some final thoughts.

LYNDA:  First of all, I want to thank you for all that you do and your continued service and those who are listening, because clearly they have a commitment to understand more about our military and Veterans and the experience of their families, caregivers, and survivors, and to be of some kind of assistance. So thank you. We all have a role to play. We all have an opportunity to play that particular role based on what skills and talents and passions that we have that we bring to other people. And I think just as the military, as you know, Duane, is a unique microcosm of the rich diversity and broad best of America. And when we see people coming together to be able to serve those who have served, I think we also see the best of America. So I thank everyone very much.  I'll continue to do this work as one, as I have a breadth of.

DUANE: I appreciate that. And for many of those listeners who are likely familiar with a lot of the work that you've done on behalf of them, I'd like to express my appreciation for all of your services as well. Thanks for coming on the show today.

LYNDA: My pleasure. Thank you, Duane.

 Once again, this show is brought to you by 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. You can find out more about what they're doing at www.psycharmor.org.  

It was great to have someone with Dr. Davis's level of experience on the show. For those of us who live the daily lives in the middle of the crowd, it's always interesting to hear from key decision makers and understand that we're all motivated by the same thing and working towards the same goal. 

One of the first things that came out of the conversation for me was the idea of how long it can take things to change and how quickly it can take us to realize that things haven't changed enough. I'm thinking about both the VA and the DOD here, but when I first joined the military in the mid nineties, I was stationed in Germany. I clearly remember some of my NCS lamenting about how they used to be allowed two beer lunch, not too long before that. The military was always a drinking culture. The phrase drunk as a sailor came about for a reason, but a two beer lunch in 1992 is absolutely inconceivable in the military in 2022. Back then mental health wasn't even discussed, much less accessible. If you had a problem, you talked to your squad leader.  If it was something that they couldn't handle, you talked to the chaplain, that was the end of the process. These were the days of, if the Army wanted you to have a family, they would have issued you one and suck it up and drive on. Sure, some of those ideas may still linger, but the military of today is completely different from the military that I joined 30 years ago. 

And the same for the VA. The Department of Veterans Affairs of today is not like it was even 10 years ago. And definitely not like it was 20 years ago. And the VA of 10 years from now is not going to be like the VA of today. There have absolutely been improvements. Even if individual Veterans may not see it. Changing culture and a massive bureaucracy is like turning a battleship in the ocean. You're not making a hard right hand turn. Change isn't immediate. It's gradual. And yet when we're in the middle of that gradual change, it's not helpful to understand that things will get better someday. 

For somebody who may not be getting their needs met at the VA or experiencing some lingering cultural elements in the DOD. It's all well and good to be told. Well, as bad as it is, it's better than it was, but it's certainly not helpful if what we're experiencing in that moment is really, really bad. 

So change takes time and change is absolutely necessary. And even after changes have been made, more change needs to happen. It's a matter of constant improvement, and improvement only comes from listening and applying the results of that feedback to the process. It was great to hear Dr. Davis's insights on how that may work in our conversation. 

The other point that I'd like to make is how Dr. Davis pointed out that when someone reaches out for help they're more likely to reach out for help to those in their immediate community. When we ask for something, we usually do that with people that we can trust and we trust those things that are familiar to us. 

It's why many Veteran organizations are chapter base. There are some common things for every VFW or American Legion post or local chapters of the Mission Continues or Team RWB, but there are also unique things that are pertinent to each community. When it comes to reaching out for support, it could be the same way.  Calling a national number might be fine, but what I really want is someone who's in a part of town that I know whose office is on a street, whose name I can recognize. 

Being in a place where you need help is already uncomfortable. Deciding to reach out for help when you're in a dysregulated state could be even more uncomfortable. And the last thing someone might be wanting is to talk to a faceless stranger in a different location that we don't know. 

A colleague of mine in Florida has a favorite saying when he's talking about suicide prevention, it's a national problem with the local solution. Any of the challenges that Veterans face in post-military life, substance use, unemployment relationship distress, homelessness are common to many, across many different locations, but the solutions must be local. What might work in San Diego has some things in common with what might work in Denver or Detroit, but the differences are going to be enough that there has to be a localized response. 

So Dr. Davis has point of needing to make sure that organizations are local, accessible and able to be trusted is a critical one and can be applied broadly to veteran support organizations in your community. 

So, hopefully you enjoyed my conversation with Lynda. If you enjoyed the show, let us know by dropping a review on your podcast player, a choice, or by sending us an email to info@psycharmor.org. 

For this week's PsychArmor resource of the week, I'd like to share the link to the PsychArmor course, Why Collaboration Is So Important And Supporting Military Members, Veterans, Their Families and Caregivers. As Dr. Davis mentioned in our conversation, she consistently pointed out that any success in her different positions was as a result of a collaborative team. This course is designed for community leaders interested in exploring some key concepts to a successful collaborative journey. You'll learn how collaboration can provide the structure needed to impact the lives of military connected people. You can find a link to the resource in our show notes.