Episode 82 Transcription

Welcome to Episode 82 of Behind The Mission, a show that sparks conversations with PsychArmor's 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 on your podcast player of choice 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 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. 

On today's episode, I’m having a conversation with Aimee Johnson, a licensed clinical social worker, and a consultant specializing in supporting businesses and organizations in designing and implementing industry-specific programs and prevention strategies. Aimee has over 20 years of experience in both the private sector and the federal government. Aimee served as a national subject matter expert with a specific focus on firearm, suicide prevention and lethal means safety strategies, creating and launching media campaigns, building leading and implementing public-private partnerships and leading innovation to bring new strategies to the field of suicide prevention. You can find out more about Aimee by checking out her bio in our show notes. So let's get into my conversation with her and come back afterward to talk about some of the key points. 

DUANE: It's really great to be able to have this conversation and especially with somebody that, I, with a lot of the guests I'm meeting them for the first time, but we've known each other for a number of years.

And so it's great to be able to have a conversation. Maybe listeners gonna be like, this is two friends chatting because it literally is two friends chatting. But a lot of the work that you and I know of each other is around suicide prevention. Before we get into that would, I’d love to hear about your backstory and how you got into working specifically in suicide prevention, but also with the military population in general.

Aimee: Sure. Yeah. I'm happy to cover that. So, I would say there's two pivotal people, and if, I could show you their pictures, now I would. But, let me see if I can do a good job of describing their role in my life. My first experience with suicide is when I was in high school. Unfortunately, a young girl who was so beautiful and so energetic and such a sweetheart.

My sister's best friend, her name is Alex. Alex died by firearm suicide. She was 14. And what I can tell you about that is, I didn't know it was gonna change the kind of course of my career path and interest. But what I knew is that wasn't right. I knew that Alex didn't really wanna die, but she must have been in a lot of pain.

Of course there was a lot of pain, for everyone after she died. I also felt very confused about why she had access to a firearm. We were just young, live in suburban, Oregon. And, I was not raised getting familiar with firearms, but regardless, I just knew that a 14 year old who was in that level of pain, the equation didn't make sense. What really drove me in my career is I loved working with kids. And so I started off working with youth. I always had a deep seated value and I don't know how much the value was stated by my family, as much as it was taught. I'm Jewish, I'm the granddaughter of a Holocaust survivor.

And when I say a survivor, what I mean is my grandfather and his brother escaped a concentration camp. Ended up getting locked up in a jail after they literally, escaped on foot and they were saved by some American service members. So the value that I was raised with that ties into my desire to always wanted to work with Veterans. I just wasn't brave enough to join the military myself was that, our life was granted to us through a second chance. I do not believe that, our family would've been, in existence if it wasn't for that. So when I started, along the path of wanting to become a clinical social worker, which is what I am and what I'm proud to be, and working alongside of people, going through struggles, what I found intriguing was not just the pain that people felt or the crises that they were in, but the recovery and the hope that they had from moving through that. Obviously by the generational trauma that you know was, again, not always overly stated and the way I was raised, but the value of having faith. The value of not giving up the value of seeking help and the value of community, whether that community was your small family or your extended community.

Those were always there. But I was always intrigued by how can people go through so much in their life and why couldn't Alex have lived. And I think that question was always in my mind. So I found myself going to school to be a social worker, and I was lucky enough to get the chance to do that at the University of Michigan school of social work.

I had a real passion, like I said, for working with kids that were in crisis. And what was so cool about working with kids when they came across the legal system is so many times they had been traumatized or they had not a lot of great opportunities in life. And after a short while you could great strides. And that you could see kids that look just depressed and really struggling with substance use, have hope again for their future. So I worked with youth for a long time, and then, I decided I wanted to expand. The work that I was doing, and I was really still intrigued with crisis work.

And I began working in emergency room settings as a psychiatric social worker. It was there where I would say both Alex and my grandfather and the desire to be of service to Veterans, really all combined. I worked in, emergency rooms in the state of Oregon. There's no active duty military installation here in Oregon.

This was after nine 9/11 2001. So this is when the wars in Iraq and Afghanistan were going on. And in Oregon, the national garden reserves were really, the citizen soldiers, had been deployed multiple times different units. And I was beginning to see people come through the emergency room and mental health or substance use or combined in crises.

So my first interface was working with the VA was actually being a clinician. Trying to safety plan with folks that were coming in. And, the majority of the time we were able to help people, but I really just wanted to do more preventative work. Being able to walk with someone, in their own crises and see them come through that is incredibly powerful.

So I carry a lot of hope for people at their worst moments. And it's also frustrating to lose people. And I thought, what better place to work than the VA. So I could try to really focus my interest and passion, to be of service, to those who have been so willing to serve our country. And so I applied for work at the VA and landed there.

DUANE: I always find it nteresting, especially in talking to other people who find themselves in the work that we do, suicide prevention, broadly, mental health and things like that  is there's usually always a reason. And I can imagine that, as you were helping the youth in the criminal justice system, either overtly or maybe even subconsciously there was, I couldn't help Alex, but I could help this young man or woman.

I obviously can't help the service members to save my grandfather and his brother. But I can help this one. And I think for me again, very specifically, and I've mentioned it on the show before, is that I knew that I could not be my father's therapist, or his brother's therapist, but when I saw the same things or, anticipated the same things that happening to soldiers of my generation that happened to theirs, I definitely could channel that into supporting them.

Aimee: Absolutely. And I really feel that the work that we do advancing mental wellness and trying to give people hope at their worst moments or trying to find more, upstream  preventative strategies that we don't have so many people who are in that suffering and pain it's, this is just human nature.

This is a way that we can connect to each other and really quickly in my work experience, this has been true. The details of where someone's from or their age, their education, their politics, whether or not they served in the military. When you're in crisis with someone and you're helping them, the details of all of that really diminish.

And it's the human suffering that is really, powerful. And I think for me, a spiritual experience in many ways. I'm not sure that it always is for others. But it's just powerful. We all bleed the same way. We all go through the same worries and fear sometimes, very different depending on, many factors, but, when someone's in crisis and you can give them hope and you get to see them get better, it is just the one of the most rewarding experiences.

Yes, I think we're, we definitely land in the places that we do from our unique backgrounds and experiences. And, I have a lot of thoughts about, what we could do more to try to help people even more, but I've been really, honored and lucky to have so many people share with me their experiences.

DUANE: Now, I think there's that if we're walking by the river and we see someone drowning and I have the capacity to jump in and save them, I have the ability to jump in and save them. If I have the skills required. It doesn't matter what shoes they're wearing or where they come from or who their father is or who their lover is.

Like, none of that matters. If we are people who have a certain ability, a skill, and have the ability to jump in and save them, carrying that metaphor forward. Now you started working, with suicide prevention in the two thousands like 2008, 2009. and here we are in 2022. And so I'm in, especially within the VA, but how have you seen suicide prevention or the awareness of suicide, or just is suicidality in service members and Veterans, has been happening for decades, centuries, of course, but really over the last 10 to 12 years, there's I get this sense from the outside, looking in a seismic shift. But you were working in suicide prevention even longer before than I was.

So I'm curious how that's been for you over these past 10 or 12 years.

Aimee: Sure. I'll try to speak to that as best I can. It's a big question. And I think there's a lot of layers there. I'll say I'm a huge fan of VA care. I obviously, as I mentioned, I'm not a Veteran, so I did not receive care there, but I was on the side of delivering care. I no longer work for the VA, but I have a lot of pride about the work there and the skill level of folks who deliver that care. It's a system that's rich in resources. And what I mean by that is from working on the outside in the community if I needed to get follow up for someone who had been in a suicidal crisis or who's struggling with addiction, it was really challenging.

If you didn't have enough cash or enough insurance, different points in time to get any level of follow up care. And the VA provides this level of resources for those who can receive care there at a remarkable level. So what I think is the VA took a significant leadership role, as you mentioned with the government to put, resources towards specifically building the largest crisis line in the world. The Veterans crisis line specifically towards embedding suicide prevention, across all different types of healthcare, not just mental health and substance use. And they were able to do that in a national way, a system that was able to hire at any rime more than 400 suicide prevention coordinators. And really what I feel to, to be a leader across a nation about the need to talk about the problem, to understand it as a public health problem and not one that's just specific to the SMBF community. But I, I really feel that,the VA itself should get a lot of credit.

Advancements that have been made for testing out new innovations, which the VA has a long history of doing across all different types of medicine. I also think that, there's been a shift in a lot of the advocacy groups that are typically Veteran service, large organizations, and their willingness to focus on carrying a different message, which was maybe at times,more focused on you can't prevent suicide or maybe focused on the myths that we now know to be, not true. And to really embrace the concept of talking about firearms, for example, and, the broader lethal mean safety discussions. I think there was earlier in my career at the VA, maybe let's say 10 to 12 years ago, that was still harder to see other organizations lean in to carry messages specifically that treatment works.

That there's hope that there's help for you, even if you're in the worst moment now, or if you've just had, some, negative experiences or stressful life events on more of a preventative level. And so I think that the combination of larger organizations leaning in, and I don't just mean those who advocate for Veterans, but you've got American Foundation For Suicide Prevention, the largest national nonprofit. You've got other federal agencies like SAMSA, the Indian Health Service.

You've got all kinds of other large groups leaning into the problem of trying to prevent suicide and to try to prevent substance use. There's such a significant connection between substance use disorders. So I think all of those things combined, the momentum really started to shift and then some really influential organizations were willing also to carry the messages that we were able to share with them through, science and evidence, but also just through education. I think a lot of people get hurt and suffer complex trauma after losing someone to suicide. And it becomes really difficult to understand that maybe their life could have been saved.

Because there's a lot of burden that we feel for those of us, us who've survived. And there's a lot of guilt. And over time it can be hard to step out of our own personal life experience, as either an attempt survivor or a law survivor and be able to say, okay, there's some significant things that we can do, to not have so many people impacted by suicide loss. And I'm still hopeful today because of some of the great momentum that's been done through different public private partnerships, and as well as a forest direct clinical care.

DUANE: But I wonder if we're not in the middle of it, if not in the beginning stages of a shift, I'm thinking of one parallel that comes to mind is how long it took the clinical community to recognize Posttraumatic Stress Disorder, not until 1981. And then really for 15 or 20 years before it actually became something that it was recognized and it was widespread, right?

It wasn't until the late nineties or two thousands, that it really became something that this is understood. And of course even PTSD is more broadly the paint brush than it actually is. But really it took 50 years for it to become a clinical condition. Then another 15 to 20 years for it to become widely understood that this is just a psychological condition. I wonder if we're in the 1980s of suicide prevention.

AIMEE: It's an interesting perspective. And now there's really promising clinical interventions, that are evidence based. Just like they're all for PTSD. And, I'm a believer that, someone like Alex would not have been in the pain that she was in. If let's say certain, I don't know all the details of what she went through in life, but certainly something traumatic was going on for her.

And what about the ability to be more preventative to avoid childhood trauma? What about, finding ways to help adults find healing quickly and rapidly through quick access to evidence based treatment for PTSD. Some of the most effective treatments as a clinician that I've ever seen certainly. Are those that are considered the treatments of choice for, therapy styles for PTSD treatment and to see someone get their life back after struggling with symptoms of PTSD, to see someone find recovery after struggling with addiction and have hope that their life can be, turned in a totally different direction when it was so close to ending.

I agree with you there's I think that we're at a great position now, and especially with the resources VA has, I'm not saying that they have everything that they should. I do think research, around suicide prevention is not funded. The way it should be, especially considering, the data that both CDC and VA have shared in the last year.

And the warning signals, that we see, coming out of a pandemic, I'm with you. I see the hope and I see the writing on the wall that you're describing. So I hope that you're right.

DUANE: And you've mentioned a couple of different times now prevention and being more preventative. And if someone is able to get treatment for substance use concerns, or some of the psychological concerns, maybe they don't end up going back to the metaphor. They don't end up getting into the river, experiencing a suicidal crisis. But there's this idea and you and I talked about it briefly before we started recording, is that a lot of people think prevention is stopping somebody from dying by suicide in the immediate short term, preventing suicide is them calling the crisis line or hey, call me and I'll come over now.

I'll help you out. Same way that preventing a DUI is call meand I'll be your designated driver, where really that's intervention. We need to start thinking about prevention as what happens a week before the suicidal crisis or a month or a year or a childhood.

AIMEE:  I agree. I really think that the traumatic events that people experience in life and how trauma affects people differently could give us a lot of opportunity for prevention. Whether it's a natural disaster, whether it's a violent crime, whether it's, something that happens in the home or at school, there's layers of trauma that can just really make it so challenging for people if they don't have treatment for it. Yes, it's true that not everyone who goes through traumatic experience ends up with PTSD, but for those who do there are resources that oftentimes can take, 20, 30, 40 years for them to find if they are alive to find them, and there's such a big crossover between trauma and substance use and addiction just like there's family history and genetics.

I agree with you when it comes to helping people consider a different way of life. Having someone take a look at whether or not they've been able to string together 30 days of life without a mind altering substance, like alcohol, marijuana, or something else. These are things that we can try to do and messages that we can carry, but our culture, could use a little bit of a shift to, but I'm hopeful.

Very hopeful. And, when people can find a different way of life where they can live transparently and honestly,and, share with other people what's worked for them, that's provided them  hope and healing, that's just an awesome place to be. And yes, hopefully we'll avoid those moments of crisis where you're describing the crisis intervention, which is absolutely lifesaving and necessary and so difficult.

I can tell you after, talking to a lot of people face to face and in person, I don't know. I would say probably have definitely helped hundreds, maybe even a thousand or more people in the span of my career in being in crisis, that also is heavy work. And so for those crisis interventions or for those healthcare providers that have been working through this pandemic, getting support for ourselves has been really helpful.

And the way I see it, that's also prevention. There's different, of course,folks who have different risk factors for suicide, whether they're in healthcare, law enforcement, but there's things that we can all do to take care of ourselves in a different way. And I'm passionate about all of that. And that's why I say I have hope that we can make some significant advancements around preventing suicide if our communities really band together to do that.

DUANE: Something you said at the early part of our conversation was that you weren't brave enough to join the military and serve the country. But yet you're brave enough to sit face to face and next to a thousand people in a suicidal like that is hugely brave, right? That is an amazing that, some people, I'm not sure, I have the ability to jump in the water and swim and save that person who's drowning.

And who's the person who has the, but that is a form of bravery to stand up and say, I am going to serve in my way and this way, this is what I'm gonna do. That is a measure of brave.

AIMEE: Thank you. It's not the way that I had looked at it, but I appreciate the perspective. And, when you find something that really that you feel fulfilled by, and that, you can see the light in someone's eyes, or you can see the change in their path of treatment. It is, like I mentioned to me, it's a spiritual experience.

There's, it, doesn't a lot of things that seem to matter or divide us really fall to the wayside. And it just gives me hope that yeah,like also you picked up on and what I said, it gives me hope for human nature, that we won't have so many 14 year olds in a suicidal crisis. It gives me hope that, we don't have to call on service members to go save other humans because of atrocities, to I just hope for a time where that's just, that's not the norm. But yeah, thanks for that perspective.

DUANE: I absolutely have that hope as well. a mentor of mine used to say, we'll get there by Friday, not this Friday, but some Friday in the future, we will get there. This has been great as always, love having a conversation with you. But if people are listening, wanna find out more about the work that you're doing, you even though not,currently working, in the VA right now, you are still doing what you're passionate about, in helping others support the suicide prevention work. So how can people find out the work that you're doing now and get in touch?

AIMEE: Sure thank you. They can visit my website: https://www.aimeejconsulting.com/. So my business now consults with organizations of all sizes to try to advance suicide prevention, advance mental wellness, prevent substance use disorders. And I have a specific area of interest around firearms, suicide prevention but what I do is help organizations embed strategies that they can do across sectors, to save lives. And I'd be happy to talk to anyone who's listening. Of course. and I appreciate the opportunity to be on the podcast.

DUANE:Absolutely. And I'll make sure the link is in the show notes in case the listeners didn't get how to spell your name. I say the same thing is I'm an easy person to find as long as you spell my name right. Parents really didn't help me out giving me an easy name, like Bob or Ted, to make sure that it was shared easily, but, I will definitely make sure all of those are in the show notes. Thank you so much for coming on the show.

AIMEE: Thank you, Duane.

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 is free to individual learners, as well as custom training options for organizations. 

I'm so glad to have had Amy on the show to talk about her work and you can absolutely hear her passion for suicide prevention. It was inspiring to hear about her reasons for getting into the work that she does. And thinking about that, we all have reasons for getting into the careers that we do. 

Take some time to consider the path that brought you to what you're doing today and why. For much of my military career, I saw myself as a high school English teacher, a history teacher after I retired. Mostly because I enjoy those subjects and I enjoy teaching. I don't know how enthusiastic I was about teaching bright young minds, but that was a sort of thing that I saw myself doing. 

But it wasn't until I started taking psychology courses that I found an affinity for mental health and wellbeing, and that interests aligned with my lived experience as a son, nephew, and grandson of soldiers who had all been impacted by combat as well as my own military experiences or like Aimee, the impact of the loss of her sister's best friend, drew her to help people. 

And the significance that soldiers in world war II had on her family helped draw her to working in the VA. And my experience, there's something about working with mental health and suicide prevention, specifically for service members, Veterans, and their families that is purposeful. 

And it needs to be purposeful. There's so many other directions that people can go in the mental health and suicide prevention field. You almost have to deliberately choose to focus on the military affiliated population and you focus on it for a reason. It's not the money is we used to say in the Army, and it's not the exotic locations, the glorious accolades. 

Or even the gratification of seeing an immediate impact of your work, it might be, as Aimee says, a very human concern for the relief of the suffering of other humans. 

It's something that is purposeful and satisfying. And if you're listening, I am talking directly to you. Thank you for doing what you're doing. If you're listening to this, that means you want to learn more. You want to help more. You want to support those who served and those who care for them as much as you can. And you're not alone. I'm right there with you. Aimee is to the folks at PsychArmor right there with you And folks around the world, listening to this podcast are also right there with you. So thanks for everything that you're done and for everything that you're going to continue to do. 

The other piece that I'd like to touch on is the thought of how far we've come in talking about suicide prevention and how that might parallel with how traumatic stress reaction has become something that's acknowledged acceptable and manageable. Suicide is nothing new. There are acts of suicide and suicidal ideation in the Bible and suicide is present in the works of Shakespeare and the Greek and Roman plays. 

Suicide in the military affiliated population is nothing new either, but looking at the data over the past 50 years, it's undeniable that suicide is on the rise, both in the wider population in general, and the military affiliated population in particular. But the first study that I recall seeing about widespread statistics on suicide in the Veteran population was the study in 2013 that looked at Veteran deaths by suicide in a certain number of states. 

We all recognize now that there were limitations to that study and studies and analyses over the years have since then, given us more specific data, but that study was published less than 10 years ago. Post-traumatic stress disorder was formally identified as a condition in 1981. 

But medical and mental health professionals recognized its symptoms as far back as a civil war, soldiers, heart, they called it back then and it was known by a number of other names, shell shock, battle fatigue, post Vietnam syndrome. Even after it was recognized in 1981, however, it really didn't start becoming a thing for about 10 years after and now combat exposure is recognized as one of the primary causes of post-traumatic stress disorder. 

And now it's 40 years later and we're still learning about the condition and there's still a lot more to learn, but we know what works to diagnose it and treat it. I'm not saying that suicide is a psychological condition, like PTSD. 

Self-directed violence during a time of crisis is a response to underlying conditions, which can be very hard to detect are not always commonly categorized and can be extremely complex in their interaction with each other. And I'm not saying that the thousands of lives lost to suicide the past 10 years are not significant or important. 

The extreme opposite. As a matter of fact, but what I am saying is perhaps there's hope. Perhaps those of you listening, who are working to reduce SMBF suicides are like those pioneers of the 1980s who were working hard to treat and support service members and Veterans suffering from traumatic stress reaction. 

They couldn't see 40 years into the future where their early efforts would end up. And we can't see into a future 30 years from now either, where we'll be able to identify and educate people about some of the causes of the distress of the human condition, as it relates to suicide. And we ensure that those who have served and those who care for them are living lives of meaning, purpose, and wellness. And if stress happens like it is of course going to do. 

The first thing that a Veteran does is reach out for help rather than experiencing that crisis alone. I know Aimee well enough to know that she has that hope envisioned for our future. And I share it as well. 

So I hope you appreciated my conversation with Aimee. If you did let us know by dropping a review or shooting us an email at info@psycharmor.org. We would appreciate knowing that you're listening, what you think and what you would like to hear about in future episodes. 

For this week PsychArmor resource of the week, I'd like to share the link to the PsychArmor course Suicide Prevention And The Safe Storage Of Firearms In The Military Connected Community Conversations For Everyone. 

This course provides critical information for members of every community about the secure storage of firearms. When people are in crisis, honest conversations about accessibility, to lethal means for suicide are vitally important. This short course, jointly narrated by four people from different cultures, including military Veterans, non-Veterans gun owners, non-gun owners and clinical psychologists aims to reduce the hesitation we often feel and talking about those that we're worried about through education. Everyone, who is worried about someone in their lives should feel confident in having frank open conversations about firearms and their safe storage, and know with certainty that those conversations save lives. You can find the link to the resource in our show notes.