Episode 97 Transcription

Welcome to episode 97 of Behind The Mission, a show that sparks conversations with PsychArmor trusted partners and educational experts.

My name is Duane France, and each week I'll be having conversations with podcasts guests that will equip you with tools and resources to effectively engage with and support military service members, Veterans, and their families. You can find the show on 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 have a conversation with joy Ashcraft, director of Maryland's commitment to veterans, a program under the Maryland department of health, behavioral health administration. Joy holds a master of social work degree from the university of Southern California, where she specialized in community organization, Planning and administration and minor to military social work. Joy also holds a master of education degree in guidance and counseling from Bowie state university. She currently serves as an S3 operations officer and behavioral health practitioner in the 10th medical regiment of the Maryland defense force. If I know more about joy 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. 

[00:00:00] duane--_17_10-21-2022_063921: So Joy, I'm so glad to be able to highlight the work that you and the team in Maryland are doing to produce suicide in the military affiliated population. Before we talk about that work, however, I would like to provide an opportunity for you to share your background and why this work in particular is important to you.

[00:00:14] joy_1_10-21-2022_083921: Dwayne, thank you so much for having me. I appreciate the opportunity to talk about the work we're doing. so my background, I am a social worker by trade. I come from a large family. Of military service members. I used to be able to say we've served all branches of the armed services, but I don't have any Space Force people yet.

So we'll see what happens, with my nieces and nephews and cousins at this point. So I, I have a strong passion for this community. I have worked with the community for many years, both as a volunteer and, my prior employment I used to work for the Maryland Army National Guard and, I was what was called an alcohol and drug control officer.

And I, manage the suicide prevention and substance use services for them.

and I think that's, having that background of military family service, that cultural connection to the military overlaid with a clinical and a social work background can be really beneficial when you're approaching this topic.

[00:01:17] joy_1_10-21-2022_083921: Definitely,it really highlighted though, even with the experience with my family, my brother served my grandfather, uncles, I had started in service, but had to leave due to, my father being ill. But even with the experience, having the education as well gave new perspective, because.

My most direct link to the military is really through the Army but every branch is very different and cultures are different within each branch, depending on where you serve, when you served,what mos you have. So it, it continues. Education continues to be a very strong, purpose for me.

and I continue that regardless. Even though I have a master's degree now with a specialty in military social work, I still take a lot of educational training to really keep up, and expand my knowledge of this population.

and being in Maryland, is, as you and I have known, and we've talked before, but I was stationed in Maryland. I mean, it's a, There's some very important strategic military installations in Maryland as well as the,the National Guard, and it's a diverse state geographically, regionally, and things like that.

[00:02:30] duane--_17_10-21-2022_063921: And so being able to support Maryland service members, veterans, and their families in particular, it's really.

[00:02:36] joy_1_10-21-2022_083921: It is. one of the. Many unique things about Maryland. we are one of probably a handful of states. I don't know exactly how many that have all eight branches represented, and I'm including, uniform public health service and Noah. We also have active duty, guard and reserve here. So even though Lake Space Forest is not headquartered here, we do have a handful here.

So we do have representation from all eight branches, which makes it a very unique, state in that manner.

and a great place to retire. Like many of them remain there. I chose not to. because the military moved me out here to Colorado. but then, and that's the thing with as broad representation, a lot of veterans choose to remain in.

[00:03:19] joy_1_10-21-2022_083921: They do. And actually, what is also very interesting is we have the largest percentage of veterans who are buried here too in our cemeteries who choose to, have their rest in place in Maryland.

[00:03:34] duane--_17_10-21-2022_063921: And I think that, and that's really one thing where,more veterans, more service members comes, the other concerns, the other issues, greater needs. for example, we're talking specifically around service member and veteran military family suicide. You and I know each other through our mutual work with the governor's challenge to prevent sm VF suicide.

Be great for you to share with your audience your role in the. Governor's Challenge Team and how that integrates with and supports Maryland's commitment to veterans program.

[00:04:01] joy_1_10-21-2022_083921: Sure. So well, let me. First say that, I am the lead of the Maryland Governor's Challenge team, and it does directly connect with my role as a director of Maryland's commitment to veterans. so for many of you, you're not gonna know what Maryland's commitment to veterans is. So it's a program within our, Maryland Department of Health, Behavioral Health Administration.

So we are directly under department of. And we have really two core functions that we do. the first is really direct service. So that's connecting our service members, veterans and families with mental health and substance use and supportive services regardless of discharge status, regardless of length of service, regardless of branch served.

we support those and connect them with services across the state Both nonprofit, state agencies, all sorts of stuff. The other aspect of what we do is really about providing, and conducting educational opportunities around military culture, unique challenges of this population, bringing evidence based treatment.

[00:05:08] joy_1_10-21-2022_083921: Educational opportunities to behavioral health providers, peer specialists, first responders. we work with many crisis intervention team programs, to train, police officers in response, for this community. We also, educate service organizations and other community organizations. We actually just held a training yesterday, Yeah, so that's some of the work that we do in Maryland's commitment of veterans and how it really overlaps is that in conjunction with that work we do crisis funding and peer support, and some suicide prevention, direct suicide prevention, with some of the service members, veterans and family members that we work with. So it really overlaps with the work we do in the Governor's challenge, because we're serving through our governor's challenge. Those we're already serving through me's commitment, veterans and many more. So it's really exciting the work that we're doing and how we're expanding both the role of Maryland's commitment veterans and the governor's challenge.

[00:06:14] duane--_17_10-21-2022_063921: I really appreciate that dual approach. it's complimentary, of course. many times we wanna get. Service members, veterans, and their families to reach out for help. And so come knock on the door. But we also have to be sure that whoever's door they knock on is ready to receive them. Because if they knock on a door and they get bad service or no service, then they're gonna walk away.

[00:06:35] joy_1_10-21-2022_083921: Most definitely. And so we are really connected, with both our local VA medical centers, the vet centers, and C box. we know that there are many who are serving or have served, Choose to not utilize either installation service or VA service. So we're well connected with our local behavioral health authorities and nonprofits, that provide these services, in, which is exciting is that several of them are also on our Governor's challenge team.

So for example, we have. Stephen, a Cohen clinic in Maryland. we're one of the lucky states that has one. They're on our governor's challenge team. We have headstrong now in our, state, and they're on the team. so we're really excited to be able to have both members that we work with directly through the work we do with Maryland's commitment of veterans.

Also help shape the work that we're doing through the governor's challenge.

as a social worker yourself, in working to support this population. and as we talked earlier, you have a military affiliated background. I have a military affiliated background. There's simply not enough of us in this space, who have military experience, that sort of live military experience.

[00:07:48] duane--_17_10-21-2022_063921: So there's a lot of people with really. Clinical experience and we're talking behavioral health and suicide prevention support here that don't have that military culture, and it's necessary for them to have that experience to serve their clients in the best way.

[00:08:03] joy_1_10-21-2022_083921: It really is. But I will say that you don't have to have served to be able to provide the service. It's about taking the opportunity to educate yourself. So you know, for example, SAMHSA and the VA partnered with Psych Armour to be able to offer training virtually through the Governor's challenge portals, to educate providers, whether they're mental health, substance use, or healthcare providers and really general public on this information.

And there's many other. Avenues for training as well that's connected. so like the National Guard works with a center for deployment psychology that offers, free training as well to providers, which. I'm excited about both the psych armor portion, which is really available to everyone. Whereas the Star Behavioral Health has really focused on those who directly, will be working with in the mental health space and behavioral health space with this population, because it also includes opportunities for some really deep dive evidence based practices that work with this popul.

[00:09:12] duane--_17_10-21-2022_063921: I really appreciate that. There's, everybody could benefit from understanding what hula means, for example, you know, or, or why a Marine says ura. but then not everybody really needs to know the unique differences between treatments for traumatic brain injury and ptsd. Like those, that's much more of a clinical focus us.

[00:09:28] joy_1_10-21-2022_083921: Yes. but what I will say, even with all the training in the world, You're still not going to know everything. So it's important when you're having those conversations or meeting with,if you're in the clinical space, if you're, if you have someone that comes in your office who's a service member, veteran, or family member, Simply ask the questions.

If you don't understand something, ask and they will share that information with you because it's giving them an opportunity to educate you instead of everything being the other way around. So it, it really opens a dialogue and builds a rapport between the two individuals by simply asking.

[00:10:08] duane--_17_10-21-2022_063921: No, I think that's a really important point. Even when I was working as a clinician with my own military experience, I, I had to have cultural humility to know that I don't know what it was like to be a Navy service member in the late seventies, early eighties. And what that experience was like.

so I can't say that just because I served for 20 something years in the Army, in the early two thousands, means that I know everything that there is to know about the military.

[00:10:32] joy_1_10-21-2022_083921: Exactly, or even if it's the same branch. So for example, with Army and Air Force, you have active duty, guard, and reserve. And so while the branch is the same, The amount of support and deployments and things like that are very different between active duty guard reserve. so it's very important if you weren't directly in that space, ask questions, get to know more about the culture that individual was part of, because we're not just talking about Like when I worked with the National Guard, everybody has layered cultures. So it's not just the Army National Guard culture. You're also looking at, I'm serving with this unit and within this unit I have this mos. But then we're also building on, we have the. Gender culture. We have ethnicity, culture, we have, I'm from Maryland versus someone else is from Texas.

the culture's different. So we have layers of culture and so it's really important to have those conversations on an individual level to really grasp what the person is, the culture of the person cuz it's many layers.

and especially with some of those, yeah. in reserve and Guard in particular, I served for a period of time in a reserve unit in which the company commander and the company First Sergeant worked together in their civilian life. But the first Sergeant was the company commander, supervisor.

[00:12:01] duane--_17_10-21-2022_063921: and so I think that idea of that multilayered culture and everyone has their own rich and combined experience and being able to understand that is very critical. Now you've talked about the trained military assistance program, the specific training for, for providers, which is one of the efforts to the Governor's Challenge, and you've partnered Withy Armer to bring to providers in your state.

What can you tell us about the program?

[00:12:23] joy_1_10-21-2022_083921: Well, I'm, I am really excited about this program. within Our Governor's Challenge overall. We were able to bring in almost a million dollars in grant funding, which is super exciting for some of the efforts we're doing. And part of that, has been put forward to really build this trained military assistance provider program.

So it's a, it's really a new initiative about, Of course, reducing suicide in this population. increasing lethal means safety and educating healthcare providers on how to have those conversations with their patients, because we know all the research shows. That those who have died by suicide saw their healthcare provider at higher percentage rates the month prior or the year prior to them dying by suicide.

So it's important to educate this population because. More than likely the person who is having thoughts are gonna see their healthcare provider before they see a mental healthcare provider. So it's important to, provide them the resources and the education because it's not something they get when they're going through nursing school or medical school.

So it's important to provide that to them. it's not just the doctors and the nurses. We hope to educate, but it's also the front desk staff. It's also. The lab techs, because everyone is a touch point in doctor's office, and so we know nowadays you don't typically spend a whole lot of time in the doctor's office.

When you go to the doctor's office, you're seeing all these other people, what, who you're spending more time with. So it's really important to educate everyone on the team on what are the signs, what to look for, what do you hear? What do you see, changes in, in health, notice those things as well as, okay, so I'm noticing something.

How do I have that conversation? How do I use, An evidence based assessment to really drill down. Do we need to just have some supports or do we really need to move forward directly to maybe emergency services? also how to have conversations around lethal means safety. And what is lethal means?

What does that mean? how to have, conversations about, if there are weapons in the home, how to safely store them if there's medication an individual is on That is an avenue that they might utilize if that's something they're thinking about. How do we provide protections in place and have those conversations about it?

So it's really exciting. We've created a, graphic around it, the course so that providers who participate in the program can utilize that and put that in their window and put that on our marketing material that yes, I am, educated to some extent in this population and challenges. And so really excited psych arm provid.

virtual online training, accessible 24 7. It's about three and a half hours of coursework that's kind of broken up. and they get free es for it. So, you know, it's kind of win-win here. And then once they finish the program, they will get both a physical toolkit that's got Locke Medicine bags in it, that's got gun locks in it, that's got. All sorts of goodies and I can't even tell you how much stuff is in it. And then we also have a virtual toolkit that they get as well. So it's not just I'm taking the class, but you're gonna get the resources that go along with that, along with, Additional training opportunities if you're looking to dive deeper into the information, like where can you go to get that information in support?

[00:16:16] joy_1_10-21-2022_083921: So really excited about it.

[00:16:19] duane--_17_10-21-2022_063921: Now I really like that, approach and especially, the idea of we're not just, you know, a. Focusing on the providers because you may have a particular provider, perhaps a nurse practitioner or a doctor who has a military background who may think I, I don't quote unquote, need this, but that goes back to our earlier conversation.

But really, modern medicine is provided collaboratively, like you were saying, from. Booking the appointment to checking into the appointment at the front desk, to who's taking my blood pressure to, who I'm talking to in the room, to who's following up to schedule, to who's billing me And those are like seven different people.

And all of those seven different people are not the care provider, but they're all individuals. They're gonna come in contact with somebody who served, who would be able to highlight or see some warning signs if something is, is not, is not right. 

[00:17:08] joy_1_10-21-2022_083921: Definitely, and we really hope that while we, reach out to providers, and practices and let them know that we have this, that, when we're sharing the information about, it's not just. You were looking at your whole team, that they really grasp that there's multiple touch points and, it's important that everybody has the education because again, like I mentioned before, you're in the doctor's office.

Maybe when you go in, you probably are there for half hour, hour, but you're only spending. 10 minutes, maybe with the practitioner you went in for. It's the sitting in the waiting room, getting your, like you said, blood pressure taken and getting your, your labs done. And so it's really important to have, Full wraparound as far as awareness and how to have those conversations.

So even if your front desk person notices something going on and maybe mentions it, then it's moving down the line. So it could just be, it could be that the doctor or the nurse practitioner is doing the assessment, but the entire team. Knows that, okay, I'm seeing this, I heard this. I need to relay this to the doctor or the nurse practitioner before they get to their office,

[00:18:25] duane--_17_10-21-2022_063921: Yeah. No, I think that, and it really is, it's an approach, it's a full wraparound approach so that the individual who's in crisis isn't the one that has to come up and say, Look, I'm in crisis right now. There's a, there's a huge sign. It's, it's, many people are, are fully aware of some of these. Things and are able to reach out and provide resources rather than just saying, Call me if you need me.

So I, I think it's a wonderful way to consider how to educate, providers and, and really excited to hear that Maryland is doing it. So if people wanted to know more about, Maryland's, commitment to veterans, or, or the governor's challenge, how can they do that?

we have a website with a really long website address. Your best bet is Google Marilyn's commitment to veterans and said, 

[00:19:08] duane--_17_10-21-2022_063921: Or, or there'll be a link in the show notes so they can go to the show notes and then they can click on the link.

[00:19:12] joy_1_10-21-2022_083921: There you go. Yeah. so we. We're really excited. launch of this, we've been in a pilot stage for a couple months with 10 practices across the state. So we wanna make sure that, our state, again, is another unique state where we have urban, suburban, rural, We have. The Waterman community. We have the farming community, we have the mountain community.

we, if you wanna season, if you wanna go and experience like anything. the only thing we don't have is desert, so can't help you there, but we got it all the rest of it in Maryland. so we wanted make sure that we had the voice. And feedback from a broad range, of providers in our state who aren't serving different communities.

So really excited that, we've had the opportunity to pilot it and get some feedback from those that are participating in most of the feedback has been, I want more

So that's been really great, to. And so that's part of what's built into the toolkits. like the virtual toolkit, there'll be some, links back to Myrick,additional resources within, psych armor, and then a and again, the, star behavioral health.

Some of that information would also be able to support healthcare providers.

[00:20:33] duane--_17_10-21-2022_063921: Yeah. that's great. And, and I, I had a mentor when I was stationed there in, in Maryland that said Maryland has everything from crabs to cows and everything in between. and so no joy. I really appreciate the opportunity to feature you in the work that you're doing on the show today.

thank you Dwayne. I really appreciate being here and I love the work that you do, and I love working with you.

[00:20:51]duane--_17_10-21-2022_063921: Thank you so much.

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 individual learners, as well as custom training options for organizations.

I'm so glad to have been able to host joy on the podcast and share her work with the Maryland governor's challenge, Marilyn's commitment to veterans program and the trained military assistance program. 

I realized one thing that didn't come across during a conversation is what the governor's challenge actually is, is no fault of Joy's of course, because she and her team live it every day. It can sometimes be surprising when you do so much and engage with so many people about the work that you do. 

That there are people out there who haven't heard about what you're doing. You might go back to listen to episode 70 where PsychArmor his own Jenna prior shared about how organizations can develop custom training options, such as Maryland's trained military assistance program and the governor's challenge portal. But I realized that we haven't really described what the governor's challenge is. 

In 2018, a joint initiative between the department of veterans affairs and the substance abuse and mental health services administration called the mayor's challenge to prevent S and VF suicide was created. This was an effort to establish local suicide prevention coalitions that will take a public health approach to suicide prevention, advanced the VA's national strategy. Do you prevent veteran suicide and incorporate evidence-based strategies from the center for disease controls, preventing suicide, technical package. 

In 2019, the initiative evolved from the mayor's challenge to the governor's challenge in which inner agency, military and civilian teams came together in each state to enhance and align local and statewide suicide prevention efforts to implement promising best in evidence-based practices to prevent and reduce suicide at the local level, and to participate in collaborative knowledge, sharing across the teams. 

Marilyn was one of the first states that joined the initiative and year two of the state level cohorts and had been an active and engaged team that is working both statewide and in collaboration with local partners to develop military and veterans specific suicide prevention efforts. 

The Maryland department of veterans affairs was recognized as a leader in suicide prevention efforts as a recipient of the 2022 Abraham Lincoln pillars of excellence award for the serving. Those who served a public library program. Which is a partnership with the Maryland state library agency, and as an effort to conduct veteran outreach and educate library staff on military and veteran culture. 

First piloted in 2014, the expansion of the program is a great example of the types of initiatives that are being implemented in teams across the country. Currently state territory and community teams in 52 states and territories and 19 communities across the country are making an effort to save lives of veterans in the local communities. 

Just like joy and her team are in Maryland. 

The other point that I'd like to emphasize was Joy's point of layered cultures and how complex they can be. All of us or many different things. We see ourselves through the lens of our race and ethnicity, gender, or gender expression, family, or community of origin. To our interests, our hobby, our work. 

Depending on who's asking I'm a father, a son, an uncle, a husband, a veteran, an army retiree. A mental health professional, a podcast host a long distance runner. although you might not think that when you look at me, I'm from Missouri, but probably not the Missouri you're thinking of, I grew up in St. Louis, but again, Maybe not the St. Louis, you might be picturing, Because even though I came from a blue collar family in lower socioeconomic circumstances. We were privileged enough to be able to move into the suburbs. 

During my early teenage years. All of those things have a direct impact on who I am in changing any one of those things in someone else We'll change the complexity of layered cultures. However, there are common things about all of those different layered cultures that may be learned and understood just as there are stories behind each of those aspects of culture that are unique to me. As Joyce said, you don't have to have served to be of service. You just have to want to learn about those who have, and anyone can be of service to those who served. Again, going back to the trained military assistance program. It's not just the direct medical provider who will see a veteran or military family member in their medical practice. 

It's the front desk staff, the schedulers, the lab techs, the billing department. When my wife was working as a scheduler for a large outpatient mental health clinic, she knew the veterans on the caseload. She was working on. And knew when some didn't sound right Oh, we're having a bad day. 

She had both lived experience and education and training around warning signs and things to look out for. It's not about finding that needle in a stack of needles, the one veteran who is in active crisis that needs to have an immediate intervention. It's about making sure that each needle in the stack of needles is recognized for what it is a veteran with a need. 

Maybe that need isn't crisis intervention. In fact, the hope is that the needs that lead to crisis are found first before intervention is needed. And so. With the layered and complex cultures of service members, veterans, and their families, there is a greater need for education for those providers who may come in contact with them, which is exactly what Maryland's trained military assistance program is designed to do. If you're in Maryland, check out their website in the show notes. 

So, hopefully you appreciated my conversation with joy. If you did drop a review in your podcast, player of choice. Or send us an email info@psycharmor.org. We always appreciate hearing from listeners, both feedback on the show and suggestions for future guests.

For this week, PsychArmor resource of the week, I'd like to share the PsychArmor course. V.A. S.A.V.E.: Preventing Caregiver Suicide, which is one of the training modules available to the governor's challenge training portal. At your taking this course, you will develop an understanding of the increased risk for suicide seen in military and veteran caregivers will be able to identify the signs of an at-risk veteran caregiver and know the steps that you can take to help a veteran caregiver. You can find the link to the resource on our show notes.