Seeking the Military Suicide Solution

Seeking the Military Suicide Solution Podcast, Episode 2: Dr. Craig J. Bryan

A new weekly podcast from Military Times examines the alarming rate of military and veterans suicide, offering new insights based on research and effective clinical and peer support practices in suicide prevention. Hosted by Duane France, a retired Army combat veteran, author and mental health counselor, and Shauna Springer, a psychologist, author and nationally recognized expert on initiatives to benefit the military community, the podcast aims to move beyond awareness to identify actionable strategies that can impact the rising suicide rate among service members, veterans, and their families.

About Today’s Guest:

Dr. Craig J. Bryan, PsyD, ABPP, is a board-certified clinical psychologist in cognitive behavioral psychology, and is currently the executive director of the National Center for Veterans Studies at The University of Utah. Bryan received his PsyD in clinical psychology in 2006 from Baylor University, and completed his clinical psychology residency at the Wilford Hall Medical Center, Lackland Air Force Base, Texas. He was retained as faculty in the Department of Psychology at Wilford Hall Medical Center, where he was chief of the primary care psychology service, as well as the suicide prevention program manager for Lackland AFB.

Bryan deployed to Balad, Iraq, in 2009, where he served as the director of the Traumatic Brain Injury Clinic at the Air Force Theater Hospital. Bryan separated from active duty service shortly after his deployment, and currently researches suicidal behaviors and suicide prevention strategies, and psychological health and resiliency. He currently manages numerous federally funded projects in excess of $10 million, to include studies testing cognitive behavioral treatments for suicidal service members, developing innovative methods to identify and detect high-risk military personnel and veterans, and disseminating effective treatments to health care providers and the public.

Bryan has published over 120 scientific articles and several books, including “Managing Suicide Risk in Primary Care, Cognitive Behavioral Therapy for Preventing Suicide Attempts: A Guide to Brief Treatments Across Clinical Settings,” and the “Handbook of Psychosocial Interventions for Veterans and Service Members: A Guide for the Non-Military Mental Health Clinician.” He is the lead risk management consultant for the $25 million STRONG STAR Research Consortium and the $45 million Consortium to Alleviate PTSD, which investigates treatments for combat-related PTSD among military personnel, and has served on the board of directors of the American Association for Suicidology. He is considered a leading national expert on military and veteran suicide. For his contributions to military mental health and suicide prevention, Bryan has received numerous awards and recognitions including the Arthur W. Melton Award for Early Career Achievement, the Peter J.N. Linnerooth National Service Award, and the Charles S. Gersoni Military Psychology Award from the American Psychological Association; and the Edwin S Shneidman Award for outstanding contributions to research in suicide from the American Association of Suicidology.

Links Mentioned in this Episode:

National Center for Veterans Studies

Episode Transcript:

Duane France: (00:00) Welcome to seeking the military suicide solution podcast brought to you by the military times. I'm Duane France

Shauna Springer: (00:06) And I'm doc Shauna Springer

Duane France: (00:08) And we'd like to thank you for taking the time to learn more about suicide in the military affiliated population. I'd like to thank our sponsors, milMedia group. milMedia group is a proven web design and digital media agency specializing in supporting organizations focusing on the military population. Find more about them at milmediagroup.com.

Duane France: (00:34) Thanks again to everybody who joined us to listen to an honest conversation about service member veteran and military family suicide. Our guest today is Dr. Craig Bryan from the University of Utah. Shauna, how about you tell us about our guest.

Shauna Springer: (00:47) Sure. Dr. Craig Bryan is an Air Force veteran, a board certified clinical psychologist and Executive Director of the National Center for Veteran Studies at the University of Utah. Greg and his wife Annabel met in Iraq in 2009 when both of them were engaged in military service roles. After separating from the military, at times, they've both considered going back in and their daughter posed this question to them: why would you think about going back to Iraq when you're both satisfied with your job, with your housing, with really just about everything else in your life? And so as Craig reflected on this question, he realized that the pull of returning to Iraq had a feeling of unfinished business and then he saw that this was actually an illusion. One that is maybe common to many who serve. As he put it, it's something we do to ourselves. Always thinking about what we've done and how it's not good enough even when we've done more than enough. Before we built a friendship, I admired Craig and AnnaBelle for their dedication to the mission of suicide prevention and their ability to engage in both in the trenches work with those who are suffering and their high level thought leadership. Craig and AnnaBelle are on mission to support fellow veterans. They are considered field leading experts on suicide and suicide prevention strategies. It's such a pleasure to have them on the podcast as one of our lead off interviews for Seeking the Military Suicide Solution.

Duane France: (02:07) I really appreciate that. You know, when we started putting this together, a lot of people, when I said, "who should we have on the show?" A lot of people said, Dr. Craig Bryan, he was usually top of the list. And so I'm really glad that we were able to have him on the show. Let's get into the conversation and we'll come back afterwards to pull out some of the key points.

Duane France: (02:35) From Your perspective, what is the thing that really works when it comes to preventing suicide in the military population?

Craig Bryan: (02:41) There's sort of two, I think, arms to thinking about what works in suicide prevention. One arm falls on the healthcare side of the house and then the other arm is outside of the healthcare system. And I point that out, because we know, you know, 70% of veterans who died by suicide are not actively seeking out of mental health care at the time of their death. And that seems to be true for both active duty currently serving military as well as those who are no longer in military service. And historically we have focused almost exclusively on the treatment side. And so when we look at that, I mean the sort of the good news, the hopeful news is that we have actually detected a signal, things that work within the healthcare setting. So a lot of the work that we've done in my lab for instance, looks at brief cognitive behavioral therapy for suicide prevention as well as crisis response planning. These are pretty simple, straight forward outpatient therapeutic interventions that have been shown to reduce suicidal behaviors by anywhere from 60 to 76%. Then the second arm, if we go to what can we do outside of the healthcare system, I think there are two key factors.

Craig Bryan: (03:54) A single most important is doing a much better job of focusing on safety as it relates to gun ownership. 70% of service members and veterans who die by suicide use a gun. And statistics suggest that, interestingly enough, the individuals who are most likely to use a gun to kill themselves, they tend to be men. And they actually tend to be people without a mental illness. But we know that if people were to lock up their guns, if they use safes, if they use gun locks or trigger locks, things along those lines, that's actually been shown to reduce suicide deaths by up to 50%. In many ways it's similar to, you know, we wear seatbelts when we drive a car, even though we don't intend to get into an accident. And of course none of us are actually bad drivers. Everybody else is the bad driver.

Craig Bryan: (04:46) But we buckle up anyway to be safe. And in many ways I think we need to buckle up those of us who are gun owners because sometimes things go down quickly. When we go from zero to 60, really fast and every second, every minute that slows us down in those moments can potentially save our lives. Then the last thing I'll point out for outside of the healthcare systems, I think we really need to focus on communities and quality of life issues. And what I mean by this is, we have become so obsessed with this whole like resiliency and individual pathology model where when we think about suicide, we say, well, this person didn't have enough coping skills. They were experiencing stress, things like that. But most of us understand the things that stress us out the most in life; you know, it's perhaps financial strain.

Craig Bryan: (05:37) It's, you know, having a job or work that isn't particularly meaningful. It's having all of these trainings, like these computer based trainings that we just keep getting asked to do over and over again. And then when we get stressed out and burnt out, it's, in essence, we say, "well, you're the problem. You just need better skills," when really it's in many ways the system itself that's pressuring us. And I think we've forgotten that one of the key ways that we can potentially reduce suicide is by improving quality of life or really kind of looking at how can we change the workplace, family life, our communities in a way that we help to remove or reduce the sort of constant pressure that wears people dpwn.

Duane France: (06:24) You know, that's really great. I am thinking of as a clinical mental health professional, myself and my colleagues and you and your colleagues we understand suicide prevention. We know what works, but the veteran or the military family member is not likely to come in contact with us right away. Right? We are that second stage intervention beyond the gatekeepers, beyond the pastors, beyond the law enforcement or first responders, or even beyond the family members. Right? So the ones who are maybe most familiar with these suicide interventions that work are least likely to come in contact with the veteran. Then on the other side, outside the healthcare system, the range owners, the gun shop owners who can have that influence over gun safety or the person that's working on veteran homelessness or veteran employment, they're not thinking about suicide prevention. So there's a disconnect there.

Craig Bryan: (07:13) Oh yeah. Yeah. And I think this is, this is sort of like one of my stomping points. Right now, it's been for the past few years, is that we have, we have gone so full tilt into this mental illness model of suicide prevention that everything we do, all of our warning signs, all of our recommendations are all geared around going and getting help. And but when we really look at the data, we know that at least half of those who die by suicide do not have a diagnosable mental illness. And so we're in essence telling people, "look out for these things that don't apply to half of the population" and that we're encouraging individuals to seek out treatment even though they don't necessarily have the problems or the conditions that would warrant them to seek out that treatment. But yeah, we have these sort of these non mental health individuals who actually probably play a way bigger role in suicide prevention in the same way that, you know, when we look at how we've been able to reduce traffic fatalities for instance, you know, as a result of drunk driving, we didn't like go around and tell everyone, well you need to go into counseling for substance abuse so that you don't get into a car crash and you know, kill yourself or kill someone else.

Craig Bryan: (08:27) What we did is we came up with ideas like "Friends don't let friends drive drunk". When does this matter the most? How do you prevent an alcohol related traffic fatality? It's when a bunch of friends are hanging out with each other at someone's house on the weekend and everyone's partying and having a good time. And then someone says, all right, I'm going home. And it's somebody else saying, no, you can't drive. And those are the moments that make a difference. The same applies when it comes to firearm ownership and suicide prevention of family members and friends stepping in and saying, let's not wait until someone becomes incredibly distressed and has a mental illness. There are these sort of key moments in time where we could potentially intervene with each other and say, "Hey, let me hang onto your guns for a while while you go through this tough time." It's these simple little things that actually can make such an enormous difference.

Duane France: (09:19) You know, and that's one of the things that, maybe that what might not be working is this focus solely on the mental health professionals. Because if, if you and I as clinicians, if we had the solution, then the problem would be solved already, right? We wouldn't have this issue. What are some of the things that people think that are working that's simply, you know, the research shows that just aren't?

Craig Bryan: (09:41) Yeah, I would say, perhaps the most pervasive idea about suicide prevention that doesn't really seem to hold as much water as we often assume as this notion that if you treat depression or if you treat some of these other mental health conditions, you can prevent suicide. The data actually suggests that the things that prevent suicide are, are actually different from mental illness.

Craig Bryan: (10:08) Now that's not to say that things like depression are totally irrelevant, but there's something else that seems to contribute to reductions in suicidal thoughts and behaviors. And so we know that if you just treat the depression, it helps a person to feel better but doesn't actually reduce their risk for trying to kill themselves. And so the best way that I've found a think about this is sort of like when we're driving our cars, we have an accelerator and we have a brake. The accelerators speeds us up and helps us go forward. But if you take your foot off the accelerator, you'll slow down, but you won't necessarily stop right away. That's what the brake is for. So these are two completely different systems within our car. And I think mental illness works in that same way. Mental illness, depression, you know, other problems in life are kind of like the accelerator.

Craig Bryan: (10:59) It might help move us towards suicide, but simply eliminating those things don't necessarily apply the brake. And so you can feel better as a result of therapy or treatment. But some people still continued to be at risk for suicide, which is why many of us, if you think about family members and friends, it's sort of like been this mystery for a long time of they were doing better. I don't really understand. And I think it's because we've, we've not really kind of conceptualize that maybe the brake pedal is different from the accelerator pedal. And so in essence, we've in many ways been barking up the wrong tree, I think for many, many years.

Duane France: (11:40) You know, and I think that's very important. You know, not everyone who has depression goes on to take their own life. Not everybody with anxiety or all of these, you know, not all of the common factors are there, which we can say this leads to suicide.I understand there's maybe like 20 different factors now that, especially looking at service member and veterans, that feed in one way or another to contribute to someone deciding to take their own life.

Craig Bryan: (12:05) Yeah. And I think, you know, kind of related to that, you know, one of the other sort of long held assumptions that we've had that seems to be wrong is, we've always looked for what is the right combination of those 20 factors that lead to suicide. But in reality there can be different combinations of those factors. And so there might be different sort of pathways or different trajectories or types of suicide. And so another reason we're not very effective is because we're looking for the one cause and the one solution, but maybe there are actually different solutions in different strategies. And so, perhaps something like on the treatment side, we've got now some interventions are actually really effective. Like I said, I mean the most, the most promise, I think we have a suicide prevention is actually on the therapy side, but that's not going to prevent all suicides and it never will because other people get to suicide through a very, very different mechanism and so we need to come up with a variety of options that are better suited to meet the unique combination of variables that exist.

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Duane France: (14:35) So that maybe we're one of the gaps are, is getting the information that we know works as clinicians. The folks at SAMHSA, the CDCs technical package to prevent suicide. The VA's a suicide prevention programs research. We know that the research works, but it's getting it into the hands of the people that can actually use it.

Craig Bryan: (14:55) I think that's part of it. Like,, we do know that there is sort of this delay between research findings and implementation of those findings. But I think a lot of it is making sure, it's sorta like understanding how seemingly contradictory research findings can perhaps not be so contradictory after all. And that's where I think sometimes a lot of confusion comes from, is you look at these studies and you know, a certain treatment works in this study, but it doesn't seem to work in that study. I think maybe part of what it comes down to is that again, some of these strategies and ideas do work under some circumstances, but I don't think as researchers you know, we've really taken that into account because it's hard. It's hard to do that. And so we can end up sort of washing out a lot of our conclusions because we're not truly capturing the actual complexity in nature of suicide.

Duane France: (15:59) And I think that goes back to the community-based aspect of it too, is what may be some of the primary in the 20 causes in one community may not be the same in another community. Here in El Paso County we're approaching probably 14 to 15% density, just veterans. But Houston for example, only has 4%, but has a greater number. Right? So what will work in El Paso County, Colorado Springs, Colorado won't necessarily work in Houston.

Craig Bryan: (16:26) Absolutely. Yeah. And, and it's, you know, those differences that we see across a community, there are different reasons that contribute to those differences. So if you look at, again, like El Paso County is a different region of the country. It's, you know, largely you know focused on army, whereas if you go to like, say, San Antonio, Texas, there's more of like an Air Force type of presence. And of course each branch of service has a somewhat different culture. You know, we have a lot in common, but we also have different ways about going about doing things. But then there are regional differences within the country as a whole. And so yeah, what works in El Paso might not necessarily be the same thing that works in San Diego. And it's one of those things where it's sort of like, it's unfortunate, right? Because it'd be nice if one thing worked everywhere. But that's just sort of a reflection of how life actually is. And it's okay. That doesn't mean that nothing ever works. It just means I think we need to be a little bit more intentional and thoughtful about trying to find the ways to take something like BCBT (Brief Cognitive Behavioral Therapy) that we know works, but how do we make sure that we tailor it and adapt it to these different communities?

Duane France: (17:42) And I think that's, in operating at the community level, that's what I've seen as a challenge is taking what we know, again, works at the national level. But then applying it to our community. Right? And we're trying to, from my observation, trying to apply interventions across the board, Irregardless of culture.

Craig Bryan: (18:03) Yeah. Yeah. And it's something that I've thought a lot about as a psychologist who does treatment research is distinguishing between the core principles and mechanisms of a particular intervention or a treatment or a program from sort of like the surface features, the packaging or the you know, the gift wrapping. And so in many cases there are these core concepts and ideas that can be sort of transported from one community to community to another.

Duane France: (18:37) So it's, you know, increasing economic stability is a factor that will keep people from getting into financial crisis or losing a job. But the way that we would implement economic security is different in a rural community than in an urban or semi-urban.

Craig Bryan: (18:55) Yeah. And, the way in which we, each of us experiences economic stability might be different. And so if we were to just come in and say, well, everybody is going to get education on, you know, like credit card management, something like that. Well that isn't necessarily going to be the way to effectively stabilize and provide financial security for every single person who feels strained. And so there, there might be a number of ways that we help people to feel more economically stable, but we shouldn't just assume that everyone is the same and everyone is stressed out for the same reason.

Duane France: (19:35) Yeah. Cause I think then we get into the transactional trap in which, you know take two financial stability classes and call me in the morning. Right? Or here, here's a resume class. So let me just get you a job.

Craig Bryan: (19:48) Yeah. Very much so. Yeah. And I think of it like, you know, for me kind of the practical impact on, you know, kind of like a mental health side is, you know, like the center that I run, we're really good at treating PTSD, suicide risk, and depression. If you're a veteran though, and we've received these calls, you know, veterans call us and they have other problems. We've had individuals, veterans diagnosed with like bipolar disorder. Or eating disorders, things like that. And you know, we say, Hey, you know, that's not our thing. You know, it's, we want to be able to help you. But it's sort of like, that's not really what we're good at. And so I don't think you're going to be well served by us and being comfortable with that. Because if all you have is a hammer, everything looks like a nail. It's like, well, if all you have is a hammer, just know what a nail looks like because that's an appropriate tool to use in that circumstance. But recognize, Hey, this isn't a nail, this is a screw. Maybe we need to find a screwdriver instead.

Duane France: (20:53) And I think that's the other piece that many of us have been working towards in the military and veteran community is making those connections is if someone does come with an eating disorder, well we may not be the place, but there's this great place at UCLA that that really does great work with military service members and eating disorders. What kind of action steps, right? You know, somebody listening to this, obviously it's two clinicians talking to each other and we've used, you know, the crazy acronyms and stuff like that, but somebody listening to this, what are some action steps that they can take to prevent suicide in their home, their community and things like that?

Craig Bryan: (21:29) Yeah, I think if, if we stick with that spirit of kind of looking at this from a community perspective and I've found it very valuable to think of suicide prevention from an injury prevention model. So what are the things that we do to prevent our loved ones, our family members from experiencing injury in general? And it involves things like, you know, removing hazards from the environment. It's, you know, all of us who have little kids, you know, we know that you can't store cleaning supplies and chemicals underneath the sink, you know, without a lock on it. And so we move things, we lock things up, we store them away to protect, you know, the people that we care about. Likewise, all of us, when we, you know, in our homes we have things like smoke detectors and carbon monoxide detectors things like that to help protect and preserve our safety and security.

Craig Bryan: (22:24) And so if we take that approach and apply it to suicide, this is where I think if we get back to the notion of do we keep large quantities of medication in the home, you know, if you're not using the medication anymore, it's expired, but yet we have lots of pills laying around that in some cases could be a potential hazard as it relates to suicide. Firearm storage is the clearest. I think that's actually the single, simplest and most effective thing we could do to prevent suicide. It's, you know, just locking up guns. You don't have to necessarily completely get rid of 'em, but just locking them up. That is we already know that's been shown to reduce suicides by 50% or more. I mean, it doesn't actually really require that much effort from us. Likewise, if you have a friend or a family member who's going through a rough patch, be the designated driver so to speak, and offer to hang on to their firearms in the same way that you would temporarily take away their keys and not let them drive.

Craig Bryan: (23:29) I think it's in the workplace as well, being sure that we express gratitude and appreciation to each other. It's something like, when I've consulted with military leaders over the years, for instance, and this is true, I think of even family sometimes and other organizations, Iask questions like, "well how often do you thank people for the work that they've done for completing tasks?" And when I hear you know, someone in an authority position saying, "well, but that's their job. They're expected to do it." It's like immediately I'm like, well, now I know what the problem is. And it's because those little things, you know, make a big difference. Think of, think of the jobs that you've had that you really enjoy. Think of the friends that you have that you care about the most. They typically express to you appreciation.

Craig Bryan: (24:18) They thank you for the little things. They back you up, they support you. They reach out to you in times of need. And even when you're not in need, they just send you a text message every once in a while and say, Hey, I was thinking about you. Hope you're doing okay. Or Hey, I read this funny article online, it reminded me of you. These are the little things that we can actually do on a day to day basis that influence and reduce the probability of a person kind of tipping over the edge when they find themselves in that momentary moment of despair.

Duane France: (24:49) You know, and that's the idea of be nice to each other. Right? And it's sort of that human piece, but that's the prevention piece. Let's keep people from getting into that suicidal crisis. And then there's that piece of the intervention piece. I really appreciate you coming on the show today. Thanks for taking the time and hopefully the listeners get some benefit out of this.

Craig Bryan: (25:11) Yeah, my pleasure. Thanks for having me.

Duane France: (25:21) It was really great to be able to talk to Craig, had a really great time. I, kinda really didn't want to cut it off. These are, again, some of these conversations that we can really have for hours and hours. What did you think about what Craig and I were talking about, Shauna?

Shauna Springer: (25:35) I thought it was a great interview. I mean, he goes into so many things that require a paradigm shift in our thinking in terms of the behavioral health emphasis that we've had as a field. You know, he makes the point that so many times people who die by suicide do not have a mental illness. So non mental health factors play a strong role and this is something that you and I both know Duane, such an important point.

Duane France: (26:01) Yeah. You know, I mean, and that was one thing that really kind of drove home for me was that you know, a financial crisis or a relationship crisis and you know, there's no diagnosis or you know, getting fired from your job. And so it may, all those things may lead to some type of anxiety, but it's sort of natural anxiety and it's just life. It's not a diagnosed mental illness,

Shauna Springer: (26:26) Right. It's just part of being human. And you know, I think so many times in the suicide prevention field we've had for many years that kind of "get thee to the doctor" model for suicide prevention. And so what Craig is sharing here is really bringing attention to the fact that there are these bigger issues in terms of life stressors and transitions.

Duane France: (26:46) Yeah, and I think this goes to, again, some of the stuff that we've talked about is that, like you said, to get thee to the doctor, but it's not just us. It's the people who are helping with employment in veterans, or military spouses or you know, people who know that the military spouse, military child is a caregiver. That it's more than just a responsibility for what we're calling "experts" like you and me.

Shauna Springer: (27:12) Right. And in fact, it's a very humbling thing. I wrote about this topic, the limitations of the professional defender model, in a chapter in my next book, which is coming out in the spring. And I talked about some recent data that was collected by the Department of Defense. It's really humbling. It said that an active duty service member who's struggling is actually more likely to turn to a military peer, a friend outside the military, parent, a spouse over a professional mental health provider. And in fact, in a list of 12 potential categories of people that an active duty service member would talk to when they're feeling stressed or overwhelmed, mental health providers are actually 10th on the list, just slightly above attorneys. You know, as a behavioral health provider I really do believe that treatment works and I believe that we need to resource a whole bunch of people to respond when those they love are in distress.

Duane France: (28:09) You know, that's a, that's definitely a great point and glad we beat out the lawyers.

Shauna Springer: (28:13) Yeah! I really liked his analogy of the injury prevention model. This really takes a public health approach and applies it to suicide prevention messaging. So just as he said, you know, how do we prevent loved ones from getting injuries? He's equating this to initiatives like wearing seatbelts or not letting friends drive drunk. These are very successful public health initiatives that have had hugely positive impacts on our behavior. So then he talks about, you know, do we keep large quantities of medications at home or I know that in Craig's work firearms are a big focus of his efforts. So, you know, talking about are these stored in ways that minimize risks of using them in ways that the owner didn't purchase them for. So in other words, many veterans own firearms because they want to use them for self protection or protection of those they love, but at a time of overwhelming stress, they can be turned on the self in a tragic turn of events. And so by thinking about this possibility in advance and approaching it from a safety focus perspective, we can ask ourselves, does the way we store a firearm align with the owner's intent or our intent as the case may be?

Duane France: (29:27) Yeah. You know, I mean, and this is a, this is something that really is on the individual. Don't talk about this very often, but my dad, after coming back from Vietnam and he was a a St. Louis city cop in the, so we don't know where PTSD from one ended and the other began. But one of the things growing up is we never had guns in our house because he saw what happened. He had so many calls that he would respond to with accidents or things like that when there were guns readily available. I mean, we obviously had different measures of protection in the house. It wasn't that we were unprotected, but it's an individual responsibility. It's a family safety responsibility, just like, not to be demeaning, but childproofing

Shauna Springer: (30:10) Well, you're coming down to the level of what the individual's values are and why they own that firearm in the first place and then how, you know, they're setting themselves up to use it in that way or not. It can be a safety issue when people are struggling or you know, at a time of overwhelming stress. And it makes a lot of sense to me, you know, intuitively to just equate that conversation to other public health initiatives that have kept people in the fight just by better safety measures, you know, in advance.

Duane France: (30:41) Yeah. You know, I think in, in even thinking back to the conversation I'd mentioned, you know, we don't even, it's not even a second thought. As soon as we get in the vehicle, we buckle up. Right? I mean, it's, I know that's the case for me. And I know that when I was growing up, it wasn't always like that, right? So we have made this shift of you know, keys in the bucket or let's take an Uber. Like, you know, so there are just things that have become part of the norm that we need to get there with suicide prevention as well.

Shauna Springer: (31:09) Yeah. I mean, at the same time, as he's saying, rightfully so, I think that it's an individual decision about how we store firearms, for example. We all play a role in kind of looking out for each other. So the public health initiative says, you know, individuals make choices. But we can influence them with the force of our love and our trust. And so at the same time, you know, there's been this focus on really, like we talked about, you know, the individual mental health provider when really it's about the tribe of individuals that surround us and how connected we are with them and how how we look out for each other in kind of a collective way.

Duane France: (31:51) I think you're absolutely right. And maybe one final thing that you you got from our conversation.

Shauna Springer: (31:57) Yeah. One of the other paradigm shifts that he talks about is, instead of simply recognizing, you know, the signs of suicide or focusing on individual resilience, maybe a shift to focusing on, again, getting away from just the individual resilience and more of those bigger level contextual factors in the social tribe that surrounds us. So it's not that, you know, these things aren't important, that behavioral health solutions, individual resilience, recognizing the signs, they're important. But I think we agree that they're not sufficient to address the issue of suicide. And so I've just, you know, one of the things I really appreciate about Craig is that he says the things that people think. He says it boldly and bravely and he makes a lot of sense and it fits with my experience as a mental health professional. I think we do need to shift the paradigm in this way. So I thought it was a great interview.

Duane France: (32:53) Yeah, I really appreciate that. And I think that again really sets a tone you know, and listeners you'll hear it through a number of these different interviews. There are some common themes and then there's something that we're going to pick up every different interview. And so hopefully we'll be able to get to a point where the message will start to change.

Shauna Springer: (33:18) Yup. I'm with you on that.

Duane France: (33:20) So thanks everybody for listening to this episode of Seeking the Military Suicide Solution. Make sure to check out the show notes at www.veteranmentalhealth.com. You can get the links to all the things that Craig and I talked about in the episode as well as finding the show notes at militarytimes.com.

Duane France: (33:35) I'd like to thank our sponsors, milMedia group. They're a web design and digital media agency with over 25 years of experience in supporting service members, veterans, and their families. They specialize in working with startups, small businesses, entrepreneurs, nonprofits and city, state and local governments. As a veteran owned business, they're uniquely qualified to work with those who want to reach an audience in the military and veteran community. If you have a dream or a vision that can help you bring it to life and get it in front of your audience. You can contact them at (254) 554-0974 or find them online at milmediagroup.com.

Duane France: (34:09) You can find out more about the work that Shawna's doing by checking out her latest book, Beyond the Military, a Leader's Handbook for Warrior Reintegration, and the work that I'm doing with my latest book, Military in the Rear View Mirror. Both are available on Amazon and we'll have links to those in the show notes.

Shauna Springer: (34:25) Just a reminder that the guests and reflections on this show are for informational purposes only and should not be considered professional advice. While Duane and I are mental health professionals, we are not your mental health professionals. We always recommend that you discuss these things with a licensed clinician

Duane France: (34:40) And always remember, you can connect with the veteran crisis line by calling (800) 273-8255 and pressing one, chat online with them at veterancrisisline.net or texting, 838255. Thanks again for joining us to talk about Seeking the Military Suicide Solution and make sure to follow Military Times on social media to keep up with the latest shows. Join us next time for another great episode and until then, remember, you’re not alone. Ever.

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